With a disease like a valvepneumothorax, oxygen enters the pleural region, the amount of which begins to increase gradually. The manifestation of such a pathology is associated with a particular functioning of the valve. Its work is disrupted due to the penetration of air from the lungs into the pleura and the impossibility of its reverse movement. Because of this, severe pain occurs in the chest area, because there is a significant decrease in lung volume and the inhalation process becomes difficult.
This pathological condition is already known very much.long, and associated its occurrence with the effects of pulmonary tuberculosis. But relatively recently, it was found that the disease appears suddenly. Often this pathology is diagnosed if breathing problems are associated with a ruptured bulla.
Пневмоторакс клапанный бывает внутренний и external and it depends on the mechanism of education. The internal appearance of pneumothorax occurs due to damage to the large bronchus and the presence of a patchwork wound of the lung. The pleural cavity is filled with air through a defect in the visceral pleura. At the same time, the flap of the lung tissue acts as a valve, which allows air to pass through while inhaling, while exhaling does not allow gas to return to the lung.
The external appearance of pneumothorax is characterized bythat, in this case, the soft tissues of the injured rib cage play the role of a valve. When you inhale the wound edges begin to expand, the air freely penetrates into the pleural cavity, and when you exhale, the wound hole collapses without releasing it back.
Valvular pneumothorax has various causes. Most often it is about the traumatic and spontaneous nature of the disease.
The cause of the wound (traumatic)pneumothorax is a closed injury of the chest, accompanied by rupture of lung tissue or penetrating wound to the chest. In this case, a sufficiently rapid “gluing” of the wound hole on the chest wall occurs, while the wound of the bronchus continues to gape. Such injuries include:
Spontaneous pneumothorax is characterized by a rupture of a modified portion of the lung tissue. The following diseases contribute to the development of this pathology:
Predisposing factors to the development of spontaneous pneumothorax are coughing, diving, physical stress, etc.
Usually with valvular pneumothorax patientis in critical condition. He becomes agitated, there is a pronounced pain in the chest, extending into the scapula, shoulder, abdominal cavity. Shortness of breath, weakness, cyanosis begins to progress rapidly, loss of consciousness is observed, intercostal spaces widen, the affected side of the chest increases in volume. Rapid shallow breathing, hypotension, tachycardia are also signs of valvular pneumothorax.
The air, quickly accumulating in the pleural cavity,able to cause heart or pulmonary insufficiency, resulting in death. Late pleural empyema and reactive pleurisy are referred to late complications of pathology.
The doctor during the examination of the patient reveals subcutaneousemphysema, lagging during breathing of the affected side of the chest, smooth intercostal spaces. With the help of radiography of the lungs, the lung is found to fall and shift to the healthy side of the mediastinal shadow.
Pleural puncture with manometry allowsto distinguish from each other open, closed and valve pneumothorax. If liquid is present, aspiration and further investigation of the pleural effusion on the cellular composition and microflora is carried out. To identify the location and size of the pleural fistula, diagnostic thoracoscopy and pleuroscopy are performed.
The first treatment of valvular pneumothoraxshould be directed to the decompression of the mediastinum and the lung, and do it as quickly as possible. To do this, perform a discharge puncture or transthoracic drainage of the pleural cavity with the mandatory imposition of passive drainage by Bulau. Only after carrying out such manipulations the patient is transported to the hospital for further treatment.
To stabilize the patient's condition, he is given non-narcotic and narcotic analgesics, cardiovascular drugs, antibiotics, antitussives.
It is very important to translate the valve pneumothorax intoclosed. To do this, you must constantly drain the pleural cavity. If the air ceases to flow through the drainage, this indicates the sealing of the cavity. Drainage is removed after two days after complete expansion of the lung, if it is confirmed radiographically.
If the lung is not able to straighten, then spendsurgical treatment of pneumothorax. Damage to the chest requires wound closure and thoracotomy. If there is a threat of re-formation of spontaneous valvular pneumothorax, then surgical treatment of the underlying disease is used. Depending on the pathology, segmentectomy, bilobectomy, marginal resection of the lung, lobectomy, pleurectomy, pleurodesis and other interventions are performed.
There are such situations that the patient may need urgent help with valvular pneumothorax. To save his life, it is necessary:
First aid is to puncture the chest wall with a thick needle. Thanks to this, it is possible to quickly reduce the high pressure inside the pleura.
A complication of valvular pneumothorax is shock lung syndrome, pyopneumothorax, cardiopulmonary insufficiency. Medical assistance in time helps to achieve recovery.
Disease prevention is aimed at injury prevention. In addition, during a routine examination, a pulmonologist, a TB specialist, and a thoracic surgeon identify patients with pulmonary pathology.
Thus, valvular pneumothorax is considereda very dangerous disease in which untimely assistance is fatal. Therefore, a patient with such a pathology must necessarily consult a doctor, and as soon as possible.
