Chronic obstructive pulmonary disease (COPD) - Symptoms and treatment

What is chronic obstructive pulmonary disease (COPD)? The causes of the occurrence, diagnosis and treatment methods will analyze in the article of Dr. Nikitina I. L., Uzi's doctor with experience in 25 years.

Definition of the disease. Causes of the disease

Chronic obstructive pulmonary disease (COPD) - The disease that is gaining momentum, moving in the rating of the causes of death of people over 45 years old. To date, the disease stands at the 6th place among the leading causes of mortality in the world, according to WHO forecasts in 2020, COPL will already take the 3rd place.

This disease is insidious in the fact that the main symptoms of the disease, in particular, with tobacco-law manifest themselves only 20 years after the start of smoking. It does not give for a long time clinical manifestations And it may be asymptomatic, however, in the absence of treatment, obstacle progresses obstruction respiratory tractwhich becomes irreversible and leads to early disability and reduce life expectancy in general. Therefore, the topic of the COPD is submitted in our days especially relevant.

It is important to know that COPD is primary chronic illnessin which it is important early diagnosis In the initial stages, since the disease tends to progression.

If the doctor diagnosed "Chronic obstructive light disease (COPD)", a number of questions arise: what it means how dangerous is it is dangerous, what to change in the lifestyle, what is the forecast of the disease?

So, chronic obstructive disease of the lungs or COPD - This is a chronic inflammatory disease with the damage to small bronchi (airways), which leads to a violation of breathing due to the narrowing of the lumen of the bronchi. Over time, emphysema develops in lungs. This is the name of the state at which the elasticity of the lungs is reduced, that is, their ability to shrink and expand in the process of breathing. Easy at the same time are constantly as if in a state of inhalation, they always, even during the exhalation, there remains a lot of air, which disrupts the normal gas exchange and leads to the development of respiratory failure.

Causes of the disease hob are:

• impact harmful factors environment;
• tobacocco;
• professional harmful factors (dust containing cadmium, silicon);
• overall environmental pollution (car exhaust gases, SO 2, NO 2);
• frequent respiratory infections;
• heredity;
• deficiency α 1 -Antrippsin.

When you find similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of chronic obstructive pulmonary disease

Cobl - The disease of the second half of life is more often evolving after 40 years. The development of the disease is a gradual long-term process, which is more often invisible for the patient.

Consult a doctor make the emerging dyspnea and cough- The most common symptoms of the disease (shortness of breath almost constant; cough frequent and daily, with sputum discharge in the morning).

A typical patient with COPD is a smoking person of 45-50 years, which complaining of frequent shortness of breath during exercise.

Cough- One of the earliest symptoms of the disease. It is often underestimated by patients. At the initial stages of the cough disease, there is an episodic character, but later becomes daily.

Sputum Also relative to the early symptom of the disease. At the first stages, it stands out in small quantities, mainly in the morning. The character of the mucous. Purulent abundant sputum appears during the exacerbation of the disease.

Dyspnea It occurs at the later stages of the disease and is noted first only with a significant and intensive physical activity, intensifying in respiratory diseases. In the future, shortness of breath is modified: a sense of lack of oxygen during conventional physical exercises is replaced by heavy respiratory failure and in time is enhanced. Dyspnea is becoming frequent cause In order to consult a doctor.

When can I suspect Hobs?

Here are a few questions of the algorithm of early diagnosis of COPD:

• Do you cough every day several times? Does it worry you?
• Does it occur when the spilion of a sputum or mucus (often / daily)?
• Do you have a faster / more frequent shortness of breath, in comparison with peers?
• Are you older than 40 years old?
• Do you smoke and had to smoke before?

With a positive answer for more than 2 questions, it is necessary to conduct spirometry with an armhole test. With the test test indicator 1 / Fezhe ≤ 70, a suspicion of COPD is determined.

Pathogenesis of chronic obstructive pulmonary disease

When COPDs suffer both respiratory tract and the fabric of the lungs itself is a lung parenchyma.

The disease begins in small respiratory tracts with the blockage of their mucus accompanied by inflammation with the formation of peribroscial fibrosis (sealing of connective tissue) and obliteration (ulusing).

With formed pathology, the bronchtic component includes:

The emphysematosis component leads to the destruction of finite departments of the respiratory tract - alveolar walls and supporting structures with the formation of significantly expanded airspaces. The absence of a tissue carcass of the respiratory tract leads to their narrowing due to the trend towards a dynamic decline during exhalation, which causes the expiratory collapse of the bronchi.

Everything else, the destruction of the alveolar-capillary membrane affects gas exchange processes in lungs, reducing their diffuse ability. As a result, a decrease in oxygenation (oxygen saturation of blood) and alveolar ventilation occurs. Excessive ventilation occurs, insufficiently perfusable zones, leading to an increase in the ventilation of the deadline and disruption of carbon dioxide CO 2. The area of \u200b\u200bthe alveolar-capillary surface is reduced, but may be sufficient for gas exchange at rest when these anomalies may not appear. However, during physical activity, when the need for oxygen increases, if there is no additional reserves of gas-applying units, hypoxemia arises - the lack of oxygen content in the blood.

The hypoxemia appeared during a long existence in patients with COPD includes a number of adaptive reactions. Damage to the alveolar and capillary units causes pressure to eastern artery. Since the right ventricle of the heart in such conditions should develop greater pressure to overcome the increased pressure in the light artery, it is hypertrophy and expand (with the development of heart failure of the right ventricle). In addition, chronic hypoxemia is able to cause an increase in erythropoese, which subsequently increases blood viscosity and strengthens the right-hand deficiencies.

Classification and stage of development of chronic obstructive lung disease

Complications of chronic obstructive pulmonary disease

Complications of COPD are infections, respiratory failure and chronic lightweight heart. Also in patients with COPD with a larger frequency there is a bronchogenic carcinoma (lung cancer), although it is not direct complication of the disease.

Respiratory failure - the state of the external breathing apparatus, in which there is no maintenance of voltage O 2 and CO 2 in arterial blood on normal levelOr it is achieved due to the increased operation of the external respiratory system. Manifests mainly shortness of breath.

Chronic Light Heart - an increase and expansion of the right heads of the heart, which occurs when the blood circulation is increasing in a small circle, which has developed, in turn, as a result of light diseases. The main complaint of patients is also shortness of breath.

Diagnosis of chronic obstructive lung disease

If patients cough, sputum, shortness of breath, and also identified the risk factors for the development of chronic obstructive diseases of the lungs, then everyone must have a diagnosis of COPD.

In order to determine the diagnosis, the data is taken into account clinical examination (Complaints, history, physical examination).

With a physical examination, symptoms characteristic of long-flowing bronchitis can be detected: "hourly glasses" and / or "drum sticks" (deformity of the fingers), Tahipne (rapid breathing) and shortness of breath, a change in the shape of the chest (for emphysema is characterized by a barrel-shaped form), small Its mobility during breathing, the bounding of intercostal intervals in the development of respiratory failure, the omission of the boundaries of the lungs, the change in the percussion sound on a boxed, weakened vesicular breathing or dry whistles, which are enhanced with the forced exhale (that is, the fast exhale after a deep breath). Heart tones may harden with difficulty. In later stages, diffuse cyanosis, a pronounced shortness of breath, appear peripheral edema. For convenience, the disease is divided into two clinical forms: emphysematous and bronchitic. Although in practical medicine, cases of mixed form of the disease are more common.

The most important stage of the diagnosis of COPD - analysis of the function of external respiration (FVD). It is necessary not only to determine the diagnosis, but also to establish the severity of the disease, drawing up an individual treatment plan, determining the effectiveness of therapy, refinement of the forecasting of disease and working capacity. Establishing the interest ratio of FEV 1 / Fire is most often used in therapeutic practice. Reducing the volume of the forced exhalation in the first second to the forced vital capacity of the light FEF 1 / Fire up to 70% is the initial sign of the airflow limit even with the preserved FEV 1\u003e 80% due value. Low peak air flow rate on exhalation, slightly changing when the use of armored vehicles also speaks in favor of COPD. With first diagnosed complaints and changes in the indicators of FVD, spirometry is repeated throughout the year. The obstruction is defined as chronic if it is fixed at least 3 times a year (despite the treatment), and the COPD is diagnosed.

Monitoring 1 - important diagnosis confirmation method. Spireometric measurement of the indicator of FEV 1 is carried out repeatedly for several years. The rate of annual fall of the FEV 1 for people of mature age is within 30 ml per year. For patients with COPD, a characteristic indicator of such a fall is 50 ml per year or more.

Broncholic test - Primary examination, in which the maximum indicator of FEV 1 is determined, the stage and severity of COPL are established, and the bronchial asthma (with a positive result) is also eliminated, the tactics and treatment is elected, the effectiveness of therapy is estimated and the course of the disease is predicted. It is very important to distinguish the COPD from bronchial asthma, since these frequently found diseases have the same clinical manifestation - broncho-structure syndrome. However, the approach to the treatment of one disease differs from the other. The main distinguishing feature in the diagnosis is the reversibility of bronchial obstruction, which is a characteristic feature of bronchial asthma. It has been established that people with a diagnosis of ho Bl after reception broncholics percentage of increment 1 - less than 12% of the initial (or ≤ 200 ml), and in patients with bronchial asthma, it, as a rule, exceeds 15%.

Radiography of the chest has auxiliary znachnome, since changes appear only in the later stages of the disease.

ECG Can detect changes that are characteristic of a light heart.

Ehocheit is necessary to identify the symptoms of light hypertension and changes in the right heads of the heart.

General blood analysis - With it, it is possible to estimate the hemoglobin and hematocrit (can be increased due to red blood cell).

Determination of blood oxygen level (SPO 2) - Pulse oximetry, non-invasive research to clarify the severity of respiratory failure, as a rule, in patients with severe bronchial obstruction. The oxygen saturation of blood is less than 88%, determined by rest, indicates a pronounced hypoxemia and the need to appoint hydroxygen therapy.

Treatment of chronic obstructive pulmonary disease

COPD treatment contributes to:

• reduction of clinical manifestations;
• an increase in tolerance to physical exertion;
• prevention of disease progression;
• prevention and treatment of complications and exacerbations;
• improving the quality of life;
• reduce mortality.

The main directions of treatment include:

• weakening the degree of influence of risk factors;
• educational programs;
• medical treatment.

Weakening of the degree of influence of risk factors

Refusal of smoking is required. This is the most effective way that reduces the risk of developing COPD.

Production harm should also be monitored and reduced their influence, applying adequate ventilation and air cleaners.

Educational programs

COPD Educational programs include:

• basic knowledge of the disease and general approaches to the treatment with the motivation of patients to the cessation of smoking;
• learning how to properly use individual inhalers, spacers, nebulizers;
• the practice of self-control using picofloumetres, the study of urgent self-help measures.

Patient education occupies a significant place in the treatment of patients and affects the subsequent forecast (the level of evidence A).

The pekfloumemetry method allows the patient every day to independently control the peak volume of the forced exhalation - an indicator, closely correlating with the value of FEV 1.

Patients with COPD at each stage show physical training programs in order to increase the tolerability of physical exertion.

Medicia treatment

Pharmacotherapy for COPD depends on the stage of the disease, the severity of symptoms, the severity of the bronchial obstruction, the presence of respiratory or rightful failure concomitant diseases. Preparations that are struggling with COPD are divided into means for removing the attack and to prevent the development of an attack. Preference is given to inhalation forms of drugs.

To relieve rare attacks of bronchospasm, the inhalation of β-adrenostimulants are prescribed short action: Salbutamol, Fenoterol.

Preparations for the prevention of attacks:

• formoterol;
• tiotropia Bromide;
• combined drugs (Berotek, Berrovant).

If the use of inhalation is impossible or their effectiveness is insufficient, then the use of theophylline is possible.

With bacterial exacerbation, COPD requires the connection of antibiotics. A amoxicillin 0.5-1 g 3 times a day, azithromycin of 500 mg three days, clarithromycin CP 1000 mg 1 time per day, clarithromycin 500 mg 2 times a day, amoxicillin + clavulanic acid 625 mg 2 times a day, cefuroxime 750 mg 2 times a day.

The removal of symptoms of the COPD also helps glucocorticosteroids, which are also injected inhalation (beclometazone dipropionate, fluticasone propionate). If the COPD is steady, then the purpose of systemic glucocorticosteroids is not shown.

Traditional expectorant and musolithic means give a weak positive effect in patients with COPD.

In severe patients with partial pressure of oxygen (PO 2), 55 mm Hg. Art. And less alone shows oxygen therapy.

Forecast. Prevention

The prediction of the disease is influenced by the stage of the COPD and the number of re-exacerbations. At the same time, any aggravation negatively affects the overall course of the process, so it is extremely desirable as an earlier diagnosis of COPD. Treating any exacerbation of COPDs should be started as early as possible. It is also important for the full therapy of exacerbation, in no case allow it to carry it "on the legs".

Often people are decided to see a doctor for medical care, starting with the second stage stage. For III Stages The disease begins to have a rather strong effect on the patient, the symptoms become more pronounced (the rise of shortness of breath and frequent exacerbations). At the IV stage, a noticeable deterioration in the quality of life occurs, each aggravation becomes a threat to life. The course of the disease becomes disabled. This stage is accompanied by respiratory failure, the development of a light heart is not excluded.

The disease forecast affects the observance of the patient medical recommendations, commitment to treating and healthy lifestyle. Continuation of smoking contributes to the progression of the disease. The refusal of smoking leads to a slowdown in the progression of the disease and slowing down the decline in FEV 1. Due to the fact that the disease has a progressive course, many patients are forced to take medicines for life, many are required by gradually increasing doses and additional funds during the exacerbation period.

The best means of preventing COPD are: a healthy lifestyle, including full nutrition, hardening the body, reasonable physical activity, and eliminating the impact of harmful factors. The disclaimer of smoking is the absolute condition for the prevention of the exacerbation of COPD. Available production harm, when diagnosing a COPD - a sufficient reason to change the place of work. Preventive measures are also the avoidance of supercooling and restriction of contacts with sick orvi.

In order to prevent the exacerbations of patients with COPD, an annual anti-happose vaccination is shown. People with Cobls aged 65 years and older and patients with FEV 1< 40% показана вакцинация поливалентной пневмококковой вакциной.

On the early stages He is an episodic disease, but later worries constantly, even in a dream. Cough is accompanied by a spray. It is usually a bit, but in the aggravation stage, the amount of separated increases. Possible purulent sputum.

Another symptom of COPD is a shortness of breath. It appears late, in some cases even 10 years after the start of the disease.

Suffering Cobls are divided into two groups - "Pink puffers" and "Blue Sights". "Pink puffers" (emphysematous type) are more often thin, their main symptom is shortness of breath. Even after a small physical activity, they puff, inflating cheeks.

"Blue Suncheeks" (bronchial type) are overweight. COPD manifests itself in them mostly strong cough with sputum. They have a blue skin, legs swell. This is due to the pulmonary heart and stagnation of blood in big circle blood circulation.

Description

According to the World Health Organization (WHO), COPD suffers 9 men from 1000 and about 7 women out of 1000. About 1 million suffering from this disease. Although there is reason to assume that they are much more.

For severe course COPD Defines the gas composition of the blood.

With the ineffectiveness of therapy take sputum on bacteriological analysis.

Treatment

Chronic obstructive pulmonary disease is an incurable disease. However, adequate therapy can reduce the frequency of exacerbations and significantly extend the patient's life. For the treatment of COPDs, preparations are used, expanding the lumen of bronchi and musolithic agents that dilute the sputum and contribute to its removal from the body.

Glucocorticoids are prescribed for inflammation. However, their long-term use is not recommended due to serious side effects.

During the exacerbation of the disease, if its infectious nature is proved, antibiotics or antibacterial agents are prescribed depending on the sensitivity of the microorganism.

Patients with respiratory failure are prescribed oxygen therapy.

Suffering pulmonary hypertension and COPD, in the presence of edema, diuretics are prescribed, with arrhythmias - heart glycosides.

In the hospital of the suffering COPD guide, if he is:

It is also important to treat infectious diseases of the respiratory tract in a timely manner.

Working in harmful proceedings should strictly observe safety techniques, wear respirators.

Unfortunately, in large cities, one of the risk factors cannot be eliminated - a polluted atmosphere.

COPD is better to begin to treat in the early stages. For timely diagnosis of this disease, you need to pass up cliserization.

Chronic obstructive pulmonary disease (COPD) - a disease accompanied by a violation of the lung ventilation, that is, air arrivals in them. At the same time, the breakdown of the supply of air is due to the obstructive decrease in bronchial patency. The bronchial obstruction in patients is reversible only partially, the bronchial lumen is not restored.

Pathology has a gradually progressive course. It is associated with excessive inflammatory and obstructive response responses for harmful impurities, gases, dust in the air.

Chronic obstructive pulmonary disease - what it is

By tradition, the concept of COPD includes obstructive bronchitis and emphysee (bloating) of the lungs.

Chronic (obstructive) bronchitis - inflammation of the bronchial tree, which is determined by clinically. The patient with has a cough with a wet. Over the past two years, a person must cough in a total of at least three months. If the duration of the cough is less, then the diagnosis of chronic bronchitis does not put. If you have, consult a doctor - the early start of therapy is able to slow down the progression of pathology.

The prevalence and importance of chronic obstructive pulmonary disease

Pathology is recognized as a global problem. In some countries, it suffers to 20% of the population (for example, in Chile). On average, among people over 40 years old, chronic obstructive pulmonary disease occurs approximately 11-14% of men and 8 - 11% of women. Among the rural population, pathology occurs about two times more often than residents of cities. With age, the frequency of occurrence of COPD is growing, and by 70, each second rural resident - a man suffers from obstructive lung disease.

Chronic obstructive pulmonary disease is the fourth among the causes of death in the world. Mortality increases from it, and there is a tendency to increase mortality from this pathology among women.

Economic expenses related to COPD occupy the first place, bypassing the costs of treating patients with asthma twice. The greatest losses occur to inpatient assistance to patients with a running stage, as well as for the treatment of exacerbations of the obstructive process. Taking into account temporary disability and reduced performance when entering the work, economic losses in Russia exceed 24 billion rubles per year.

Chronic obstructive pulmonary disease is an important social and economic problem. It significantly worsens the quality of life of a particular patient and lies with heavy load on the health care system. Therefore, prevention is very important, timely diagnosis and the treatment of this disease.

Causes and development of COPD

In 80 - 90% of cases, the cause of chronic obstructive pulmonary disease is smoking. In the smokers group, the highest mortality from this pathology, they have irreversible changes in pulmonary ventilation faster, expressive symptoms. However, in non-smoking people, pathology is also found.

The exacerbation can develop gradually, and may arise sharply, for example, against the background of a bacterial infection. A severe exacerbation can end with development or acute heart failure.

Coblforms

The manifestations of chronic obstructive pulmonary disease are largely dependent on the so-called phenotype - a set of individual characteristics of each patient. Traditionally, all patients are divided into two phenotypes: bronchtic and emphysematous.

With a bronchitic obstructive type in the clinic, the manifestations of bronchitis are predominant - cough with a spree. In the emphysematous type, shortness of breath prevails. However, "clean" phenotypes are rare, usually there is a mixed painting of the disease.

Some clinical signs Hob Phenotypes:

In addition to these forms, other phenotypes of obstructive disease are distinguished. So, recently they write a lot about Overlap-phenotype, that is, the combination of COPD and. This form develops in smoking patients with asthma. It is shown that about 25% of all patients with COPD are reversible, and eosinophils are found in their sputum. In the treatment of such patients effectively use.

Select the form of a disease accompanied by two and more exacerbations per year or the need for hospitalization more often than once a year. This demonstrates the serious course of obstructive disease. After each exacerbation, the function of the lungs is increasingly deteriorating. Therefore, an individual approach to the treatment of such patients is necessary.

Chronic obstructive pulmonary disease causes the response of the body in the form of systemic inflammation. First of all, it affects a skeletal muscles, which increases weakness in patients with COPD. Inflammation affects the vessels: the development of atherosclerosis is accelerated, risk rises ischemic Disease Hearts, myocardial infarction, stroke, which increases mortality among patients with COPD.

Other manifestations of systemic inflammation in this disease are osteoporosis (decrease in the density of bones and fractures) and anemia (decrease in the amount of hemoglobin in the blood). Neriva-mental disorders of COPD are represented by a violation of falling asleep, nightmares, depression, worsening memory.

Thus, the symptoms of the disease depend on the set of factors and during the life of the patient change.

Read about the diagnosis and treatment of obstructive disease.

Chronic obstructive pulmonary disease or COPD, one of the often occurring human health problems at present. This is connected with the deplorable state of our ecology.

The quality of air, which inhales a person, has worsened noticeably, which cannot but not reflect on the state of the health of the organs responsible for the air exchange process.

What is COPL?

COPD - is a general term for many respiratory diseases, such as, and. It may also include other diseases of the respiratory tract.

The most common causal factor is smoking.

Inflammatory processes in the lungs provoked under the influence of exhausts, various impurities of atmospheric air, cigarette smoke (passive smoking is not excluded) - these are fundamental processes for the development of COPD.

According to the statistics of the World Health Organization (WHO) - chronic obstructive in adults, occupies a fourth position in mortality in the population.

People suffer from these diseases from developing complications such as:

• respiratory failure;
• cardiovascular disorders (which provokes COPD).

This disease, with proper diagnosis in the early stages of development, is treated fully, applying a number of actions for the prevention of this ailment, it is possible to prevent its development.

On the ICD 10 are encoded asJ.44.0 - If the COPD is developing together with the lower respiratory tract. Code of PO international Classification Diseases 10 helps to systematize and trace statistics for each disease.

COB MKB 10 with code J44.9 is reflected in uncertain genesis.

Signs of Cobl

Symptoms and signs may include:

• fatigue;
• shortness of breath;
• paroxysmal night dyspnea (PND);
• wheezing with sigh;
• cough with wet (mucous and / or purulent);
• fever;
• pain in the chest.

Risk factors

• In most part, such a factor as smoking becomes the most harmful and frequent. Tobacco smoke and cigarette resins negatively affect all respiratory organs. Passive smoking is absolutely no less harmful, but on the contrary even more dangerous. A person who is close to the smokers consumes a much higher smoke content than he himself. The category of people who smoke are dangerous not only themselves, but also those around them. Among the groups of avid smokers are diagnosed about 15-20% of the clinical manifestations of COPD.
• Genetic predisposition. An example of disorders leading to this disease becomes a state, such as:
  • alpha-AntitripSin deficiency (people who have never smoked and increases the risk to the diseases of smokers);
• Bacteria. The aggravation of the considered disease can influence bacteria such groups as Haemophilus Influenza, Moraxella Catarrhalis. Another type of bacteria affecting the development of the disease is pneumonic streptococcus;
• Professional harm (dust, evaporation of various acids and alkalis, released harmful masses from chemicals);
• Bronchi hyperreactivity.

Pathogenesis

With long-term exposure to any risk factor on the human body, inflammation of the walls of a chronic character is developing. Most likely damage to the distal department (located in the maximum for alveolum and the pulmonary passagem of proximity).

Violates the development and removal of mucus. Small bronons are clogged and a different kind of infection is developing on this background. Muscle cells die, replacement connective tissue. As a result, emphysema is developing - the pulmonary fabric is overwhelmed with air because of this, their elasticity decreases noticeably.

From armor, damaged emphysens, air is released with great difficulty. The air volume is reduced since gas exchange is not at proper quality. As a consequence, one of the main symptoms is shown - shortness of breath. When loading or just walking, shortness of breath creates an increasing effect.

As a result of respiratory failure, hypoxia develops. Upon the protracted effects of hypoxia on the human body, the lumens of the pulmonary vessels decrease, this leads to (in the course of this disease, the increase and expansion of the right heart departments).

Classification

This disease is classified in accordance with the severity of the flow and the clinical picture.

• LatentIt is almost impossible to recognize, does not have pronounced symptoms.
• Middle severity, Cough is manifested in the first half of the day (with a sputter or dry). Shortness of breath more often with minor physical Loads.
• Heavy flow, meets chronic flow And accompanied by attacks of a strong cough with sputum, frequent misses.
• The fourth stage can lead to a fatal outcome, is characterized by unsubscribing cough, shortness of breath, even at rest, rapid decrease in body weight.

Exacerbation

We will analyze that such an exacerbation of housing.

This condition is aggravated by the course of the disease. The clinical picture is worsening, shortness of breath is growing, cough attacks and strengthened. There is a general oppression of the body. The treatment that was previously used does not bring a positive effect. In most cases, the patient needs hospitalization, revision and adjustment of the treatment prescribed earlier.

The state of exacerbation can develop on the background of the suffering disease (Ori, bacterial infections). The usual infection of the upper respiratory tract for a person suffering from the COPD is a state at which the functionality of the lungs is significantly reduced. The period of normalization is delayed for a longer time.

The state is diagnosed as an aggravation of COPD on symptomatic manifestations, complaints of patient, hardware and laboratory studies).

How does the COPD on the body affect

Any disease has chronic character has a negative impact on the body in general. So COPL leads to violations, it would seem, in no way associated with the physiological structure of the lungs.

• Violation of the functions of intercostal muscles (participate in the act of breathing), muscle atrophy may be adopted;
• Reducing glomerular filtration kidney;
• Risk increases;
• Reduction of memory;
• Tendency to depression;
• Reducing the protective functions of the body.

Diagnostics

• Blood test. This analysis is mandatory for the diagnosis of COPD. In the aggravation stage, it is possible to trace an increased, neutrophilic leukocytosis. In patients with developing hypoxia, there is an increase in the number of erythrocytes, a low SE indicator and an enlarged hemoglobin.
• The sputum analysis is what it is is an essential procedure for patients allocating sputum. The results of this analysis will be able to give answers to many questions. The nature of inflammation, the degree of its severity. You can also trace the presence of atypical cells, in this kind of diseases it is necessary to make sure there is no oncological disease.

The sputum in patients with caps of the mucous, and in the aggravation stage can be purulent. The viscosity of sputum increases, as is its number, the color acquires a greenish shade with the streaks of yellow.

The range of sputum is still necessary for such patients, because thanks to it, it becomes possible to find out the causative agents of infection and the stability of them to a particular drug of the antibacterial group.

• X-ray diagnostic method is required for the correct formulation of the diagnosis and elimination of other lung diseases (many diseases of the respiratory system may have similar clinical picture). X-ray is made in two front and lateral positions.

In periods of exacerbations makes it possible to exclude or.

• ECG, use to exclude or confirm such a diagnosis of a pulmonary heart (muscle hypertrophy of the right heart).

Step test initial stage Diseases are usually not pronounced pronounced and for diagnostics It is necessary to check if it is not possible with a small exercise.

Symptoms for which you need to pay attention

Consider a number of symptoms to pay attention to and, if necessary, consult a doctor for the correct diagnosis.

• Often recurrent acute;
• Attacks of painful cough, gradually their number increases;
• Cough with constantly released wet;
• Increasing body temperature;
• Attacks of shortness of breath, which is enhanced with the course of the disease.

Is it possible to conduct an active image with such a disease like COPD

The disease under consideration certainly reduces the quality of life, but it is necessary to remember that it is important not to forget - an active lifestyle will help in the treatment of the disease and improve psycho-emotional state.

You need to start physically carefully carefully and gradually!

With special caution, a group of people should begin training with a training session, which is not a very active lifestyle.

Start with a duration of no more than ten minutes, the load increases slowly from several workouts per week.

Engage in everyday domestic affairs, such a way of physical impact on the body will be gentle by patients with this disease. We walk along the stairs, walk in the fresh air, the landscaping business (wash the floor, windows, dishes), take part of the duties in the courtyard (sweep, plant and take care of plants).

Before performing the scheduled actions, do not forget about the warm-up.

The warm-up helps to safely perform loads, it slowly and will gradually prepare the body to a more serious load. An important point will be considered that the warm-up will contribute to increasing the frequency of respiratory movements, to temper heart abbreviations, normalize body temperature.

Treatment

There are several basic principles for the treatment of this disease.

• Full rejection of the destructive habit - smoking;
• Medical method of treatment, with help medicinal preparations various setting groups;
• Vaccination against infections caused by pneumococcus and;
• Moderate physical activity has a significant impact;
• Inhalation with oxygen, used with serious respiratory failure as a way to extend life.

Medicinal groups used in the treatment

• Broncholitics (Atrovant, Salbutamol, Eufillin);
• Hormonal preparations from the group of corticosteroids (symbi-cortic, sulfur);
• Drugs that contribute to the discharge of sputum (ambroben, codelk);
• Immunomodulatory funds (immunal, derinat);
• Drugs of the group of phosphodiesterase 4 inhibitors (DAKSAS, Dalirez).

COPD treatment by folk remedies

Treating some symptoms of this disease can be carried out using the recipes of traditional medicine.

It is important to remember the need for consultation with a specialist! Treatment of non-traditional medicine is an addition to the treatment that the doctor should appoint.

Steam inhalation

It is carried out at home such a procedure with ease. It is necessary to make a container for a solution, a towel and a little time.

• For one liter of hot water (90-100 degrees), 5-6 drops essential oil Pines, eucalyptus oil and chamomile.
• Inhalation with adding sea salt (liter boiling water, 2-3 tablespoons of sea salt).
• Inhalation of mint grass collection, calendula and souls (on liter boiling water 2 spoons of collection).

Also, with the treatment of chronic lung obstruction, you can do.

Breathing exercises

Respiratory gymnastics, events aimed at strengthening musculatures of lungs and intercostal muscles have a very beneficial effect.

An option for gymnastics. On the breath to raise your hands up, and on the exhalation, perform the slopes of the body and hands to the left, on the next breath raising the hands up, and the slopes of the body and the hands are doing in the right.

Chronic obstructive pulmonary disease (COPD) is a disease of the lungs, in which a person is difficult to breathe. This is due to the damage to the lungs over the years, as a rule, from smoking.

Cobls most often this is a combination of two diseases:

1. Chronical bronchitis. For chronic bronchitis The respiratory tract for which the air enters the light (bronchi) is in the state of inflammation, while a lot of mucus is constantly produced. The walls of the bronchi are thicken, which may be the cause of the narrowing of the lumen (obstruction) of the respiratory tract. At the same time, a person is extremely difficult to breathe.
2. Emphysema. In the emphysema of the lungs, the walls of the Alveol are damaged and lose their elasticity. As a result, the useful lung area for gas exchange (oxygen and carbon dioxide) Between blood and inhaled air. The result of insufficient oxygen flow into the blood is a shortness of breath, which a person feels like a lack of air.

Over time, COPD, as a rule, becomes harder. Stop once the process of lung tissue damage is impossible. But you can take action to slow down the process of destruction of the alveoli in the lungs, as well as improve the well-being of a person suffering from COPD.

What is the cause of COPD?

In most cases, COPD is caused by smoking. Over the years, inhalation of tobacco smoke annoys the respiratory tract and destroys elastic fibers in the lungs alveoli. Passive smoking is also very harmful. Other factors that may cause COPDs include inhalation of chemical vapor, dust and contaminated air over a long period of time. Usually the process of destruction of lung fabric takes many years before the appearance of the first symptoms of the disease, so COPD is the most common among people who over 60 years old.

In addition, the probability of occurrence of COPD increases if a person had a lot of serious infectious diseases Easy throughout life, but it is especially important if these diseases proceeded in childhood. In persons having a diagnosis of emphysema of the lungs at the age of 30 or 40, the hereditary abnormalist of the Alpha-1-antitripsein protein can be. But, fortunately, this pathology is rare.

Basic symptoms Hobl

• Long (chronic) cough.
• Wet, which appears when coughing.
• Dyspnea, which is amplified during exercise.

What's happening?

Over time, COPD progresses and shortness of breath in man appears even with minor physical exertion. The patient becomes more difficult to make food independently or perform simple physical exercises. At the same time, breathing requires considerable energy costs. Sick Cobls are often losing weight, and become much weaker in physical abilities.

At some point symptoms hobl They can suddenly increase, which leads to a deterioration in the physical state of health. This is called the exacerbation of COPD. COPD exacerbations can vary from a slight degree to threatening state life. The larger the duration of the COPD, the more difficult to flow such outbreaks of exacerbations.

How Cobl is diagnosed

To find out if a man has COPD, it is necessary to come to a consultation to the pulmonologist (the doctor lungs), which will make a medical examination and listen to the lungs.

Then he will ask questions about diseases transferred in the past. Asks whether you are smoking or contact with other chemicals that can irritate the lungs.

The doctor can prescribe an X-ray of the chest and other tests to eliminate other problems that may be the cause of the same symptoms.

It is important to identify COPL as soon as possible. This will make measures to slow down the lung damage.

COPL treatment

The best way to slow down the progression of COPD is to quit smoking! This is the most important and necessary of what can be done. Regardless of the duration of smoking and the degree of COPD, the refusal of smoking can significantly slow down the destruction of the lungs. The attending physician will appoint a treatment that will help facilitate the symptoms of the disease and improve well-being, which significantly improves the quality of life. Medicines can help relieve breath, remove or reduce shortness of breath.

In the treatment of COPDs use:

• broncholitics preparations causing the expansion of bronchi, mainly due to the relaxation of the smooth muscles of their walls (Fenoterol, Atrovant, Salbutamol),
• multic drugs lead to a slurry of mucus and facilitate its evacuation of bronchi (bromgexin, ambroxol)
• antibiotics are a necessary component of drug therapy when aggravating the disease (penicillins, cephalosporins)
• inhibitors of pro-inflammatory mediators or receptors to them that brake the activation of substances responsible for inflammatory process (Erispal).
• glucocorticosteroids (prednisone), hormonal preparations are used in exacerbation of the disease, to relieve the attack of pronounced respiratory failure.

Most bronchoditics are prescribed in the form of inhalation, which allows the medicine directly into the lungs. It is very important to use the inhaler strictly on the prescriptions of the attending physician.

There is a program of rehabilitation for diseases of the lungs, which helps learn how to control the attacks. Specialists in this program advise and train patients with the technique of proper breathing during the COPD - to ease their breath, show what you can and do exercise, how to eat.

With the progression of the disease, it may be necessary for some patients to pass oxygen courses.

Prevention of infectious diseases of the respiratory tract when COPD.

A special place is occupied by the prevention of infectious diseases of the respiratory tract. People suffering from COPD are more susceptible to pulmonary infections. Such patients showing an annual vaccination against influenza. In addition, the use of a pneumococcal vaccine allows to reduce the frequency of exacerbations of COPD and the development of community-hospital pneumonia, in this regard, vaccination is recommended for patients with senior age groups over 65 years and patients with severe COPD, regardless of age. If still patient Cobl Dreams of pneumonia, then vaccinated patients with pneumonia proceeds much easier.

While at home, some rules should be followed to prevent exacerbations and progression of COPD:

• it is worth avoiding contact with different chemicals that can irritate light (smoke, exhaust gases, polluted air). In addition, the attack can provoke cold or dry air;
• the house is better to use air conditioning or air filter;
• during the working day, you need to take breaks for rest;
• regularly engage in physical exercises to stay in good physical form for so long as possible;
• well feed in order not to test the deficit in nutrients. If weight loss is still happening, then you need to consult a doctor or a nutritionist who will help in choosing a diet to replenish the daily energy costs of the body.

What else should be known?

With an increase in the severity of Cobl attacks of suffocation become more and harder, while the symptoms are rapidly growing and remain longer. It is important to know what to do when the attacks of suffocation. The attending physician will help you choose medications that will help with such attacks. But in cases of a very heavy attack, a challenge of emergency medical care may be required. Optimal is hospitalization into a specialized pulmonary compartment, however, if it is absent or completed the patient, it can be hospitalized in the therapeutic hospital to stop aggravation and prevent complications of the disease.

In such patients with time, depression and anxiety often appears due to the awareness of the disease, which becomes worse. Dyspnea and the difficulty of breathing also contribute to the feeling of anxiety. In such cases, it is necessary to talk to the attending physician about what types of treatment can be chosen to facilitate problems with breathing during attacks of shortness of breath.

Forecast at COPD

The disease has a steadily progressive course leading to disability. The forecast for recovery is unfavorable. The estimate of the forecast is characterized by the following parameters: the possibility of eliminating provoking factors, the commitment of the patient to treatment, socio-economic conditions.

Adverse prognostic signs: severe concomitant diseases, cardiac and respiratory failure, elderly age patients.