Mbiri ya matenda COPD. Gulu la COPD. Matenda matenda a m'mapapo

Panopa matenda a dongosolo kupuma kwambiri wamba. Izi zilili zoona, modetsa nkhawa madokotala. Iwo amalangiza kuti anthu aakulu kwambiri za thanzi lawo.

Anayi COPD

Mayiko akatswiri kupitirira wa COPD kusiyanitsa magawo angapo:

- kalasi 0 (koma osati matenda). Izi siteji koyamba limene pali chiopsezo COPD, koma mantha kuti si nthawi zonse wolungama. Man zambiri kutsokomola ndi kutsokomola mpaka phlegm. Mu gulu ili la COPD wayamba chabe. Kodi yotsatira?

- Digiri I (ofatsa njira ya matenda). Yodziwika ndi kusintha yaing'ono obstructive, chifuwa chosatha ndi expectoration wa sputum.

- Digiri II (zolimbitsa chiwindi). kusintha Obstructive patsogolo. Man kutsamwa poyenda, zizindikiro matenda, zoipa pa zolimbitsa thupi.

- Digiri III (aakulu njira ya matenda). Kumawonjezera mpweya otaya chiletso munthu exhales. Wodwala kwambiri ndi kutsamwa pa zofuna kukhetsa thukuta ndi exacerbations zimachitika kawirikawiri. Pa nthawi imeneyi munthu dongosolo kupuma zikhoza kukhala zoopsa kwambiri.

- Digiri IV (kwambiri zochita za matenda). Yodziwika ndi mawonekedwe zovuta cha kutsekeka bronchial, nthawi zambiri kuwopsezedwa kuti awapha. Pali kupuma kulephera, pali mtima m'mapapo mwanga.

mankhwalawa COPD

Therapy matenda anatsimikiza ndi digiri ya kapangidwe kake. Kuyenera anamvetsetsa kuti mankhwala amalola yekha m'mbuyo kupitirira kwa matenda, komanso kupanga izo pa khola. Ngati mulibe kuthetsa zinthu zimene zimachititsa kupitirira kwa matenda (mwachitsanzo, ndudu), mankhwala mwina kubweretsa zotsatira ankafuna. A mndandanda wa mankhwala, chiwerengero chawo ndi kuthekera kwa kaphatikizidwe ndi njira zina pharmacological Mzimuyo dokotala. Pa matenda a m'mapapo imakhazikika pulmonologist. Makamaka, imathamanga gulu la COPD, ngati akudziwa mmene kuchiza matenda amenewa.

Therapy matenda zolimbitsa kusalekerera

Pamene zizindikiro zosonyeza wa breathlessness mtima angayambe ntchito bronchodilators Mpweya. Dokotala angakupatseni mankhwala zotsatirazi: "Salbutamol" "Ventolin", "Berotek", "terbutaline", "fenoterol". Koma iwo sangakhoze kutenga ndi tachyarrhythmias, UPU, decompensated shuga, khungu, myocarditis, kung'ambika stenosis, komanso hyperthyroidism. Wodwala kumwa mankhwala kuposa kanayi pa tsiku. Muyenera kuchita izo zambiri. COPD ndi matenda, mankhwala ikuchitika mpaka kufa kwa wodwala, izo yofuna udindo.

M'pofunika bwino kuchita inhalation. Ngati inu anawerengedwa kwa nthawi yoyamba mankhwala, muyenera kuchita ndi ndondomeko kukambirana ndi dokotala kuti iye kuuzidwa za tchimolo zotheka. Medicament kufunika Mpweya m'kamwa (jekeseni) ndendende pa mlingo pakhomo: chifukwa akafika ndendende bronchi, osati kugwera mu mmero. Pambuyo ndondomeko, muyenera kukoka mpweya wanu kwa mpweya ndi pansi masekondi 5-10.

Kodi kuchita ngati muli ndi matenda aakulu amtengo?

Apa izo sizidzakhala mankhwala okwanira analamula kuti COPD zolimbitsa. Kupatula iwo, muyenera kumwa mankhwala kumapangitsanso bronchi ndi yaitali akuchita. Nthawi zonse muyenera kugula iwo. matenda Broncho-m'mapapo mwanga ndi zambiri zamtengo wapatali.

Makamaka mankhwala "Serevent" akapatsidwa. Izo zinabala mu mawonekedwe a mlingo inhaler metered. The momwe akadakwanitsira tsiku mlingo akuluakulu - 50-100 mg ndi kawiri pa tsiku. Inhalation ayenera kuchitika mogwirizana ndi malamulo onse.

Madokotala mankhwala amatanthauza "Formoterol". Izo zinabala mu makapisozi, amene inhalable ufa. Kayendesedwe vpyolnyaetsya kudzera chipangizo handihaler. Childs, dokotala zotchulidwa 12 mg wa kawiri pa tsiku. Tikumbukenso kuti mankhwala a matenda a m'mapapo sikuti kubala zotsatira ankafuna. Ndi zomvetsa chisoni koma izo nzoona.

matenda aakulu

Pa nthawi imeneyi, munthu amafuna mosalekeza odana ndi yotupa mankhwala. Lembani pang'ono ndi mkulu Mlingo wa glucocorticosteroids kwa inhalation. Anatumidwa ndi mankhwala zotsatirazi :. "Beclason", "benacort", "Fliksotid", "bekotid" "Pulmicort", etc. Iwo chopangidwa mu mawonekedwe a aerosols metered kapena njira inhalation jekeseni pakhosi kudzera nebulizer lapansi. Mwa njira, ichi ndi chipangizo chothandiza kwambiri. Ngati muli ndi matenda m'mapapo mwanga (COPD), inu mukhoza kugula izo.

Komanso, panthawi imeneyi matendawa mankhwala wosanganiza awerenge, yomwe ndi yaitali wotenga mankhwala ndi kuti chimafikira bronchi ndi corticosteroid kwa inhalation. dokotala anu angakupatseni mankhwala "Symbicort" kapena "Seretide". mankhwala obwerawa panopa ankaona mankhwala yabwino kwambiri zochizira matenda a m'mapapo nthawi imeneyi. Iwo kulandira chithandizo. Matenda matenda a m'mapapo chingaimitse chitukuko mu ntchito zawo.

siteji kwambiri a COPD: chochita?

Kuwonjezera mankhwala analamula kuti siteji kwambiri chifukwa cha matenda, kuti anawonjezera mpweya mankhwala (inhalation ya mpweya munali kwambiri mpweya, ikuchitika pafupipafupi). Kwa njirayi, m'masitolo kuti kugulitsa katundu zachipatala, kapena pharmacies zikuluzikulu zikhoza kugulidwa monga chipangizo m'malo chachikulu chifukwa ntchito ufulu ndi zitini yaing'ono. Yotsirizira akhoza kutenga ndi iwe pa msewu ndi ntchito, pamene iwo amayamba kufika kuchepa kwa mpweya. Mphumu - COPD, ndipo oopsa, kotero inu nthawi zonse kunyamula akhoza.

Ngati munthu si wokalamba kwambiri ndipo ali mu mawonekedwe zogwira mtima, n'zotheka kuchita opaleshoni. Pa mwakayakaya wa wodwalayo angafunike makina mpweya wabwino.

Momwe mungapewere chitukuko cha COPD?

Kupewa matenda a dongosolo kupuma ndi zofunika kwambiri. Woyamba ndi unachita kwambiri umalimbana popewa matenda a m'mapapo ndi kuwonongedwa kwa ndudu moyo wake. Izi muyeso ndi zothandiza kupewa matenda, komanso kuti asiye chitukuko cha matenda wayamba kale. Ngati ntchito yanu amagwirizana ndi kupanga aliyense, kumene ali nthawizonse kwambiri zitsulo aerosol kapena fumbi mafakitale, onetsetsani kuti amachita ntchito kazipangizo zodzitetezera. Koma muyeso zothandiza kwambiri kuteteza matenda - kuchotsedwa ntchito zoipa. Mu matenda osachiritsika a dongosolo kupuma, muyenera nthawi kupita kwa dokotala ndi kuyezedwa.

mbiri Chitsanzo matenda

Ofuna COPD, mbiri zachipatala mankhwala angaone chidwi. Tiyeni tione chitsanzo.

I. Information ku pasipoti ndi

dzina 1. Wodwala: Sergeev Vladimir Kuzmich.

2. Wodwala Gender: Male.

3. Age: '53.

4. Location: Omsk, up. Red Road, 18/7.

5. ulova.

6. chiwerengero ndi nthawi ya kufika ku chipatala: 19.02.2014 pa 14:55.

7. Tsiku kusiya kuchipatala kapena kunditumiza ku chipatala china -.

8. Kodi ndani amene wakutuma wodwalayo: anabweretsa ndi ndodo ambulansi.

9. A matenda bungwe limene anapulumutsa mtima ammudzi-anapeza ufulu amaganiza lobar chibayo.

10. matenda pa chikuonetseratu: kupuma insufficiency gawo loyamba. Kumanja amaganiza lobar chibayo, dera zinazake.

II. Madandaulo yaikulu ya mtima

Wodwala inanena kuti thupi kutentha wake umafika 39,5 ° C. Komanso, nthawi zonse akutsokomola ndipo anadandaula kwa ntchofu serous kuti n'zovuta otharknut. Izi kungasonyeze dongosolo kupuma.

III. madandaulo mtima Secondary

Wodwala nkhawa prostration, malaise, thupi kunthunthumira, amalephera bwino kugwira ntchito zawo, thukuta, migraine.

Kafukufuku wa dongosolo kupuma

Dyspnea: kumachitika pamene zolimbitsa thupi chikuphatikizidwa khalidwe.

Chifuwa sasiya tsiku lonse, mu pang'ono allocated mucous expectoration. N'zovuta otharknut.

Sputum; kumeneko slimy, katundu expectoration, ¼ chikho cha tsiku, sikudalira malo a mtima, fungo la unremarkable ake (zinadziwika matenda ambiri kupuma).

IV. mbiri zachipatala

matendawo anayamba mwadzidzidzi February 13, 2014 patapita kukhala yaitali kuzizira pamene kutentha wodwalayo anakonzeka 39,5ºS ndipo panali chifuwa youma. Wodwala sanamwe mankhwala aliwonse. Patapita masiku awiri chifuwa anali kale yonyowa ndi sputum katundu expectorated. Kutentha komanso sichinasinthe kwa masiku anayi. February 19, 2014 wodwala otchedwa ambulansi ndipo anamutengera Omsk mzinda kuchipatala. Iye atapezeka ndi dera anapeza ufulu amaganiza lobar chibayo. Wodwala sanali m'kaundula. Iye ananena kuti poyamba analibe matenda aliwonse a dongosolo kupuma, kuwonjezera matenda pachimake kupuma tizilombo. Pomaliza mbiri ya matenda zolimbitsa COPD.

V. Wodwala Moyo

Sergeev Vladimir Kuzmich anabadwa mu 1961 mu mzinda wa Omsk. Iye anali mwana woyamba wa makolo ake. Imatha kulemera atabadwa anali 2700 Mayi wa mtima pa nthawi ya kubadwa kwake anali ndi zaka 20, ndipo bambo wake - 28. mtima anali breastfed. Mu kalasi loyamba anapita pamene anali ndi zaka 6. Ndinaphunzira makamaka anayi. Pambuyo sukulu adalowa koleji. Anaphunzitsa zomangamanga.

Information za ntchito. Wodwala anayamba kugwira ntchito pa zaka 22, anakhala mmisiri. Zoopsa: ntchito pa msewu, fumbi, thupi ndi maganizo zimamuchulukira. Osati kale litali, iye anasiya ntchito.

osauka yachibadwa. chuma ndi kuleza mtima kuchipinda nyumba nyumba njerwa ndi. Pamaso pa zikamera wa dongosolo kupuma, anakhala kumeneko mwakachetechete ndi sanayembekezere vuto.

Odwala ngati mwana, sakumbukiranso. Malipoti kuti zowawa kamodzi matenda pachimake kupuma tizilombo. Amanena kuti si odwala kapena chifuwa chachikulu kapena opatsirana pogonana matenda kapena AIDS kapena matenda a chiwindi.

VI. Kuphunzira thupi

The chikhalidwe ambiri wodwala angatchedwe zolimbitsa, ndi malo yogwira, ndi chikumbu - osati ndimitambo ndi chilichonse. Nkhope akuti mwachizolowezi, maonekedwe a lodana ndi akuchita misala si anati. Easy gait. Kumanga zogwira mtima. Malinga ndi malamulo ndi normostenik. Kutalika kwa khosi, manja ndi mapazi ndi njila kutalika thupi. Kutalika - 165 masentimita; kulemera - 73 kg. Wodwalayo thupi kwambiri, kunenepa posachedwapa kukhala.

System kuonekera mucous nembanemba ndi khungu

Chikopa kuwala pinki hue, zikopa mucous, kufufuza kupezeka (maso, milomo, mphuno, pakamwa) wa mtundu womwewo. mtundu chowawa anapeza. Khungu mokwanira zotanuka. Kodi pali turgor. chinyezi wa khungu yachibadwa. Mu Kufufuza edema ambiri anapeza. Thupi palibe totupa, palibe mabala, palibe khungu, palibe amasonyeza mwa capillaries khungu.

Kupenda chifuwa

Thorax amatanthauza mtundu normostenicheskaya. Epigastric ngodya yoongoka. Unachitikira mwamphamvu kuti masamba ake pachifuwa. Zokambirana m'mbali yoongoka. mipata chidwi pakati pawo. Phewa komanso kumatanthauza, pang'ono kuonekera mabowo pamwamba ndi pansi pa iwo. Pa chifuwa zimaonekera palibe tokhala asymmetrical kapena concavities. Kupindika msana sakunena.

Kungotengeka m'mimba palpation

Padziko, akufufuza mpata wodwala analibe kusapeza aliyense, pamimba ndi yofewa, mwaonapo minofu aliyense silikuyenda kapena chophukacho bulges. Zizindikiro Shchetkina-Blumberg si anatsimikizira. Inguinal ndi umbilical mphete bwinobwino.

Maonekedwe a pamimba ndi wodwala atagona pa nsana wake

Pamimba zikuwoneka kwakukulu chifukwa cha mafuta subcutaneous minofu, mawonekedwe ake yachibadwa, ndi ofananira, kwinaku mukupuma kukacha. panalibe peristalsis appreciable anapeza. Pali venous maukonde pansi pa khungu m'mbali mwa mimba ndi kuzungulira m'michombo lapansi. Kusiyana rectus minofu ndi hernias anapeza. umbilicus The limachokera.

VII. A matenda presumptive

Pamaziko a nkhani wodwalayo, mbiri ya matenda, zambiri pa moyo ndi kafukufuku cholinga kuti wodwala akhoza kuika lotsatira matenda presumptive a chibayo gawo m'munsi mwa m'mapapo komwe ndi dera zinazake. matenda ndi amtengo. Palinso vuto, ndicho choyamba siteji kupuma kulephera. Komanso, mbiri ya matenda COPD akhoza kupanga kwambiri apeza zofunika.

VIII. The ndondomeko ya kafukufuku mtima

1. Complete magazi.

2. ultrasound Kupenda ziwalo ili mkati zonse m'mimba.

3. Analysis wa sayansi magazi (mapuloteni, urea, shuga, creatinine).

4. Total mkodzo.

5. Mwazi Wasserman.

6. Electrocardiogram.

7. Radiography ziwalo ili mu chifuwa.

8. ndowe pamaso pa mphutsi.

9. Bacteriological Kupenda sputum.

XI. Matenda komaliza ndi malongosoledwe

Pamaziko a nkhani wodwala, mbiri ya matenda, malangizo ndi zasayansi mayesero akhoza adzaikidwa pafupi ndi wodwala matenda ndi chibayo m'munsi gawo la m'mapapo komwe ndi dera zinazake. matenda ndi amtengo. Pano kupuma insufficiency gawo loyamba.

XII. mankhwala ngati pakufunika

1. Febrile nthawi amafuna okhwima bedi zina.

2. Wodwala ayenera kumamwa kowirikiza madzi ndi zakudya nambala 15 ndi Pevsner.

3. Causal mankhwala - mankhwala a mtundu "+ lotopetsa kwa masiku 5-7."

Chitsanzo china cha m'mbiri ya nthenda COPD

Tiyeni tikambirane za mbiri mlandu wina, ndi chimodzimodzi chidwi. madokotala watsopano adzakhala zothandiza kuwerenga ndi kutanthauzira.

I. Information Personal

dzina 1. Wodwala: Ivanov, Pyotr Ilyich.

2. Wodwala Gender: Male.

3. Tsiku la kubadwa: 1958 (zaka 56).

4. Occupation: zomangamanga.

5. Education: ntchito zamanja.

6. Location: Omsk, up. Marx, 23/2.

7. chiwerengero ndi nthawi ya kufika ku chipatala: 15.04.2014 pa 20:15.

8. Matendawa: pachimake exacerbation wa chifuwa. Kupuma kulephera kwa gawo loyamba.

9. Matenda ena: oopsa, mlingo wa ine, ngozi II.

II. Information za ntchito wodwalayo

Zinachitikira ambiri - zaka 40 ntchito zapaderazi ndi - 27.

Kufotokozera za kantchito. Kutalika kwa tsiku logwira ntchito - maola 8, yopuma - mphindi 60. Wodwala kupita pa tchuthi m'nthawi yake. The zapaderazi chachikulu - omanga.

III. Nkhani ya chikhalidwe wodwalayo

Atafika ku chipatala, wodwalayo inanena kuti iye anali malungo, amamva akudwala, iye anazunzidwa sputum ndi chifuwa, ndipo iye wayamba zitsamwitsa pa zolimbitsa thupi. Mu mbiri imeneyi matenda COPD n'zosadabwitsa, ndi mmene ndithu.

IV. Information za moyo wa wodwala

The limati mtima kuti si wodwala STD kapena shuga kapena kuvutika cholowa kapena matenda okhudza ubongo. Iye ananenanso kuti analibe zotupa ndi neoplasms. Pa mawu a wodwalayo, achibale ake komanso alibe matenda aliwonse kuchokera mndandanda. Wodwala inanena kuti mwana sadalole matenda (kutanthauza chikuku), kuwonjezera, iye anali ozizira ndi chibayo mu 2008. Koopsa zizolowezi: kusuta fodya, nthawi zimatengera mowa (madeti zofunika). Iye anabadwa mu 1958. Iye anali mwana wachiwiri m'banja. Ndinakulira ndipo anayamba moyo wabwino komanso a zikhalidwe zosiyanasiyana. Mwaphunzira kusukulu, ndinamaliza maphunziro anga ku koleji ndi digiri ku zomangamanga. Iye anayamba kugwira ntchito mu 1985.

V. Wodwala Survey

Kulemera kwake - 95 makilogalamu, kutalika - 188 masentimita. Chikhalidwe cha wodwalayo ndi chachilendo, malowa akugwira ntchito, ndipo chidziwitso sichimangokhala.

Khungu lakuda mthunzi wamthunzi, wotentha. Turgor ndi elasticity ndi zachilendo. Mafuta ochepetsetsa amatha kutchedwa oyenerera, amagawidwa mofanana. Nkhumba zowonongeka zilipo kuti zisayang'ane zilibe zolakwika. Zilonda zam'mimba zamtunduwu: zotsekemera, zofutukuka, osati zogulitsidwa ndi matenda omwe ali pafupi nawo. Panthawi yoyezetsa magazi, wodwalayo sanasangalale nazo.

Mapangidwe a mafupa a zofooka sanapezeke. Mafundo ndi oyenera, kusuntha kwawo sikungokwanira, palibe ululu. Mlingo wa chitukuko cha minofu, mawu awo, komanso mphamvu zimakhutiritsa.

Ponena za chithokomiro, zimakhala zazikulu zedi, sizimagulitsidwa kumatenda omwe ali pambali pake, imayenda, imakhala yosalala, sizimawonekera pamene ikuyang'ana zowawa zosangalatsa. Kuyezetsa kofunikira ndikofunika kuti munthu adziwe, koma mbiri ya COPD yokha siidakwanira.

Matenda omwe amayenera kupuma

Nthata imakhala yofanana, ya mawonekedwe abwino, mbali ziwiri zonse zomwe zimagwira ntchito ndikupuma. Kufufuza kwa maenje pamwamba ndi pansi pa clavicles kunkachitika. Iwo ali otchulidwa bwino ndi ofanana. Mipata pakati pa nthitiyo imatchulidwa bwino, imatuluka, pamene zovuta zimakhudza iwo, wodwalayo sauka.

Ziwalo zobisika

Mimba ndi mawonekedwe abwino. Pansi pa nthaka kuyesa zosavuta. Palibe kupweteka. Panthawi yozama, palibe zovuta zomwe zinkapezeka. Chiwindi chili ndi kukula kwake, sichiwoloka pamphepete mwa chigoba chotengera mtengo. Pa ululu wa ululu samawuka. Poyang'ana kuzungulira Kurlov, m'mphepete mwawo simukulirakulira. Nyongolotsi ndi ndulu sizingatheke. Wodwala amapita kuchimbudzi nthawi zonse, kamodzi patsiku, ntchito ya defecation ndi yachibadwa.

VI. Kufufuza koyambirira

Malinga ndi nkhani ya wodwalayo, iye amadzikweza pa masewero olimbitsa thupi (kukwera masitepe mpaka 3-4 pansi) kuti ali ndi mimba yam'mimba komanso chifuwa chosasangalatsa, chifuwa chosasangalatsa m'chifuwa, chidziwitso kuchokera kwa anamnesis (wodwala amene adafunsidwa mu dipatimenti yogwira ntchito, Kumeneku kunapezeka kuti anali ndi matenda a bronchitis) ndipo kufufuza kwa thupi (ngati kuyerekezerana kwapadera pamwamba pa mapapu ndikumveka phokoso la bokosi, panthawi yovuta kupuma kulimbidwa pamwamba pa ziwalo zonse , pali anthu owuma E wheeses) zikhoza kutsutsidwa kuti Ivanov kuchulukitsidwa kwa khate lachilendo. Motero, zizindikiro za madokotala zimatsimikiziridwa. Ngati kupewa matenda a mapulaneti kunali, ndiye kuti wodwalayo sanamuthandize.

VII. Ndondomeko yofufuza

1. Kawirikawiri kuyesa mkodzo: kokwanira.

2. Kuyezetsa magazi kwa chilengedwe: zachibadwa.

3. Kujambula: kuchepa kwa chiwerengero cha Tiffno.

4. Kuyezetsa magazi ambiri: zogwira mtima.

5. X-ray ya ziwalo zomwe zili mu chifuwa: ndondomeko yomveka bwino ya pulmonary.

Kupezeka kwa "kuchulukitsidwa kwa khate lachilendo" kumachokera pa zotsatirazi:

Nkhani ya wodwala kuti ali ndi mimba, chifuwa komanso kusowa kwa mpweya ndi zochitika.

2. Kudziwa za moyo wa wodwala: amasuta, ali ndi matenda aakulu.

3. Kufufuza kwa wodwalayo, pamene mndandanda wouma umaululidwa, komanso kupuma molimbika.

4. Maphunziro a Laboratory, pomwe kuchepa kwa chiwerengero cha Tiffno, kuchepa kwa chiwopsezo chazomwe zimayenda bwino, ndi X-ray, ndondomeko ya pulmonary yosavuta kwambiri inakhazikitsidwa.

VIII. Chithandizo

1. Zofunikira zoyenera: wamba.

2. Zakudya: № 15.

3. Mankhwala "Macropen" - piritsi limodzi katatu patsiku. 400 mg.

4. Sirasi "Khaliksol" - supuni imodzi yaikulu katatu patsiku.

5. Vitamini "Revit" - mapiritsi awiri kawiri pa tsiku.

6. Mapiritsi "Bromhexine" - katatu patsiku mpaka 0.008 g.

7. Physiotherapy: quartz pachifuwa, komanso iontophoresis.

Nthawi zonse n'kofunika kukumbukira kuti COPD ndi yoopsa. Mbiri ya zamankhwala ya matenda imatsimikizira izi.