{"id":7623,"date":"2018-01-19T13:49:25","date_gmt":"2018-01-19T13:49:25","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=7623"},"modified":"2018-01-19T14:15:20","modified_gmt":"2018-01-19T14:15:20","slug":"aspectele-patologice-si-terapeutice-ale-aparatului-respirator-la-varstnici-2","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/aspectele-patologice-si-terapeutice-ale-aparatului-respirator-la-varstnici-2\/","title":{"rendered":"Aspectele patologice \u015fi terapeutice ale aparatului respirator la v\u00e2rstnici"},"content":{"rendered":"
\"Conf.dr.<\/a>
Conf.dr. Mavritsakis Nikolaos, Medic primar Geriatrie \u015fi Gerontologie, \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Medical Pegasus<\/em><\/figcaption><\/figure>\n

\u00a0<\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

Cutia toracic\u0103 este regiunea anatomic\u0103 cu modific\u0103ri evidente odat\u0103 cu \u00eenaintarea \u00een v\u00e2rst\u0103.<\/p>\n

Deseori, v\u00e2rstnicii dezvolt\u0103 cifoz\u0103 sau cifoscolioza pe fond de osteoporoz\u0103, mai ales la femei, iar cartilajele costale se calcific\u0103. Consecin\u0163a modific\u0103rilor osoase este cre\u015fterea raportului dintre diametrul antero-posterior \u015fi cel transversal al cutiei toracice. La v\u00e2rstnicii s\u0103n\u0103to\u015fi, aceast\u0103 modificare nu produce o deteriorare semnificativ\u0103 a performan\u0163ei pulmonare.<\/p>\n

Cutia toracica la v\u00e2rstnici prezint\u0103 o mobilitate sc\u0103zut\u0103 care rezult\u0103 o mai mare utilizare a musculaturii diafragmatice \u015fi a peretelui abdominal \u00een ventila\u0163ia pulmonar\u0103 produc\u00e2nd o sc\u0103dere \u00een activitatea mu\u015fchilor intercostali, iar cei accesori devin cei mai importan\u0163i mu\u015fchi.<\/p>\n

Structura bronhiilor se modific\u0103 nesemnificativ odat\u0103 cu \u00eenaintarea \u00een v\u00e2rst\u0103, \u00eens\u0103 c\u0103ile respiratorii mici (bronhiole) se modific\u0103 semnificativ; ca urmare complian\u0163a lor cre\u015fte cu v\u00e2rsta, iar structurile lor devin mai pu\u0163in reversibile.<\/p>\n

Func\u0163ia pl\u0103m\u00e2nului este influen\u0163at\u0103 de \u00eenaintarea \u00een v\u00e2rst\u0103, suprafa\u0163a alveolar\u0103 scade\u00a0aprox 4% pe decad\u0103 de v\u00e2rst\u0103 duc\u00e2nd implicit la o sc\u0103dere masiv\u0103 a suprafe\u0163ei alveolare de oxigenare. Deseori alveolele apar mai turtite \u015fi mai pu\u0163in voluminoase cu l\u0103rgirea ductelor alveolare. Cu \u00eenaintarea \u00een v\u00e2rst\u0103 scade extensibilitatea pere\u0163ilor alveolari duc\u00e2nd la cre\u015fterea complian\u0163ei. Alveolele se sub\u0163iaz\u0103 \u015fi con\u0163in mai pu\u0163ine capilare contribuind la \u00eengreunarea schimburilor gazoase respiratorii.<\/p>\n

Din punct de vedere\u00a0 func\u0163ional se produce o sc\u0103dere fiziologic\u0103 a capacit\u0103\u0163ii vitale (CV), volumul rezidual (VR) cre\u015fte duc\u00e2nd la sc\u0103derea ventila\u0163iei, volumul curent (VC) scade prin cre\u015fterea volumului residual \u015fi a spa\u0163iului mort, iar debitul ventilator de repaus \u015fi VEMS-ul scad.<\/p>\n

\u00cen consecin\u0163\u0103 la v\u00e2rstnici apar mai frecvent bolile pulmonare cornice precum bronhopatie cronic\u0103 obstructiv\u0103, bronsiectazia, emfizem pulmonar, Hipertensiune pulmonar\u0103, neoplasm bronhopulmonar primar sau secundar, tuberculoz\u0103 pulmonar\u0103, iar apari\u0163ia unei bronhopneumonii poate avea o evolu\u0163ie sever\u0103 la aceast\u0103 grup\u0103 popula\u0163ional\u0103.<\/p>\n

Factorii predispozan\u0163i afec\u0163iunilor respiratorii la v\u00e2rstnici sunt flora saprofit\u0103 asociat\u0103 cu flora condi\u0163ionat patogen\u0103 precum Haemophilusinfluente, S pneumonie, stafilococi coagulazo-pozitivi, entero-bacterii precum \u015fi aspira\u0163ia de germeni din sfera orofaringian\u0103 (germenianaerobi), gingivite, paradontoz\u0103, sinuzite, faringite, amigdalectomie, \u015fi de unele st\u0103ri patologice care pot altera refluxul tusei sau deglutitiei (AVC, coma), reflux gastroesofagian, acalazie.<\/p>\n

Conduita-algoritmul terapeutic la patologia pulmonar\u0103 specific a v\u00e2rstnicilor : <\/strong><\/p>\n

Modific\u0103rile multifactoriale care contribuie la declinul apratului respirator la v\u00e2rstnici impun o serie de m\u0103suri non farmacologice \u015fi farmacologice pentru sus\u0163inerea func\u0163iei pulmonare v\u00e2rstnicului.<\/p>\n

Cele non farmacologice se rezum\u0103 \u00een:<\/strong><\/p>\n

Evitarea toxicelor: tabagismului \u015fi alergenilor polen, praf etc.<\/p>\n

Adaptarea unui ambient de locuit corespunz\u0103tor; cu temperatur\u0103 constant\u0103, aerisire zilnic\u0103.<\/p>\n

Plimb\u0103ri frecvente \u00een spa\u0163ii bogate \u00een oxigen, p\u0103duri, parcuri,etc<\/p>\n

Efortul fizic adaptat v\u00e2rstei contribuie la ameliorarea respira\u0163iei la v\u00e2rstnici. Dup\u0103 v\u00e2rsta de 55 de ani efortul fizic dozat amelioreaz\u0103 debitul respirator, reduce dezvoltarea emfizemului, \u015fi favorizeaz\u0103 calitatea hematozei amelior\u00e2nd declinul respirator, st\u0103ri clinice \u015fi influen\u0163area favorabil a evolu\u0163iei bolilor pulmonare.<\/p>\n

De asemenea fizioterapia respiratorie cu aparatele portabile de suflat de mici dimensiuni din material u\u015for, compartimentate pentru a asigura grad diferen\u0163iat de dificultate sufl\u0103rii antrenand \u00eentregul aparatul respirator poate \u00eembun\u0103t\u0103\u0163i semnificativ func\u0163ia pulmonar\u0103 \u015fi evolu\u0163ia unei boli pulmonare .<\/p>\n

\u015eedin\u0163ele de magnetoterapie la nivelul coloanei toracale pot \u00eembun\u0103t\u0103\u0163i calitatea vertebrelor osteoporotice care sus\u0163in \u00eentreaga cutie toracic\u0103, \u00eembun\u0103t\u0103\u0163ind secundar func\u0163ia pulmonar\u0103.<\/p>\n

M\u0103suri farmacologice cu caracter terapeutic nespecific:<\/strong><\/p>\n

Cure complete cu tratamente GEROVITAL\u00a0 injectabile, tablete, aerosoli, sub supravegherea \u015fi \u00eendrumarea medicului geriatru pot contribui la \u00eencetinirea declinului func\u0163iei pulmonare \u015fi evolu\u0163ia favorabil\u0103 afec\u0163iunilor pulmonare cornice sau acute la v\u00e2rstnici. \u00centotdeauna aceste m\u0103suri farmacologice trebuie individualizate \u00een func\u0163ie de starea clinic\u0103 a individului. Se pot administra cure preventive la v\u00e2rstnicii s\u0103n\u0103to\u015fi sau curative adjuvante la v\u00e2rstnicii cu patologie pulmonar\u0103, contribuind \u00een felul acesta la reducerea bolilor pulmonare la v\u00e2rstnici \u015fi spitalizarilor, precum \u015fi la folosirea unor doze, semnificativ mai mici, de corticosteroizi reduc\u00e2nd costurile tratamentelor cornice \u015fi evitarea iatrogeniilor.<\/p>\n","protected":false},"excerpt":{"rendered":"

\u00a0 \u00a0 Cutia toracic\u0103 este regiunea anatomic\u0103 cu modific\u0103ri evidente odat\u0103 cu \u00eenaintarea \u00een v\u00e2rst\u0103. Deseori, v\u00e2rstnicii dezvolt\u0103 cifoz\u0103 sau cifoscolioza pe fond de osteoporoz\u0103, mai ales la femei, iar […]<\/p>\n","protected":false},"author":4,"featured_media":7636,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[77],"tags":[],"class_list":["post-7623","post","type-post","status-publish","format-standard","has-post-thumbnail","category-psihiatrie"],"yoast_head":"\nAspectele patologice \u015fi terapeutice ale aparatului respirator la v\u00e2rstnici<\/title>\n<meta name=\"description\" content=\"aparatului respirator la v\u00e2rstnici prezint\u0103 o mobilitate sc\u0103zut\u0103\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/aspectele-patologice-si-terapeutice-ale-aparatului-respirator-la-varstnici-2\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Aspectele patologice \u015fi terapeutice ale aparatului respirator la v\u00e2rstnici\" \/>\n<meta property=\"og:description\" content=\"aparatului respirator la v\u00e2rstnici prezint\u0103 o mobilitate sc\u0103zut\u0103\" \/>\n<meta property=\"og:url\" content=\"https:\/\/jurmed.ro\/medici\/aspectele-patologice-si-terapeutice-ale-aparatului-respirator-la-varstnici-2\/\" \/>\n<meta property=\"og:site_name\" content=\"Jurmed - 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