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Chronic diffuse inflammatory lung disease

in accordance with the functional and morphological features, the lesions of their air-conducting or respiratory departments are divided into three groups: obstructive, restrictive, mixed - obstructive with restrictive disorders or restrictive with obstructive disorders. The combination of restriction with obstruction is observed in the late stages of almost all chronic diffuse lung diseases.

Chronic obstructive pulmonary diseases are diseases of the airways, characterized by an increase in resistance to air passage due to their partial or complete obstruction at any level (from the trachea to respiratory bronchioles), other than bronchial asthma. The following diseases are considered obstructive: chronic obstructive bronchitis, chronic obstructive pulmonary emphysema, bronchiectatic disease, chronic bronchiolitis. At the heart of obstructive pulmonary diseases is a violation of the drainage function of the bronchi, which is the main reason for their obstruction. In recent years, the group concept of "obstructive pulmonary disease" has been widely used in relation to the group of chronic obstructive diseases.

Restrictive lung diseases are characterized by a decrease in the volume of the pulmonary parenchyma with a decrease in the vital capacity of the lungs. This group includes interstitial lung diseases. Restrictive pulmonary diseases are based on the development of inflammation and fibrosis in the interstitium of the respiratory parts of the lungs, often on an immune basis, leading to interstitial fibrosis and an aerogemic block, which is accompanied by clinical symptoms of progressive respiratory failure. Most pulmonary diseases in the late stages of development usually have both obstructive and restrictive components.

In the literature in relation to chronic diffuse lung diseases, the term "Chronic non-specific lung diseases" (COPD) is also used, proposed at a symposium organized by the pharmacological firm "Ciba" in 1962. Then the group concept of COPD as a group of lung diseases was finally formed of various etiologies, pathogenesis and morphology, in which the development of chronic cough with sputum production and paraxismal or constant difficulty in breathing is characteristic, which is not associated with specific and Infectious diseases, especially pulmonary tuberculosis.

Until the 80s isolated a nosological unit such as chronic pneumonia, emphasizing that this type of chronic lung disease is characterized by a combination of many pathological processes - carnification, chronic abscesses, bronchiectasis, chronic bronchitis, pneumofibrosis with a clear predominance of damage to the respiratory parts of the lungs.

In modern literature (Hirschman J., Murray J., 1995), in such cases, the issue is resolved by elucidating the prevailing pathology, medical history in order to establish the root cause of the pathological process in the lungs - a chronic abscess, bronchiectatic disease, or chronic bronchitis.
Currently, chronic pneumonia as a nosological form is not recognized by all.

Etiology and epidemiology. There is a high dependence of the development of chronic diffuse lung diseases on adverse environmental factors (emission of pollutants into the atmosphere), smoking, occupational factors (contact with organic and mineral dusts, toxic gases, isocyanates, etc.), acute respiratory infections (primarily viral) , the state of the immune system, the presence of a genetic predisposition (phenotypes PiZZ, PiSS).

The relationship between chronic diffuse lung diseases and adverse environmental factors can be explained by morphofunctional features of the lungs. The lungs form the largest membrane in size between the internal environment of the body and the outside world. When exhaling, the area of ​​this membrane is approximately 80 m, and when inhaling - 120 m. Therefore, the vast majority of chronic diffuse lung diseases can be called "environmental diseases", and their prevention should include mandatory measures to improve the environment.

The number of patients with chronic kidney disease is almost doubled every 10-12 years. The greatest specific weight in the structure of chronic lung infections belongs to chronic bronchitis - 65–90% of patients. Of particular concern is the increase in the incidence of bronchial asthma, epidemic outbreaks of which have been described in Russian cities (Kirishi, Angarsk).

The morphogenesis of chronic diffuse lung diseases develops along one of three morphogenetic pathways: bronchitogenic, pneumoniogenic and pneumonitogenic. The development of chronic diffuse lung diseases by the bronchitogenic mechanism is caused by a violation of the drainage function of the lungs and bronchial obstruction and leads to the development of obstructive pulmonary diseases such as chronic bronchitis, bronchiectatic disease, chronic obstructive pulmonary emphysema. The pneumoniogenic mechanism is associated with bronchopneumonia, croupous pneumonia and their complications - acute abscess and carnification. Complications developing in this case - a chronic abscess and chronic pneumonia have a pronounced restrictive component. The pneumonitogenic mechanism determines the development of chronic inflammation and fibrosis in the interstitium of the respiratory lungs and is found in interstitial lung diseases. In the final, all three mechanisms of chronic diffuse pulmonary diseases lead to the development of pneumosclerosis (pneumocirrhosis), secondary pulmonary hypertension, right ventricular hypertrophy and pulmonary heart disease. Chronic diffuse lung diseases are the background diseases for lung cancer.

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Chronic diffuse inflammatory lung disease

  1. Chronic diffuse inflammatory diseases of the lungs. Bronchial asthma. Lungs' cancer. Pneumoconiosis
    1. The main types of diffuse lung lesions 1. interstitial 4. small focal 2. obstructive 5. panacinar 3. restrictive 2. Causes of death with obstructive emphysema 1. gas acidosis and coma 2. renal failure 3. left ventricular heart failure 4. right ventricular heart failure 5. collapse of the lungs with spontaneous pneumothorax 3. The most important
    Chronic obstructive pulmonary disease is a pathological condition characterized by the formation of chronic airway obstruction due to chronic bronchitis / chronic obstructive pulmonary disease and / or pulmonary emphysema / EL /. Chronic obstructive pulmonary disease is widespread. It is estimated that HB affects about 14–20% of the male and about 3–8% of the female adult population, but only
  4. Diffuse interstitial (infiltrative and restrictive) lung diseases
    In this section of the chapter, a combined group of noncommunicable diseases is described, characterized mainly by diffuse and usually chronic changes that affect mainly the stroma of the lungs, i.e. interstitial tissue of the alveolar walls, consisting of the basement membrane of the endothelium and epithelial cells, collagen fibers, elastic structures, proteoglycans, fibroblasts,
    Acute pneumonia is a group of acute etiological, pathogenesis and morphological characteristics of acute infectious inflammatory diseases of the lungs with a primary lesion of the respiratory departments and the presence of intra-alveolar exudate. Most commonly caused by bacteria, mycoplasmas and viruses. According to clinical and morphological features, croupous (lobar) pneumonia is distinguished,
  6. Acute inflammatory lung diseases (pneumonia)
    Among acute pneumonia, there are croupous (lobar), having the nature of an independent disease, and focal bronchopneumonia as a manifestation or complication of another disease. Croupous pneumonia is an acute infectious and allergic disease in which fibrinous inflammation seizes the lobe of the lung (lobar or lobar pneumonia) and its pleura (pleuropneumonia). Morphologically during
  7. Chronic inflammatory diseases
    Chronic pharyngitis. Inflammation of the mucous membrane of the pharynx is sluggish, manifested by an unstable sensation of pain, dryness and discomfort in the pharynx, and rapid fatigue of the voice. Often this happens when exposed to domestic and professional factors, including alcohol, smoking, air pollution by dust (especially cement), caustic chemicals. In recent years, the impact of
  8. Chronic non-specific lung diseases. Lung cancer
    Chronic non-specific lung diseases based on the common pathogenesis include chronic bronchitis, bronchiectasis, chronic abscess, chronic pneumonia, emphysema, pneumosclerosis, interstitial lung diseases. These diseases develop as a result of chronic bronchitis or complications of acute pneumonia with abscess formation or carnification. Chronic
  9. Chronic obstructive pulmonary disease
    The group of chronic obstructive pulmonary diseases includes chronic bronchitis, bronchiectasis, bronchial asthma, and pulmonary emphysema (Table 15.1). Quite certain groups are made up of individuals with predominant chronic bronchitis or emphysema (Table 15.2). Many patients develop destructive processes overlapping at the level of the bronchi (in chronic bronchitis) and acini
  10. Chronic non-specific lung diseases
    Chronic non-specific lung diseases (COPD) is a group of lung diseases of various etiologies, pathogenesis and morphology, characterized by the development of chronic cough with sputum production and paroxysmal or persistent breathing difficulties that are not associated with specific infectious diseases, primarily pulmonary tuberculosis. Chronic bronchitis,
  11. Chronic obstructive pulmonary disease.
    Obstructive pulmonary diseases include the following: chronic obstructive pulmonary emphysema, chronic obstructive bronchitis, bronchiectasis, chronic bronchiolitis. Chronic obstructive bronchitis. Chronic bronchitis can be simple and obstructive. Simple chronic bronchitis is a disease characterized by hyperplasia and excessive production of bronchial mucus
  12. Chronic lung disease
    This group of pathological conditions is called interstitial lung disease (mechanical ventilation). They are characterized, regardless of the etiology, a gradual onset, chronic inflammation of the alveolar walls and perialveolar tissues, as well as progressive pulmonary fibrosis, which causes disturbances in gas exchange and ventilation. Inflammation may be limited to the lungs or be part of a generalized
  13. Chronic obstructive pulmonary disease
    General Information Chronic obstructive pulmonary disease (COPD) is the most common form of lung disease found in anesthetic practice. COPD incidence increases with age of patients; risk factors include smoking and male gender (about 20% of men have COPD). In the vast majority of cases, COPD is asymptomatic or with minor
  14. Chronic obstructive pulmonary disease
    Comparative characteristics of obstructive pulmonary diseases {foto239} Preoperative assessment of the condition of patients with chronic obstructive pulmonary diseases Analysis of clinical and instrumental data, incl. functions of external respiration, arterial blood gases, chest X-ray (reduction of FEV <50% of the norm corresponds to compensated respiratory failure / shortness of breath
  15. Chronic Obstructive Pulmonary Disease (COPD)
    Characteristic features Obstructive pulmonary disease associated with cigarette smoking - pulmonary emphysema and chronic bronchitis - are often combined, but are completely different processes. Emphysema destroys the alveolar surface membrane and blood vessels, reducing the elasticity of the lung tissue and the diffusion capacity of the lungs, leaving the airways morphologically
    About 7% of the total adult population is sick with COPD. Classification: Chronic diseases. Genetically determined pulmonary dysplasias are also chronic. Acquired diseases a) with a primary lesion of the bronchi b) with a primary lesion of the parenchyma. Tracheobronchial dyskinesia. During exhalation, stenosis of the bronchus with a prolated membrane occurs
  18. Features of preoperative preparation of patients with chronic pulmonary diseases (COP)
    As a rule, patients with chronic obstructive pulmonary disease receive planned drug therapy: - sympathomimetics or S-agonists cause bronchodilation due to the effect on adenylate cyclase (an increase in cAMP leads to relaxation of the smooth muscles of the bronchi; drugs with nonspecific activity against B1 and B2 receptors: adrenaline, isoproterenol, etc. .d can provoke the development of arrhythmias and
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