Емфізема легенів і аспекти її лікування
Development of emphysema is associated with irreversible changes in the wall of the bronchi and lungs under the influence of long-term inflammation, long-term narrowing of the airways. Violated the elastic properties of the lungs: they begin to remain after exhaling more air than it should be normal that causes hyperextension (swelling) of the lungs. This excess air is not involved in respiration and overstretched lung tissue does not work fully. That, in turn, accompanied by the loss of ability to reduce and difficult sufficient exhaling, resulting in disrupted blood flow of oxygen and excretion of carbon dioxide therefrom. Compensatory, to improve the removal of carbon dioxide, there is shortness of breath. Also in the bronchi and lungs starts to increase progressively the amount of connective tissue, which, as it "replaces" aerial portions of the lung tissue, and promotes long-term narrowing of the bronchial tubes is regardless of existing inflammation. Due to these changes in the lung air sacs formed numerous different sizes, which can be scattered throughout the lung (emphysema diffuse form). Sometimes swollen parts of the lungs combined with normal lung tissue (local form of emphysema). Also separately isolated bullous emphysema (emphysematous bulla it (bloated) plot size of more than 1 cm). Patients with emphysema in the early stages of the disease take a forced position on his stomach with his head bowed down and shoulder belt that brings them relief. However, in severe emphysema with pronounced changes of the chest and respiratory muscle fatigue horizontal position of the diaphragm causes the hard work, so patients have to even sleep in a sitting position. Patients with emphysema often occupy a position of sitting with several trunk bent forward, resting his hands on his knees or the edge of the bed, which allows you to record and shoulder girdle muscles to include an additional act of breathing. Treatment should begin at the stage of bronchitis, before the development of emphysema. Since most commonly due to late presentation of the patient to the doctor at the time of first contact with the lung is usually irreversible changes, which greatly complicates the subsequent treatment. Currently, the primary means of inhibition of the progression of emphysema is the long-term use of inhaled glucocorticosteroid.