Exposure to asbestos is not only provokes the formation of plaques in the parietal pleura, but can lead to the development of diffuse Foot pleural fibrosis. Although some authors consider diffuse fibrosis of the pleura as one of the manifestations of asbestosis of the parenchyma , this pathology has a significant difference . Diffuse fibrosis of the pleura, as opposed to plaques, also affects the costal-diaphragmatic sinuses. In the pathological process involves the visceral pleura, which contributes to the fusion of the pleura . As a result, the patient is a significant reduction in pulmonary function tion, which in connection with hypercapnia may lead to respiratory tion failure . The frequency of diffuse fibro for pleural much less than pleural plaques. Hillerdal conducted a survey of workers in the asbestos industry. On examination at the 827 workers were found pleural plaques, and diffuse pleural thickening progressing to lofound only in 27 cases.
Patients exposed to asbestos, diffuse fib roses pleura often develops after a benign Pleven eral effusion . Epier and colleagues conducted an adherence to 1135 people working in the asbestos industry STI, in 44 of them were found to diffuse thickening of Pleven ry, greater than 5 mm, almost 50% of patients with diffuse thickening of the pleural effusion had previously . Of 35 workers with pleural effusion, residual diffuse pleural thickening
The front roll stands straight thoracic radiograph ki visible diffuse pleural thickening and smoothing of edge-left diaphragmatic B cone; a patient in the past had contact with asbestos.
noted in 54% of cases. Hillerdal documented for recorded that 4 of 27 patients with advanced thickened scheniem pleural disease began with the formation of dobroka tive pleural effusion. Diffuse thickening of Pleven ry, caused by contact with asbestos are almost always Prevalence nyaetsya on edge-diaphragmatic sinuses and is bilateral him, although initially thickening could be one-sided. Thickening begins at the base of the lung and may progression Rowanat different speeds. The thickening of the apices of the pleura can also be significant. . Although conventional radiograph in most cases difficult to identify pleural calcification, it can be detected by computer tomography . Many patients with diffuse fibro Zoom pleura CT does not detect intrapulmonary fibrosis .
In patients with diffuse thickening of the pleura, there is a significant decrease in VC . Repeated studies of pulmonary function showed that with this pathology, the VC decreases faster than it usually happens with age . In patients with diffuse thickening of the pleura, an increase in the elastic tension of the lungs occurs; It is believed that the decrease in VC is caused by fibrosis of the pleura, which prevents the smoothing of the lung . Diffusing capacity for a given PA scientists are reduced, but if it ‘corrected according to the amount of light, in most cases it will be above normal .
Optimal methods for the management of patients with progressive fibrosis of the pleura caused by asbestos exposure, not from is known. Wright and soavt.vyskazali assumption that’ve royatno, patients with this pathology shows decortication ^ because they have increased the elastic thrust of the lung, and the diffusion onnaya ability, if it is ‘ corrected in accordance with the volume of the lung, is within normal limits . Hillerdal made decortication 4 patients with progressive fibrosis of the pleura, and only one of them mentioned sub projective improvement . He explained the lack of improvement by the presence of concomitant fibrosis of the parenchyma.