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Card 19
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Lung Abscess
Lung abscess may develop because of various factors. In cases where an abscess develops as a complication of pneumonia the patient's general condi­tion gradually becomes worse. Sometimes the first clinical manifestations of a chill, pain in the affected side, fever elevating to 39-40^cC, and loss of appetite are present. There is a profuse perspiration at night, dry cough, and a consider­able increase of the white blood cell count up to 20, 000 per cu mm of blood and accelerated ESR. Both fever and the increase in the number of leucocytes de­pend on the presence of pus in the cavity. When pus is evacuated from thethoracic cavity the temperature decreases and the white blood cell count returns to normal. The repeated increase of white blood cells may be observed when pus is again accumulated in the cavity.
The course of the lung abscess may be divided into two periods: that before and that after the rupture of the abscess into a bronchus. The length of the first period varies in different cases. The second period begins from the moment of the abscess rupture into a bronchus usually with 0.5 litre or more of sputum discharge.
After the rupture of sputum into a bronchus, the body temperature returns to normal, and the patient's general condition becomes better. The spu­tum discharge gradually reduces in its amount. The appetite increases, the white blood cell count and ESR return to normal. Within 4-5 weeks of effective treat­ment complete recovery is usually observed in most cases of lung abscess.

O'pka xo'ppozi

O'pka xo'ppozi turli omillar tufayli rivojlanishi mumkin. Pnevmoniyaning asoratlari bilan xo'ppoz paydo bo'lgan hollarda bemorning umumiy ahvoli asta-sekin yomonlashadi. Ba'zida sovuqning birinchi klinik ko'rinishlari, zararlangan tomonda og'riq, isitma 39-40CS ga ko'tarilishi va ishtahani yo'qotishi mavjud. Kechasi ko'p terlash, quruq yo'tal va oq qon hujayralari sonining bir kub mm qoniga 20 000 000 gacha ko'payishi va ESR tezlashadi. Ham isitma, ham leykotsitlar sonining ko'payishi bo'shliqda yiring borligiga bog'liq. Ko'krak qafasi bo'shlig'idan yiring chiqarilganda harorat pasayadi va oq qon hujayralari normal holatga keladi. Bo'shliqda yana yiring to'planganda oq qon hujayralarining takroriy ko'payishi kuzatilishi mumkin.

O'pka xo'ppozini ikki davrga bo'lish mumkin: xo'ppoz bronxga yorilishidan oldin va keyin. Birinchi davrning davomiyligi turli holatlarda o'zgarib turadi. Ikkinchi davr xo'ppoz bronxga yorilgan paytdan boshlab odatda 0,5 yoki undan ko'p balg'am ajralishi bilan boshlanadi.

Balg'am bronxga yorilganidan keyin tana harorati normallashadi va bemorning umumiy ahvoli yaxshilanadi. Balg'am chiqishi uning miqdorini asta-sekin kamaytiradi. Ishtaha kuchayadi, oq qon hujayralari soni va ESR normal holatga keladi. 4-5 hafta davomida samarali davolanish odatda o'pka xo'ppozining ko'p holatlarida to'liq tiklanish kuzatiladi.