Today there is a male patient in his 50s in the ward, which is a very regrettable patient, a very painful patient, if the medical treatment can be as convenient as picking up the mobile phone to brush the video, his disease will definitely not develop into today's state.
This patient has asthma since childhood, before the age of 10 is very frequent, after the age of 10 his asthma symptoms have slowly been alleviated to a certain extent, especially after the age of 20, the symptoms have eased a lot, and then he began to smoke, causing his asthma, relapsed at the age of 40, more serious than the original, the result of 50 years old, has been completely unable to walk, sitting still feel breathing difficulties.
When he came, his lips were purple, obviously in a state of hypoxia, the oxygen saturation of his fingers was only 80% in the state of not inhaling oxygen, and he was measured with a lung function, and there was still 19% left, and 81% had been lost.
Ask him how is the disease usually controlled? He said he had never used medicine in his life, so why not come to the hospital? He said it was too much trouble to see a doctor.
His words speak to everyone's voice, our country's medical resources are still very scarce, especially high-quality medical resources, extremely scarce. In order to obtain high-quality medical resources, you need to register in advance, queue up for a long time, queue up for examinations, and queue up for follow-up, which often takes a lot of time, which is really very inconvenient. If seeing a doctor can be as simple as picking up a mobile phone to watch a video, he can at least consult a doctor on his mobile phone.
Can asthma be cured? What are the treatment goals? Unfortunately not. But it can be completely controlled, and the stages of asthma are as follows: 1. Acute onset: refers to the sudden onset of wheezing, shortness of breath, cough, chest tightness and other symptoms, or the aggravation of the original symptoms, often with dyspnea, characterized by decreased expiratory flow, often induced by exposure to allergens, irritants or respiratory infections. 2． Chronic duration: refers to the patient's symptoms such as wheezing, shortness of breath, chest tightness, and cough at different frequencies and/or degrees each week. 3． Clinical remission period: refers to the patient without wheezing, shortness of breath, chest tightness, cough and other symptoms, and maintained for more than 1 year. From this staging, we can see that there is no seizure, not completely good, but in the clinical remission period, and if you are exposed to allergens in the future, you will have another attack. The goal of asthma treatment is to try to keep all patients in clinical remission, without any symptoms, and for more than a year.
How do I know how well I have asthma control? 1, there is economic strength, conditional can buy a lung function or peak flow meter, blow it every day, monitor whether their lung function is stable, good control. 2, the economic strength is not very good conditions do not allow, you can use the act questionnaire, go to the Internet to search for this questionnaire, fill in it regularly.
Act is simple and easy to operate, suitable for application in primary hospitals. Note: Act questionnaire score interpretation: 20 to 25 points, asthma is well controlled; 16 to 19 points, asthma is partially controlled; 5 to 15 points, asthma is not controlled
Common drugs: Drugs used to treat asthma are mainly divided into two categories:
First, control drugs: that is, drugs that need to be used every day and maintained for a long time, mainly through their anti-inflammatory effects to maintain asthma patients in a state of clinical control, including budesonide, fluticasone, budesonide formoterol, salmeterol ticasone, systemic sex hormones, leukotriene modulators (ltra), sustained-release theophylline, anti-ige monoclonal antibodies;
The second is remission drugs: also known as emergency drugs, which can be used as needed during acute attacks, mainly by rapidly relieving bronchospasm to alleviate asthma symptoms in patients, including rapid inhalation and short-acting oral beta2 receptor agonists salbutamol, ics/formoterol, systemic hormones, inhaled anticholinergic drugs, and short-acting theophylline.
Principles of de-escalation treatment:
(a) When asthma symptoms are under control and lung function is stable for at least 3 months, treatment may be considered for downgrading, and if the patient has risk factors for acute exacerbations or fixed airflow restriction, de-escalation therapy needs to be carried out under close supervision;
(b) Choose the right time for downgrade treatment: avoid respiratory infections, pregnancy, travel, etc.;
(c) Each reduction treatment should be considered a trial to involve the patient in treatment, record asthma status (symptom control, lung function, risk factors), write an asthma action plan, closely observe symptom control, pef changes, and follow up regularly to ensure that patients have enough medication to return to their original treatment regimen;
(d) It is usually safe to reduce the ics dose by 25% to 50% every 3 months.
Discontinuation of medication may be considered if the patient has achieved asthma control for 1 year with the lowest dose of controlled agents and asthma symptoms do not occur again.
If you have any questions about asthma and lung diseases, you can ask me about the image link below.
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