In the workplace, many patients must rest in bed due to cerebral infarction, cerebral hemorrhage, head trauma, spinal trauma, and other reasons. Patients who stay in bed for a long time will have many complications, such as pneumonia, bedsores, urinary tract infections, lower limb venous thrombosis, etc. Today, we will popularize knowledge about pneumoconiosis, so that everyone can understand and prevent it early, and avoid tragedies caused by untimely treatment.
What is pneumoconiosis? Convolute pneumonia is a common complication in elderly bedridden patients, caused by long-term bed rest due to cerebrovascular disease, spinal fractures, spinal cord injuries, head trauma, and other reasons. The respiratory secretion clearance function is weakened, and it cannot be coughed up smoothly, resulting in pulmonary infection that accumulates in the lungs.
Causes of the disease
Patients often have other underlying diseases, poor immune system, and long-term bed rest. Due to age, position, consciousness disorders, weak sputum production, poor nutritional status, etc., respiratory secretions cannot be discharged in a timely manner. When lying flat, they accumulate under both lungs and become a good culture medium for bacteria, inducing and aggravating lung inflammation. Some patients suffer from spinal cord injury and respiratory muscle paralysis, leading to respiratory weakness, atelectasis, pulmonary edema, pleural effusion, and accumulation of secretions at the bottom of the lungs. Common causes include aspiration of oral and nasal secretions, reflux of gastric contents from the digestive tract, etc. Due to weak sputum production and difficulty in excretion, it can also lead to pneumonia.
Clinical manifestations: Fever, cough, and sputum are the main clinical manifestations. Usually, sputum is thick and difficult to cough up, which can easily lead to coughing or aspiration. It is often accompanied by symptoms such as increased heart rate, restlessness, shortness of breath, loss of appetite, chills, drowsiness, blurred consciousness, and delayed response. In severe cases, pleural effusion, respiratory failure, septic shock, and even multiple organ failure may occur. Significant wet rales can be heard during lung auscultation, and respiratory sounds are weakened. Chest percussion shows solid sounds.
Usually, the total number of white blood cells in the blood test indicators is normal or high, and most neutrophils are significantly elevated, with left shift of the nucleus. The erythrocyte sedimentation rate and C-reactive protein were significantly elevated. Sputum culture is usually positive for Gram negative bacteria, which can detect pathogenic bacteria early and facilitate targeted use of antibiotics in treatment. Chest X-ray examination revealed irregular patchy high-density shadows in one or both lower lungs, with blurred edges. Chest CT can more intuitively observe the area and degree of pulmonary inflammatory lesions, as well as pleural effusion, atelectasis, pleural reactions, and other conditions. It has high clinical guidance value for treatment and prognosis evaluation. Based on the patient's medical history, blood tests, and imaging data, it is usually not difficult to make a diagnosis.
What are the treatments for the occurrence of pneumoconiosis? Firstly, treat the underlying disease, and then use antibiotics that are sensitive to pathogens for a long time based on the condition of lung inflammation. We also need to strengthen patient care, such as changing bed rest positions from time to time, assisting with back patting and sputum coughing exercises, nebulizing medication, and other ways to improve lung inflammation. Commonly used anti-inflammatory drugs in clinical practice include cefuroxime capsules and amoxicillin capsules; Phlegm resolving drugs include acetylcysteine, ambroxol tablets, etc; Cough suppressants include compound licorice tablets, compound methoxypheniramine capsules, etc. Most cases can improve lung inflammation and significantly alleviate symptoms through medication treatment, with only a few patients requiring surgical treatment due to complications such as pleural effusion and atelectasis.
Nursing and preventive measures
1. Actively treat underlying diseases, improve the patient's physical condition, engage in early rehabilitation exercises, restore independent activities, and reduce bed rest time.
2. Strengthen oral care, remove food residues, reduce bacterial growth, and prevent oral bacteria from migrating to the respiratory tract.
3. Moderate lung function exercises, such as blowing balloons and increasing lung capacity.
4. Regularly changing positions, turning over and patting the back, or using expectorants can reduce the deposition of secretions and facilitate the discharge of phlegm. But when patting the back, apply even force and pat the back with an empty palm, from bottom to top, preferably in a semi recumbent or sitting position.
5. According to the needs of the condition, a combination of suction, nebulization, oxygen inhalation, etc. can significantly alleviate respiratory muscle fatigue.
6. Raise the head of the bed about 45 ° while eating, and swallow slowly to effectively prevent aspiration.
7. Long term bed rest can lead to weakened immune and digestive functions. Therefore, it is important to strengthen nutritional support and consume more vegetables and fruits that are rich in dietary fiber and vitamins. Adjust the diet structure, timely supplement meat and egg foods, and maintain a reasonable combination of nutrients.
8. The living environment should open windows frequently for ventilation, or use ultraviolet light air to disinfection and sterilization, and change clothes and bedding regularly.
9. Regularly monitor vital signs, blood routine, erythrocyte sedimentation rate, C-reactive protein, X-rays, CT scans, etc.
Falling pneumonia is different from ordinary pneumonia. In the treatment process, in addition to medication, respiratory care is also particularly important. Most long-term bedridden patients, after early and timely medication treatment, often turn over and pat their backs to maintain airway patency, can generally achieve good recovery results, thereby improving the quality of life of patients.