Monday, 29 February 2016

Η ΧΡΟΝΙΑ ΑΠΟΦΡΑΚΤΙΚΗ ΠΝΕΥΜΟΝΟΠΑΘΕΙΑ, ΕΙΝΑΙ ΝΟΣΟΣ ΠΡΟΒΛΕΨΙΜΗ ΚΑΙ ΘΕΡΑΠΕΥΣΙΜΗ, ΧΑΡΑΚΤΗΡΙΖΕΤΑΙ ΑΠΟ ΧΡΟΝΙΑ ΑΠΟΦΡΑΞΗ ΣΤΗ ΡΟΗ ΤΟΥ ΑΕΡΑ ΣΤΙΣ ΕΝΔΟΘΩΡΑΚΙΚΕΣ ΑΝΑΠΝΕΥΣΤΙΚΕΣ ΟΔΟΥΣ, ΜΟΝΙΜΗ ΚΑΙ ΕΞΕΛΙΣΣΟΜΕΝΗ που οφείλεται σε ανωμαλίες αεραγωγών ή / και των κυψελίδων που προκαλούνται συνήθως από σημαντική έκθεση σε επιβλαβή σωματίδια ή αέρια.. Ο χρόνιος περιορισμός της ροής του αέρα που είναι χαρακτηριστικό της ΧΑΠ προκαλείται από συνέργεια της νόσου των μικρών αεραγωγών (π.χ., αποφρακτική βρογχιολίτιδα) και της καταστροφής του παρεγχύματος (εμφύσημα), οι σχετικές συνέργειες των οποίων ποικίλλουν από άτομο σε άτομο. Η χρόνια φλεγμονή προκαλεί δομικές αλλαγές, στένωση των μικρών αεραγωγών, καταστροφή του πνευμονικού παρεγχύματος που οδηγεί στην απώλεια στήριξης των μικρών αεραγωγών και μειώνει την πνευμονική ελαστική επαναφορά. Με τη σειρά τους, αυτές οι αλλαγές μειώνουν την ικανότητα των αεραγωγών να παραμένουν ανοικτοί κατά την εκπνοή. ΑΥΤΗ Η ΑΠΟΦΡΑΞΗ, ΜΕ ΤΗΝ ΠΡΟΟΔΕΥΤΙΚΑ ΕΠΙΔΕΙΝΟΥΜΕΝΗ ΦΥΣΗ ΤΗΣ ΚΑΙ ΜΟΝΟ ΜΕΡΙΚΩΣ ΑΝΑΣΤΡΕΨΙΜΗ ΜΕ ΚΑΤΑΛΛΗΛΕΣ ΘΕΡΑΠΕΙΕΣ, ΜΠΟΡΕΙ ΝΑ ΣΥΝΥΠΑΡΧΕΙ ΜΕ ΣΗΜΑΝΤΙΚΕΣ ΣΥΣΤΗΜΑΤΙΚΕΣ ΕΚΔΗΛΩΣΕΙΣ Η΄ ΜΕ ΤΗΝ ΠΑΡΟΥΣΙΑ ΣΥΓΧΡΟΝΩΣ ΚΑΙ ΑΛΛΩΝ ΑΣΘΕΝΙΩΝ. ΤΟ ΚΑΠΝΙΣΜΑ ΕΙΝΑΙ Η ΣΗΜΑΝΤΙΚΟΤΕΡΗ ΑΙΤΙΑ ΓΙΑ ΤΗΝ ΑΝΑΠΤΥΞΗ ΤΗΣ ΧΑΠ, ΠΡΕΠΕΙ ΝΑ ΥΠΟΠΤΕΥΘΟΥΜΕ ΤΗΝ ΥΠΑΡΞΗ ΤΗΣ ΣΕ ΟΛΟΥΣ ΤΟΥΣ ΚΑΠΝΙΣΤΕΣ Ή ΠΡΩΗΝ ΚΑΠΝΙΣΤΕΣ ΑΝΩ ΤΩΝ 40 ΕΤΩΝ ΚΑΙ ΣΕ ΑΣΘΕΝΕΙΣ ΜΕ ΑΣΘΕΝΕΙΕΣ ΕΞΩ-ΠΝΕΥΜΟΝΙΚΕΣ ΣΧΕΤΙΚΕΣ ΜΕ ΤΟ ΚΑΠΝΙΣΜΑ (ΛΧ ΕΜΦΡΑΓΜΑ ΜΥΟΚΑΡΔΙΟΥ ..) ΧΑΠ : Βασικές Αρχές στη Διάγνωση 1)Ιστορικό: (δύσπνοια, χρόνιος βήχας, χρόνια απόχρεμψη) 2)Έκθεση σε παράγοντες κινδύνου 3)Σπιρομέτρηση:Η διάγνωση επιβεβαιώνεται με τη σπιρομέτρηση. Μετά από βρογχοδιαστολή FEV1/FVC <0,70 σημαίνει μόνιμη απόφραξη των αεραγωγών. ΕΚΤΟΣ ΑΠΟ ΤΟ ΚΑΠΝΙΣΜΑ, Η ΑΤΜΟΣΦΑΙΡΙΚΗ ΡΥΠΑΝΣΗ ΤΩΝ ΜΕΓΑΛΟΥΠΟΛΕΩΝ ΚΑΙ Η ΕΚΘΕΣΗ ΣΕ ΣΚΟΝΕΣ ΚΑΙ ΜΙΚΡΟΣΩΜΑΤΙΔΙΑ ΘΕΩΡΟΥΝΤΑΙ ΑΙΤΙΟΛΟΓΙΚΟΙ ΠΑΡΑΓΟΝΤΕΣ ΒΕΒΑΙΟΙ ΓΙΑ ΑΝΑΠΤΥΞΗ ΧΑΠ. Η ΠΡΟΛΗΨΗ ΕΙΝΑΙ Ο ΜΕΓΙΣΤΟΣ ΣΤΟΧΟΣ. ΠΡΩΤΑ ΣΥΜΠΤΩΜΑΤΑ: ΑΡΑΙΟΣ ΒΗΧΑΣ ΙΔΙΩΣ ΠΡΩΙΝΟΣ, ΒΛΕΝΗ Ή ΠΤΥΕΛΑ, ΚΟΥΡΑΣΗ ΣΤΗΝ ΑΝΗΦΟΡΑ Ή ΣΤΙΣ ΣΚΑΛΕΣ.. Η ΕΓΚΑΙΡΗ ΕΝΑΡΞΗ ΘΕΡΑΠΕΥΤΙΚΗΣ ΑΓΩΓΗΣ ΣΤΟΥΣ ΑΣΘΕΝΕΙΣ ΜΕ ΧΑΠ- ΜΑΖΙ ΜΕ ΤΗΝ ΔΙΑΚΟΠΗ ΚΑΠΝΙΣΜΑΤΟΣ ΕΙΝΑΙ ΣΗΜΑΝΤΙΚΟ ΓΙΑ ΤΗΝ ΑΝΤΙΜΕΤΩΠΙΣΗ ΤΗΣ ΝΟΣΟΥ. Ο ΑΓΩΝΑΣ ΓΙΑ ΕΝΑ ΚΑΘΑΡΟ ΠΕΡΙΒΑΛΛΟΝ ΧΩΡΙΣ ΡΥΠΟΥΣ ΚΑΙ ΚΑΠΝΟ ΠΡΕΠΕΙ ΝΑ ΕΙΝΑΙ ΣΥΝΕΧΗΣ ΚΑΙ ΙΣΧΥΡΟΣ.
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