成人哮喘急性发作的非常规药物治疗

哮喘是由包括嗜酸性粒细胞、肥大细胞、中性粒细胞、T细胞、气道上皮细胞等在内的各种细胞及细胞组分参与的气道慢性炎症性疾病,并以气流受限的可逆性为特点。支气管哮喘急性发作是急诊常见疾病之一,     

哮喘急性发作的糖皮质激素疗法

哮喘急性发作时往往需要在有效舒张支气管的同时给予糖皮质激素治疗。这时激素的选择应根据病情的进展速度、严重程度、既往哮喘发作的严重程度、药物的药效学和不良反应来决定。临床上用于哮喘治疗的糖皮质激素是多种多样的 ,吸入激素一般不作为首选 ,而静脉、肌注和口服激素的选择应根据具体情况决定。1　用于哮喘急性发作的常用糖皮质激素1.1　静脉注射给药　静脉和肌注糖皮质激素的特点是经静脉滴注或推注给药后可直接进入血液 ,因此一般起效快 ,但必然要经血液分布到周身各组织、器官 ,易产生全身不良反应 ,故疗程不宜过长。常用的静脉…     

支气管哮喘急性发作治疗的护理配合

通过总结26例支气管哮喘急性发作病人的护理,认为在哮喘息性发作时,护士主动积极地配合医生进行治疗、药物浓度检测和护理,对哮喘急性发作的缓解起着重要的作用.     

小儿支气管哮喘急性发作治疗的护理配合

近年来,支气管哮喘的发病率和病死率由于环境等因素的影响呈现逐年增高的趋势。在小儿哮喘急性发作时,护士主动积极地配合医生进行治疗、药物浓度检测和护理,对小儿哮喘急性发作缓解起着重要的作用。     

应用喷射式雾化器雾化治疗哮喘急性发作的护理

目的 探讨喷射式雾化器雾化治疗对哮喘急性发作的应用价值。方法 观察哮喘急性发作患者经雾化器药物雾化治疗后病人症状积分、最大呼气流量（PEF）、血流饱和度（SaO20）的改变。结果 雾化吸入后患者哮喘症状积分下降和PEF增加,血氧饱和度无明显降低。结论 应用喷射式雾化器治疗哮喘急性发作,可显著改善哮喘症状和肺功能。     

三联药物背肌注射治疗支气管哮喘急性发作临床研究--附600例病例报告

目的:探讨选择背部肌肉注射药物治疗支气管哮喘急性发作的治疗效果,皆在寻求一种方便、快捷、高效、安全的平喘治疗途径.方法:将确诊为支气管哮喘急性发作的963例患者中资料完整的600例随机分为A、B、C 3组.A组:在患者的背部注射本院配制的三联药物(决明茶碱,薯芋皂甙,莨菪碱);B组:常规肌肉注射上述三联药物;C组:质量分数为5%的葡萄糖20 ml 氨茶碱0.25 g 地塞米松10 mg静脉注射.治疗前及治疗20 min后3组均行肺功能测定,治疗20 min后评价疗效.结果:A组:显效时间1～10 min,明显改善率为49.0%,中度改善率为37.5%,轻度改善率为12.0%,无改善率为1.5%;B组:显效时间30～45 min,明显改善率为14.0%,中度改善率为11.5%,轻度改善率为42.5%,无改善率为32.0%;C组:显效时间5～15 min,明显改善率为46.0% ,中度改善率为36.5%,轻度改善率为13.0%,无改善率为4.5%;A、B两组疗效有显著性差异(P<0.01),A、C两组间无显著性差异(P>0.05).A组和C组治疗后用力肺活量(FVC)、第1秒呼出气量(FEV1)、呼气中段流量(MMEF)3项肺功能指标改善明显,B组治疗后无明显改善.结论:背肌注射药物方便易行、快捷、高效、安全,疗效可靠,同时避免了静脉用氨茶碱及激素带来的不良反应,临床值得推广.     

小儿支气管哮喘急性发作的药物治疗进展

目前临床上较常见的儿科疾病是小儿支气管哮喘,主要是指多项细胞或细胞组分参与的气道慢性炎症性疾病,往往与气道高反应性有直接联系,主要受到可逆性气流的限制,患儿往往表现为胸闷气短、反复性喘息与咳嗽等临床症状,在晨间或夜间易发作,若疾病早期不能实施有效的治疗措施,则极易对患儿的生活质量造成直接影响,病情严重者可危及生命,因此以患儿病情为基点,切实采取有效的治疗手段对改善其预后效果具有极重要的意义。本文分析小儿支气管哮喘急性发作的药物治疗进展,以供参考。     

支气管哮喘急性发作的动脉血气分析

支气管哮喘(以下简称哮喘)急性发作,特别是哮喘持续状态,存在动脉血气及酸碱紊乱,为指导临床治疗,估计预后,本文对1987年1月～1996年10月在我院内科呼吸病房住院100例资料完整的哮喘病人急性发作期的动脉血气进行回顾性分析,报告如下。 1 资料和方法 1.1 按1992年全国第一届哮喘会议制定的诊断标准选择病例,男性69例,女性31例,年龄19～80岁,平均49.8岁;均为哮喘急性发作患者,其     

支气管哮喘患者吸入糖皮质激素治疗依从性的研究

目的 调查门诊成人支气管哮喘患者吸入糖皮质激素治疗的依从状况,并探讨其影响因素.方法 采用便利抽样方法,选取北京市某三级甲等医院呼吸科门诊就诊的167例成人哮喘患者.用一般资料调查表、哮喘用药依从性量表和哮喘知识问卷分别测评患者的一般资料、吸入糖皮质激素治疗的依从性和哮喘知识水平;让患者采用吸入装置模型演示糖皮质激素的吸入方法,依据吸入技术的6个步骤判断患者的吸入方法是否正确.采用二元logistic回归对吸入糖皮质激素治疗依从性的影响因素进行统计分析.结果 哮喘患者吸入糖皮质激素治疗依从性好的比例为37.7％.logistic回归结果显示,疾病严重程度[OR =0.61,95％CI(0.44,0.86),P=0.01]、哮喘知识[OR=1.12,95％CI(1.01,1.25),P=0.03]及吸入技术[OR=2.94,95％CI(1.36,6.36),P＜0.01]对哮喘患者吸入糖皮质激素治疗依从性的影响有显著性差异.结论 门诊成人哮喘患者吸入糖皮质激素治疗的依从性不佳.疾病严重程度、哮喘知识及吸入技术影响患者吸入糖皮质激素治疗的依从性.     

Non-adherence to medication in asthma

Asthma morbidity and mortality continues to be high. One of the main reasons for this is non-adherence with medication. A health promotion strategy using Becker's Health Belief Model may help devise methods to improve adherence. Audit is vital to monitor the quality of services provided and ensure good standards of practice are maintained.     

Factors influencing compliance with asthma medication regimes

Asthma is a chronic illness that affects 1 in 4 children, 1 in 7 adults and 1 in 10 adults. Effective control of asthma requires a good level of knowledge and self-management. Current literature supports the premise that education is a vital ingredient in self-management. In this paper, the author has studied the literature to determine the factors which influence asthma management to determine if education alone is the key to good control or if compliance with asthma management regimens is reliant on factors other than education.     

Discovering asthma in the older adult

New-onset asthma may occur at any time in the life cycle, but it is often difficult to diagnose in older adults. The symptoms of asthma are strikingly similar to the symptoms of many cardiac and pulmonary diseases prevalent in this age group. This article discusses the presentation of undiagnosed asthma in the older adult, key management issues for this population, and techniques for assisting clinicians in identifying triggers that precipitate or worsen symptoms.     

Differential diagnosis of adult asthma

Although the term "all that wheezes is not asthma" is not new, and the long list of asthma masqueraders has remained essentially the same for several decades, the importance of knowing when to question the accuracy ofa diagnosis of asthma has remained critical for physicians who care for patients with respiratory symptoms. The concepts of "asthma control" and"asthma severity" are currently evolving, although the fundamental hall-marks that define the syndrome of asthma endure and should be mastered by asthma specialists. Asthma masqueraders, including several that may confound a correct diagnosis of asthma, are important to consider when either the presentation of asthma is atypical or the response of the patient to treatment is suboptimal. COPD and VCD head the list of diagnoses most likely to be confused with asthma in everyday practice. Correctly identifying the diagnosis of COPD enables implementation of an up-to-date treatment plan that differs from asthma management. VCD is a vastly under recognized syndrome whose existence is widely accepted but whose pathophysiology is poorly understood, and correctly identifying a VCD component to asthma symptoms enables both a reduction in costly and potentially harmful asthma medications and focus on specific VCD treatment, such as speech therapy. For less common and uncommon asthma masqueraders, it is important to be familiar with their typical clinical presentation and basic diagnostic approaches.     

Advances in therapy for adult asthma

There are >22 million Americans with asthma. Chronic asthma is a worldwide problem with an increasing socioeconomic burden on individuals and on society. Recent advances have been made in diagnostic lung imaging, defining control of asthma, as well as in the education of patients with asthma. Accurate diagnosis of the cause of chronic cough in adults and of asthma in elderly individuals will help affected individuals receive appropriate treatment. Inhaled corticosteroids are the recommended first-line therapy for persistent asthma and can help prevent exacerbations in patients with asthma that are not well controlled. Early intervention and improved management can significantly reduce the socioeconomic burden of asthma. Patient education is an essential part of asthma management.