Pneumorrhagia

The pneumorrhagia is expectoration with impurity of blood or considerable volume of blood at cough from respiratory tracts. Blood can evenly paint over a phlegm in brown, red or pink color depending on a disease. The phlegm at the same time can have a foamy or jellylike appearance. Sometimes blood impurity in saliva is taken for a pneumorrhagia. Though nasal bleeding or the bleeding gingivas can be blood dopant sources in saliva.

Pneumorrhagia reasons

Most often the syndrome of a pneumorrhagia is observed at a bronchoectatic disease, tuberculosis, bronchitis, pneumonia, abscess. Bronchial tube adenoma, a lung carcinoma, a thromboembolism of an artery of lungs, a stenosis of the mitral valve can be the reasons of a pneumorrhagia. The pneumorrhagia is one of the main symptoms of pulmonary hypertensia, a pulmonary angiitis, the idiopathic progressing induration of lungs, amyloid dystrophy and a hemorrhagic gemostaziopatiya.

The syndrome of a pneumorrhagia and pulmonary bleeding can develop at a rupture of an aortic aneurysm with its subsequent hit in a bronchial tube.

At a pulmonary tuberculosis the syndrome of a pneumorrhagia and pulmonary bleeding also quite often develops. At the same time bleeding is followed by the pain in a thorax connected with a pleura inflammation, long dry cough of various intensity and fervescence.

The regular and long pneumorrhagia at smokers can demonstrate existence of a new growth in lungs.

Diagnosis of a pneumorrhagia

The regular pneumorrhagia at patients up to thirty years without symptoms of other disease indicates bronchial tube adenoma. At a bronchoectatic disease the renewing pneumorrhagia is followed by regular allocations of a purulent phlegm. Severe pleural pain at a blood spitting indicates a possible myocardial infarction. Physical inspection helps to establish an actual reason of a pneumorrhagia: noise at friction of a serous cover of lungs demonstrates existence of any pathology connected with defeat of the cover of lungs (abscessing pneumonia, a coccidioidosis, an angiitis); local rattles indicate a possible carcinoma of a lung. Primary inspection surely includes radiodiagnosis of a thorax. But even at normal results of the roentgenogram there is a probability of existence of a bronkhoektatichesky disease or a new growth as bleeding factor. The x-ray film of a thorax allows to check the liquid level which indicates accumulation of pus or the tumor located distally corking a bronchial tube. To some patients the computer tomography of a thorax and a trakheobronkhoskopiya is appointed. Inspection by the rigid endoscope is especially necessary at a plentiful blood spitting.

The help at a blood spitting and pulmonary bleeding

Pulmonary pneumorrhagia – allocation of a large amount of blood through respiratory tracts without cough or during cough. Without cough blood in an oral cavity follows from respiratory tracts a stream. Most often lung cancer and tuberculosis are the reasons of a pulmonary pneumorrhagia.

The blood emitted at a pulmonary blood spitting, scarlet color foams and is not turned. At a pulmonary blood spitting the emergency hospitalization in medical institution is shown.

First aid at a blood spitting consists that it is necessary to give to the person situation "semi-sitting", sublime situation to calm him, to prohibit to talk and move. On a thorax it is strictly forbidden to put cups, to impose mustard plasters, hot-water bottles and hot compresses. On the struck area of a thorax it is necessary to put a bubble with ice, and to the patient to allow to swallow small pieces of ice. The reflex spasm at a proglatyvaniye will reduce a krovenapolneniye of blood vessels of lungs.

Treatment of a pneumorrhagia

Main objective of treatment of a pneumorrhagia is ensuring normal functioning of lungs and heart and prevention of asphyxia. Treatment of a pneumorrhagia consists in a bed rest and reception of medicines which suppress cough – opiates (a digidroksikodeinon on 5 mg four-six times a day, codeine of 10-30 mg).

In the initiation of treatment by means of the rigid bronchoscope reveal a bleeding point, and then isolate not affected lung and provide its ventilation. At respiratory insufficiency and the massive blood spitting (allocation about 0,6 liters of blood within two days) which resulted from hit of blood in respiratory tracts aspiration is required. For isolation of the damaged site of a lung the special tube with the inflated barrel for holding a procedure of an incubation of lungs is entered. Considering localization of a bleeding point and a condition of respiratory function of the patient, choose a classical or surgical way of treatment of a pneumorrhagia. The resection of an affected area of a lung cannot be carried out at inoperable cancer and the expected heavy dysfunction of external respiration. At considerable dysfunction of lungs carry out catheterization and embolization of a bronchial artery. In this case before the procedure the bleeding site is tamponed a balloon catheter, carry out lavage by solution of fibrinogen or normal saline solution, intravenously enter vasopressin.

At a massive and submassive blood spitting the angiography method including the selection embolization of a bronchial artery is applied. The method of an angiography allows to keep a significant amount of pulmonary fabric. This method is used at chronic diseases of lungs at patients.