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The term “pneumosclerosis” has been used by medicine since 1819, the first to introduce it into use was Laennec, who did this to describe the condition of a patient whose bronchus wall was damaged, part of it was enlarged. The concept combined two Greek words – light and compaction.
What is pulmonary fibrosis?
Pneumosclerosis of the lungs is an abnormal increase in the size of the connective tissue that can occur in the lung (s) of a person as a result of inflammation, a dystrophic process. Zones affected by such tissue lose their elasticity, pathological changes in the structure of the bronchi are observed. The lung tissue shrinks and thickens, the organ acquires a dense, airless consistency, and compression occurs. Most often, this disease is faced by males (but women are not protected either), the age group does not play a role.
Causes of pneumosclerosis
There are diseases, the lack of timely and adequate therapy of which can result in the development of pneumosclerosis in a patient:
sarcoidosis of the lungs;
tuberculosis (pleura, lungs), mycosis;
bronchitis in a chronic form;
pneumonia (infectious, aspiratory, viral);
industrial gases;
radiation therapy (in the fight against cancer);
alveolitis (fibrosing, allergic);
damage to the walls of blood vessels (granulomatosis);
chronic gastroesophageal reflux;
damage to the sternum, trauma to the lung parenchyma;
genetic predisposition (pulmonary diseases);
exudative pleurisy (severe form, prolonged course);
foreign element in the bronchi.
The disease can also be triggered by taking a number of medications (apressin, cordarone). In addition, bad habits (smoking), poor ecology (living in a dangerous zone) are considered risk factors.
There are professions whose owners are at increased risk. Harmful production, mines are places where harmful gases and dust flourish. Danger threatens glass cutters, builders, grinders and so on.
Symptom pneumosclerosis
The main signs of pulmonary pneumosclerosis are the manifestations of the disease, the result of which it became.
You may also experience the following symptoms, indicating the need to visit a doctor immediately:
shortness of breath, acquiring a permanent character, remaining even in a state of inactivity;
severe cough, accompanied by secretions in the form of mucopurulent sputum;
chronic fatigue, weakness, bouts of dizziness;
pain in the chest;
cyanosis of the skin;
weight loss;
chest deformity;
severe pulmonary insufficiency;
phalanges of fingers resembling drumsticks (fingers of Hippocrates);
rales on auscultation (dry, finely bubbling).
The severity of the symptoms of the disease directly depends on the amount of pathological connective tissue. Minor manifestations are mainly characteristic of limited pneumosclerosis.
Types of pneumosclerosis
According to the intensity of distribution in the pulmonary parenchyma of the connective tissue, it is customary to distinguish the following types of pneumosclerosis:
Fibrosis. It is characterized by alternation of connective and lung tissue in a patient.
Sclerosis. There is a replacement of the lung parenchyma with connective tissue, deformation of its structure.
Cirrhosis. Compaction of the pleura, replacement of blood vessels, bronchi and alveoli with collagen, failures of gas exchange functions. This stage is considered the most dangerous.
According to the site of the lesion, the following types of the disease are distinguished:
interstitial;
peribronchial;
alveolar;
perilobular;
perivascular.
If a patient develops interstitial pneumosclerosis, interstitial pneumonia is most likely its source. The main target of the connective tissue is the area located next to the bronchi, blood vessels, and the interalveolar septa also suffer.
Peribronchial appearance is often the result of chronic bronchitis. For this form, the capture of the area surrounding the bronchi of the patient is typical, the formation of connective tissue occurs instead of the lung tissue. The disease in most cases reports itself only with a cough, after a while sputum discharge may be added.
Perivascular pneumosclerosis means damage to the area surrounding the blood vessels. Perilobular leads to the localization of the lesion along the interlobular bridges.
Also, pneumosclerosis is divided into types depending on which disease ensures its spread.
The following groups are distinguished:
sclerosis of lung tissue;
postnecrotic;
discirculatory.
In addition, the degree of prevalence of the disease is taken into account – limited, diffuse pneumosclerosis.
The limited form, in turn, is divided into local and focal:
Local pneumosclerosis can be present in the human body for a long time without giving any symptoms. It can be detected only by fine bubbling wheezing and hard breathing when listening. An x-ray will also help to make a diagnosis, the picture will display a section of compacted lung tissue. This species cannot become the cause of pulmonary insufficiency.
The source of the focal species is a lung abscess, leading to damage to the lung parenchyma. Also, the reason may lie in caverns (tuberculosis). Perhaps an increase in connective tissue, damage to existing and already cured foci.
Diffuse pneumosclerosis of the lungs
The target of diffuse pneumosclerosis can be not only one lung (left or right), but both. In this case, the occurrence of cysts in the lungs is likely, and pathological changes that occur with the vessels are also possible. The quality of nutrition of the lung tissue with oxygen deteriorates, ventilation processes are disturbed. The diffuse form can cause the formation of a “cor pulmonale”. This condition is characterized by the rapid growth of the right heart, caused by high blood pressure.
The anatomy of the lungs in diffuse pneumosclerosis undergoes the following changes:
Collagenization of the lung – instead of degeneration of elastic fibers, large areas of collagen fibers appear.
The volume of the lungs is reduced, the structure is deformed.
Cavities (cysts) lined with bronchoalveolar epithelium appear.
The main reasons for the development of this disease are inflammatory processes occurring in the chest. Their source can be different – tuberculosis, chronic pneumonia, radiation sickness, exposure to chemicals, syphilis, chest damage.
Far from always diffuse pneumosclerosis warns about itself with specific symptoms. The patient may experience shortness of breath, at first occurring only with fatigue, hard work, sports training. Then comes the stage when shortness of breath appears even in a calm state, during rest. This symptom is not the only one, it is also possible to cough (dry, frequent), constant aching pain in the chest area.
Also, manifestations such as shortness of breath, cyanosis of the skin, provided by a lack of oxygen, are also possible. The patient may suddenly lose weight, feel constant weakness.
Peripheral pneumosclerosis
The most common source of hilar pneumosclerosis is bronchitis, which has a chronic form. The “culprits” of the disease can also become poisoning with harmful substances, pneumonia, and tuberculosis. The development of the disease, as a rule, occurs against the background of inflammatory processes, dystrophy. Characteristic signs are loss of elasticity in the affected area, an increase in the size of the connective tissue that occurs in the basal areas of the lung. Also added is a violation of gas exchange.
Basal pneumosclerosis
If lung tissue is replaced by connective tissue mainly in the basal sections, this condition is called basal pneumosclerosis. One of the main sources of this disease is considered to be lower lobe pneumonia, perhaps the patient once had to deal with this disease. An x-ray will show an increased clarity of the tissues of the basal sections, an increase in the pattern.
Treatment of pulmonary pneumosclerosis
If you have symptoms of pneumosclerosis, you should definitely sign up for a consultation with a general practitioner or pulmonologist. Treatment methods are determined by the stage at which the disease is located. The initial, mild form, not accompanied by severe symptoms, does not need active therapy. Given that pneumosclerosis in most cases acts as a concomitant disease, it is necessary to treat its source.
Stem cells
An innovative way to combat pneumosclerosis is cell therapy. Stem cells are the precursors of all cells in the human body. Their unique “talents” lie in the ability to transform into any other cells. This quality is actively used in cell therapy against pulmonary pneumosclerosis.
Being injected intravenously, stem cells seep through the bloodstream to the affected organ. Next, they replace the tissues damaged by the disease. In parallel, the immune defense of the body is activated, metabolic processes are activated. Normal lung tissue is reborn.
The effectiveness of cell therapy is determined by the date of its initiation. It is advisable to begin treatment before all the lungs are captured by the fibrosis process. Success also depends on the presence of a platform of healthy tissue, which is necessary for cells to securely attach and start reconstruction processes.
Stem cell treatment normalizes the metabolic processes occurring in the body of a patient with pneumosclerosis. The functions of the endocrine, immune and nervous systems are restored. The cells also produce an effective antitumor effect. As a result of therapy, the affected organ regains its lost functionality and becomes healthy.
The result of the “cellular” treatment is the restoration of the structure of the lungs, the disappearance of shortness of breath and dry cough, which were the main causes of the patient’s eternal torment. The safety and efficacy of therapy has been proven by multiple studies.
Oxygen therapy
Oxygen therapy is a modern therapeutic technique based on the inhalation of an oxygen-gas mixture by the patient. The procedure allows you to compensate for the oxygen deficiency that has formed in the body. One of the main indications for its implementation is pneumosclerosis of the lungs.
The gas, which is an instrument of oxygen therapy, is saturated with oxygen in the same volume that it is concentrated in the atmospheric air. Gas supply is most often done using nasal (intranasal) catheters, it can also be:
masks (mouth and nasal);
oxygen tents;
tubes (tracheostomy, intubation);
hyperbaric oxygenation.
Thanks to oxygen supply, an active restoration of cellular metabolism occurs.
Medication Therapy
If the course of pneumosclerosis is accompanied by inflammatory exacerbations (pneumonia, bronchitis), the patient is prescribed medications:
antibacterial;
anti-inflammatory;
expectorant;
mucolytic;
bronchodilators.
If pneumosclerosis is severe, there is a rapid progression of the disease, doctors connect glucocorticosteroids. Course therapy, which involves the use of hormonal drugs in small doses, is practiced to stop the inflammatory process, suppress the growth of connective tissue. Often these drugs are combined with immunosuppressive agents. Anabolic and vitamin preparations may also be prescribed.
In order for drug treatment to be as effective as possible, therapeutic bronchoscopy is used. This manipulation allows you to deliver drugs directly to the bronchial tissue, remove congestive and inflammatory contents of the bronchopulmonary system.
Physiotherapy
If the patient has pneumosclerosis, he may be prescribed physiotherapy. The task of physiotherapeutic procedures in this case is to relieve the syndrome in the inactive phase, to stabilize the process in the active phase.
In the absence of pulmonary insufficiency, iontophoresis with calcium chloride, novocaine is indicated. An ultrasound with novocaine may also be prescribed. If the disease is at a compensated stage, it is advisable to conduct inductometry and diathermy in the chest area. With poor sputum separation, the Vermel system (electrophoresis with iodine) is used, with malnutrition – ultraviolet irradiation. A less effective alternative is irradiation with a solux lamp.
If possible, physiotherapy is recommended to be combined with climatic treatment. Patients with pneumosclerosis are shown to rest on the coast of the Dead Sea. The local climate will have a healing effect on the affected organism.
Therapeutic exercise
The main task, the achievement of which is facilitated by therapeutic physical exercises, is the strengthening of the respiratory muscles. Classes are necessarily held under the close supervision of professional instructors, amateur performances can rather harm.
Compensated pneumosclerosis is an indication for respiratory gymnastics. Each exercise should be performed without tension, adhering to a slow or medium pace, gradually increasing the load. The best place to practice is the street, fresh air increases the effectiveness of exercises. Physiotherapy exercises have contraindications – high fever, severe form of the disease, repeated hemoptysis.
When compensating for the pathological process, patients can connect some sports. With pneumosclerosis, rowing, skating and skiing are useful. Doctors often recommend chest massage as well. With the help of procedures, congestion that forms in the lung tissue is eliminated. Massage improves the condition of the heart, bronchi, lungs, and inhibits the development of pulmonary fibrosis.
Operative intervention
Radical intervention may be appropriate if the patient has a local form of the disease, destruction of the lung tissue, suppuration of the lung parenchyma, fibrosis and cirrhosis of the lung. The essence of the treatment is to surgically remove the affected area of the lung tissue.
preventive measures
It is always easier to prevent pneumosclerosis than to completely get rid of it. The most important thing for this is the timely treatment of pneumonia, tuberculosis, bronchitis, and colds. The following will also be helpful:
to give up smoking;
job change with frequent interaction with occupational hazards;
minimizing the consumption of alcoholic beverages;
hardening procedures;
regular breathing exercises, gymnastics;
balanced nutrition, intake of vitamin complexes;
frequent walks in the air;
annual radiography.
Quitting smoking is the most important item on this list. Cigarettes seriously worsen the condition of the lungs, contribute to the development of diseases of the respiratory organs.
If pneumosclerosis is detected in a timely manner, subjected to the correct treatment, the patient strictly adheres to all the doctor’s recommendations and leads a healthy lifestyle, the disease will be defeated.