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November 24, 2016 00:01

Dust bronchitis |Symptoms and treatment of dust bronchitis

Dust bronchi bronchitis is a disease in which their diffuse lesion does not occur due to infection, and as a result of mechanical or chemical action on the mucous membranes of the bronchial tree of the dust particles that are inhaled into the air.This disease belongs to the category of professional and has a chronic form.

professional dust bronchitis is most often diagnosed in miners in the coal mines and ore quarries, workers of metallurgical and chemical industries, enterprises for the production of building materials, where the production processes associated with the grinding of materials and hit a large amount of particulate matter in the atmosphere.Dusty distinguished work in the textile, flour mills and woodworking factories.

This disease has two etiological types: dust bronchitis and toxic-dust bronchitis (in the presence of various toxic components in the dust).

Causes dust bronchitis

So, as can be seen from the very name of the disease, the cause of bronchitis dust - the dust, that is,

solid microscopic particles of different origin.The pathophysiological mechanism of destruction of the bronchi look like.Inhalation of air dust particles through the nasal passages and throat come in tubular pneumatic branching trachea - bronchi.Functional bronchial challenge lies not only in the supply air to the lungs and gas mixture deriving from respiratory systems but also in clearing inhaled air.

bronchial walls are covered with mucosa, consisting of ciliated (ciliary) epithelium, and in a deeper layer contains glands that produce mucus.Dust particles are deposited on the ciliary epithelium and villi, enveloped with mucus and are removed by reducing the muscle of the bronchi of the plate - when a person coughs (coughs and phlegm).

When the dust content in the air exceeds the physiological capabilities of the bronchi, the dust settles on the epithelial cilia, reducing or completely blocking their reduction.This leads to the degeneration and desquamation of entire sections of the ciliated epithelium and functional disorders of the bronchi.This mucus that accumulates in the bronchial lumen, becomes thicker and constantly irritates the nerve endings of the reflex zones of the bronchi.The result is a cough.

significant defeat bronchial mucosa prevents the timely removal of mucus, and it starts to close their gaps.In clinical medicine, this is called the obstruction or obstruction of the bronchial tubes and is frequently seen at such disease as chronic dust bronchitis.

Symptoms dust bronchitis

A clear classification of this disease is not present, but typical signs of varying degrees of destruction of the bronchi specialists identify chronic dust bronchitis three degrees.

Symptoms dust bronchitis first (mild) degree:

  • overcome dry cough (sputum is very small, it is difficult to cough up);
  • 1-2 times during the year occur long periods of exacerbation of cough;
  • shortness of breath may occur with significant physical exertion;
  • in the bronchi auscultation via stethoscope listening on a hard breathing, sometimes - dry wheezing.

Symptoms dust bronchitis second (middle) degree:

  • constantly repeated prolonged bouts of coughing, accompanied by slight separation of sputum;
  • shortness of breath during normal physical activities;
  • possible sense of breathing difficulties and asthma attacks;
  • listening breathing fixes its rigidity and attenuation, as well as the presence of wheezing in the lower part of the lungs;
  • more frequent exacerbations up to 3-4 times a year;
  • during acute volume increased sputum (may be the presence of a small amount of pus);
  • change in respiratory function with a reduction in forced expiratory volume up to 70-80%;
  • X-ray examination revealed a moderate change in the pattern of the lower parts of the lungs, abnormal thickening of the bronchial walls, swelling of the mucous membrane, as well as diffuse enlargement of airspaces distal bronchioles, which is characteristic of emphysema;
  • signs of pulmonary heart (increase and expansion of the right heart).

Symptoms dust bronchitis third (severe) degree

  • cough becomes persistent and productive (with sputum);
  • shortness of breath is not only with minimal physical exertion, but also in a state of rest;
  • significant change in the pattern of basal and lower parts of the lungs;
  • appears asthmatic syndrome and signs of perifocal pneumonia (noninflammatory focal lung lesions);
  • expressed syndrome of diffuse emphysema with obstruction (narrowing or complete obstruction of individual sections of the bronchial tree);
  • exacerbation periods are often last long;
  • significantly compromised respiratory function (forced expiratory volume reduced to 50% or less), reducing the oxygen content in the blood (hypoxemia) to 85%;
  • manifested obvious signs of decompensated pulmonary heart disease (fatigue, increased drowsiness, rash, abdominal pulsation at the top, pressing feeling in the chest, swelling of the neck veins).

Symptoms of toxic-dust bronchitis

toxic-dust bronchitis - as a kind of professional dust bronchitis - is complicated by the fact that in the inhaled air, but dust, there are toxic substances, such as formaldehyde, sulfur compounds, chlorinated hydrocarbons, ethylene glycol, nitritesmetals, metal oxides, etc.Entering them into bronchial mucosa leading to its inflammation and irritation.

Symptoms of toxic-dust bronchitis are expressed not only in fits of coughing, but also in the form of fever, pus in the sputum, changes in blood chemistry.In the process of the bronchial mucosa of the wall exposed to the strain of inflammation, the gaps are narrowed, there may be scarring, violating the air permeability of the lungs.

Diagnostics dust bronchitis

Diagnosis of chronic dust bronchitis is based on a complete history, taking into account all the complaints of patients and the nature of their professional activity.In this case, the following survey methods:

  • general analysis of blood and urine;
  • biochemical and bacteriological analysis of sputum;
  • chest radiography (bronchi and lungs in two projections, exhale and inhale);
  • spirography (established and vital capacity graphically recorded);
  • spirometry (determined by the forced expiratory volume);
  • oximetry (as determined by blood oxygen saturation level);
  • capnography (determined by the pressure of carbon dioxide in the air, filling the lung alveoli);
  • pneumotachograph (determined by the degree of airway resistance and lung tissue elasticity);
  • electromyography (determined by the bioelectrical activity of the respiratory muscles);
  • bronchography (with contrast medium);
  • CT and MRI scans of the lungs.

In the process of setting the dust bronchitis diagnosis must rule out other diseases of the respiratory system, in particular, chronic pneumonia, pulmonary tuberculosis, malignancy (sarcoidosis, lifogranulematoz), diffuse fibrosing alveolitis, bronchiectasis, and others. It is therefore very importantdifferential diagnosis of dust bronchitis.To this end, a bronchoscopy is performed simultaneously with transbronchial biopsy of lung tissue and histological examination, as well as puncture of the lymph nodes, located at the roots of the lungs.

Treatment of dust bronchitis

It should be noted that the treatment of dust bronchitis long and, above all, aimed at the restoration of patency of the bronchi and removing their spasm.

Drug therapy of this disease involves medication to facilitate sputum, ie, expectorants based Thermopsis grass, leaves mother and stepmother, marshmallow root and licorice - in the form of ready-made syrups, juices or homemade concoctions.

to improve sputum discharge in chronic dust bronchitis, doctors prescribe alkaline inhalations: 100 ml of distilled or boiled water - 3 g of sodium bicarbonate and 1 g of sodium tetraborate and sodium chloride.Inhalation should be done several times a day (15-20 mL per procedure).

the same purpose used acetylcysteine ​​medications Bisolvon, Ambroxol (Lasolvan) and other acetylcysteine ​​(synonyms -. ACC, Bronholizin, Mukobene, Tussikom, Fluimucil etc.). Is assigned to 0.2 g three times a day (or at 0,6 g once only).Possible side effects such as nausea and vomiting, tinnitus and urticaria.Contraindicated in patients with severe bronchospasm, liver, kidney, adrenal dysfunction, gastric ulcer and duodenal ulcer in the acute stage of pregnancy.

Tablets Bisolvon (synonyms - Bromhexine, Solvin, Flegamin) at 0,008 g administered 8 mg 2 times a day for the liquefaction of sputum.The drug can cause nausea and vomiting, and dyspepsia and peptic ulcer disease exacerbation.A drug Ambroxol (synonyms - Lasolvan, Bronhopront, Flyuiksol, Mukovent, secret Viskomtsil and OE) is taken to reduce the viscosity of mucus and its removal from the best of the bronchi - one tablet (30 mg) was not more than three times a day (at the timemeal).Among its undesirable but possible effects listed nausea and vomiting.

to remove bronchospasm in professional dust bronchitis bronchodilators used such as Teopek and terbutaline.

drug Teopek (analogues - Theophylline, Teostat, Teotard, Retafil, Asmolept, Spofillin, Eufilong) not only expands the bronchi and reduces the tension of the respiratory muscles, but also activates the function of the ciliated epithelium of the bronchi.Dosage strictly individually determined by a physician, and the unit dose are as follows: the first 1-2 days - poltabletki (0.15 g), 1-2 times a day (after meals, with an interval 12 hours between doses);0.2-0.3 g followed by twice during the day.The course of treatment can last up to three months.Teopek not prescribed for hyperthyroidism, myocardial infarction, heart rhythm disturbances, epilepsy.Among its side effects: dizziness, headache, nausea, vomiting, abdominal pain, tachycardia, anxiety, sleep disorders and appetite.

The group polling beta2-agonists include terbutaline (synonyms - Brikanil, Arubendol, Spiranov, Terbasmin, Terbutol, tergite et al.), Available in tablets of 2.5 mg.His doctors prescribed a tablet twice a day.Contraindications to the use of this drug are thyroid dysfunction, tachycardia, infectious diseases of the uterus, chronic pyelitis.A possible side effects manifested as palpitations and tremors.

Expand bronchial lumen M-cholinergic receptor blockers.For example, available in the form of aerosol inhalation of ipratropium bromide (synonyms - Atrovent, Vagos, Itrop, Arutropid, Normosekretol) recommended by doctors for the treatment and prevention of respiratory failure in chronic dust bronchitis - 1-2 doses (1 dose - 0.02 mg) three times per day.However, this drug causes dry mouth and increases the viscosity of sputum.It should be used with caution with increased intraocular pressure (glaucoma) and violation of patency of urinary pathologies of the prostate gland.

dust bronchitis treatment is carried out using a special breathing exercises, pressurized oxygen in hyperbaric chambers (the method of hyperbaric oxygenation).The positive effect is given physiotherapy such as electrophoresis with calcium chloride solution (the chest), UHF and microwaves currents (on the root zone of the lung), and on the short-wave diathermy area between the shoulder blades.

Prevention of dust bronchitis

primary prevention of dust bronchitis is the use of dust exposure on the production of individual protective equipment (respiratory masks, masks and the petals etc.).And the obligatory presence in the premises ventilation and other means of collective protection of workers.

time necessary to undergo preventive medical examinations provided for personnel of similar companies and industries.

prognosis of dust bronchitis

should be borne in mind that dust bronchitis - a very serious disease, which is fraught with irreversible negative consequences.As its development from one stage to the threat of pulmonary heart makes a prediction dust bronchitis is very pessimistic.After increasing the size of the right ventricle of the heart and changes in large vessels of the pulmonary circulation occur degenerative and even necrotic processes in the tissues of the heart muscle.Dust bronchitis third degree threatening disability and disability.