bronxialnaya astma

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prezentatsiya powerpoint buxarskiy gosudarstvenniy meditsinskiy institut kafedra 2-pediatriya bronxialnaya astma. etiologiya, patogenez, klinika, diagnostika, lechenie, profilaktika. bronxialnaya astma xronicheskoe retsidiviruyushee obstruktivnoe zabolevanie dixatelnix putey, kotoroe proyavlyaetsya pristupami udushya, vsledstvie bronxospazma, oteka, gipersekretsii, diskrinii, na fone geneticheski determinirovanoy sklonnosti k allergii (i.s.smiyan, 2006) anatomo-fiziologicheskie osobennosti organov dixaniya maloe kolichestvo ellasticheskix volokon  uzkie bronxi+otek slizmstoy, gipersekretsiya bronxialnix jelez  obstruktsiya (gipoventilyatsiya-emfizema-atelektaz); nezrelost resnichnogo epiteliya  sklonnost k narusheniyu evakuatornoy funktsii traxeobronxialnogo dereva; etiologiya i patogenez bronxialnoy astmi і. geneticheskaya predraspolojennost – vrojdenniy immunodefitsit: defekt -adrenergicheskix rts povishena chuvstitelnost bronxov k bav  bronxialnaya giperreaktivnost; іі. sensibilizatsiya organizma: induktori (ekzogennie, endogennie allergeni); trigeri (fizicheskaya nagruzka, meteoizmeneniya, pasivnoe kurenie, rezke zapaxi); ііі. allergicheskie reaktsii – tri posledovatelnie fazi: immunologeskaya, patoximicheskaya, patofiziologicheskaya; patogenez bronxialnoy astmi і. nasledstvennie faktori іі. sensibilizatsiya organizma: allergeni ііі. allergicheskie reaktsii defekt adrenergicheskix rts povishena chuvstvitelnost slizistoy k bav narushenie immunologicheskoy reaktivnosti antigen + antitelo videlenie bav vliyanie na kletki-misheni …

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skim antigenam etiopatogenez bronxialnoy astmi ekzogennie allergeni і. neinfektsionnie: bitovie – domashnyaya pil (75-80 %):klesh dermofagoideus pteronissimus (50 %); piltsovie – piltsa trav, derevev (35 %); pishevie (25-30 %): rostitelnie – frukti, ovoshi, zlaki; jivotnie – myaso, riba, yaytsa, epidermalnie – sherst, volosi, perxot jivotnix; lekarstvennie – medikamenti, vaktsini, sivorotki; ximicheskie; іі. infektsionnie: bakterii, virusi, gribki (10-25 %); ekzogennie allergeni: pishevie: produkti s visokoy allergizatsiey: yaytsa, riba, ikra, moreprodukti, krupi – pshenitsa, roj; ovoshi – morkov, pomidori; frukti – tsitrusovie, granati, dinya, xurma; yagodi – klubnika, malina; shokolad, kakao, orexi, med, gribi; produkti so sredney allergizatsiey: tselnoe moloko, maslo, govyadina, kuryatina, grechka, oves, ris, gorox, bobi, soya; ovoshi – kartofel, svekla; frukti – persiki, abrikosi; yagodi – vishni, chernika, smorodina; klassifikatsiya ba і. po techeniyu: intermitiruyushaya ba (epizodicheskaya) - (і stepen), persistiruyushaya ba (postoyannaya): legkaya persistiruyushaya (іі stepen) seredney tyajesti (ііі stepen tyajelaya persistiruyushaya (іv stepen) іі. period zabolevaniya: obostrenie; …

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ostrenii. – narushen. fiz. aktivnosti, sna snijenie trudosposobnosti,fiz.aktivn, sna ogranichenie fizich. aktivn., korotkiy son psv ≥80% psv 80 % ot normi; sutochnie kolebaniya ofv1abo pshv 80 % ot normi; sutochnie kolebaniya ofv1abo psv – 20-30 %; klassifikatsiya ba sredney tyajesti persistiruyushaya ba – ііі stepen simptomi -ejednevno; nochnie simptomi – chashe 1 raza/nedelyu; neobxodimost ejednevnogo ispolzovaniya 2-agonistov korotkogo deystviya; pokazateli ofv1abo psv – 60-80 % ot normi; sutochnie kolebaniya ofv1abo psv > 30 %; klassifikatsiya ba tyajelaya persistiruyushaya ba – іv stepen simptomi est ejednevno; astmaticheskie sostoyaniya; nochnie simptomi –kajduyu noch; ogranichenie fizicheskoy aktivnosti; pokazateli ofv1ili psv – menshe 60 % ot normi; sutochnie kolebaniya ofv1ili psv > 30 %; pikfloumetr narushenie proxodimosti bronxov – ob'em vozduxa na vidoxe v edinitsu vremeni ( psv - pikovaya skorost vidoxa), l/min pikfloumetr ( psv - pikovaya skorost vidoxa), l/min provoditsya 2 raza v sutki (utrom i vecherom); ispolzuetsya u detey posle 5-let; …

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yasa); klinika osobennosti pristupa: vtyajenie mejreberiy; vibuxanie nad- i podklyuchichnix yamok; perkutorno - korobochniy zvuk, auskultativno - oslablenie dixaniya s udlinennim vidixom, diffuznie rasseyanie suxie svistyashie xripi na vidoxe; u detey rannego vozrasta - raznokalibernie vlajnie xripi na vdoxe; taxikardiya, povisheno ad, boli v jivote, rvota; klinika osobennosti poslepristupnogo perioda: umenshaetsya chd, usilivayutsya kataralnie proyavleniya, uvelichivaetsya raznoobrazie fizikalnoy kartini (kolichestvo vlajnix xripov), kotorie bistro ischezayut, uluchshaetsya obshee sostoyanie; remissiya (mejpristupniy period): klinicheskie proyavleniya zabolevaniya otsutstvuyut . kriterii klinicheskogo diagnoza ba dlya detey mladshe 3 let: nalichie postoyannix/retsidiviruyushix xripov + odin bolshoy faktor riska (astma ili ekzema v semeynom anamneze) ili tri malix faktora riska (eozinofiliya, allergicheskiy rinit, xripi bez priznakov prostudi) dlya detey starshe 5 let: klinicheskie proyavleniya + pokazateli skorosti vidixaemogo vozduxa (spirogramma, pikfloumetriya ); astmaticheskiy status obuslovlen glubokoy blokadoy β-adrenergicheskix retseptorov: chastim ispolzovaniem simpatomimetikov; infektsionnim protsessom; nedostatochnostyu gks v lechenii; astmaticheskiy status zatyajnoy pristup, nekupiruemiy bolshe 6 chasov; …

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menti lecheniya ba (global strategy for asthma management and prevention, revised 2006) dlya lecheniya ba: kontroliruyushie i simptomaticheskie preparati preparati kontrolya (bazisnie, profilakticheskie) – ispolzuyutsya ejednevno, dlitelno, pozvolyayut kontrolirovat techenie ba; preparati kontrolya (bazisnie): ingalyatsionnie gks (igks), modifikatori leykotrienov, β2-agonisti tdlitelnogo deystviya (ingalyatsionnie i oralnie), teofilini, kromoni, sistemnie gks, antigistaminnie; preparati kontrolya ba - profilaktika (bazisnaya terapiya): 3. kombinirovannie preparati - ingalyatsionnie β2-agonisti dlitelnogo deystviya (salmeterol - serevent) + igks (fliksotid): seretid, simbikort sredstva ingalyatsionnoy texniki: nebulayzer sredstva ingalyatsionnoy texniki: nebulayzer s mundshtukom nebulayzer s maskoy sredstva ingalyatsionnoy texniki: dai - dozirovanniy aerozolniy ingalyator; sredstva ingalyatsionnoy texniki: speyser sredstva ingalyatsionnoy texniki: speyser sredstva ingalyatsionnoy texniki: zaderjivayushie kameri - speyser, sinxroner, bebixaler sredstva ingalyatsionnoy texniki: speyser s maskoy sredstva ingalyatsionnoy texniki: zaderjivayushie kameri - bebixaler sredstva ingalyatsionnoy texniki: diskus, dai dpi - dozirovannie poroshkovidnie ingalyatori - spinxaler, rotaxaler, turboxaler, diskxaler, diskus astmaticheskiy status neotlojnaya terapiya otmenit simpatomimetiki (adrenalin, efedrin)! uvlajnenniy kislorod …

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prezentatsiya powerpoint buxarskiy gosudarstvenniy meditsinskiy institut kafedra 2-pediatriya bronxialnaya astma. etiologiya, patogenez, klinika, diagnostika, lechenie, profilaktika. bronxialnaya astma xronicheskoe retsidiviruyushee obstruktivnoe zabolevanie dixatelnix putey, kotoroe proyavlyaetsya pristupami udushya, vsledstvie bronxospazma, oteka, gipersekretsii, diskrinii, na fone geneticheski determinirovanoy sklonnosti k allergii (i.s.smiyan, 2006) anatomo-fiziologicheskie osobennosti organov dixaniya maloe kolichestvo ellasticheskix volokon  uzkie bronxi+otek slizmstoy, gipersekretsiya bronxialnix jelez  obstruktsiya (gipoventilyatsiya-emfizema-atelektaz); nezrelost resnichnogo epiteliya  sklonnost k narusheniyu evakuatornoy funktsii traxeobronxialnogo dereva; etiologiya i patogen...

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