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Abstract: Interstitial pneumonia is a group of diffuse lung diseases with complex etiology. This case is a 73-year-old patient who was treated with our hospital due to chest tightness and shortness of breath with cough and sputum for more than 1 month, and the effect of anti-infection treatment in external hospitals was not good. After perfecting CT examination, it was confirmed that he had interstitial lung disease – interstitial pneumonia, and after giving the patient medication, the patient’s symptoms were significantly relieved and his condition gradually recovered.
Basic information】Male, 73 years old
Disease Type】Interstitial pneumonia
Hospital】The First Affiliated Hospital of Anhui Medical University
Date of consultation】May 2022
Treatment plan】Medication (moxifloxacin hydrochloride sodium chloride injection, human albumin, doxorubicin injection, glucose sodium chloride injection, methylprednisolone tablets, pirfenidone tablets)
Treatment Period】11 days of hospitalization
Treatment effect] The patient’s symptoms were significantly relieved and the condition gradually recovered
I. Initial consultation
The patient was a 73-male patient, accompanied by his family, who had suffered from a malignant tumor of the colon. The patient reported that he had chest tightness and shortness of breath with no obvious cause more than 1 month ago, which worsened after activity, accompanied by paroxysmal cough and occasional white mucus-like sputum, and was seen at a local hospital.
The patient was admitted to our hospital with interstitial lung disease – interstitial pneumonia, which was suggested by the combination of the patient’s symptoms, signs and CT examination.
II. Treatment history
After the patient was admitted to the hospital, pulmonary function tests were actively improved. Combining the patient’s clinical symptoms, physical signs, outpatient chest CT and pulmonary function tests, the diagnosis of interstitial lung disease was clear (figure below). The patient was given moxifloxacin hydrochloride sodium chloride injection as anti-infection treatment and methylprednisolone tablets combined with pirfenidone tablets as oral treatment because of the patient’s cough and sputum symptoms. Due to the personal history of colonic malignancy, the general condition of the patient was poor, and the biochemical examination indicated hypoproteinemia. To enhance nutritional support, human albumin was infused, and doxorubicin injection was given to calm asthma, and glucose sodium chloride injection was given to actively maintain water-electrolyte balance and supportive treatment.
III. Treatment effect
The patient’s cough and sputum improved significantly after anti-infection treatment, and the patient’s chest tightness and shortness of breath were relieved after 7 days of treatment; after 11 days of continued treatment, the patient’s cough, sputum and chest tightness and shortness of breath were significantly relieved, and no other uncomfortable symptoms occurred, and the patient’s respiration and heart rate were basically stable, and no fever occurred, so the patient was discharged.
IV. Notes
We are glad that the patient’s condition has improved, but we still need to advise the patient to follow regular and stable daily habits, stay away from allergens, quit smoking, maintain sufficient sleep and an optimistic attitude. The following pulmonary rehabilitation exercises are recommended for patients in the stable phase of the disease.
1, abdominal breathing: hands are placed on the front chest and upper abdomen, shut up and inhale deeply through the nose and then slowly exhale the gas by the mouth.
2, lip reduction breathing: sitting position with the nose after deep inhalation will be closed lips for whistling, slowly exhale gas from the mouth, inhalation and exhalation time of 1 to 2.
3, against resistance breathing training: deep inhalation after holding the balloon with the mouth, blowing the air in the lungs into the balloon.
V. Personal insight
Patients with interstitial lung disease, especially interstitial pneumonia, lack specificity of clinical symptoms, early symptoms are absent or inconspicuous, such as this patient, may only be accompanied by cough, cough, chest tightness, shortness of breath and other symptoms, but with the progression of the disease, progressive decline in lung function, exercise tolerance is reduced, if not treated in a timely manner, the phenomenon of respiratory failure may occur, and in severe cases, rapid deterioration of respiratory function, mortality is extremely high, and The prognosis is poor. In recent years, the incidence of idiopathic interstitial lung disease in particular has increased, and symptoms of chest tightness, shortness of breath, cough and sputum that appear without obvious causes should be given sufficient attention, and a clear diagnosis at an early stage of the disease and active and effective treatment measures can prolong the survival of patients.