As a result of inflammation, the visceral pleura can cover by fibrous mooring . Such a Schwart may prevent the lung under it from straightening . In this case, talking about armor-clad. When the lung is covered with mooring , the intrapleural pressure becomes even more affected . It is desirable because the chest wall is drawn inward. From negative pressure causes an increase in the formation of chaff fluid and reduces resorption of pleural fluid , which leads to chronic pleural effusion.
The frequency of formation of pleural effusion in patients with pan The cirrtic lung is unknown, but it is probably much higher than usually assumed. Primary inflammation of the pleura is more often the result of pneumonia or hemothorax, but may be associated with spontaneous pneumothorax, thoracic surgery. walkie-talkie, uremia or vascular collagenosis. The presence of transudative pleural fluid in the pleural cavity for many months probably causes the formation of a mooring on the visceral pleura, which leads to the development of shell foot lung.
In patients with pleural effusion and armored lungs due to dysfunction caused by restriction of ventilation, difficulty breathing is observed, but in some cases the chant The effusion does not give any symptoms. Symptoms of an acute inflammatory process, such as pleural pain and fever, absolutely not typical for this disease, but often patients note that they had similar symptoms toms in the past. A characteristic feature of the pleural effusion in the armored lung, as indicated by various authors, is the preservation of its size from study to study [40J. After thoracocentesis, there is a rapid accumulation of fluid. STI to the previous level. Although one would expect that pleural fluid in an armored lung should be ex Sudata, since the pleura is involved in the process, usually in such patients the pleural effusion is exudate close to the transudate. The ratio of protein content in pleural fluid bone to its content in serum is about OD and the ratio of LDH in the pleural fluid to its level in serum is about 0.6. The glucose content in the pleural fluid is within the normal range, the number of leukocytes is less than 1000 / mm3, mononuclear cells predominate.
The diagnosis of pleural effusion associated with a crustacean Kim, should be borne in mind in every patient with nonabsorbable schimsya chronic pleural effusion, especially if you do not Go in the past were pneumonia, pneumothorax, hemothorax or thoracic surgery. The thickening of the visceral pleura can be identified by introducing into the pleural cavity with di agnostic thoracentesis 200-400 ml of air. Set lenii diagnosis helps define intrapleuralgiving which is carried out after the removal of the fluid during the t nical thoracentesis. The intrapleural pressure is low and as the fluid is removed from the pleural cavity in patients with an armor-clad lung, it is very quickly removed. is being harvested. If at the beginning the intrapleural pressure is lower than —10 cm of water. Art. or if it decreases at a rate of 20 cm of water. Art. when removing 1000 ml of fluid, this indicates that the patient has an armor-clad lung, unless he has bronchial obstruction or a malignant pleural lesion ry.
The final diagnosis of an armor lung can be fasting. only after thoracotomy or decortication ^ since the result should be easy Go, which will fill the pleural cavity. This operation is a treatment, but it probably does not show pain. with asymptomatic process. Such patients after blowing to keep under surveillance to find out whether the clinical picture, laboratory test data of the pleural fluid and the values of intrapleural pressure the diagnosis .