Pneumonia chronic

Pneumonia is chronic (see the chapter "Diseases of the respiratory system"). For chronic inflammatory processes, formed in children on the basis of congenital malformation of the bronchopulmonary system (agenesis, aplasia, hypoplasia, polycystic lung, tracheal bronchus, bronchomethalia, etc.), systemic (collagenosis, etc.) and hereditary diseases (immunodeficiency states - agammaglobulinemia and Dysgamaglobulinemia, diffuse pulmonary fibrosis, alpha1 antitrypsin deficiency, etc.), the term "secondary chronic pneumonia" is proposed.

The clinical picture is different polymorphism. In children of early and preschool age, exacerbations occur more severely and are repeated more often. In children of school age with exacerbations, the temperature can remain normal. The degree of respiratory failure depends on the prevalence of the process. In some children, deformity of the chest and delay in physical development are noted.

The diagnosis is established on the basis of the history of the disease (repeated SARS and pneumonia), the presence of foci of chronic infection, clinical symptoms and data of X-ray examination (cellular pattern, bronchiectasis, pneumosclerosis), tracheobronchoscopy, bronchography.

Differential diagnosis is performed in the presence of obstructive syndrome with bronchial asthma, chronic bronchitis, tuberculosis, cystic fibrosis, hemosiderosis.

Treatment. A system of step-by-step, successive treatment of patients in a hospital, a specialized sanatorium, and a polyclinic was widely used. During the exacerbation of the treatment is carried out in the hospital. Apply antibiotics penicillin series. If they are ineffective appoint a chain of / m-40-60 mg / (kg-day) for 2-3 admission; Kanamycin, gentamicin (a combination of antibiotics is justified only in severe forms of the disease). The duration of treatment with antibiotics is 10-14 days. Assign nystatin, antihistamines, vitamins. To improve bronchial patency, the drainage function of bronchial inhalation with solutions of sodium hydrogencarbonate, proteolytic enzymes (trypsin, chymopsin), acetylcysteine, diluting sputum; Expectorants inside; "Drainage position", medical bronchoscopy (toilet bronchial tubes, endobronchial administration of antibiotics, enzymes, antiseptic agents, etc.). With pulmonary heart failure - strophanthin, korglikon, moistened oxygen. With indications, the introduction of gamma globulin. LFK and physiotherapy are necessary; UHF (with catarrhal symptoms in the lungs), inductothelium, ozocerite application (with localized forms), high frequency electromagnetic field (microwave therapy), electrophoresis of various medicinal substances (2-5% solutions of calcium chloride, 5% solution of copper sulfate, etc.) ). It is obligatory to sanitize secondary foci of infection.

For aftercare after stay in the hospital, it is desirable to go to a local specialized sanatorium. In the conditions of the polyclinic, preventive therapy (prophylaxis of exacerbation) is administered, which is combined with the stay of children in sanatoriums and resorts, in pioneer camps of a sanatorium type. In the absence of effect from the measures applied - consultation of the surgeon-pulmonologist about the surgical treatment. The most favorable results are observed with localized forms of chronic pneumonia.

The prognosis depends on the correctness of treatment, the presence of complications. With limited forms it is favorable, with common forms - the pathological process often progresses.

Prevention is the timely treatment of acute and protracted pneumonia, foci of chronic infection.