Pneumosclerosis of the lung: symptoms and treatment, causes, prognosis

What is it - a large number of pneumo-pulmonary diseases - pneumonia karnifitsiruyuschaya, interstitial, chronic, pnevmotsirroz and many more definitions, in which the lung function is violated, expressed by the proliferation of scar connective tissue in the lungs, in medical practice is united by one name - pneumosclerosis.

The replacement pathology of pulmonary tissue in connective tissue, with pneumosclerosis, is caused by a lack of air volume in the lungs, which is a consequence of diffuse gas exchange and negative regional pulmonary hysteresis caused by dystrophic changes or acute inflammatory processes in the pulmonary lobes.

Development in the lungs of connective strands promotes deformation - compression, obturation( congestion of mucus) and bronchial lumen disturbance. It leads to the destruction of the blood and lymph vessels. Such changes provoke violations of the purifying and ventilation process in the bronchi, causing stagnation and elimination of excess secret, which is fraught with the development of various kinds of infections. The lobes of the lung become denser, lose their airiness, wrinkle, and lose their normal volume.

It is the destructive processes in the bronchopulmonary vascular system associated with disorders in the lymph circulation and blood supply system that contribute to the destruction and degeneration in the parenchyma and the capillary network of the pulmonary lobes. This pathology leads to an increased proliferation of connective strands. Which is the main indicator of various manifestations of pneumosclerosis - diffuse or focal, with large-focal or fine-focal localization.

Classification of pneumosclerosis

Depending on the prevalence in the lungs, pneumosclerosis is divided:

1. 1) On the focal form( segmental or lobar) - with this form, the gas exchange function and elasticity of lung tissue are not violated. Areas with parenchyma condensation are noted. The volume of lesions is reduced. During the investigation, sclerotic purulent focal lesions, fibrotic foci of atelectasis with the release of fibrous exudate are found. Focal pneumosclerosis is distinguished by small or large focal formations.
   
2. 2) Diffuse or diffuse form, in which the lesion covers one or both lobes simultaneously, tissue structures are broken, they are compacted and reduced in volume, ventilation is reduced.

According to the etiological factor of pneumosclerosis, it happens:

• of postnecrotic etiology;
  
• dyscircular;
  
• is a consequence of the interaction of inflammatory and dystrophic processes.

Depending on the structural lesions of the lung, the disease is divided:

• into the alveolar;
  
• peribronchial;
  
• perivascular;
  
• interstitial;
  
• perilobular.

According to the degree of replacement pathology - pulmonary parenchyma on connective tissue classified:

1. 1) Fibrous degree - characterized by limited areas of damage, with minor strands of substitute dense tissue alternating with healthy tissues.
   
2. 2) Conventional sclerosis degree - a substitution pathology causes compaction of the organ, with loss of airiness.
   
3. 3) Cirrhotic degree - complete replacement of alveoli of bronchi and vessels with replacement connective formations. The organs located in the middle section of the sternum move towards the lesion focus.

The development of the disease occurs in three "hypostases":

• of the compensated stage;
  
• is subcompensated;
  
• decompensated

Causes of pneumosclerosis

Usually the causes and formation of a mechanism for the development of pneumosclerosis of the lungs depend on the outcome of the existing bronchopulmonary disease. Provocative impetus is:

• is the infectious and viral nature of background diseases;
  
• infections that give rise to aspiration pneumonia;
  
• consequence of mycosis of internal organs and tuberculosis infection;
  
• consequence of complications of chronic bronchitis and peribronhitis;
  
• consequence of pneumoconikosis, fibrosing and allergic alveolitis;
  
• systemic granulomatosis;
  
• complications after ingress of foreign bodies into the bronchi.

1) Another form - post-pneumatic, characterized by development after incomplete cure of pulmonary inflammatory processes. The development of connective strands continues, the luminal lumens of the pulmonary alveoli are clogged with exudate. Manifestations of post-pneumatic pneumosclerosis, a frequent consequence of staphylococcal pneumonia. The disease is characterized by:

• by the formation of necrosis in the parenchyma;
  
• formation of a protective wall of abscesses;
  
• fibrous tissue proliferation.

2) In diseases of the post-tuberculosis form, the same substitution pathology is observed, but with the formation of irregular tissue( cicatricial) and the formation of air cavities in the pulmonary lobes( emphysema).

3) Pneumosclerosis of pleurogenic etiology is a consequence of exudative pressure on the parenchyma, the duration of the process causes inflammation of the upper layers of the lung tissue.

4) Diffuse form of perilobular species is caused by chronic bronchial disease and bronchiolitis.

5) The result of fibrosing alveolitis, granulomatosis or radiation exposure is diffuse pneumosclerosis.

6) Cardiogenic form of the disease, is a consequence of violations of the cardiac myocardium, mitral stenosis or sudden clogging of the embolus pulmonary arteries.

Even such a short, far from complete list, gives a general idea of ​​the mechanism of the development of the disease.

Symptoms of pneumosclerosis of the lung

Symptoms of clinical manifestations of pulmonary pneumosclerosis are similar to those with a companion or accompaniment of which it is. In addition, the specific signs of pneumosclerosis will depend on the form of the disease:

• various forms of chronic bronchitis;
  
• bronchiectasis and other forms of chronic pneumonia

Limited form of pneumosclerosis is manifested:

• with a small cough;
  
• by discharging a small amount of sputum;
  
• marked slightly sunken chest in the affected area.

The diffuse form is characterized by:

• dyspnoea with loads, and subsequently in the usual, calm state;
  
• in the separated sputum there are impurities of pus;
  
• with significant tachycardia and marked diffuse cyanosis;
  
• vesicular breathing is impaired;
  
• by strengthening of cardiac tremors - cardiac auscultation;
  
• by rapid surface breathing - tachypnea;

In the cirrhotic degree of lesion, the signs are expressed:

• by the development of thoracic deformation;
  
• with mild, shallow breathing;
  
• dry and wet rales are heard;
  
• there are signs of weakness of the intercostal muscles;
  
• marked displacement of the thoracic organs into the affected area.

Diagnosis of pneumosclerosis

Diagnostic methods of pneumosclerosis include:

1. 1) Physical examination - determining the general pathology.
   
2. 2) Radiographic study, computer and magnetic resonance methods - refining diagnostics, which allows to determine the changed structure, the nature of lesions, evaluation of the severity of pathology, its prevalence.
   
3. 3) Bronchoscopy is used to detect bronchoderma.
   
4. 4) Flushing from the bronchi - its analysis, determines the activity of pathology and the etiology of the processes.
   
5. 5) Methods of spirometry and picloumetry reveal a decrease in vital capacity in the pulmonary lobes and a violation of bronchial patency.

Treatment of pneumosclerosis of the lungs

The main direction in the treatment of pulmonary pneumosclerosis is aimed at arresting the causative factors. Active therapy with a limited form of the disease is used only for acute development of the processes caused by repeated manifestations of pneumo- pulmonary pathologies. The following are prescribed:

• antimicrobial agents;
  
• expectorant properties;
  
• bronchodilator.
  
• bronchial drainage

For relief of myocarditis symptoms and congestive form of cardiomyopathy,

• cardiac glycosides are prescribed;
  
• potassium-sparing diuretics;
  
• glucocorticoid agents.

In the absence of signs of pulmonary insufficiency, physiotherapeutic procedures are recommended:

• iontophoresis and ultrasound in conjunction with medications;
  
• diathermic and inductometric procedures on the thorax;
  
• electrophoresis and ultraviolet irradiation;

Oxygen therapy is used to improve cellular metabolism and oxygen saturation of the lungs. Radical, surgical method of treatment of pulmonary pneumosclerosis is used for cirrhosis and fibrosis lesions and suppuration in the parenchyma. In such cases, resection of the affected area or the entire lung is performed.

Prevention of disease is the main rule in the prevention:

• timely treatment of colds;
  
• infections and bronchopulmonary diseases;
  
• to avoid provoking factors associated with production activities;
  
• restrict exposure to toxic preparations of
  
• to quit smoking;
  
• deal with hardening and easy sports.

Complications and prognosis

Like any disease, pulmonary pneumosclerosis, with insufficient attention to and delaying treatment, causes complications expressed by:

• morphological changes in the alveoli;
  
• thickening of the vascular bed in the lungs;
  
• bronchial ventilation disorder;
  
• development of heart failure;
  
• emphysema.

Timely treatment and elimination of the development of pulmonary lesion provides a favorable prognosis. Progression of the disease, the attachment of secondary infections, leads to extensive damage to lung tissue, which can result in a fatal outcome.

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