Caso Clinico de Asma

 

EKH^JTKD DN EKRIKHLK \ BLA[^ÉILHK

NXH^NJK VRAENXLA@KJ DN EKRIKHLK \ BLA[^ÉILHK KXLOK@T^RK7 EKRIKHATNRKÌ^TLHK TKRNK @¶ L@EARIN V-8 \ V-4 TNIK7 TNIK 8 \ TNIK 4 DAHN@TN7 TARRNX UNJLW, NR@NXTA RK^J T^R@A7 EB=@;

HLHJA7 ULLL

L@TNORK@TNX7  

 

 

HHARKM^K DN JK HR^W, IALXÌX HKXTLJJA UNRDN, @LRK TRA@HAX JLULKVAIK, TMKJLK RN@NN JLIK\JJK ^RBK@A, NJLWKBNTM ILRLKI

ENHMK DN N@TRNOK7 ;;/;6/2626

 

Hksa hjé`lha pkrk ldn`tlelhkhlø` dn VRI y eu`dkin`tkhlø` Rask B. dn 82 kûas, ksiëtlhk hrø`lhk ha`trajkdk ha` indlhkin`tas, dlkbìtlhk ha`trajkdk, ha` dlntk, ha` k`tnhndn`tns dn ujhnrk pìptlhk, khudn k jk ekrikhlk k ha`sujtkr sabrn kjou`as prabjniks ha` rnspnhta k su n`enrindkd y sus indlhl`ks. Hain`zø k trkbkgkr mkhn qul`hn déks n` u` hksl`a da`dn `a mky za`k pkrk euikdarns y dnblda k qun tln`n qun nstkr pkrkdk hksl tada nj dék nstë pkdnhln`da dn dajarns dn radljjk, par ja qun sn kutaindlhk ksplrl`k (khlda khntlj skjlhéjlha). Mkhn u` pkr dn déks mk hain`zkda k tn`nr prabjniks rnsplrktarlas sl` hkusk kpkrn`tn, su ejuga plha khtukj ns in`ar dn 56% dnj vkjar prnvlsta, n` jk ÷jtlik snik`k sn dnspnrtø ha` sé`taiks `ahtur`as ernhun`tnin`tn, k pnskr qun taik tnaeljl`k k`tns dn khastkrsn. Khtukjin`tn nstë prnahupkdk parqun mk kuin`tkda su kpntlta y su ojuhask nstk njnvkdk. Nstk rnhlì` hkskdk, y dnsnk tn`nr mlgas ja iës pra`ta paslbjn. Nstë usk`da n` nj iain`ta iain`ta skjbutkiaj dlkrlkin`tn  Kj rnvlskr jk rnhntk khtukj sn n`hun`trk qun taik7

Bnhjaintksa`k 2>6 uo/l`mkjkhlø`. >66 uo dék

Tnaeljl`k 266 io ;

tkbjntk k`tns dn darilr.

Vrnd`lsa`k 26 io 2 tkbjntk n` jk ikûk`k (par huktra snik`ks). Trkbkgn sabrn jk mlpøtnsls dlko`østlhk dn ksik bra`qulkj hrø`lhk. ±[uì pkskrék sl n` atra hksa taik hlpraejaxkhl`a1

Nj pkhln`tn ha` jk ndkd qun tln`n dn 82 kûas dn ndkd, padrlk prnsn`tkr u`k sabrndaslelhkhlø` dn kjou`as indlhkin`tas, khaipkûkda ha` RKI (rnkhhla`ns kdvnrsks), yk qun kj ha`suilr jk tnaeljl`k padrlk k njjk kuin`tkrjn jas prabjniks sìrlhas y padrék` jjnokr k dlsil`ulr huk`da sn kdil`lstrn nj ha`suia dn hlpraejaxkhl`a, ksl dkrékias jk ha`hjuslø` dn qun jk tnaeljl`k jjnokrék k kuin`tkr nj intkbajlsia dn jks n`zliks mnpëtlhks dnj pkhln`tn.

 

VR VRI I NXV XVNH NHLE LELLHA

Rnkj Rn kj a

Tlpa dn

Eu`dkin`ta (ekrikhadl`ëilha, ekrikhahl`ìha, nstudlas

patn`hlkj

VRI(Il``nsatk)

absnrvkhla`kjns, nth.)

;. Vrabjniks rnsplrktarlas l`duhlda par nj muia dn tkbkha par (Tnajl`k)

2. Mlpnrojuhnilk ahksla`kda par jk Vrnd`lsa`k.

 

Nenhvldkd RNKJ

Vatn`hlkj

Xnourldkd 

Jk dnorkdkhlø` dn jk tnaejl`k pundn khnjnrkrsn y/a su bladlspa`lbljldkd bladlspa`lbl jldkd y nehkhlk rnduhlrsn, n` pkhln`tns uikdarns, Jk tnaejl`k pnrtn`nhn kj orupa dn jks injxk``ks (dnrlvkdas dn jk purl`k). Nj intkbajlsia dn tnaejl`k ns slo`lehkvkin`tn iës rëplda n` uikdarns, ns par njja qun kj ksahlkrsn nj muia dnj tkbkha ha` jk tnaejl`k `a prnsn`tkrék bra`hadljktkhlø` y ns par nsa qun pravahkrék u`k dlsil`uhlø` dn jks Ha`hn`trkhhla`ns dn jk tnaejl`k y ns par njja qun jjnok k tn`nr prabjniks rnsplrktarlas rnjkhla`kda ha` u`k bra`haha`strlhhlø`. Kuin`tk nj kpnta y jk l`onstk hkjørlhk, nsiujk` jk jlpøjlsls. Var atra jkda, kuin`tk jk jlpaoì`nsls, nnhta qun padrék nstkr indlkda par jk l`sujl`k jlbnrkdk n` rnspunstk k jk mlpnrojuhnilk, ns par njja qun sno÷` nj inhk`lsia dn khhlø` kuin`tk ha` rnhun`hlk jk ojuha`naoì`nsls mnpëhk, dlsil`uhlø` dn jk rnslstn`hlk pnrlìrlhk dn jk ojuhask y kuin`tk` jk rnslstn`hlk k jk l`sujl`k ns par njja qun sn vlnrk n` nj hksa su kjta é`dlhn njnvkda dn ojuhask.

Xnourldkd

8. Dls`nk rnjkhla`kda ha` ksplrl`k (ëhlda

RNKJ

L`dlhkhlø`

khnjskjlhéjlha)

4. L`enrjldkd nstk rnjkhla`kda ha` jk prnd`lsa`k

>. L`tnrkhhlø` n`trn tnajl`kprnd`lsa`k

 Vatn`hlkj

Vatn`hlkj

Xnourldkd

Xnourldkd

Nj ëhlda khnjskjlhéjlha l`mlbn jk arikhlø` dnj traibaxk`a K2, par jk khnjkhlø` dn jk hlhjaaxlon`ksk dn jks pjkquntks. Nstn nnhta k`kornok`tn ns lrrnvnrslbjn durk`tn jk vldk dn jks pjkquntks, ns par njja qun kuin`tk jas jnuhatrln`as, jk bra`haha`strlhhlø` y jk hukj vk k dnsn`hkdn`kr nj ksik pkrk praduhlr u`k khhlø` lrrnvnrslbjn x nj ëhlda krkquldø`lha ksl praduhlrék u`k bra`haha`strlhhlø`/ bra`hanspksia. Jas harhaldns sa` u` orupa dn maria`ks qun snornok `unstra arok`lsia dn arik `kturkj pkrk rnoujkr jk l`kikhlø`, nj slstnik l`iu`ltkrla y nj intkbajlsia dn pratné`ks, pundn` dlsil`ulr jk praduhhlø` dn jk maria`k ajéhuja-nsiujk`tn (EXM) y jk maria`k jutnl`lzk`tn (JM) l`tnrerln`da dn nstk ik`nrk n` jk avujkhlø`. Jk tnaejl`k rnjkgk nj i÷shuja jlsa bra`qulkj, ksé haia jas vksas pujia`krns. Nj harhaldn pundn pravahkr u`k paslbjn patn`hlkhlø` dnj nnhta y/a taxlhldkd dnj ërikha par l`mlblhlø` dn su intkbajlsia mnpëha

 

5. L`duhlr nj rlnsoa dn

RKI

kpkrlhlø` dn ujhnrk pìphk k

Vatn`hlkj

L`tnrkhhlø` 

ksplrl`k ‘ prnd`lsa`k

?. Rlnsoa dn l`taxlhkhlø` dn jk tnajl`k l`duhldk par nj hlpraaxkhl`a.

Vatn`hlkj

Xnourldkd

Vrnd`lsa`k l`mlbn k jk asajlpksk LL, par atra jkda, jk hlhjaaxlon`ksk qun vk k nstkr l`mlblda, dn kmé l`mlbn k jk hlhjaaxlon`ksk jk ksplrl`k kht÷k k `lvnj dn jas traibaxk`as. Dlsil`uyn jks prastkojk`dl`ks (sa` vksadljktkdarks / in`ar rnpkrkhla` hnjujkr dnj tnglda) qun sa` oksta pratnhtarks qun sa` l`mlbldks par nj iaha, nj blhkrba`kta y dlsil`ulr nj khlda hjarmédrlha (dkûk jks hìjujks), y dnbn dn mkbnr u`k iuy bun`k rnoujkhlø`. Jk kdil`lstrkhlø` ha`hailtk`tn dn hlpraaxkhl`a y zk`ldl`k nstë ha`trkl`dlhkdk. Var ja tk`ta, sn dnbnrë ha`trajkr nstrnhmkin`tn k jas pkhln`tns qun tain` nstas ërikhas ha`hailtk`tnin`tn ha` hlpraaxkhl`a, pkrk dntnril`kr jk prnsn`hlk dn slo`as hjé`lhas dn sabrndasls, y pundn snr `nhnskrlk jk dntnril`khlø` dn jks ha`hn`trkhla`ns sìrlhks (p.ng. tnaejl`k). Hlpraaxkhl`a l`mlbn nj H\V;K2 y, par ja tk`ta, pundn hkuskr u` kuin`ta dn jk ha`hn`trkhlø` sìrlhk dn ërikhas qun sn intkbajlzk` par nstk vék, huk`da sn kdil`lstrk` ha`hailtk`tnin`tn.