chronic suppurative pleurisy
Introduction
Introduction to chronic suppurative pleurisy Acute empyema after 4 to 6 weeks of treatment of the abscess did not disappear, the pus thick and a large number of sediments, suggesting that the empyema has entered the chronic phase. Chronic empyema patients due to long-term infection, physical exertion, high pleural thickening, especially parietal pleural thickening is particularly significant. Chronic empyema patients due to long-term infection, physical exertion, pleural hypertrophy, especially parietal pleural thickening is particularly significant, chest wall invagination, ribs gather, the intercostal space narrows, the spine bends to the opposite side, the patient has restricted respiratory function Obstacles, some patients have clubbing, chronic empyema through the intercostal space, and the chest wall to form a dumbbell-shaped abscess, called exogenous empyema, mostly for the treatment of tuberculous empyema is not timely complications, long-term chronic empyema patients can Hypoproteinemia and hypohemoglobinemia and liver and kidney function decline, patients often have weight loss, anemia, plasma protein reduction, and varying degrees of chronic systemic symptoms, such as low fever, fatigue, poor appetite. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: multiple lung infections
Cause
Causes of chronic suppurative pleurisy
Infection factor (30%):
When the pathogenic bacteria enter the thoracic cavity and cause inflammatory exudation, causing inflammatory or purulent effusion of the chest, leading to acute empyema or tuberculous empyema, the treatment is not timely and inappropriate. Chest is adjacent to chronic infections, such as subarachnoid abscess, liver abscess, mediastinal abscess and rib osteomyelitis and other sources of infection have not been completely eliminated, but also easy to form chronic empyema.
Foreign body factor (30%):
There are foreign objects in the chest cavity: foreign objects such as trauma, metal foreign bodies, bone fragments, clothes and debris remain in the chest cavity and cause secondary infection.
Surgical factors (20%):
If there is bronchopleural fistula or esophageal fistula after surgery.
Prevention
Chronic suppurative pleurisy prevention
1. Active and thorough treatment of diseases inside and outside the lungs is of great significance in preventing the occurrence of suppurative pleurisy.
2, exercise the body, enhance physical fitness, improve disease resistance.
Complication
Chronic suppurative pleurisy complications Complications multiple lung infections
More as a complication after pulmonary infection.
Symptom
Chronic suppurative pleural inflammatory symptoms Common symptoms Breathing chest pain Chest pain Pain shock Low fever side Thoracic collapse Low proteinemia Pleural calcification Weakness Intercostal space Narrow empyema
Chronic empyema patients due to long-term infection, physical exertion, pleural hypertrophy, especially parietal pleural thickening is particularly significant, chest wall invagination, ribs gather, the intercostal space narrows, the spine bends to the opposite side, the patient has restricted respiratory function Obstacles, some patients have clubbing, chronic empyema through the intercostal space, and the chest wall to form a dumbbell-shaped abscess, called exogenous empyema, mostly for the treatment of tuberculous empyema is not timely complications, long-term chronic empyema patients can Hypoproteinemia and hypohemoglobinemia and liver and kidney function decline, patients often have weight loss, anemia, plasma protein reduction, and varying degrees of chronic systemic symptoms, such as low fever, fatigue, poor appetite.
Examine
Examination of chronic suppurative pleurisy
Chest X-ray showed thickening of the affected side of the pleura, narrowing of the intercostal space, mediastinal shift to the affected side, and the chest cavity became smaller. If suspected bronchiectasis, bronchial angiography should be performed.
Chronic empyema, if not drained, must be chest puncture, pus bacterial culture, to identify the pathogenic strain of empyema, due to the use of antibiotics, culture can be negative, such as bronchopleural fistula, inject into the chest cavity Lan will soon appear in the coughing sputum.
Blood routine examination, white blood cells rise.
Diagnosis
Diagnosis and diagnosis of chronic suppurative pleurisy
1. Acute onset patients have obvious toxic symptoms, such as aversion to cold, high fever, excessive sweating, dry cough, chest pain, pleural effusion, chest tightness, shortness of breath, accompanied by bronchopleural fistula, then suddenly cough a lot of purulent, related to body position.
2. Chronic empyema, more weight loss, anemia, persistent fever, cough, cough, due to chest collapse, limited respiratory activity, chest tightness, shortness of breath symptoms, sinus fistula can be seen in the chest wall, and pus out.
3. In patients with acute empyema, there is a pleural effusion in the affected chest. The local chest wall may have redness, fever and tenderness. The chronic empyema is chronically ill, pale, and the affected thoracic cavity is deformed. The intercostal space is narrow and the activity is limited. There is a clubbing (toe).
