lung is called a pathological condition in which there is a loss of light airiness portion (segment share) or all of the lungs. Translated from the Greek "atelectasis" means incomplete or abandoned stretch fabric.
There are innate (not smoothing of the lung) or acquired forms of the disease. Acquired atelectasis divided into compression and obstructive.
The cause compression atelectasis is a compression of the bronchi outside. Obstructive atelectasis develops due to blockage of the lumen of the bronchus leads.
The etiology and pathogenesis of lung atelectasis
To the development of atelectasis can cause the following reasons:
- Pathology of the inner walls of the bronchial mucosa - deformation bronhomalyatsiya, edema, swelling;
- Increasing the surface tension on the walls of the alveoli cause lung edema (cardiogenic and noncardiogenic genesis), infectious processes, or lack of surfactant;
- The obstruction (blockage) of the lumen of the bronchus foreign body, cheesy masses tuberculosis, mucus, mucosal edema;
- Compression of the lung and / or airway due to various external factors (mediastinal tumor, lymphadenopathy, abnormal development of large blood vessels, myocardial hypertrophy, etc.);
- Increased pressure within the pleural cavity (hemothorax, hydrothorax, empyema, pneumothorax);
- Violations of the normal chest rise, arising from general anesthesia, paralysis of the phrenic nerve, neuromuscular diseases, scoliosis;
- Massive acute lung collapse that occurs as a postoperative complication as a result of prolonged immobility of the patient, an overdose of oxygen in the breathing mix, use of high doses of opiates and sedatives, vasodilators, hypothermia.
Risk factors for lung atelectasis are obesity, smoking. In addition, the disease is more common in people with asthma or cystic fibrosis.
Pathology of the disease
Insufficient intake air leads to tissue hypoxia lesion of the lung tissue. This leads to the fact that the interior of the alveoli begins to fill transudate (exudative fluid), exfoliated epithelial cells and bronchial secretions. Very quickly in the affected area of emerging infectious processes that lead to the development of fibrosis and the appearance of bronchiectasis.
The clinical picture of atelectasis
Symptoms atelectasis, mainly determined by the nature of the main process leading to the emergence of the disease. So when obstructive atelectasis in most cases, a doctor can easily detect signs of lung obstruction, and compression atelectasis in the majority of patients have symptoms of lung or mediastinal tumor.
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 site of atelectasis (more than 1 - 2 segments) are often unable to grasp the weakened breathing and shortening of percussion sound.
During the radiographic examination is determined by the X-ray shadow with clearly concave border. During the X-ray in patients with pulmonary atelectasis can identify symptom-Geltsnehta Jacobson (jerky displacement of the mediastinum shadow directed towards destruction).
The course and prognosis
When you save the causes that led to the development of atelectasis, the disease is prolonged. Upon accession, the inflammatory process gives impetus to the development of pneumonia. When you save a portion of atelectasis lung fibrosis occurs more than six months, and later chronic pneumonia.
Treatment of lung atelectasis should primarily be aimed at addressing the causes of its development. In obstructive atelectasis resorted to bronchoscopy, in which deletes from the lumen of the bronchus foreign body or cheesy mass. After the restoration of patency leads bronchial atelectasis in the fastest time allowed.
atelectasis reflex origin or associated with occlusion of the lumen of the bronchi mucus is to apply the methods of accelerating the cleansing of the bronchi (cough stimulation, massage, postural drainage).
Compression atelectasis, in cases where it is caused by a tumor or lymph node enlargement requires surgical treatment.
In severe cases, atelectasis treatment of the disease often begins with the transfer of the patient to a controlled mechanical ventilation.
Atelectasis in newborns
or hypoplasia of the respiratory center, hypoplasia of the pulmonary and bronchial tissue (main reasons for not straightening portion of lung tissue and the appearance of atelectasis in newborns are more likely to decrease in excitability in preterm children) and obstruction of the respiratory tract mucus, blood or amniotic fluid.
The clinical picture of atelectasis in newborns manifested by shortness of breath, tachycardia, cyanosis.
In most cases, sites are not the expanded lung tissue to straighten out on their own during the first week of life. Prognosis is much worse when joining edematous hemorrhagic syndrome, infectious and inflammatory processes, or the formation of hyaline membrane.
Treatment of atelectasis in newborns is to carry oxygen therapy or in severe cases, mechanical ventilation. Carry-glucose infusion therapy alkaline mixtures prescribed cardiovascular drugs and vitamins.