Pulmonary edema. Acute, subacute, protracted course. A protracted course of orvi in adults: what to do if the disease is in no hurry to pass

14.08.2017

AT medical reference books no diagnosis prolonged bronchitis. By this term, doctors designate a condition in which bronchitis in an adult is not treated, a person suffers from coughing for a long time. Synonymous with the characteristic "lingering" becomes "chronic" when we are talking about bronchitis. The reasons why the disease does not go away for a long time are as follows:

treatment acute bronchitis assigned illiterately;
the patient did not follow the recommendations of the doctor, changed the dosage of drugs and the duration of therapy;
treatment started later than necessary;
the patient did not go to the doctor, deciding to cure bronchitis on his own.

The last of these causes is common. Presented on the Internet a large number of information that people try to use, but do not always do it correctly. Why do people not want to be examined in a polyclinic and get a doctor's recommendation?

Some do not want to stand in queues and waste time on the road, others naively consider bronchitis a benign disease. Because of such misconceptions, precious time is lost, acute bronchitis is transformed into a protracted one. The treatment of the latter can last for years.

Another reason why prolonged bronchitis can occur is an interrupted course of treatment. Having received the recommendations and prescriptions of the doctor, the patient begins treatment, after a few days he feels better and decides that he does not need to continue drinking pills, since the symptoms have disappeared. At this moment, bronchitis is not completely cured, just the cause is hidden, it will begin to remind of itself with renewed vigor.

Additional factors that provoke protracted bronchitis are: smoking, alcohol abuse, work harmful production living in damp climate.

Identification of chronic bronchitis

Weakness, loss of appetite, fatigue for no reason are signs reduced immunity and microbial toxicity

Bronchitis is provoked bacterial infection. If the patient cannot recover in any way while taking the prescribed drugs, then they were chosen incorrectly. You should consult a doctor when symptoms persist for more than 3 weeks:

weakness, loss of appetite, fatigue for no reason - these are signs of reduced immunity and microbial intoxication;
persistent cough against the background of difficult expectoration of sputum;
pleurisy, neurasthenia, chest pain;
shortness of breath is a constant companion of prolonged bronchitis.

After examining and collecting anamnesis, the doctor will refer the patient for diagnosis in order to determine the causes of prolonged bronchitis in adults. Bronchoscopy allows you to see how much inflammation has spread in the respiratory system. At chronic pathology bronchi are affected at all levels. Treatment of prolonged bronchitis will be prescribed depending on the stage of inflammation, and there are 3 of them:

Small changes in the bronchial mucosa.
The mucous epithelium is bright red and dense, suppuration and bleeding are possible.
The color of the mucosa changes to cyanotic, it bleeds, a lot of pus is revealed.

If it is necessary to do a bronchography, sanitation is carried out first bronchial tree, otherwise the accumulated pus will not let you see the small bronchi. X-ray in the chronic form of bronchitis, it will show a deformation of the pattern of the lungs and an increase in the transparency of their tissue, expansion of the roots.

How is chronic bronchitis treated?

With the diagnosis of protracted bronchitis in adults, treatment without drugs, as in acute form pathology is not possible. Doctors often prescribe antibacterial drugs Augmentin and Amoxiclav, but another drug may be selected, depending on the sensitivity of bacteria to active substance. Additionally, with the diagnosis of protracted bronchitis, treatment includes medications:

mucolytics, thinning sputum, which facilitate its removal from the bronchi;
bronchodilators that improve breathing;
vitamins that strengthen the body;
expectorants, accelerating the excretion of sputum.

Folk remedies for chronic bronchitis

A simple remedy that can stop a protracted course of bronchitis is aloe with honey

Among the recipes traditional medicine There are many decoctions and tinctures that can strengthen the immune system and help treat bronchitis. Below are recipes and indicated how and what to do in order to recover faster. Most recipes suggest using aloe, a plant with healing properties:

a simple remedy that can stop a protracted course of bronchitis is aloe with honey. You need to take a glass of aloe juice and the same amount of honey, mix and add 100 ml of alcohol or vodka. Infuse the mixture for 5 days, store in the refrigerator and take from inflammatory diseases respiratory tract, 1 tsp. twice a day;
simple "grandmother's" way - add to a glass warm milk 1 tbsp honey and cocoa butter. The drink is drunk before going to bed, the next morning the sputum is well coughed up;
350 ground aloe leaves, 750 ml of Cahors and 100 ml of alcohol are mixed. The tincture is stored in a dark place, taken 2 times a day, 1 tablespoon;
mix 150 ml of aloe juice with 200 g of cocoa and 300 g natural honey, add to this mixture badger fat. All components are mixed, then the mixture is stored in the refrigerator. It is taken in 1 tbsp. 2 times a day;
you will need 1 cup of birch buds, 500 g of honey, 3-4 thick leaves of aloe. On the steam bath honey is heated, birch buds and crushed aloe leaves are added to it. The mixture is stored in the refrigerator, take 1 tsp. 3 times a day;
300 g of aloe leaves are passed through a meat grinder, the same amount of honey, 500 ml of cognac and juice from 2 lemons are added. A mixture of 1 tsp is taken. 2 times a day.

Those patients who do not delay going to the clinic and take care of their well-being recover faster. The doctor may prescribe such procedures from chronic bronchitis: exercise therapy, massage, compresses and pepper patch, mustard plasters (if the disease proceeds without fever), correction of the daily routine and diet, inhalations to relieve itching and inflammation.

What to do with chronic bronchitis?

Among medical advice to get rid of bronchitis in the first place is an increase in the daily volume of fluid consumed, if there are no contraindications to this. The patient can drink tea with lemon and honey, jelly and compote, juice and fruit drink, milk with honey and mineral water without gas. From the diet it is desirable to exclude salty and spicy dishes which can irritate an already sore throat.

The room in which the patient is located should be regularly ventilated, and the humidity and air temperature recommended by the doctor should be maintained in it. For the duration of therapy, it is important to give up smoking and alcohol, and it is desirable to completely quit these habits. In good weather, you definitely need to walk more, this will improve blood circulation and gas exchange. Apart from traditional medicines can be successfully used folk remedies. Of course, you first need to discuss the possibility of their use with your doctor.

Prolonged bronchitis prevention

It is necessary to consult a doctor in a timely manner, and not rely on acquaintances, neighbors and the all-knowing Internet

Prevention measures are simple and understandable to everyone, it is not difficult to follow them, and as a result, this will help prevent serious complications.

First, you need to see a doctor in a timely manner, and not rely on friends, neighbors and the all-knowing Internet. The doctor will accurately diagnose, find the cause and select the treatment on an individual basis, so you can count on recovery and the absence of relapses in the future. Conversely, self-treatment can cause an increase in the number pathogenic microorganisms, complications in the work of other organs.

Secondly, during the treatment of bronchitis main task becomes the excretion of sputum and stop inflammatory process. This applies to both protracted and recurrent bronchitis. Can expel mucus plentiful drink and a nebulizer (inhaler).

Thirdly, it is important to devote time to the cleanliness and freshness of the surrounding space. We are talking about choosing a place for walking (away from the highway), and about regular cleaning and ventilation in the room.

Summing up, it is worth emphasizing that prolonged bronchitis is nothing more than a consequence of undertreated acute bronchitis. Due to the reasons listed above, microorganisms become resistant to drugs, other pathologies develop, and therapy becomes complex and long-term. Therefore, it is better and easier to complete the treatment of acute bronchitis, which will save you from problems in the future.

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currents

WATER FLOW IN THE RIVER- the movement of water particles in the river along the channel under the influence of gravity. As the slope of the water surface increases, the speed of the current increases. The energy of the river flow is spent on the internal friction of the water and on overcoming friction on the bottom and banks. Therefore, in general, no acceleration of water movement in the river flow is observed, however, local acceleration may occur, for example, on riffles and rapids.

The flow of water in the river has features, sometimes they are called wrong currents. Quiet water - a slow current that forms behind convex banks, large sandy deposits in the channel, etc. When moving the vessel upwards, to increase speed, where possible, you should go in a slow way. Suvod - a body of water with a rotational movement of water, usually located behind the ledges of the banks, capes, convex banks, strongly protruding into the channel (Fig. 1). In these places, the current, flowing around the coast at high speed, meets a ledge on its way and creates water backwater and a rise in level in front of it. Passing the ledge, the water flow deviates from it and travels a certain distance by inertia. Behind the ledge, the water level is lowered, due to which, in the lower part of the suvodi, water is drawn from the main stream, and in the upper part, on the contrary, from the suvodi area into the main stream of the stream. This process occurs continuously and causes the rotational movement of water.

When the water rotates in the suvody, the bottom has a braking effect. As a result, closer to the surface of the river, the speed of rotation of water and centrifugal forces increase. Under the influence of centrifugal forces, there is a greater ejection of water from the axis of the river near the surface and less - at the bottom. From bottom to top along the axis of the suvodi, an upward flow is formed, replenishing the discarded water. It erodes the bottom, captures the erosion products, creating a funnel-shaped bottom depression (Fig. 1). With a decrease in speed, the water smoothly flows around the ledge, forming a quiet water behind it.

Near the concave banks, in the steep bends of the riverbed, suvodi also form (Fig. 2). In contrast to the swedes located behind the ledges of the banks, here the descending currents of water descend into the ascending flow of water in the swaddle center of the swaddle to the bottom and spread to the sides. This type of suvodi with a distinct funnel on the surface of the water is sometimes called a whirlpool. Suvodi near concave banks are formed in cases where the smooth flow around the banks of the bend is disturbed.

Suwodi can exist permanently or appear only during high water. On the big rivers large swedes are created, having a sphere of action of tens of meters and a speed of rotation of water in the central part - several meters per second. In some basins, the suvod has its own local name, for example, on the Yenisei - a catch, on the Irtysh - a backwater. Suwodi present a serious difficulty for navigation. Vessels lose control in them, shift sharply towards the shore, and the ropes of the ships' moorings and towing cables are often torn, rudders break, etc.

Maidan is a chaotic rotational movement of water in the form of mobile vortices ranging in size from several centimeters to several meters in diameter. Maidans are formed above large underwater objects at a shallow depth above them (Fig. 3), during floods and floods in those places where a stream going through the floodplain meets at an angle with another stream going along a low-water channel, with intensive local reformations of the channel and at rifts, at abrupt changes bottom shapes, etc. Maidans are unfavorable for navigation, as they cause the ships to yaw.

Disputed waters - Maidans, formed at the mouths of tributaries and at their confluence. The closer the meeting angle is to a straight line, the stronger the vortices develop, which reach several meters in diameter.

The downstream is created near the shore in the section of the river where the water discharge is directed towards the shore. For example, on the curvatures of the channel, the downstream flow occurs near the concave bank, since the water, due to inertia, tends to maintain its former rectilinear direction, but, encountering an obstacle in the form of a concave bank on its way, it presses against it (Fig. 4). In areas with a downstream flow, ships roll towards the shore.

Stall current - water discharge directed at an angle to the ship's course (Fig. 5). Stall current occurs due to the difference in water levels across the width of the river. On the riffles, such currents are created as a result of the backwater of the flow by the saddle of the rift, so they are directed from the upper reach hollow to the backwater part of the lower reach hollow (see rift). By displacing ships from the axis of the ship's passage, stall currents can cause ships and rafts to pile up on the shallows, bridge supports, etc.

lingering current occurs at the entrance to the ducts (Fig. 6). Protracted currents are especially strong during floods, when the flow of water in the channels increases significantly. A lingering current can cause a bulk of ships on the island. The nature of the flow is also influenced by bridges, dams, dams, structures in the channel, etc.

whirlpool- constant rotational movement of water in the channel. V. often create deep pits (pools) and are typical for mountain and semi-mountain rivers.

Other diseases of the cardiovascular system Pulmonary edema. Acute, subacute, protracted course

Pulmonary edema. Acute, subacute, protracted course

The acute onset of pulmonary edema is characteristic of myocardial infarction, hypertensive crises, heart defects, pulmonary embolism, and anaphylactic shock.

Acute pulmonary edema

At acute course pulmonary edema, symptoms develop rapidly, an unfavorable outcome can occur very quickly and only urgent measures allow sometimes to bring the patient out of a serious, life threatening states.

Patients take forced position- they sit with their legs down, resting their hands on the bed, chair, armchair, fixing the shoulder girdle; Accessory muscles are involved in breathing. They are usually agitated (psychological arousal), experiencing fear of death. An anxious look, with hope for possible help. Skin hyperemic if the edema develops against the background of hypertension, bacterial pneumonia, or pale if the edema is due to hypotension, renal or liver failure. Acrocyanosis appears, turning into diffuse cyanosis.

Immediately develops severe shortness of breath inspiratory or mixed type, the number of breaths reaches 40-60 per minute, the wings of the nose swell. A dry cough appears, which is soon replaced by a wet one with the release of bloody, and then foamy sputum. Auscultatory in the lungs, at first, moist small bubbling rales are determined in the upper and middle parts of the lungs, then they quickly spread to all parts of the lungs (in contrast to chronic heart failure, in which congestive rales are heard for a long time only in lower sections lungs). Fine bubbling wet rales can be transformed into medium and large bubbling. Noisy and bubbling breathing appears, heard in the distance.

Auscultation of the heart can determine the gallop rhythm, accent II tone over pulmonary artery, its expansion, etc. Often, auscultation of the heart is difficult because pulmonary rales are heard over the entire surface chest. At the same time, in the pulmonary alveoli, an increased formation of foamy fluid occurs, which, having filled the alveoli, rises along the bronchioles and higher along the bronchi of an increasingly larger caliber. Then the foamy liquid begins to stand out from the mouth, from the nose. The airways are completely blocked by the foamy liquid, and death can occur.

Subacute pulmonary edema

Subacute pulmonary edema occurs against the background of congenital or acquired heart defects, pneumonia, renal and hepatic insufficiency. The process can take 10-12 hours.

Protracted course of pulmonary edema

A prolonged course of pulmonary edema develops against the background of chronic diseases lung, diffuse diseases connective tissue, chronic renal or hepatic insufficiency. The process lasts from 10-12 hours to several days.

The course of pulmonary edema is always severe, the prognosis is serious. Even with successful treatment the disease tends to recur later.

B.V. Gorbachev

"Pulmonary edema. Acute, subacute, protracted course" and other articles from the section

The incidence of pneumonia is about 1% among the adult population, and children suffer from it twice as often. And in a third of cases, the pathology proceeds for a longer time than with acute pneumonia. But nevertheless, the disease has not yet passed into chronic form. If it lasts for 1-1.5 months, eventually ending in recovery, then we are talking about prolonged pneumonia. Why does it happen, how does it manifest pulmonary pathology and what should be done to effective treatment These are questions for the doctor. Only a specialist can provide competent information.

Pneumonia is an infectious and inflammatory disease lung tissue. It usually resolves within 3 weeks, but a protracted process is quite common. This development of events indicates a decrease in immune reactivity. Violations relate to various links of natural protection: a decrease in the intensity of alveolar phagocytosis and inhibition of the activity of complement components, a decrease in the number of T- and B-lymphocytes, suppression of the production of interferon and antibodies. Cellular and humoral factors, which leads to a drop in the level of protection and allows inflammation to acquire a protracted course. This situation may arise in the following cases:

Congenital and acquired immunodeficiencies (including HIV infection).
Chronic diseases of infectious and inflammatory nature (tuberculosis, hepatitis).
Common tumor processes.
Metabolic and metabolic pathology (diabetes mellitus).
Reception medicines(immunosuppressants, cytostatics, glucocorticoids).
Chemical intoxication (including smoking and alcohol abuse).
Prematurity in children and age-related changes in the elderly.

But in addition to the reduced reactivity of the body, other factors also take part in the origin of prolonged pneumonia. Additional Negative influence to resolve the inflammatory process have:

Irrational and delayed antibiotic therapy.
Violation of bronchial drainage (foreign bodies, developmental anomalies).
Complications acute pneumonia(abscess formation, pulmonary atelectasis, pleural empyema).
Atypical pathogens (mycoplasmas, pneumocystis).

Based on the foregoing, the origin of prolonged pneumonia is most often associated with general disorders in the body, local structural and functional changes and defects in medical tactics. And in order to prevent such a development of events, all possible factors should be taken into account.

A key role in prolonged inflammation of the lungs belongs to the weakening defensive forces organism, but there are other predisposing factors.

Classification

Pneumonia that lasts longer than usual can have a different distribution. The classification of the disease is based on the extent of inflammation. So, prolonged pneumonia happens:

Segmental.
Polysegmental.
Equity.

It should be noted that the process is one- or two-sided, the lower, middle (right) and upper (lingual segments) lobes of the lungs can be affected. The severity of the clinical picture also depends on the prevalence of the process.

Symptoms

Inflammation of the lung tissue, which has a long course, is manifested by almost the same symptoms as acute pneumonia. We can talk about a protracted character if, after 2-3 weeks after the onset of the disease, the patient's condition worsens again, the previously occurring symptoms intensify:

Cough.
Dyspnea.
Fever.
Sweating.
Malaise and weakness.

The defeat of one segment corresponds to the lightest Clinical signs, but for multiple inflammation of the lobes, especially bilateral, a more severe course is characteristic. Such pneumonia often relapses and is accompanied by complications. During a physical examination, the doctor reveals signs of an infiltrative process in the lung tissue: wheezing, weakened breathing, dullness of percussion sound.

Effects

If pneumonia is prolonged, then the risk of adverse outcomes is significantly higher than with rapid resolution. inflammatory infiltrate. Complications of the disease can be local and extrapulmonary. The first ones include:

Abscess and gangrene.
Pulmonary edema.
Pleurisy (dry or exudative).
pneumosclerosis and fibrosis.
Respiratory failure.

Extrapulmonary conditions are associated with dissemination of the pathogen, toxic, hematological and immune disorders in the patient's body. Prolonged inflammation can cause septic shock, anemia, endo- and myocarditis, meningoencephalitis, glomerulonephritis, hepatitis. But as a rule, with adequate medical care complications are not observed, but recovery can last from several weeks to months.

Protracted pneumonia should be treated as soon as possible so that it does not develop dangerous violations at the pulmonary or systemic level.

Additional diagnostics

Regardless of whether a child has developed pneumonia or an adult, a protracted inflammatory process needs to be verified. The first arguments in its favor are clinical characteristics, but further confirmation is needed. For this purpose, the doctor prescribes laboratory and instrumental studies:

Complete blood count: leuko-, erythro- and platelets, ESR.
Urinalysis: protein, shaped elements, salt.
Blood biochemistry: protein fractions, markers of inflammation ( C-reactive protein, glycopeptides, sialic acids, ceruloplasmin, seromucoids), coagulogram ( prothrombin index, fibrin).
Immunogram: antibodies or immunoglobulins (A, M, G), lymphocytes (T and B), complement protein activity (C3, C4 and C9).
Sputum analysis (clinical and bacteriological).
Chest X-ray.
Tomography.
Bronchoscopy.

An important criterion, besides laboratory signs persisting inflammation and immunosuppression is the absence of regression of infiltrative changes on x-rays and the appearance of peribronchitis on endoscopic examination.

Treatment

Therapeutic tactics for prolonged pneumonia is formed on the basis of individual characteristics: prevalence of inflammation, activity of immunity, concomitant diseases. After evaluating all the nuances, the doctor will offer the patient the optimal therapeutic program to speed up recovery.

Medicines

Prolonged pneumonia in children and adults, as well as acute process without the use of drugs. For liquidation infectious factor, suppressing inflammation, improving the discharge of pathological exudate and increasing the body's defenses, use the following medicines:

Antibiotics (protected penicillins, aminoglycosides, fluoroquinolones, macrolides, cephalosporins).
Mucolytics and expectorants (Mukolvan, ACC, Bronchocode).
Anti-inflammatory (Erespal, Glyciram).
Immunocorrectors (Polyoxidonium, Cycloferon, Laferon).
Vitamins and microelements.

Any drug should be prescribed only by a doctor. Medications are taken under his supervision and without deviations from the prescribed course. This is especially important, because inadequate treatment can nullify all efforts.

It is impossible to treat prolonged pneumonia without drugs that affect the cause of the disease and the factors contributing to its long-term development.

Physiotherapy

Great importance in treatment regimens is given to methods of non-drug effects on the body. In order for inflammation in the lung tissue to resolve as soon as possible, the following procedures are prescribed:

Respiratory and general medical gymnastics.
Chest massage.
postural drainage.
Reflexology.
Electrophoresis.
Inhalations.

For an additional local effect with severe forms can carry out the so-called bronchoalveolar lavage, i.e. washing with solutions and evacuation of pathological exudate during bronchoscopy. And you can increase the reactivity of the body by irradiating the blood (laser or infrared).

Operation

Sometimes lingering pneumonias require surgical correction. Most often, we are talking about the removal of foreign bodies or the treatment of certain complications (pleural puncture for empyema). And with frequent relapses, the issue of segmental resection of the affected lung can be considered. But in most cases, they still try to help with conservative means.

Prolonged pneumonia is not an uncommon situation. It occurs in both adults and children. And the main role in correcting this problem should be given to preventive measures aimed at early and complete cure acute inflammation lungs. And when pneumonia has passed into a protracted form, a mandatory review of therapy and its intensification is required.

Acute inflammation in the lung tissue, in which, according to clinical and radiological data, the pneumonic infiltrate is resolved slowly, in an extended period (over 4-6 weeks). Unlike chronic inflammation lungs, prolonged pneumonia usually ends with the recovery of the patient. About 30% of acute pneumonias take a protracted course. The reasons for this may be chronic intoxication or a weakened state of the body, irrational antibiotic therapy, collateral disorder drainage function of the bronchi, elderly age and prematurity, complicated course of acute pneumonia. Treatment Algorithm with prolonged pneumonia, it consists of carefully selected rational antibiotic therapy, mandatory restoration of the drainage function of the bronchi, restorative and immunocorrective treatment.

Polysegmental pneumonia can be unilateral and affect individual segments in different lobes of one lung, or bilateral and affect segments in different lobes of both lungs at once. Most often, prolonged pneumonia is localized in the segments of the lower and middle lobe. right lung, lower lobe of the left lung, and reed segments upper lobes of the lungs.

Symptoms of protracted pneumonia

Monosegmental protracted pneumonia has a relatively smooth course in comparison with polysegmental pneumonia, which is characterized by relapses, severe manifestations, and prolonged regression of the inflammation focus. With the fusion of inflammatory foci, the patient's condition worsens 2-3 weeks after initial manifestations diseases. are rising again subfebrile temperature, sweating, fatigue, general weakness, lethargy, cough. Distinctive feature prolonged pneumonia is the scarcity of manifestations with pronounced radiological changes in the lungs. In the area of the affected segment, moist small bubbling rales are heard, a shortening of the percussion sound is determined.

Complications

Complications of prolonged pneumonia affect the outcome and subsequent prognosis of the disease. Allocate extrapulmonary and pulmonary complications of prolonged pneumonia. Extrapulmonary complications of prolonged pneumonia include: pulmonary edema, bacteriotoxic shock, DIC, nonspecific endocarditis and myocarditis, meningitis and meningoencephalitis, anemia, toxic hepatitis, glomerulonephritis, psychosis. Pulmonary complications of prolonged pneumonia are exudative pleurisy, gangrene and lung abscess, obstructive syndrome, acute respiratory failure, pneumosclerosis, deforming bronchitis. Frequently recurring prolonged pneumonia with the same localization, pneumonia severe course, as well as pneumonia, developing as a result of foreign bodies entering the Airways, especially in children, lead to the development of chronic pneumonia.

Diagnostics

The basis for the diagnosis of prolonged pneumonia are laboratory and clinical and radiological data. The program of examination of patients with suspected prolonged pneumonia includes: general analyzes blood and urine biochemical analysis blood ( total protein, protein fractions, sialic acids, fibrin, seromucoids, C-reactive protein), blood immunogram (immunoglobulins M and A, B- and T-lymphocytes), roentgenogram of the lungs (in 2 projections), bronchography, sputum examination (bacanal analysis and sensitivity to antibiotics, cytology, atypical cells), bronchoscopy - to exclude a foreign body in the bronchi.

The diagnostic criteria for chronic pneumonia are:

prolonged course of pneumonia (over 4 weeks);
phenomena of local segmental endobronchitis, determined by bronchoscopy;
radiologically determined peribronchial and focal infiltration of segmental or lobar (lobar) localization that does not regress for more than 4 weeks, increased pulmonary and vascular pattern on the side of the lesion;
laboratory signs of an ongoing inflammatory process: leukocytosis, elevated ESR, an increase in the blood level of fibrin, sialic acids, seromucoids;
signs of immunological disorders: a decrease in the blood level of IgM and an increase in IgA, a decrease in the activity of T-lymphocytes-killers and helpers and an increase in the activity of T-lymphocytes - suppressors, etc .;
clinical, laboratory and radiological recovery of the patient in individual terms (up to 3-12 months).

Treatment of protracted pneumonia

The principles of treatment of prolonged pneumonia have their own characteristics. The question of whether to continue antibiotic therapy with prolonged pneumonia, it is decided after analyzing the methodology and results of the previous one. The need to continue antibiotic therapy arises if pronounced infiltrative changes in the lung tissue, changes in peripheral blood and signs of intoxication persist. Antibiotics are selected based on data bacteriological analysis sputum. More commonly prescribed antibiotics a wide range actions (aminoglycosides, cephalosporins, etc.).

Particular attention in prolonged pneumonia is drawn to the restoration of drainage and bronchial patency. For this purpose, expectorants, positional drainage, bronchodilators, chest massage are prescribed. In some cases (with persistent phenomena of purulent endobronchitis) for the sanitation of the bronchial tree, it becomes necessary to conduct bronchoalveolar lavage. Widely used in the treatment of chronic pneumonia breathing exercises, exercise therapy, physiotherapy, reflexology.

With persistent pneumonia Special attention is given to the study of the immune system and the assessment of factors of nonspecific protection. If necessary, medicinal immunocorrection is carried out. Frequent relapses prolonged pneumonia with a clear localization are an indication for a consultation with a thoracic surgeon to resolve the issue of surgical treatment(segmental resection of the lung or lobectomy).

Forecast and prevention

An unfavorable outcome of prolonged pneumonia is the development of pulmonary and extrapulmonary forms complications. Most often, with prolonged pneumonia, complete clinical recovery occurs after 2-6 months and is characterized by resorption of the pneumonic focus and restoration of the ventilation function of the lungs. Prevention prolonged pneumonia is reduced to a complete and adequate course of treatment of acute pneumonia, thorough sanitation of the nasopharynx and oral cavity, measures to strengthen the immune system, quitting smoking and drinking alcohol.

Pulmonary edema. Acute, subacute, protracted course. A protracted course of orvi in ​​adults: what to do if the disease is in no hurry to pass