Forced lateral position

Introduction Forced lateral position: pleural inflammatory disease patients are more unilateral to the affected side, mainly to relieve chest pain, a large number of pleural effusion patients with multiple sided to the affected side is mainly to reduce breathing difficulties. Pleuritis refers to pleural inflammation caused by pathogenic factors (usually viruses or bacteria) that stimulate the pleura, also known as "pleural inflammation." The thoracic cavity can be accompanied by fluid accumulation (exudative pleurisy) or no fluid accumulation (dry pleurisy). After inflammation is controlled, the pleura can return to normal, or two layers of pleural adhesions can occur. The main clinical manifestations are chest pain, cough, chest tightness, shortness of breath, and even difficulty breathing.

Cause

Seen in one side of pleurisy or a large number of pleural effusions.

an examination

Related inspection

Thoracic fluoroscopy chest CT examination bacteriological examination

Patients with pleural disease tend to lie on the affected side to relieve pain or cough, and help the side to compensate for breathing.

an examination:

(A) routine examination: blood routine, erythrocyte sedimentation rate, liver function, blood sugar, hepatitis B five TB-AB.

(B) bacteriology: sputum smear, pleural effusion, culture or pleural TB-DNA check tuberculosis.

(C) pleural effusion: conventional, biochemical, pleural effusion and blood LDH and protein ratio, ADA.

(4) X-ray, chest lateral radiograph, high KV, fault or CT examination if necessary.

(5) Ultrasound examination: chest A ultrasound or B-ultrasound examination, can measure the amount of liquid and positioning.

(6) Tuberculin test.

(7) Pulmonary function tests.

(8) Those with negative pleural biopsy and bacteriological examination.

(9) Thoracoscopic examination: used for the above examination can not be diagnosed.

Differential diagnosis

Differential diagnosis of forced lateral position:

(1) Compulsive lying on the back: The patient is supine, and the legs are flexed to relieve the tension of the abdominal muscles, which is seen in acute peritonitis.

(2) Compulsive lying on the face: The prone position can relax the back muscles and be seen in spinal diseases.

(3) Forced sitting position (sitting breathing, orthopenea): sitting position, hands on the knee or supporting the bed, so that the diaphragmatic muscles decrease, the lung volume and the lower limbs return to the heart, the blood volume is reduced, the burden of the heart is reduced, and the heart and lung dysfunction are seen. .

(4) Compulsive squatting: In short-distance walking or other activities, due to dyspnea and palpitations, the distance between the body position and the knee position is relieved. It is seen in cyanotic congenital heart disease.

(5) Forced standing position: Suddenly standing in the precordial area during walking and being forced to stand immediately, and pressing the right front area with the right hand, seen in angina.

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