Persistent bronchial asthma of moderate severity is characterized. Important bronchial asthma

Bronchial asthma is classified as type, form, phase for several signs (causes, control, stage of manifestation of bronchial obstruction). Aleksei one of the most important classifications, which make it possible for people to become ill, є classifications beyond the degree of gravity. For example, see the chotiri form bronchial asthma, Naybіlsh is not safe for you є the importance is persistent.

Classification of illness beyond the degree of gravity

The stage of severity of overcoming bronchial asthma begins by:

• Lots of attacks on the day at night;
• Number of attacks on the day in the afternoon;
• Frequency and triviality of intake of short-acting beta 2 -agonist preparations;
• Indicators of peak performance of a vidikh, її good news;

A person who is sick is diagnosed:

1. Epizodic bronchial asthma, or mild intermittent asthma;

The qia form of becoming ill is characterized by episodic short sharpening (from decilkoh years to decilkoh days). Attack the scent (bad or coughing) during the day to drink no more than 1 time per day, at night - 2 times per month. Pіkova іsvіdkіst vidikhu become 80% of the proper indicator, for the additional amount it is not more than 20% less.

Period mіzh sharpened bronchial asthma easy form do not show any symptoms, the legacies of people function normally.

It’s a pity, I don’t want to see the ailment in this form. First of all, there are not many people pouring into the life of the people, it is just that you can ignore the symptoms and not go to waste. In another way, the signs of asthma episodic interruption are similar to the signs of other ailments of organs of the environment, for example, chronic bronchitis... Thirdly, asthma is most often epizodic, so in this case, the same role is played by allergic and infectious-fallow officials. Ailments can be diagnosed in older adults when they come into contact with allergens, in children - during the first hour of infectious ailments of the lower dikhalnyh nobles.

To confirm the diagnosis of a sick person, you should:

• Vizmut at new back-to-back analyzes blood and slaughter;
• Crumble shkirni allergoprobi;
• Conduct a radiological examination of the organs of the breast;
• Finish the function of the outgoing action with a beta2-agonist.

Adequately lіkuvannya, rasspochat todі, if the ailment has not typed in wraps, in addition to streaming її and seeking a stіykoі remіsis. It includes the reception of beta 2 -agonism of a short episode and theophilin of a short episode with the help of coping with episodic attacks, for physical options, We can contact with allergens). People with asthma of a mild intermittent leak also need to take the regime established for asthmatic ailments. Likuvannya protizapalnyh drugs їm, as a rule, not required.

2. Persistent bronchial asthma. Have your own heart, post-asthma can be mild, moderate and important form.

As the disease progresses in a light persistent form, the appearance of a sick person becomes 80% as good, and it can be increased by 20-30%. Attack a cough, bad mouths, poisons trap at a new one a day, 1 time per day, up to 1 time per day. Attack at night is repeated more than 2 times per month. Symptoms of ailments for an hour are recognized on the quality of the life of a sick person, through them the suffering of his day can be active or a night's sleep.

A person who is sick with asthma of an easy persistent form needs to be treated. For the prevention of attacks, it is necessary to use the corticosteroids, cromoglycate sodium, nedocromil, and also theophilin. Some corticosteroids are prescribed in a dose of 200-500 mcg for dobu, when bronchial asthma is progressing, and dots of corticosteroids are up to 750-800 mcg for dobu. Before going to bed, it is recommended to take a prolonged bronchodilator, for example, Clenbuterol, Salmeterol or Formoterol.

Persistent bronchial asthma, moderately severe, is characterized by frequent manifestation of symptoms, such as sutta disruption of the day's activity of the sick person and their nighttime sleep. At night, attack coughs, breaths, sniffs, trap once a day and often. The indicator of peak performance is observed between 60% and 80% of good quality.

Even though people are diagnosed with a form of asthma, they need to take beta 2 agonists and anti-inflammatory drugs, only to control the ailment. Recommendations for beclomethasone dipropionate or analogue corticosteroid in a dose of 800-2000 mcg. Dodatkovo to the new necessary reception of bronchodilators of trivial diy, and, especially, as the attack is often trawled at night. Zazvychay, zastosovayutsya theophilin, for example, Teofil.

How can I get severe bronchial asthma?

Persistent asthma of severe interruption often changes. Parts of the fire, which are repeated every day and practically attack, provoke asthma triggers of an allergic and infectious nature. Pіkova іsvidkіst vidikhu in a sick person become less than 60% of the nasty, numbered by 30% or more. Through a heavy camp of wines, I will encircle vlasna physical activity.

Persistent bronchial asthma of severe interruptions to be controlled with a little or no control. To assess the severity of a sick person, a fluometry is required.

The treatment of ailments form is carried out with the help of minimizing the manifestation of symptoms.

High doses of corticosteroids are shown to those who are sick today (even persistent asthma of severe interruption is sometimes called steroid). Accept it through an inhaler or a spacer.

Spacer є a flask (reservoir), vikoristovuvanu dodatkovo to an aerosol inhaler to make the efficiency more efficient. Vikoristovuchi a small intestine with spacers, ailments can be caused by an important attack of poison, I can help you. Youmu will not need the coordinates of the inward and the onslaught. Children are more beautiful than a spacer with a mask.

Lyudin, who has diagnosed persistent severe bronchial asthma, it is recommended:

Obviously, ailments with an important stage of post-asthma disturbances take a great number of drugs that control symptoms. It’s a pity that the effective stench isn’t hungry, but the axis of the side effects is often spared. The important thing about asthma is that it is important to be in the hospital, so medication therapy is taken on an ad hoc basis. Whether self-reliance is turned on in likuvanni, so it is fraught with perfection I will become even to a lethal result.

In addition, as the sickness is over, and there is a result, the sick person will have a change in the sickness class, as they are suspected of treating the symptoms. If there is a diagnosis of persistent asthma of severe interruption on a medium-heavy stretch, it will only be possible, if the ailment is more likely to be eliminated drug therapy, It is typical for the given degree of severity.

Video: Bronchial asthma in children and older adults. Who is in the Riziku group?

- not infectious disease of the upper dichnyh nobles, which has a lack of chronicity and how to appear at the sight of the attacks of the poison They develop through bronchial spasm. The process of pathology is guilty of transferring the principle of complexity and frequency and to lay down the frequency, so that attacks develop.

For vikoristovuyutsya lykarski zasobi, as it is possible to intelligently add to two groups: preparations inconvenient help for the suppression of bronchial spasms, і allow control over the overloading and the frequency of festering.

For the nobility I will attack

Bronchodilator therapy in case of symptoms symptomatic and does not infuse on the overloading of the disease and the number of hypersensitivity, more effectively we know the symptoms of breath.

The frequency of bronchodilator infection is incurred 2-3 times for up to 1 time for a few cases (for demand) in the presence of severe pathology and є an indicator of the effectiveness of the basic treatment... For performance, the need for an effect to be stuck in the form of ingestion.

DOVIDKA! When you vibrate, you can get sick of the grown-ups, varto vrahovuvati, who do the drugs may be powerful, if you want to do it in the middle of the hour.

To suppress bronchospasm vikoristovuyut offensive groups of lykarsky vasob_v:

• Beta-2-agony of short and prolonged production... Therapeutic effect with a group of communication groups diyuchy speech with beta-2-adrenergic receptors, rostasovaniye in the walls of the bronchial tree, as a result of the infusion of weakening of smooth muscle fibers, expanding the enlightenment of bronchial tubes and increasing the condition. Likewise a little bit of life for the life of the legends.
• theophilin... To stop an asthmatic attack, theophilin shvidkoy deiya will be stagnant. For the rakhunok, the link with the adenosine receptors is reached to the weakening of the smooth muscle fibers of the stinok internal organs Including bronchial tubes, an increase in the tone of the dyshal muscles and an expansion of blood-bearing vices in the legends, which increased instead of sourness in the blood. Teofilin also detects active patients from stovbrovykh clitin, which has become more obstructed and spasm of bronchial tubes.
• Anticholinergics. The principle of a series of stimuli for the connection of active speech to the drug with m-cholinergic receptors, blockade and reduction of the passage of nerve impulses, for the reason why the tone of the muscle component of the bronchial vasculature decreases. Anticholinergics can also positively infuse mucociliary cleansing, which lays down on sputum release to stop the spasm.

salbutamol

Introduced to selective agonists of beta-2-adrenergic receptors and infusion on the smooth ovarian component of the bronchial system, not binding to receptors rosted in the myocardium.

Vypuskayutsya in the English form and і efficiently to suppress the spasm of the hospitable, the therapeutic type of spasm is developed after 3-5 hilines.

The triviality of salbutamol to become 4-6 years old (short-life bronchodilator).

Vikoristovuatsya for the nobility will attack poisons, as well as for the loss of its development, before contact with the allergen or advise the physical benefits.

IMPORTANT! Prototype indications in early childish(Up to 2 rockets) and in case of obvious allergic reactions to any component, go to the warehouse. It is intended to be protected by persons who suffer from decompensation of hearts, pechinkovy or nirkova lack, Heart defects, pheochromocytoma and thyrotoxicosis.

Dovidka! During the period of lactation, the victorious hour of vaginosity is allowed in the same way as the cinnamon for the mother's body is replacing the potent risik for the child.

How to use the drug in older adults: 2 inhalational doses (200 mcg) up to 4 times a day. For the development of bronchospasm, tied with physical zusillas: 1-2 inhalations for 15-20 quills before being added.

berotek

To be included in the list of drugs, a short-acting beta-2-agonist, which is issued by a German pharmaceutical company. The effect is spontaneous after 2-3 minutes of inhalation and take up to 6 years. Get victorious for symptomatic treatment bronchial asthma and increased development of asthma associated with advanced physical zusillias.

Important! When the therapeutic dose is changed, more than 4 times for additional infusion into the myocardium, the frequency of the heart is very fast.

In one ingalatization dose, 100 mcg of the pure component of fenoterol is replaced. For the suppression of bronchospasm, 1 dose is stagnant, with an overall development of the effect after 5 hours, it is possible to repeat the injection.

IMPORTANT! Prototype indications for cardiomyopathy, illness, heart rhythm, Decompensated diabetes mellitus, occlusive glaucoma, threatening abortion, persistent vaginosis.

atrovent

Іmportne zіb, scho є blocker m-cholinoreceptors. Usuvaє the cause of the asphyxiation and reducing the secretion of the mucous membranes of the bronchi.

Remembrance effect is infused after 10-15 hvili, for victorian and trivial until 6 years.

Important! Atrovent of contraindications for children up to 6 years old, in the first trimester of vaginosity, with the presence of an allergy to a component of lykarsky disease.

The high-grade component is ipratropium bromide, 0.021 mg of spoluca should be added to the inhalational dose. Freeze on 2 іngalyatsії per demand up to 6 times per demand.

Theotard

For the loss of xanthine and for the group to be treated with theophylline, in the form of capsules. Volodya prolonged vivilnenny, to go to prevent bronchospasm at night and in the rank of year.

IMPORTANT! Forfeited the sign of the hour of vaginosity in the period of lactation, in case of epilepsy, myocardial infarction in the state period, vyrazkovyh urazhennya herbal tract and in a child's life up to 3 years.

Oskilki bronchodilator infused step by step, reaching a maximum in 2-3 days from the ear to the ear, Theotard does not vikoristovuyutsya to stop the acute bronchospasm.

Stagnate in the middle of the drink, 1 capsule (200 mg) of the skin is 12 years old.

terbutaline

Lay up a group of beta-adrenergic drugs until the lykarsky zasobіv, let go to the viglyadі aerosol in tablet form. Go yak for nobility bronchospasm in case of a rogue attack cob stage status asthmatic, as well as for the prevention of accidents. The necessary effect is infused after 10 minutes of consumption in viglyad іngalyatsії, through a period of time for oral administration.

For symptoms of odor symptoms, 1 dose should be taken, the inhalation should be repeated after 3-5 minutes. For prophylaxis, a tablet form is used for 1-2 tablets (2.5-5 mg) 3 times for dobu.

IMPORTANT! Prototype indications up to є: the first trimester of vaginosis, epilepsy, decompensation of the heart of wadi, thyrotoxicosis, before the disappearance of the placenta.

For basic therapy

The basic therapy is a complex of medical visits, straight on the back of the forged progression, Zapobigannya yogo transition to a more important form and development is not safe for life accelerated. Prior to the specific type of pharmacotherapy, include:

• control of frequency and triviality of symptoms of breath;
• zapobіgannya development of asthmatic status і mate with him faster;
• pidbir medications, Volodyut by the smallest side effects;

Apparently and the intensity of the baseline treatment should not lie in the middle of the frequency, so that attacks on bronchospasm and severity develop. At that moment, if the episodic bronchial asthma turns into a mild persistent (persistent), and in the absence of pathology, the basis can be stagnant for one or a few hours.

IMPORTANT! Preparations of the basic therapy for the proper control of the frequency and hypertension need to be adopted on a permanent basis.

To control sickness, you must use:

• glucocorticoids zastosovytsya in the main in іnalyatsіonnyh forms in aerosolі. Positive efekt at lіkuvannі asthma obumovleny zbіlshennyam kіlkostі beta-2 adrenoretseptorіv on poverhnі bronhіalnih stіnok, galmuvannі vivіlnennya medіatorіv іz stovburovih klіtin i znizhennya alergіchnogo vospalenіya.Prі zastosuvannі glyukokortikoїdnih gormonіv znizhuєtsya nabryak slizovoї Ilya Obolonkov, znizhuєtsya її secretory zdatnіst scho polegshuє prohodzhennya CHIN in kіntsevі vіddіli bronchial tree. In case of a severe interruption of illness, or the development of asthmatic status, the internal form of the drug should be used in the minimum therapeutic dose.
• Stabilizers of the membranes of the garden cells in case of trivial stagnation, reduce the allergic allegations of the slack dystopian nobles to the frantic officials, provoking an attack of breath, for the galvanizing of the histamines of the allergic mediators.
• Antagonism of leukotrine receptors - new classification of drugs, as additional help to reduce the need for symptomatic therapy, Intermittent spasm of the smooth component of the bronchial wall by blocking specific receptors. It can also cause an anti-firing effect and reduce the reactivity of the mucous membrane, which is easily damaged and ignited when contacting with allergens.

zafirlukast

Introduced to a group of blockers of leukotrinovyh receptors, put into tablet form. Control over ailments is reached for the rakhunok connection of the dialectical speech with specific receptors, in which case the speed of smooth muscles of the bronchial wall can be detected. I also reduce the turn ignition processes and the filling of the mucous membrane, which will reduce the ventilation of the leg.

IMPORTANT! Prototypical indications until the end of the day є: circulating cyrotic processes in the furnace with the development of liver deficiency, a young child. During the period of vaginosti it is victorious to be protected.

How to consume: 20 mg (1 tablet) 2 times for doba. When consumed, the dosage should be increased to a maximum of 80 mg per day.

Flixotide

Є Ingalatory glucocorticosteroid of the import virobnitstva, Volodya is a strong anti-fiery effect, stagnant to reduce the number of attacks.

In case of persistent viciousness, it reduces the turn of the ignition processes, reduces the development of the mucous membrane of the bronchial tree when it comes into contact with provoking factors.

Important! Chi is not recognized in case of a hostile attack of poison and asthmatic status, in an early child's life.

Stagnate for the control of getting sick in case of moderate and important forms of asthma, the therapeutic effect develops in 5-7 days from the ear of the disease.

Methods of consuming: 1-2 ingestions (125-250 mcg) 2 times per dose, while controlling the frequency of diagnosing bronchospasm, it will decrease to the minimum effective.

tiled

Ingalyats_yny stabilizer of membranes of fat cells. More often than not, the disease is given by the drug, then there is a significant decrease in the allergic response to teens, to provoke bronchospasm, for the development of galvanization of ignition mediators. There is a prototypal diyu, a sign of a mucous membrane, a chance to develop at the night and early rankings of the year.

Vikoristovuvana dozuvannya: 2 іngalyatsії from 2 to 4 times for additional fallow because of the severity of illness.

IMPORTANT! Prototype indications prior to the recognition of this likarskiy zasobu є the first trimester of vaginosti and allergic reactions to components that enter the storehouse.

Combination for

Symbicort>

Є combinovan lykarsky zasob (glucocorticoid + beta-2-agonist), Volodya protisapalny and bronchodilator... It is dispensed in the form of a dosed powder for inhalation, for one inhalation attack, 80 / 4.5 μg or 160 / 4.5 μg of daily doses.

Symbicort can be used for the basic therapy of bronchial asthma of the middle and severe interruption, it can be used as a permanent addiction, as well as for the suppression of delusions in case of symptoms of breathlessness.

IMPORTANT! Prototype indications in a child (younger than 6 years), with an active form of tuberculosis, pheochromocytomy, decompensated endocrine pathology ( diabet, Thyrotoxicosis), the manifestation of aneurysms of any localization.

With a trivial stagnation, the frequency of development of bronchospasm significantly decreases for the development of an anti-apical effect and a decrease in the reactivity of the mucous bronchial tree;

I will protect myself when ischemic ailments heart, heart wads and pathology, which is supervised by disturbed rhythm.

On the cob of lіkuvannya Symbicort vikoristovuyut 1-2 times a day and dob, to reduce the control over the sickness to the minimum effective (1 іngalyatsіyna dose once a day).

Seretid

Combinations lykarskiy zab, scho can in its warehouse antiapalny (fluticasone) and bronchodilating (salmeterol) components. With a trivial stagnation, the frequency of attacks of poison decreases, the ventilation function of the legends increases, and the ignition reaction in the bronchial walls is known. The drug is vicarious for an adaptable basic therapy, it is not recommended for the knowledge of a hospitable attack of breath in connection with the triviality of the necessary effect.

IMPORTANT! Chi is not recognized in active forms of legeny tuberculosis, bacterial and fungal pneumonia, fibrillation of shlunochki and in an early child.

Ways to get rid of: 2 inhalations 2 times per day, when control over illnesses is achieved, the dosage is reduced to the minimum effective (1-2 inhalations 1 time per day).

Corisne video

Get to know visually about those preparations for the treatment of asthma vibrati, on the video below.

Persistent asthma is a serious pathology. Symptoms can develop in humans, intertwining their life with activity. However, the children of the children are advancing during the remission.

Persistent asthma - chronic ailment... Bronchial spasms are systematically observed. Tse naiposhirenisha form of BA. On the smallest flaming nobles, the grinning is constantly trawling. A slimy secret (it is necessary for the organism to get rid of it) is to be found in the great number.

With the manifestation of such pathology, the patient cannot inhale the swelling on the back of the chest. Likewise, it’s not a date that I’ve gotten to see it. Deyakі ailments stick with the problem, either vidihu, or vidihu.

Classification of persistent asthma

I see the chotiri form over the given ailment. The stage of gravity arises, based on the symptoms and the patient's age. The form of overcoming pathology is established with the help of this method, so that the maximum effective therapy... Yakіsne lіkuvannya dopomagає solicit for a trivial period of an hour.

Form axis of persistent asthma.

• Vazhka. Suffocating trampolate systematically, occur at night, and during the day. It is important to enclose physical activity. Supplement only special medications.
• Middle. More often than one or two times a day they will be attacked at a certain hour. In the afternoon, the stench is trawling more. Through the dysfunctional inadequacies of the life of people, they fall.
• Easy. Attack trapyayutsya one or two times per day, even during the day. May be a sleep disturbance.

• Get up the allergen provocateur at once and survive the new calls.
• Conduct immediate vaccinations for children.
• Scrupulously vibrate the profession (it is important to bring to zero the inflow of negative officials).
• Harchuvatisya correctly.
• Maintain a healthy lifestyle, and regularly.
• Regularly buwati on a fresh meal, dovgo festivities.

Uwaga! Great value is the quality of the qualifications. Tse allow not to allow acceleration.

1. Sharpening.

2. Extinguishing zagostrennya.

3. Remisia.

Vi. accelerating

1. Legenevs: legeny emphysema, legeneva deficiency, atelectasis, pneumothorax and others.

2. Pozalegenev: myocardial dystrophy, heart failure, heart failure and in.

However, in Danish hour, in the first place, bronchial asthma follows the classification of the degree of severity, so as the main reason is the tactics of treating a sick person. The stage of gravity begins with the following indicators: 1. Number of certain symptoms per day. 2. Number of daytime symptoms per day and per day. 3. Multiplicity of storing b 2 -agons of short stories. 4. The variability of physical activity and sleep. 5. Values ​​of PSV і її percentage of correlation with proper or most beautiful values. 6. Add a collection of PSV. 7. Review of the conducted therapy. There are 5 grades of severity over bronchial asthma: easy intermittent, light persistent; medium severity persistent, severe persistent, severe persistent steroid dependent. (Div. Table). Bronchial asthma of intermittent flow. Symptoms of asthma before 1 time per day; short sharpening from decіlkoh years to decіlkoh days. Nichni symptoms 2 times a month or more; the number of symptoms and normal function lungs mіzh sharpened. PSV> 80% as a regular і colony PSV less than 20%. Bronchial asthma of light persistent interruption. Symptoms are 1 time per day or more often, or more than 1 time per day. An aggravated anxiety can cause activity and sleep. Some symptoms occur more than 2 times per month. PSV is more than 80% of nalezhny; the amount of PSV is 20-30% of nalledny. Bronchial asthma of moderate severity. Symptoms. Sharpening to disrupt activity and sleep. Nichni symptoms occur more than 1 time per day. A generous priyom b 2 -agonistv of a short story. PSV 60-80% of nalezhny type. The amount of PSV is more than 30%. Bronchial asthma of severe interruption. Potential symptoms, parts of acute symptoms, parts of non-symptoms, physical activity are surrounded by manifestations of asthma; PSV less than 60% of nalezhny; the amount is more than 30%. It is necessary to indicate that the degree of severity of asthma is indicated for the number of indicators, perhaps just before the cob of lіkuvannya. If the ailment is already taking away the necessary therapy, then the obsyag will also be vrahovuvatisya. In such a rank, if a patient has a clinical picture, there is a mild persistent asthma, but at the same time I will not take medication for treatment, as if it is an important persistent asthma, then this patient is suffering from bronchial asthma. Bronchial asthma of severe interruption, steroid-dependent. Regardless of the clinical picture of a patient who will take away the trivial treatment with systemic corticosteroids, he is guilty of being diagnosed as suffering from severe bronchial asthma interruption and admission to the 5th stage.

Criteria for setting the diagnosis of bronchial asthma 1. Anamnesis and assessment of symptoms Naybіlsh widening symptoms of illness є epizodic attacks of breathlessness, bad breath, wheezing wheezing, feeling of seriousness in breast cancer, And also a cough. An important clinical marker of bronchial asthma is the manifestation of symptoms spontaneously as a result of the intake of bronchodilators and protivopalnyh drugs. When assessing and taking the anamnesis, it was possible to assess the factors that provoke aggravation, and also mean seasonal variability of symptoms and the manifestation of atopic illness in ailments or relatives. 2. klinichne provision In connection with the variable obstruction, the characteristic symptoms of the ailment do not necessarily appear with a physical obstructive posture of aggravated bronchial asthma. In case of acute illnesses, the patient may experience the following symptoms: expiratory congestion, swelling of the nose during inhalation, distortion of mova, anxiety, inclusion of additional dyshal muscles, posture orthopedic, frequent With auscultation, the drug is most often viscous dry wheezing. It is necessary to remember that during the period of agitation during auscultation, wheezing may not be lingering, unimpressed on the significant bronchial obstruction for the rash of the overwhelming gain in the process of other dyshly gleys. 3. Prescription of the function of the international community The pre-development of the function of the outgoing dichotomy will significantly reduce the diagnosis. Vimiruvannya funktsii zovnіshny dikhannya will not provide an active assessment of bronchial obstruction, and vimіr її colivan - an indirect assessment of hyperreactivity of dyshlikhs. Naybilsh widened the amount of forced life in 1 s (OFV 1) and they linked it with a lot of legends (FZHEL), and also in the form of a forced (pivot) type. An important diagnostic criterion is the increase in OFV 1 (greater than 12%) and PSV (greater than 15%) for the ingestion b 2 -agonism of a short episode. Skin ailments for bronchial asthma are shown to have a well-known pikflometriya. Monitoring asthma for an additional peak flow meter gives the following possibilities of the doctor: assess the severity of getting ill; assessment of bronchial hyperreactivity; predict aggravated asthma; Identification of professional asthma, assessment of the effectiveness of treatment. 4. Assessment of allergological status Naybilsha often vikoristovyutsya scarification, internal and prick test (prick test). However, in a number of vypadkіv shkіrnі testi to produce up to false negative or hybnopositive results. This is often carried out for additional monitoring of specific IgE-antibodies in syrovatz blood. Eosinophilia of blood and phlegm can also indicate an allergic process. Thus, the diagnosis of asthma will be based on the analysis of symptoms and anamnesis, as well as the pre-existing function of the allergic response and allergic examination. Some important spirometric functional tests are used to detect evidence for the diagnosis of b 2 agonists, change the variability of bronchial progress for additional monitoring of the PSV, provoking the diagnosis for additional testing. An important criterion in the diagnosis of an allergic status (if there is a symptom of atopy in the presence of other symptoms is not a diagnosis of asthma). 5. Using differential diagnostics to carry out:

X-ray of the legends (for the diagnosis of pneumothorax, general processes in the legends, lesions of pleurisy, bullosa changes, interstitial fibrosis, etc.);

EKG (for viklyuchennya urazhennya myocardium);

clinical analysis of blood (for detecting undiagnosed anemia, detecting gross findings);

zagalny analysis of phlegm (MBT, fungi, atypical cells).

Broncho-obstructive syndrome (BOS) - tse symptom scho zustrіchaєtsya in klіnіchnіy kartinі rіznih vrodzhenih i Nabutov, іnfektsіynih i neіnfektsіynih, alergіchnih i nealergіchnih zahvoryuvan Rann Dityache vіku yak one іz proyavіv dihalnoї nedostatnostі (NAM) yaky obumovleny obstruktsієyu drіbnih bronhіv i bronhіol for rakhunok gіpersekretsії , mucous і / or bronchospasm.

On the basis of bronchial asthma at chronic obstructive bronchitis, obstructive syndrome, does not develop steadily and does not develop rapidly when using hormonal drugs, but in sputum when analyzing daily eosinophilia.

In case of left ventricular failure, the development of heart asthma, the yak, is manifested by an attack of bad sleep at night; Feeling the instability, the squeezing in the breasts grew into breath.

Go to the arrhythmia and tachycardia (with bronchial asthma more often than bradycardia). On the basis of bronchial asthma, offending the phase of dichotomy. An attack of heart asthma can be trivial (before the severity of the disease is lost or neuroglycerol).

Hysteroid asthma malformations. The Persha form is similar to the dichny Sudomu. The dichotomy of the "driven dog" is the strength of both the vidih ​​and the vidih. Visible pathological signs in case of physical condition.

Another form of odor is to be observed in steroid people and to suffer from the destructions of fast diaphragms. For an hour I will attack the dichotomy is not or is not ill-humored, in the area of ​​sleepy gossip - there is a feeling of pain.

To start the attack of the patient, breathe in a hot water steam or give anesthesia.

Obturation asthma is a symptom complex of breath, which is based on the deterioration of the upper dysfunctional paths.

The reason for the obturation can be chubby, Alien tilo, stenosis, aortic aneurysm. Most significant in the production diagnosis to trace the tomography of the breast cancer and bronchoscopy.

A recurrence of symptoms of sickness and poisonousness in patients with other camps (anemic, uremic, cerebral asthma, periarthritis, carcinoma syndrome).

Polynosis, or a sinna fever, is not self-conscious, allergic, in case of any sensitization of an organism to a file of roselin.

For those who are ill, they are characteristic: bronchospasm, rhinorrhea and conjunctivitis. Seasonal illness is characteristic. To fix from the period of the growth of the rose and to change, if it ends

The stage of sharpening is characterized by dulling undead, crying in the eyes and tearing, coughing before developing an attack scent.

You can change the temperature, but at the slopes. In the blood analysis, eosinophilia (up to 20%). During the period of remission, there is no clinically evident manifestation.

Bronchial asthma, acute stage before therapy. Carrying out basic therapy for ill health. Lіkuvannya zagostrenia sickness bronchial asthma. Indicated for the purpose of inhalational and systemic glucocorticosteroids. Dispensary for the prevention of bronchial asthma ailments, indicated for hospitalization of patients. The value of the time and timelessness. Shown before being sent to MSEC.

Treatment of bronchial asthma The treatment of ailments on bronchial asthma is complex, including medication and non-medication for treatment of anti-allergic regimen. All preparations for medicinal treatment of illnesses are divided into two types: preparations for treatment according to the need and consumption of hot spots and preparations of basic (post-mortem) therapy. In this hour, I will look at the persistent nature of inflammation in bronchial asthma, the basis of therapy for concomitant disease is the sign of anti-asthma anti-asthma therapy. Both the level of obstruction and the steps of turnover allow asthma to become intermittent, light persistent, moderate and severe. In case of asthma elimination in the Danish hour, stop "Stupinchasty" pidhid When the intensity of therapy increases, the world increases in the severity of asthma. The stage of development before asthma therapy is recommended through those who promote a great increase in the severity of asthma interruption in children and in one and the same patient in the middle of the day. Methods for improving the control of asthma due to the use of the least amount of drugs. The number and the frequency of reception will increase ( gorse up), As a stretch of asthma to go down, and change ( gutter down), Iakshcho stretching asthmi is good to be controlled. There is also a need for unique control of triggers on the cutaneous stage. Slid vrahovuvati, who correctly took ailments of the first stage, and why there was no contact with allergens or provoking factors. The control is not satisfactory, even in the case of a sick person:

for coughing, whistling or difficult dichotomy, occur more than 3 times per week;

symptoms occur at night or in early wounds;

to improve the need for short-acting bronchodilators;

the distribution of PEF indicators is improved.

Step down. Decrease in adherence therapy is possible, if asthma becomes obsolete before control is not less than 3 m / s. Tse additional help to reduce the risk of bitter action and to improve the reduction of the sick person to the planned treatment. Zmenshuvati therapy slid "step-by-step", lowering or skasovoyuchi remaining dose or additional preparation. It is necessary to monitor the symptoms, clinical manifestations and indicators of the function of the external environment. Slid vrahovuvati, for the least severity of asthma interruption is presented in step 1, and the most severe - in step 5. Step 1. Ailments with mild intermittent (episodic) asthma interruption- atopic, in some symptoms of asthma, there are only when they come into contact with allergens (for example, a file, or even food), as well as for physical options, as well as children, for those who are sick with whistling symptoms during the respiratory period. Slid vrahovuvati the power of the fire. The severity of zagostren can be significant in children with ailments in the early hour. Innocent zagostrennya can be dangerous for life, if you want to develop in the edge of the country when you intermittently get overwhelmed. Triva therapy with anti-pyretic drugs, as a rule, is not seen as a disease. Treatment includes prophylactic reception of licks before physical appointments if necessary (ingalatization b 2 agony, either cromicat, or nedocromil). It is an alternative to the short-range ingestion b 2 -agonists. It is possible to propose anticholinergic medications, oral b 2-agonies in short diets, or theophilin short diets, if you want the preparation to fix your food / nutritional problems. Step 2. Ailments with mild persistent asthma interruption require a trivial and trivial prophylactic reception. today:

either inhalation corticosteroids 200-500 mcg, or cromoglycate sodium, or nedocromil.

If the symptoms persist, they are unimpressed on the cob dose of ingestion corticosteroids, and if the disease is correct for the preparation, the dose of inhalant preparations in the case of 400-500 mg per day to 750-800 mg / day A possible alternative to an increase in the dose of inhalation hormones, especially for the control of any symptoms of asthma, can be supplemented (up to a dose of 500 mcg of inhalation corticosteroids) of prolonged bronchodilators at the beginning. If asthma control does not reach its limits, but there are more frequent symptoms, an increase in consumption in bronchodilators in a short period, or in the fall of PEF indicators, then the next step is 3. Step 3. sick s average gravity overcoming asthma vimagayut a generic reception of prophylactic anti-pyretic drugs for the establishment and preparation of asthma control. The dose of inhalational corticosteroids is guilty of 800-2000 mcg of beclomethasone dipropionate or equivalent. It is recommended to use an inhalator with spacers. Bronchodilators of triviality can also be used for supplementation with ingestion of corticosteroids, especially for the control of other symptoms. It is possible to store the theophilin trivaloi diy, oral and ingalatization b 2 agony of the trivialoi diya. Treat symptoms with 2 short-term agonists or alternative medications. In case of more important zagostrennya, take a course of oral corticosteroids. If the asthma control does not reach the point of reaching more frequent symptoms, the increase in consumption in the bronchodilator, or the PSV indicators fall, then the next step is 4. Step 4. We are sick with severe interruption of bronchial asthma Do not get sucked in to control asthma. Methods of improving the number of possible results: minimal number of symptoms, minimal need for b 2 -agonist of a short day, fewer PSV indicators, minimal loss of PSV and minimal Likuvannya urge to spend a great number of control over asthma medications. Primary treatment includes corticosteroids at high doses (from 800 to 2000 mcg per day to beclomethasone dipropionate or equivalent). Prolonged bronchodilators are recommended for the duration of the intake of corticosteroids. It is also possible 1 time per day to collect a 2-short episode to achieve an effect. You can try an anticholinergic drug (ipratropium bromide), especially if we are sick, which means bitter appearances when accepting b 2 -agonist. Іngalyatsіynі b 2 -agony of a short episode can be victorious if necessary to relieve symptoms, but the frequency of these symptoms is not guilty of changing 3-4 times. It is more important to sharpen the course of oral corticosteroids. Step 5. We are sick with severe interruption of bronchial asthma, as we take trivial therapy with systemic steroids It should be noted that the therapy with inhalation drugs, as at stage 4 More times later, it’s one of the central missions in the treatment of asthma in the Danish hour, the coverage of the program of the ailments and the dispensary is overwhelmed.

The level of BA control is based on the following parameters:

 minimal turnover of chronic symptoms, including none;

 minimal (infrequent) sharpening;

 the visibility of the consumer in non-essential supplementary aid;

 minimum (in the ideal of visibility) victorious ß2-agony "for demand";

 the visibility of some activity, including physical;

 additional amount of PSV less than 20%;

 normal or close to normal values ​​of PSV;

 Minimally show if there is a lack of good results in medicinal preparations.

Preparations for vikoristannya for needs and kuіruvannya zagostrennya:1. Beta-2-agony of a short story (Salbutamol, fenoterol, terbutalin) to reduce the weakening of the smooth muscles of the bronchial tubes, to improve the mucociliary cells, to reduce the permeability of the brain. We are reducing the method of introducing cich preparations in є ingalyatsіyny. For a whole b 2 agonies are released from dosed aerosols, dry powder and roses. If necessary, try to get salbutamol through a nebulizer. 2. Anticholinergic drugs (Ipratropium bromide): fewer tighter bronchodilators, less than 2 agony, as a rule, they fix it after the day. Slide means that ipratropium bromide leads to b 2 -agonism in case of alcohol consumption. Methods of introducing ingalatizny (dosages of aerosol, nebulizer rods). 3. Berodual - a combination of a drug to avenge b 2 agonist and anticholinergic drug. Methods of introducing ingalatizny (dosages of aerosol, nebulizer rods). 4. Systemic glucocorticosteroids (Prednizolone, methylprednizolone, triamsinalone, dexamethasone, betamethasone). The method of introduction is parenteral or oral. Perevaga is considered to be oral therapy. 5. Theophilin short story - bronchodilators, which in the whole are less effective, less ingestion and 2 agony. Volodyut by significant side effects, which can be unique, the drug is correctly dosed and monitored. It is impossible to vikoristovuvati without viznennya concentration of theophilin in the blood plasma, as well as ailments will reject the preparation with the vivilnenny of theophilin.

Basic therapy preparations

Basic therapy of asthma in older adults

The basis of the treatment of bronchial asthma is the inhalation of glucocorticosteroids.1.Inhalation corticosteroids (Beclomethasone dipropionate; budesonide; flunizolide; fluticosone propionate) freeze as an anti-fatigue for a three-hour hour to control the interruption of bronchial asthma. Dozi viznachayutsya degree of severity of bronchial asthma. The use of high doses of aerosolized corticosteroids is indicated through a spacer, which will increase the effective control of asthma and reduce the number of side effects, or even a "lightweight" inhaler. In case of an important interruption of bronchial asthma, it is more effective to suck budesonid through a nebulizer. іngalyatsіynі GCS borrow the most important place in the BA league. Smell of such perevagi in front of the systemic GKS:

 Visoka spore to receptors;

 Virazhena mistsev anti-firing activity;

 Large low (approximately 100 times) therapeutic dose;

 Low availability.

Іngalyatsіynі GCS є with a Vibor preparation for ailments persisting BA of any degree of severity.

Prior to non-essential effects of the corticosteroids, the following should be considered: oropharyngeal mycosis, dysphonia, and cough.

Rizik of uncontrolled BA is signified to change the rhizik of uncontrolled manifestations of the inhalational corticosteroids.

2. Systemic glucocorticosteroids (Methylprednizolone, prednizolone, triamcinolone, betamethasone) in case of an important interruption of bronchial asthma should be indicated at the lowest effective dose. In case of trivial use, the alternating scheme of recognition and reception in the first half of the day is victorious to the least number side effects... It is a sign of adherence, that in all patients there is a sign of systemic steroids, the sick person is at fault, but there are signs of high doses of inhalational glucocorticoids. 3. Beta-2-agony of trivial diy (Salmeterol; formoterol; salbutamol hemisuccinate) is widely used in the therapy of important asthma. The drugs are used for oral and ingalatory and also parenteral administration. However, in pulmonary practice we will expand and efficiently deliver the drug in the most effective way. The overhaul of the inglyatsyynyh forms is summed up by the swift development of the maximum effect, the microscopic (topical) character of the action, the appearance of the circulating influences on the internal organisms at the vikorstanna in therapeutic doses. The drugs are also effective for the prevention of other attacks of poison. Stomach in patients with anti-pyretic anti-asthmatic drugs. In the given hour, two drugs are used, which are carried to the group b 2 -agonistiv trivaloi diy: formoterol fumarate and salmeterol xinafoate. Formoterol is the most active b 2 agonist of trivial action and is effective in two lykarsky forms: Oxis and foradil. Salmeterol representations of such drugs, yak serevent, Salmeter. The drugs improve the function of the outgoing dysfunction, change the need for b 2 -agonist for a short day, effective in the case of bronchospasm caused by allergens, physical problems. Salmeterol and salbutamol hemisuccinate are vicious only in basic therapy.

The preparation does not become vicious for the suppression of symptoms or symptoms of hypertension. Formoterol fumarate is a drug for which unique pharmacological powers are characteristic:

visoka efficiency in the presence of high b 2-selective, which will preserve a unique profile without the preparation;

shvidky ear of diy (stretching 1-3 minutes);

triviality to the effect lasting 12 years;

the duration of the antagonistic action in relation to short-acting b 2 -agonistic action and in the flow of liquid on its effect, which is of great importance in situations such as transferring a three-hour one-hour reception

accumulation rate in therapeutic doses.

High indicators of safety allow for the consumption of formoterol for demand, and a small ear of corn allows for viciousness in the drug, which lays down symptoms (rescue medication). In such a rank, formoterol can be the only bronchodilator necessary for a sick person in any situation. Particularly, it has been shown to increase potency by 2 agonists of trivial diy, and sprinkle with formoterol and salmeterol, effective glucocorticosteroids. With insufficient control of symptoms of bronchial asthma, it is therapeutically greater to indicate a combination of low doses of inhalational glucocorticoids and prolonged b 2 agonists, and a lower dose of steroids.

The presence of one of the indicators of the importance of exceeding the permissibility of bringing the sick person into one of the categories. If the degree of severity is significant, it is necessary to interrupt the therapy to control the symptoms of asthma.

4. Theophilin prolonged art. Methods of oral administration: the prolonged period of time to reduce the frequency of new attacks, to promote an early and early phase of asthmatic reactions to the allergen. Stagnation of a theophilic can with a swelling of side effects: headache, tremor, nudity, blues, tachycardia, disturbed heart rhythm, abdominal pain, wild style. It is necessary to conduct monitoring of the removal of theophilin in plasma. 5. Antagonism of leukotrenic receptors (Zafirlukast, montelukast) - a new group of anti-inflammatory anti-asthmatic drugs. Sposib zasosuvannya tableting. The drugs improve the function of the outgoing dysfunction, change the need for b 2 -agonist for a short day, effective in the case of bronchospasm caused by allergens, physical problems. In the therapy of severe bronchial asthma, it is especially indicated for quiet forms of bronchial asthma, the severity of these is associated with an increase in the metabolism of leukotroins (aspirinov, post-exercise bronchospasm syndrome, reactions to cold weather and injected allergen). 6. M-holinolitics - anticholinergic drugs (ipratropium bromide) - not drugs of the first line in the therapy of bronchial asthma, as sympathomimetics are used in terms of efficiency. However, in a number of vypadkiv and victorious in the combination of b 2 agonists, it can be effective in patients with refractoriness up to b 2 agonists. 7. Combined preparations ... In this hour, it is of great importance to take combined drugs (additional b 2 -agonisti of prolonged diets and ingestion of glucocorticoids). Look for two lykarsky forms: seretide (according to salmeterol and fluticasone propionate) and sіmbicort (according to formoterol and budesonide). Slide means that the preparation is potent for one and one and in the end may be turned against the fiery one. 8. Cromoglycate sodium i nedocromil: non-steroidal antiapaline drugs for trivial control of bronchial asthma. Effective in case of bronchospasm provoked by allergens, physical problems and cold weather.

Therapy for asthma asthma in older adults

Zagostrennya BA - there are occasionally diagnoses of stays, which are supportive of coughing, bad breaths, wheezing, poisonousness, and the appearance of a marriage. Sharpening BA supravodzhutsya fall of the peak volume of the vidikh and the volume of the forced vidih ​​for the first second.

There are two options for the development of an important warning BA:

 Increase the development of asthma at an increased rate, if the growth of respiratory syndromes is prevented by prolonged periods of time, do not marvel at increasing doses of bronchodilators;

 It is important to sharpen BA with a raptor cob є it is more acute, with any appearance of the first symptoms, it can take 1-3 years until the disease or death occurs.

Riziku development factor

(Asthmatic status):

 Anamnesis obstructs the life of acute asthma.

 Sharpening of BA on the trivial stagnation of systemic GCS і / abo їх recent skasuvannya.

 Gospitalizatsiya z drive zagretennaya BA stretching past fate in the form of reanimation and intensive therapy.

 Evidence in the anamnesis of the unit ventilation of the legends in the actuator of the sharpened BA.

 Psychic illnesses or psychosocial problems.

 Non-compliance with the patient's BA treatment plan.

 The appearance of unremitting asthma symptoms lasting a trivial hour (more than 3 years) before visiting medical services.

 Unfriendly home mind.

 Social and economic factors (low income, inaccessibility of medicines).

Treatment of acute transmission to contact with causally significant allergens, treatment of chronic bronchodilators in short-term (β2-agony or β2-agony + m-holinolitics) for rapid suppression of bronchospasmodic diseases

β2-agony of a short dayє drugs of the first row in the therapy of asthma aggravation, which are tied to the rapidity of the disease and an altogether high profile of safety.

anticholinergic drugs In case of asthma aggravation, because the stench of β2-agonists is used in terms of efficiency, it is practical not to give a delay, but in the case of β2-agonists, it gives a greater bronchodilating monotherapy effect.

If the patient is suffering from premorbid background in viglyad IVC, heart rhythm disorder, COPD, then the role of anticholinergic drugs in symptomatic therapy of BA is rapidly growing, stinks with bronchodilators of the first row.

Teofilin short story Introduce the preparation in another row for the treatment of asthma aggravation and recommend until it is consumed not earlier than after 4 years after the β2-agonist. Sered bronchodilators teofilin є the most effective drug , And the therapeutic dose is the least expensive toxic, but the least amount of side effects (nudota, head bill, Bezsonnya, elektrolitnі rozladi, arrhythmias, sudomi).

glucocorticosteroid hormones as the most tough antiapalny drugs є binding for the treatment of asthma aggravations. It has been reported that the efficacy of oral and parenteral forms of systemic corticosteroids in the treatment of BA is practically the same. The ingestion method of introducing a nonbulized rose, or a suspension of budesonids (Benacort, Pulmicort), saves a larger ear of antiapalania, less systemic glucocorticosteroids, with a larger amount of corticosteroids.

In the Danish hour, the injection of drugs in case of acute asthma medical aid(On an outpatient basis, by a joint venture team, in a hospital). The rapidity of the development of bronchodilator response to parenteral administration of the drug. Possibility of taking a small dose of a drug into the bloodstream with a given method of changing the development of side effects of bronchodilators and corticosteroids (table 8).

Table 8

Algorithm for Likuvannya zagostren BA

(Order No. 300 of the Ministry of Health of the Russian Federation dated 09.10.98 r)

oxygen therapy in case of acute BA, life is more important, since it is a non-mediated cause of death in all cases, hypoxia. Oxygen therapy is carried out at viglyadі іngalyatsіy, kissen vikoristovutsya as a non-volatile gas in the nebulizer. In case of life-threatening attacks, it is effective to carry out piece ventilation of the legends. Optimum is considered non-invasive ventilation of the legends, however, it is necessary to admit that there are important signs of acute asthma without deficiencies.

 Antihistamines drugs;

 Sedative drugs;

 Phytopreparations;

 Girchichniki, banks;

 Preparations of calcium, magnesium sulfate;

 Mucolytics;

 Antibacterial infection (it may be shown if there is evidence of pneumonia or even bacterial infection);

 Prolonged β2-agony.

Tactics for the prevention of ailments from the aggravated BA in the minds of the joint venture

To provide additional help to a sick person from the aggravated BA, the placement of the JV brigade is guilty of revenge:

 Kisnevy inhaler, peak flow meter;

 Nebulizer chamber complete with a compressor;

 Disposable syringes;

 Nabir lykarskiy zasobіv (table 9);

 Venous jgut;

 "Metelik" golki і / abo infusion cannulas

Table 9

Likarskі zasobi obov'yazkovogo і additional assortment for lіkuvannya zagostren BA

Shown before non-open hospitalization:

 Unsatisfactory view on the topic (POSVID<50% от должного после применения бронходилятаторов);

 Symptoms of acute asthma build up or during the day there is a clear positive dynamics of symptoms lasting 3 years from the moment the ear of non-emergency visits;

 Chi does not spontaneously eat polish for 4-6 years for a cob of treatment with systemic corticosteroids.

The transfer of a sick person from ICU to pulmonology (therapeutic) is necessary:

 Conduct a 7-10 day course of GCS treatment for the continuation of the treatment with bronchodilators;

 Try to continue the treatment with the use of corticosteroids in an additional dose, which will lead to the severity of BA;

 It is necessary to re-adjust the switch of the inhaler, the peak flow meter for the monitoring of the camp.

There are no absolute criteria for whiskey from the stationary. Before the vipiska, the patient is guilty of 12-24 years of age, taking drugs for the outpatient treatment regimen, and the patient will be more effective.

Improvement in the life of patients, in the introduction of new drugs into the medical practice, and in a high biological activity, to lead to a significant improvement in the acceleration of pharmacotherapy. Whether a drug that is directly pharmacological to a direct pharmacological effect, it is not often necessary to infuse negatively into the urozheniye, so also on the intact organisms and tissues, which may be the reason for changing the nature of the BA in the main conquest, because of the pharmacotherapy.

Oscillations of bronchial asthma є chronic ailments with periods of aggravation and remission, ailments require constant caution. Medication for treatment is also required for post-mortem correction in the fallowness of the severity of ailments. In case of mild and moderate interruption, it is necessary to look around at the pulmonologist or the therapist 2-3 times for the risk, and in case of an important one - 1 time in 1-2 months. The development of bronchial asthma has a great role in the development of an allergic reaction to infectious agents, and such patients are shown consultations of an allergologist (1 time per day). With bronchial asthma, it is indicated that there is damage to the side of the nervous system; For the sanitation of chronic infections, it is necessary to regularly (not earlier than once per day) consult an otolaryngologist and dentist. It is necessary 2-3 times for the preparation of a blood and sputum analysis for the ignition process in the bronchogenic tissue. To establish the functional standard of the mental system 2 times in the year, it is necessary to check the spirography.

The need for a labor examination and the identification of a group of disabilities in patients with bronchial asthma is diagnosed with frequent, recurrent or trivial attacks of breath, clinically lacking in a lesion-serous or leprosy. And also, if the main disease is accelerated by hormonal depletion, asthmatic status or bronchial asthma protested against the chronic recurrent ignition process in the legends.

The characteristic rice of bronchial asthma is povna, either part of the turnover is mimic or for the flow of food. To that, bronchial asthma from the ear itself does not carry over to the disease, it is unhealthy to produce it to the point of being ineffective and incapacitating. Adding new methods of getting rid of and entering through contact with provocative factors (in Persha, with Tyutyunov dim and causally significant allergens), will allow more patients to seek control of ill health. Protest, directly on medical and social examination (MCE) with asthma, it is not easy to diagnose. In the first place, there is a need for a change of minds of pratsi: if there is evidence of a contradiction in the minds and the nature of the practice and the ill-health of the preoccupation in an accessible profession, without lowering the quality of the most important economic problems. If there is a trivial inconsistency, the patient should be sent to the MSEC for a nutritional update about a fraction of the problem or the establishment of a group of invalidity. The establishment of a group of invalids is guilty of being supervised not only by the kind of evidence, but by the folding of individual programs of rehabilitation. Power about vstanovlennya groupies іnvalіdnostі vinikaє takozh at tyazhkіy astmі at gormonozalezhnih (postіyny priyah gormonіv tablets) at vazhkih suputnіh zahvoryuvannyah abo uskladnennyah at formuvannі nezvorotnoyu bronhіalnoї obstruktsії (rozvivaєtsya at poєdnannі asthma i COPD abo at trivalomu uncontrolled perebіgu zahvoryuvannya for vіdsutnostі nalezhnogo lіkuvannya ). Transfer of documents, as it is necessary to pay to the MSEK for passing, I will look at the rejection of the group of incidents: form No. 88; additional KEK; outpatient card from the clinic; Completion of the robotics mission; passport; an act about an unhappy vipadok (yaksho є); directly by% of the cost of the original; vіyskovy receipt and vіyskovo-medical documents (yakscho є); completion of the MCE (when re-examining). Food about the provision of a group of indivisibility should be provided individually. By itself, the diagnosis of bronchial asthma is not evident for the establishment of a group of disabilities.

Reduced bronchial asthma (asthmatic status). Klinika, diagnostics. Unaddressed therapy for status asthmaticus.

accelerating

A.Infectious diseases- frequent accelerated bronchial asthma. The stench can be recognized as the hour of fire, so before the hour of remission, and it is not easy to provoke the attack of bronchial asthma. Dry wheezing, sensitive on arrival, before the hour of a grievous respiratory illness may be the first manifestation of bronchial asthma in children. Bronchial asthma is followed by all children with frequent bronchitis and respiratory distress.

1. State Respiratory Disorders most often suffer from bronchial asthma. Most widespread infections, respiratory syncytial viruses, parainfluenza viruses and influenza viruses, rhinitis and adenoviruses. It is transmitted, that the virus does not pass through the middle to the bronchi, which increases its reactivity. Possibly, the diagnosis of attacks in bronchial asthma for an hour is due to the IgE, specific to the given virus, or because of the decreased sensitivity of beta-blockers and virus mediators.

2. bacterial infections rarely provoke attacks of bronchial asthma. Vinyatok to become chronic sinusitis and microplasmic infection.

3. pneumonia Get ready to develop suddenly, when there are trivial or frequent attacks of bronchial asthma, if a large amount of mucus accumulates in the bronchi. In the first up to 5 rocky, in most cases there are viral, 5-30 rocky - microplasmic, and for 30 rocky - pneumococcal and іnshі bacterial pneumonia.

B.atelectasis- partial, segmental and subsegmental - it can be done for an hour as it is sharpened, as well as remission. Zazvychay їkh belly is tied with blockage of bronchial tubes with mucus plugs. Atelectasis is characterized by a stronger cough, persistent wheezing, dullness, fever, weakened vesicular dysfunction and dullness of the percussion sound in the atelectasis zone. Most often atelectasis of the middle part of the right legacy is promoted. The stench cannot be diagnosed. In case of adolescence for atelectasis, chest x-ray is shown. Atelectasis is characteristic of young children, often recurring, and at the same time you are encouraged to get one of the lungs.

V.Pneumothorax and pneumomediastinum

1. pneumothorax- Ridkisne accelerated bronchial asthma. In case of recurrence of pneumothorax, cyst, congenital emphysema, and lesions become ill. Pneumothorax can be diagnosed with severe coughing during the first hour. The process of accelerating the appearance of pain in the bots during rapid onset of pain, when dysfunctional and superfluous, tachy, sometimes - coughing. Diagnosis is confirmed by chest x-ray. In case of a small pneumothorax (less than 25% of the pleural emptying), due to the presence of a strong stagnation and pain of indications, the post-treatment regime and caution. Wash in the pleural empty space to dry up independently. In some cases, the drainage of pleural emptying is required.

2. Pneumomediastinum and Pediatric Emphіzema sposterіgayutsya often, nіzh pneumothorax. Ailments, as a rule, do not exhibit scarg, which is why they appear vaguely during X-ray of the breast, looking around and palpation of the breast. Inodi pneumomediastinum is manifested by pain in the sternum, early - sluggishness, tachypnea, tachycardia, arterial hypotonia and cyanosis of the upper half of the body. A characteristic sign of pneumomedicastinum is Hamman's symptom (crepitant murmur during auscultation of the heart). Pneumomediastinum and pediatric emphysema induce an hour of severe coughing and IVL. Likuvannya in large vapors is not required, in important vapors the middle is drained.

G.bronchiectasis- Ridkisne accelerated bronchial asthma. Smell a stink in case of common bronchial asthma with chronic bronchitis, trivial atelectasis or allergic broncholegenic aspergillosis. With bronchiectasis, a trivial cough, sputum, hemoptysis, a symptom of drumsticks is observed. Slid means that in case of persistent bronchial asthma, there is still a sign of the day. One diagnosis can be made on the display of chest x-ray, but in most cases, x-ray tomography or CT is required. Bronchography should be performed in small patients.

D.Allergic broncholegenic aspergilosis. Zbudnik - Aspergillus fumigatus. In the pathogenesis of ailment, the role of an allergic reaction is played, a vicious one. Sposterіgaєtsya mainly in grown-ups with ailments to bronchial asthma.

E.Heart-Sudinni accelerated in case of bronchial asthma, arrhythmias are most often manifested - from childish suckling extrasystoles to fibrilating suckers. Arrhythmias are often promoted by the ailments on the heart-vindicated ailments. The severity of growth arrhythmias with hypoxemia and malignant beta-adrenostimulants. Before the hour of the attack of bronchial asthma, you can see the re-entanglement of the right side of the heart. Right ventricular failure to develop even more rarely - only in the development of trivial important hypoxemia and re-entanglement in volume. Before an hour an attack of bronchial asthma is not often susceptible to the presence of a Legendary hypertension, however, the Legend's heart is diagnosed only in case of additional bronchial asthma of SCOPD. For a change in hypoxemia, it is necessary to use the English language. Between the intake of beta-adrenostimulants (both inhalational and systemic) and theophilin. In case of important arrhythmias and right-sided deficiencies, the heart is diagnosed with glucosides (as arrhythmias are not affected by drugs) and antiarrhythmic problems. With a bunch of obov'yazkovo vrahoyut, which does not viklikayut the stench of bronchospasm.

J.Status asthma and mental deficiency .

Status asthma (AS) is a syndrome of hostile dyskhalnaya deficiency, which develops in patients with bronchial asthma as a result of obstruction of the dysfunctional paths, resistant to therapy with euphillosis and sympathomimetics, including selective P2-stimulants.

Bronchial asthma is carried up to the number of the most serious illnesses of the mental system and only a few depressions. A persistent form of bronchial asthma is a type of ailment, which supravoduzhuetsya persistent manifestations, including regular spasms of the bronchi.

Most of the severity of bronchial asthma is associated with intermittent, tobto epizodic, and persistent - chronic type of pathology. Such ailments can be trivial, it is characterized by an important break from the bagatma accelerated and in the process of post-mortem treatment.

When the diagnosis of bronchial asthma is diagnosed, the words "persistent interruption" can be applied to those with chronic pathology, which are accompanied by regular bronchial spasms. Є one of the broadened and insecure forms of the sickness system.

Potentially zagostrennya, as supervoluzhuyut persistent overrun of asthma, to see on the smallest flaming nobles, wicked in the pouring of singing taunts. As a result, the mucous membrane of the bronchial tubes clotted and started actively circulating the amount of mucous secretion necessary for the seizure.

In the key picture of persistent bronchial asthma, there is a feeling of severity in the area of ​​the chest wall, attack of breath, impatience, and also a persistent cough. Sickness is not enough for the power of dichati on the outside of the chest, but rather to see it.

Inquisitiveness to develop on the backs of many years of rock, during the period of remission, it regularly changes from time to time, delivering people inappropriateness to normal life.

Classification of persistent asthma

Falling along the stage of severity of the dysfunctional system and seeing a few types of persistent asthma, the skin of which may be characteristic to show that particularity of interruption:

• easy;
• average;
• important.

In case of light persistent bronchial asthma attack the patient 1-2 times and 2-4 times a month at night. Frequent attacks from the outside, which are not even aggressive factors in the flow. Attack you can seize the life of a sick person, porushuvati a dream.

In case of severity, the following symptoms are suspected: some attacks are often 1-2 times per day, days can be attacked more than 7 days. Lyudin cannot lead an active life, because he grows up to show dysfunctional deficiencies.

An important form of asthma disease is supravulated by regular suffocating attacks, as can turbuvati of a patient's skin day and night. Physical activity is very limited. Bleeding of the scent is carried out with the help of special drugs.

It is also possible to see an understanding of the asthmatic status - a pathological camp, not uncomfortable for the life of a people. Most often it develops rapidly and unsupported, supervised by important attacks of breath, persistent to drug addiction.

For їkh usunennya, drug preparations from a group of corticosteroids are used. The treatment of asthmatic status is carried out only in the minds of the stationary, as this country presents a serious threat to the life of the sick.

Causes of persistent asthma development

The development of persistent asthma is tied to the aggressive inflow of singing factors in the midst of the colony and the peculiarities of the human organism. Prior to the most widespread reasons for this disease, the following should be reported:

1. Slump factor.
2. Allergy.
3. Infectious disease.
4. Fatty step.
5. Robot on awesome virobits.
6. Pogana ecological situation.

Genetic power is highly important in the formation of persistent bronchial asthma. If someone has diagnosed a pathology, the development of a child is significant.

Allergic reactions - one z. Allergens can penetrate into the dizzying paths at home, as well as on the street, in the office or on the street. Prior to the most widespread allergens, food products, medications, homemade wool, cosmetics and other chemicals, saw particles, tyutyunovy dim, perfumery are introduced.

Such infectious diseases, such as bronchitis, pneumonia, GDVI, or GDVI, or flu, repair a negative inflow on the weakening of the allergic organism, which may be the reason for the development of a suffocating Chergovy attack, for those who know how to become stagnant.

key picture

With a persistent interruption of bronchial asthma, a key picture is spun around, so the diagnosis of becoming ill is not a great difficulty.

The main symptoms of illness:

• breath, vazhke dikhannya;
• severity in the area of ​​bronchial and breast cancer;
• wheezing and whistling sounds that appear before you see it;
• unproductive bark-type cough;
• ruining sleep through sharpening attacks in the same hour;
• overworldly blandness of shkіrnyh curves;
• swelling of blood-bearing sudins in the shia.

Attack the scent of being periodically - the stench can turbuvati of the patient, both for a month, so it is a skinny day. Anxiety is characterized by growing symptoms of aggravated symptoms, even at the severity level of bronchial asthma, there are signs of pathology and the same. It may be wrong to pick or mislead a cliché picture.

diagnostic methods

The main methods of diagnostics, such as stagnation in persistent asthma, are the examination of the patient and the anamnesis of illness. In most cases, the symptomatology of the pathology is clearly indicative of the presence of bronchial asthma in the patient.

Dodatkovі diagnostics enter:

1. Laboratory analysis of blood.
2. Doslidzhennya sputum, vidokremlyuvanoi with cough.
3. Conducting electrocardiography.
4. Spirometry, that is, to increase the function of the outgoing dichotomy.
5. X-ray of the organs of the breast.

When a person is susceptible to an allergic progression of persistent bronchial asthma, an ailing allergologist is in charge, who will stand up, which is the very allergen, having provoked the development of the disease.

lykuvannya

Persistent asthma is sought after for the help of new drugs, which are selected individually in the fallowness of the particularities of development and the degree of severity of illness.

Bronchial asthma of the lung will be stopped by corticosteroids, which are indicative for inhalational obstruction, as well as bronchodilators, which assimilate the symptoms of debility. Asthmatics who are diagnosed with a pathology of the middle stage of severity are assigned beta-agony of a short period for termic assistance in case of breathlessness and agony of a trivial one for the prevention of day-and-night attacks.

In case of an important form of sickness of the mental system and the intake of ingestion of corticosteroids, it is combined with a one-hour intake of drugs in the form of tablets. Ale so yak such medications can be victoriously zgodnya, їkh dozuvannya step by step improve. The elimination of allergic manifestations is carried out for additional intake of antihistamines.

prophylaxis

In order to get sick with bronchial asthma, you need to take a few important recommendations.

Allergies are not recommended to use homemade food, since wool is one of the main allergens to provoke the development and aggravation of persistent bronchial asthma. It is also necessary to be involved in the process of being active as well as passive.

Even more regularly come and go for walks on a fresh day, given from galaslivy trails and shkidlivy virobnits. Vikonannya has the right to dichotomous gymnastics to help polypsychitis to the robot of bronchial tubes and legends, as well as to prevent a suffocating attack.

Persistent bronchial asthma is one of the most important illnesses of the mental system, as it is supervised by attacks of breath, severe coughing, and sleep disturbance. Likuvannya ailments of the light and middle stage of severity are allowed to be carried out at home.

Pathology, which is opposed to an important form, only appears in the minds of the stationary, as it is a serious problem for the patient's life.