Left diaphragmatic adhesion

Left diaphragmatic adhesion is a relatively common symptom and one of the most important symptoms of pleurisy. Pleurisy is a relatively serious disease. When it occurs, it will cause great pain to the patient. Therefore, when it occurs, it must be treated in time to avoid delaying the best period for treatment. Below, I will introduce the treatment methods of pleurisy in detail.

1. General treatment

Exudative pleurisy is often accompanied by fever, and the patient should lie down to rest, lying on the affected side so that the healthy lung can fully play its compensatory role. Strengthen nutrition, increase appetite, and provide high-protein, high-calorie, multivitamin and easily digestible diet. For patients with high fever, physical cooling should be used and antipyretics should be given when necessary

2. Antibiotics

Anti-tuberculosis drug therapy is suitable for the treatment of tuberculous (dry or exudative) pleurisy. The principle of anti-tuberculosis treatment is early treatment, sufficient medication and long-term use. Isoniazid, rifampicin, ethambutol, and streptomycin are used alternately, with a total course of treatment of 6 to 9 months. Tuberculous pleurisy is often treated with a combination of streptomycin and isoniazid. During the use of streptomycin, the patient should be observed for toxic reactions such as numbness of the lips, tinnitus, and deafness. If these reactions occur, the drug should be discontinued immediately. The hearing impairment caused by streptomycin is permanent, so we must be vigilant and be more cautious when using the drug on children.

Isoniazid has a strong bactericidal effect and can penetrate tissues and cross the blood-brain barrier. It can be dripped into the trachea or administered into the chest cavity. Long-term use of isoniazid should monitor liver damage, conduct regular liver function tests, and promptly add liver-protecting drugs. If central nervous system reactions such as dizziness, insomnia or convulsions occur, vitamin B6 can be added for symptomatic treatment. Non-tuberculous pleurisy should be treated with appropriate drugs based on the primary disease (such as infection, tumor, etc.). Patients with purulent pleurisy or tuberculous empyema with infection are treated with penicillin.

3. Relieve Pain

Take aspirin, indomethacin, or codeine by mouth.

4. Thoracentesis

It is suitable for patients with exudative pleurisy, large pleural effusion, mediastinal or cardiac compression, obvious dyspnea or effusion that is not absorbed after long-term treatment. Drain exudate to relieve symptoms and avoid fibrin deposition that may cause pleural adhesion and thickening. The speed of fluid extraction should not be too fast. 400-600 ml of fluid can be extracted for the first time, and it can be gradually increased later. The amount of fluid extracted each time should not exceed 1000 ml to avoid circulatory disorders or shock due to a sudden decrease in chest pressure and mediastinal shift. 2 to 3 times a week.

5. Hormone therapy

The combination of adrenal cortical hormones and anti-tuberculosis drugs is suitable for acute tuberculous exudative pleurisy. It has a positive therapeutic effect on eliminating systemic toxic symptoms, promoting effusion absorption, and preventing pleural thickening and adhesion. Hormones can be taken systemically or topically. You can take prednisone orally. When systemic symptoms improve and the effusion is significantly absorbed, you should gradually reduce the dosage of hormones to avoid rebound phenomenon. Take the medicine for 4 to 6 weeks.