Anectasis most often diagnosed in children weak and premature due to the immaturity of the lung and bronchial tissue, blockage of mucus or amniotic fluid. If a small area of the lung is involved, then after some time he cracked down on their own, with extensive spadenie poor prognosis.
What it is?
lung atelectasis - a pathological condition in which the whole lung or part of it collapses (A convergence of the walls and the compression of the lung, wherein the air exits from this plot) and off from gas exchange. The disease is based violation bronchus permeability due to blockage of its lumen (e.g., sputum plug, foreign body) or compression of the lung.
Causes of
The causes of atelectasis are divided into several groups:
- Increasing the pressure in the pleural cavity. These include a collapsed lung (pneumothorax), hemothorax, empyema pleura, hydrothorax.
- Paralysis of the major nerves, as the phrenic, vagus wrong anesthesia, and scoliosis other changes in the shape of the spine lead to violations of chest rise and oppression breathing.
- Compression of light from the outside - hypertrophic large vessels, benign or malignant tumor, cardiac enlargement in volume (myocardial hypertrophy), lymphadenopathy.
- Patients legkieKardiogenny or non-cardiogenic pulmonary edema, an insufficient amount of surfactant, inflammation caused by pathogenic microorganisms, which causes increase in the surface tension.
- Improper operation or a decrease in lung bronchial drainage function in the postoperative period.
- The sharp reduction or occlusion of the lumen of the bronchi mucus thick, foreign body, due to a sharp body smooth muscle spasm.
- Bed rest for a long time.
Those at risk include people with a high body mass, suffering from cystic fibrosis and asthma, do not follow a healthy lifestyle.
Classification
Characteristics of the possible forms:
- compression - compression of light under the influence of fluid or air that had accumulated in the pleural cavity;
- obstructive - disturbance of the air passage bronchi with occlusion of the lumen due to the entry of foreign bodies or liquids.
Also, there is a congenital (occurs in premature and weak babies or having a birth trauma) and acquired (as a result of comorbidities, disease or injury).
Atelectasis in newborns
Form of the disease, in which segments of the lung or the entire lung with the birth of the child is not involved in the breathing process. Atelectasis in newborns occurs, as a rule, weak, non-viable child, stillborn, as well as children who died shortly after birth due to falling fruit or meconium waters in breathing way. Extensive atelectasis in newborns in nearly all cases, unfortunately, leads to death. In focal pulmonary atelectasis prognosis is more favorable. In this form of the disease atelectasis may eventually crack or transformed into small sizes scars.
When spadenie pulmonary vesicles (alveoli) due to exposure to certain factors may develop acquired atelectasis in the newborn.
In some cases, atelectasis in newborns takes quite a long time without showing any symptoms. When massive atelectasis can occur in newborn disorders of respiratory function, manifested in the form of nasolabial triangle cyanosis and dyspnea. If atelectasis in newborns can develop lung abscess, or pneumonia.
Symptoms of pulmonary atelectasis
Symptomatology atelectasis mainly determined by the nature of the basic process, leading to the appearance of the disease. So when obstructive atelectasis in most cases, a doctor can easily detect signs of obstruction light, and when the compression atelectasis, most patients have mild symptoms or tumor mediastinum.
- Extensive atelectasis accompanied by violation of the frequency and nature of breathing, the appearance of tachycardia and cyanotic (bluish) color of the skin.
- Above the portion of atelectasis (over 1 - 2 segments) are often unable to capture a weakened breath and shortening of percussion sound.
In carrying out X-ray radiographs defined shadow with a clear concave border. In carrying out X-ray in patients with pulmonary atelectasis can be detected symptom Jacobson-Geltsnehta (jerky shadows mediastinal shift aimed toward the defeat).
Diagnostics
Are diagnosed with the help of X-ray in different projections. The photograph shows blackout injured lung portion, the diaphragm occupies a raised position with respect to the affected side. pictures often do not provide an accurate diagnosis, and then runs diagnostics when using a different method - computed tomography lung.
To ascertain the condition of the lung parenchyma need data AAH. How much reduced oxygen pressure shows blood gases. Diagnostics can also include radiopaque study bronhografii, angiopulmonography.
Studies exclude other possible diagnoses - pulmonary hypoplasia, diaphragmatic hernia, cirrhosis, hemothorax and others.
Treatment of pulmonary atelectasis
Detection of lung atelectasis requires a doctor (neonatologist, pulmonologist, thoracic surgeon, traumatologist) active, active tactics. Infants with primary pulmonary atelectasis suction is performed in the first minutes of life content airway rubber catheter, if necessary - tracheal intubation and smoothing easy.
When obstructive atelectasis, bronchial caused by a foreign body, for its removal is necessary to conduct medical diagnostic bronchoscopy. Endoscopic rehabilitation of the bronchial tree (bronchoalveolar lavage) is necessary in the event that atelectasis is caused by the accumulation of difficult to cough up secretions. In order to eliminate postoperative pulmonary atelectasis shown holding tracheal aspiration, percussion massage of the chest, breathing exercises, postural drainage, inhalations with bronchodilators and enzyme drugs. When pulmonary atelectasis any cause should be the appointment of preventive anti-inflammatory therapy.
During the collapse of lung due to the presence of air in the pleural cavity, exudate, blood and other pathological content, shows the urgent holding of thoracentesis or pleural drainage cavity. In the case of long-term existence of atelectasis, lung impossibility of unfolding conservative methods, the formation of bronchiectasis raises the question of resection of the affected area of the lung.
The prognosis of lung atelectasis
Sudden a momentary total (subtotal) atelectasis one or two light which has developed as a result of trauma (of air into the chest cell) or during complex surgical procedures in virtually all cases results in death immediately or in the early postoperative period.
- Obstructive atelectasis, evolved during sudden blockage of foreign bodies on the main level (right, left) bronchi - are also forecast in the absence of serious emergency.
- Compression and atelectasis distenzionny that developed when hydrothorax, with the removal of the causes that caused they do not leave any residual changes and do not change the amount of lung capacity in further.
Significantly change the forecast recovery of the compressed lung function can join pneumonia, which is behind in these cases leaves scar, replacement collapsed alveoli tissue.
