VRACHNING KLINIK AMALIYOTIDA CHO’QQI INSPIRATOR OQIMINI BAHOLASHNING MUHIMLIGI
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eng yuqori nafas olish oqimi (PIF), suboptimal eng yuqori nafas olish oqimi (sPIF), o'lchovli dozali inhaler (MDI), kukunli inhaler (PI)##article.abstract##
Nafas olishning obstruktiv patologiyasi bo'lgan 100 nafar bemorda nafas olishning eng yuqori oqimini (PIF) baholash uchun ingalatsiyali respirator terapiyani optimallashtirish uchun ingalatsiya moslamasini tanlash doirasida In-Check DIAL(Clement Clarke International Ltd., Buyuk Britaniya) qurilmasi yordamida PIPni funktsional o'rganish o'tkazildi, bunda nafas olishda simulyatsiya qilingan qarshilik inhaleri bilan, asboblar paneli qo’yidagi oqimlarni hisobga oldi: qarshiliksiz R0 va qarshilikning 4 darajasi, shu jumladan R1 - past qarshilik, R2 - o'rta-past, R3 - o'rta, R4 - o'rta-yuqori qarshilik.
Klinik tadqiqot natijalari shuni ko'rsatdiki, inhalerlardan foydalanganda nafas olish havosining eng yuqori oqimi o'rta-past, o'rta va o'rta-yuqori qarshilikka ega bo'lgan nafas olish moslamalari orqali optimal nafas olish uchun zarur bo'lgan darajadan past bo'lgan bemorlarning yuqori qismi (34-85%) ko’rsatdi, natijada bemorlar dori vositalarining yetarli dozasini qabul qilmaganligi sababli, ular inhaler qarshiligiga adekvat inspirator oqim hosil qila oladigan bemorlarga nisbatan tez-tez avj olishlarni va kasalxonaga yotqizishni boshdan kechiradilar.
Fenotipik ko'rsatkichlar, shu jumladan ayol jinsi, bo'yi 1,6 m dan kam, BMI 20 kg / m2 dan kam yoki 30 kg / m2 dan yuqori, 70 yoshdan oshgan yosh, klinik va funktsional belgilar bilan belgilanadigan eng yuqori nafas olish oqimining suboptimal qiymatlari, shu jumladan mMRC bo'yicha dispnaning klinik zo'ravonlik darajasi 3 balldan ortiq, obstruktiv buzilishlarning og'irligi FEV1 kutilganidan 50% dan kam va klinik kursning xususiyatlari, 2 yoki undan ortiq kasalxonaga yotqizishni talab qiladigan ko’rsatmaning yuqori chastotasi bilan tavsiflanadi. Optimal qarshilikka ega bo'lgan inhalatsiya moslamasini tanlashning asosiy komponenti bo'lib, obstruktiv nafas olish patologiyasi, shu jumladan SOO’K va astma terapiyasining samaradorligini ta'minlaydi, davolash samaradorligini bashorat qiladi, nazoratni optimallashtiradi va tez-tez kasalxonaga yotqizishni talab qiladigan ko’rsatma chastotasini kamaytiradi.
Obstruktiv nafas olish patologiyasi bo'lgan bemorlarda kasallikning fenotipik, klinik va funktsional xususiyatlari va variantlari asosida nafas olish oqimining eng yuqori darajasini va uning inhaler qarshiligi darajasiga nisbatan suboptimal cho'qqi nafas olish oqimini baholash klinisyenlarga preparatni tanlashni shaxsiylashtirishga yordam beradi. Obstruktiv nafas olish patologiyasi kuchaygan bemorlarda inhaler va barqaror kasallik uchun inhalatsiya moslamasini tanlashni optimallashtirish maqolaning asosiy maqsadidir.
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