Dry and exudative pleurisy
Pleuritis is called inflammatory disease of the pleura leaves with deposition of fibrin on their surface (dry pleurisy) or accumulation of fluid in pleural cavity (exudative pleurisy). This is not an independent disease, it develops as a complication of the pathological process in the lungs, the mediastinum, the thorax. This disease is often a manifestation of tuberculosis, rheumatism, diffuse collagenosis and cancer.
In pleurisy, the infection enters the pleural cavity in various ways: contact, lymphogenically, hematogenically and with open injuries, wounds, surgical interventions.
In the clinic of these diseases several syndromes are distinguished:
- inflammation of the pleura;
- collecting fluid in the pleural cavity;
- inflammation;
- intoxication.
Dry Pleurisy
The disease begins acutely with the appearance of pain in thethe area of the chest, which is strengthened by deep breathing, coughing, and movements of the trunk. The patient, trying to protect a sore spot, tries to lie on a healthy side. Breathing is frequent, superficial. A dry, unproductive cough is characteristic, which is aggravated by movement.
Clinical course of dry pleurisymainly light. The disease lasts two to three weeks and depends on the course of the underlying disease. Prolonged relapsing dry pleurisy is characteristic for the tuberculous process, which requires prolonged specific treatment.
Excessive pleurisy
Exudative pleurisy can be a continuationdry or complication of another disease. The nature of the exudate depends on the severity of the disease and the cause of pleurisy. For example, bloody exudate occurs with lung cancer, metastases, tuberculosis, lung infarction; serous and serous-fibrinous - with rheumatism, tuberculosis, chronic renal failure, collagenoses.
In the clinical course of exudative orexudate pleurisy occurs three phases: accumulation of exudate, its stabilization and resorption. Occasional pleural effusion develops, which can have different localization.
Exudative pleurisy can develop acutely andgradually. In acute course, body temperature rises rapidly, chills appear, pain in the chest area from the side of the lesion, dry cough, shortness of breath, severe weakness. With the appearance of exudate, the pain gradually decreases, but dyspnea increases and becomes noticeable even at rest.
An intensive homogenous darkening in the place of accumulation of exudate is determined by X-ray examination.
Treatment of pleurisy
In the case of dry pleurisy in the first placethe main disease is treated. In the tuberculosis process, specific antituberculous drugs are prescribed. If dry pleurisy is caused by pneumonia, antibiotics are prescribed. With anti-inflammatory, salicylates and non-steroidal anti-inflammatory drugs are prescribed. For analgesia, analgesics are used. According to the indications, glucocorticoids, detoxification and desensitizing therapy are used. In the early stages of dry pleurisy, electrophoresis is used. With a decrease in acute manifestations of the disease, massage and thermal physiotherapy procedures are indicated.
If exudative pleurisy is diagnosed,The main method of therapy is the pleural puncture. After the puncture, treatment of exudative or exudative pleurisy is carried out in the same way as a dry one. With a reduction in the inflammatory process and no signs of reassembling fluid in the cavity, a resorption therapy is prescribed.
Usually pleurisy is favorable, but canbe protracted. Exceptions are pleural inflammation in cancer and systemic diseases. Exudative pleurisy is more severe than dry. After convalescence, spikes, thickening of pleura sheets, and the development of heart failure may remain.
