laporan batuk sesak dewasa kelompok 6

8/18/2019 Laporan Batuk Sesak Dewasa Kelompok 6

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LAPORAN TUTURIAL

BATUK & SESAK PADA DEWASA

KELOMPOK 3

OLEH:

Theresia A. Nor (1408010005)

Gloria J. Tarigan (1408010006)

Ansieta V.C. Bulu Olu (1408010010)

!el"a #. #auti (1408010015)

$utri ntan Atasoge (14080100%&)

'iti ha"ia (14080100*1)

FAKULTAS KEDOKTERAN

UNIVERSITAS NUSA CENDANA

2016

#aria C.N. Ganggut (140801004*)

#. Glau+ia $.#. $e,o (140801005%)

$ris-a Nino (140801005*)

sne A. Barus (1408010055)

eo"atus Th 'uriasa (1%0801&0**)


2/32

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5/32

isiologi 'iste! $erna/asan

Ke("k */! (#-e! en7," %>e#%"+ #k-"$en kn e!$e!k /!" %>e#%" e%"n(-"

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6/32

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/%) HO2 HO2


7/32

istologi 'iste! $erna,asan

S"-(e ,e!n,-n e!*,kn -"-(e n$ e!*n$-" *n(*k en$-#!-" #k-"$en /n

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9/32

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%>e#%*-+ e,"(e% !#nk"#%*- en(* /en$n -e% %>e#%*- (",e 14 Sek"n ke /"-(%

%>e#%*-n -ek"n e!() nk /n -"%" -ek"n .!n$("/k /".*,"4 Te!/,(

#(#( ,#%#- /n .!"n$n "k( e%-("- /" ) e,"(e% !#nk"#%*- !e-,"!(#!"*-4

D*k(*- %>e#%!"-

Sek"n ke /"-(% /!" !#nk"#%*- !e-,"!(#!"*- k -ek"n nk (e!/,( *!

%>e#%*-+ )"n$$ -e%*!*)n e!*, *! %>e#%*- n$ /"-e*( -e$" /*k(*-

%>e#%!"-4 Te!/,( nn -e% #(#( ,#%#- ,/ %"n ,!#,!"n+ n$ -ek"n-e/"k"(

,/ -e$en /"-(% /*k(*- %>e#%!"- /n /"$n("kn #%e) -e!( e%-("n /n k#%$en4

D*k(*- %>e#%!"- e!*! ke (!"* n$ e!)**n$n /en$n -k*- %>e#%!"-4

A/n -e!( e%-("n /n !e("k*%"n n$ en$e%"%"n$" *! (!"*+ -k*- %>e#%!"- /n

%>e#%" e*n$k"nkn %>e#%*- en$en$ -ek(* "n-,"!-"+ e!k#n(!k-" -e7!

,-" ,/ k(* ek-,"!-" -e7! n#!%+ en7e$) (e!./"n ,en$en$n -e7!

e!%e")n /n ,en$!*-kn ,/ k,"%e!k,"%e! )%*- /n -e,( %>e#%! n$ (","-4

A%>e#%*-

A%>e#%*- e!*,kn -(!*k(*! e!#n$$ (e,( ,e!(*k!n $- #k-"$en /n

k!#n/"#k-"/ n(! */! /n /!)4 Se,(* "n(e!%>e#%! e"-)kn /* %>e#%*-

n$ e!/ek(n+ -e,(* (e!-e*( (e!/"!" (- 2 %,"- e,"(e% $e,en$ (","- /en$n k,"%e!+

"!#%-+ -e!( e%-("n+ !e("k*%"n+ (!"k- /n -e% .!"n$n "k(4


10/32

Te!/,( -e% %>e#%*- (",e 1 n$ e%,"-" ';J ,e!*kn %>e#%*-+ *n$-"n *n(*k

een(*k -! /en$n ke(e%n n$ /,( /"%%*" $- /en$n */)4

S"(#,%-n en$n/*n$ nk >e-"ke% ,"n#-"(#("k n$ e!,e!n /% ,en$$n("n

-*!k(n ?n$ /")-"%kn #%e) -e% %>e#%*- (",e 2@ /n ,e*n$n ,!("ke% k#n("nn

ke7"%4 An(! -e% %>e#%*- (",e 1 /")**n$kn #%e) /e-#-# /n (*( ke/, n$

en7e$) ,e!ee-n 7"!n /!" .!"n$n ke !*n$ */!4

Se% %>e#%*- (",e 2 (e!-e! /" n(! -e% %>e#%*- (",e 1+ ke/*n -%"n$ e%ek( e%%*"

(*( ke/, /n /e-#-#4 Se% (",e 2 (e!-e*( e!/ /" (- e!n -%+ e!en(*k

k*#"/ /n /,( e!"(#-"- *n(*k en$$n(" /"!"n -en/"!" /n -e% (",e 14 Se% (",e 2 "n"

e"%"k" 7"!" en$n/*n$ /n %e% n$ e!*n$-" en$)-"%kn -*!k(n ,!*

n$ en*!*nkn (e$n$n %>e#%*- ,!*4

Se,(* "n(e!%>e#%! en$n/*n$ ,#!",#!" n$ en$)**n$kn %>e#%" n$

e!-ee%)n+ *n$-"n *n(*k ene"n$kn (eknn */! /% %>e#%" /n

e*/)kn -"!k*%-" k#%(e!% */! "% -e*) !#nk"#%*- (e!-*(4

P%e*!

P%e*! e!*,kn %,"-n n$ e"-)kn n(! ,!* /n /"n/"n$ (#!k-4 P%e*! (e!/"!"

(- /* %,"-n: ,!- ,!"e(% /n ,!- >"-e!%4 Ke/* %,"-n (e!/"!" /!" -e%-e% e-#(e%

n$ e!/ /" (- -e!( k#%$en /n e%-("n4

24 A-,ek "*n#%#$" /n "k!#"#%#$" ,/ k-*-

M"k!#"#%#$" n$ /,( ene!n$ -"-(e ,e!n,-n:


11/32


12/32

I*n#%#$" -"-(e Pe!n,-n :

T",e /-! !ek-" "*n -,e-""k :

14 I*n"(- -e%*%e!

- Se% T

- Be!-% /!" ,e(n$n %",#-"( /" SLT n$ e!"$!-" ke ("*-

24 I*n"(- )*#!%


13/32

- An("#/" /")-"%kn -e% ,%- /!" %",#-"( B

- Be!-% /!" ,e(n$n %",#-"( /" STL

Rek-" "*n /,(" :

14 K!k(e!"-("k : !ek-" "*n -e/e!)n+!e-,#n 7e,(+n#n -,e-""k+/n ("/k(e!$n(*n$ k#n(k -ee%*n /en$n ,(#$en4

24 =en"- -e% "*n /,(" :

- F$#-"(

- Se% ,e*n*) %"

Mekn"-e ,e!()nn -"-(e ,e!n,-n :

• Mekn"-e n#n -,e-""k :

- P!("ke% 10 * kn (e!()n /" !#n$$ )"/*n$

- P!("ke% *k*!n 210 * kn (e!,e!n$k, #%e) e,"(e% e!-"%" n$

e!%,"-kn *k*- -e)"n$$ /e!"- /" "k( #%e) *k*- ke*/"n /" -,* #%e)

-"%"

- Re%ek (*k /,( en$e%*!kn ,!("ke% (- n$ e!-% /!" (!ke /n

)"/*n$ %e( ekn"-e /)k (* e!-"n

- P!("ke% %e") ke7"% kn /"e!-")kn k!#$ %>e#%*-4

• Mekn"-e -,e-""k :

- S"-(e "*n#%#$"- *k#- ,/ -%*!n n,- / 3 "(* :

4 NALT ? n#-e --#7"(e/ %,)#"/ ("--*e@

4 LALT ? %!"n8--#7"(e/ %,)#"/ ("--*e@

74 BALT ? !#n7)*---#7"(e/ %,)#"/ ("--*e@- P!#-e- "*n#%#$"- /" !#nk*- /"ken% /en$n BALT -n$( e!k"(n /en$n

,e!nn k!#$ %>e#%"

- T#n-"% /n /en#"/ e!*,kn -%) -(* ,e%k-n ,e!()nn "*n#%#$"-

,/ -"-(e ,e!n,-n4

34 P(#ekn"-e B(*k+ Se-k N,-+ /n S,*(* e!!n 7#k%(

#e-anis!e Batu-

Men*!*( We"ne!$e! ?200@ (*k e!*,kn ek-,"!-" ek-,%#-" n$

ene/"kn ekn"-e ,!#(ek(" n#!% *n(*k ee!-")kn 7n$ (!ke#!#nk"%

/!" -ek!e( /n G(G( -"n$4 M-!k( %e") 7en/e!*n$ *n(*k en7!" ,en$#(n

,"% (*kn e!ke,n.n$n -e)"n$$ en$$n$$* k(">"(- -e)!"n (*

en7*!"$" knke!4 (*k "- (e!./" -e7! >#%*n(e! (e(," -e%%*n (e!./" k"(


14/32


15/32

/n k#!(ek- -"n$*%* ,#-(e!"#!4 A!e "n" .*$ /"k("kn #%e) -en--" ne!" /n

-("*%-" ("/k enenn$kn %"nn ?)*-+ *%@4

Pe!"n() M#(#!"k /n Central Corollary Discharge

Sen--" /"-,ne en*n.*kkn ke-/!n -e-e#!n$ *n(*k en$*) k(">"(-#(#!"k !e-,"!-"n4 Ke("k (n$ #(k (* k#!(ek- #(#!"k en$"!" ,e!"n()

ee!en ke #(#(#(#( >en("%(#!+ ee!, .!- .*$ /"-*n$kn ke k#!(ek- -en-#!"k4

H**n$n "n" n$ /"-e*( central corollary discharge4 Ak"(n+ ke-/!n ,en*)

*n(*k *-) ek-(! e!n,- ("*%4

! 14 Central Corollary Discharge

K#n-e, Afferent Mismatch

D"-#-"-" n(! ,%"(*/# output #(#!"k /n "n,*( -en-#!"k /!" ekn#!e-e,(#!

,e!"e! /,( enekn (* e,e!,!) /"-,ne4 Se$" 7#n(#)+ ke("k k"(

e!-kn -en--" -e-k n,-+ -e,e!(" ekn"-e central corollary

discharge -ee%*n+ k"( kn e!e-,#n /en$n *-) -/! ()n *n(*k

en!"k n,-4 U-) ()n "n" .*-(!* ,* e,e!,!) /"-,ne /en$n

en) -en--" ke("/knnn e!n,-+ -een(! #(#(#(#( >en("%(#!

e%e) k"( ,en"n$k(n en ekn"k4

D"-,ne P/ Penk"( Te!(en(*

P/ ,enk"( n$ ene!n$ -"-(e ,e!n,-n+ ,(#"-"#%#$" /"-,ne ("/k

-,e-""k (e!)/, -(* .%*! -.4 A/ nk ekn"-e n$ /"*(*)kn *n(*k "-

en"*%kn -en--" /"-,ne ,/ ,enk"(,enk"( (e!-e*(4 Pen$e()*n


16/32

en$en" ,(#"-"#%#$" n$ en/-!" ,enk"(,enk"( ?-e,e!(" -+ COPD@

en./" /-! )",#(e-"- ekn"-e /"-,ne ,/ ,enk"( "n"4

• A-

P/ -+ en #(#( "n-,"!-" en"n$k(+ -e)"n$$ *-) n$ /"*(*)kn *n(*k

e%n !e-"-(en-" %"!n n,- k"( !#nk#k#n-(!"k-" .*$ en"n$k(4 Ke("k

(e!./" )",e!"n%-"+ #(#( "n-,"!-" en./" een/ek4 Ke./"n "n" ,*

en$*) !/"*- k*!>(*! /"!$+ -e)"n$$ (e!./" mechanical disadvantage4

Ak"(n+ /"*(*)kn *-) ()n *n(*k en7," threshold $! (e!./"

"n-,"!-"4 H% "n" enekn /"-,ne4 P/ -+ -en--" /"-,ne .*$

/",e!k"!kn e!-% /!" -("*%-" !e-e,(#! >$%4 P/ ,-"en /en$n ke%"nn

ne*!#%#$"k -e,e!(" -(en" $!>"-+ /"*(*)kn *-) n$ %e") e-! *n(*k

ee!"kn neural drive $! #(#(#(#( !e-,"!-" n$ e%e)

(e!-("*%-"4 Output ne*!##(#! n$ en"n$k( "n"+ e%%*" .%*! central

corollary discharge+ /"!-kn -e$" ,en"n$k(n eek !e-,"!(#!"k4 Ak"(n+

(e!./" /"-,ne4

• Penk"( P!* O-(!*k(" K!#n"k

P/ ,-"en COPD+ !e-e,(#! ,/ -%*!n n,- /n ke#!e-e,(#! e!k#n(!"*-"

(e!)/, ,(#"-"#%#$" /"-,ne4 H",#k-" k*( (* k!#n"k (* )",e!k,n" ,/

COPD .*$ enekn /"-,ne (e!-e*(4 Se%"n "(*+ ,/ ,en/e!"( ,enk"(

/en$n ke%"nn /"n"k ,e!n,-n+ k#,!e-" ekn"k (e!-e*( /,( /"/e(ek-"

#%e) -e!*( e!en >$*-4 P-"en,-"en n$ ene!" treatment >en("%-"

ekn"k "-n -e-k n,- e-k",*n ke!. #(#( ,e!n,-nn e!k*!n$4

Penen "- ./" e!*,kn ,en"n$k(n (eknn ,!-"% k!#n/"#k-"/

n$ ("/k -e-*" /en$n ke*(*)n ("/% ,-"en4 P/ k-*- e#%" ,!*+

ke("/k-e"n$n ekn"k !e-,"!-" (* ,e!(*k!n $- en./" ,(#"-"#%#$"

/-! -e-k n,- n$ en./" $e.%4 P/ %,#!n k-*-+ /"-,ne n$ (e!./"

,/ ,-"en e#%" ,!* ,* /"#(" /en$n %"-"- ek*n /!)4 Ke*n$k"nn

n$ ,%"n$ k*(+ !e-e,(#! (eknn /" ,e*%*) /!) ,*%#ne! (* (!"* knn

-e!( -e!*( C /" ,e*%*) ,!* ee/"-" -en--" (e!-e*(4


17/32

#e-anis!e ',utu! +o-lat

P!#-e- Te!en(*kn S,*(* O!n$ /e- n#!% "- e,!#/*k-" *k*-

-e.*%) 100 % /% -%*!n n,- -e(", )!"4 M*k*- "n" /"$"!"n$ ke !"n$ /en$n

ekn"-e ,ee!-")n -"%" /!" e,"(e% n$ e%,"-" -%*!n ,e!n,-n4 Ke/nn#!% ,!#/*k-" *k*- n$ e!%e")n ?k!en $n$$*n "-"k+ k""" (* "nek-"

n$ (e!./" ,/ e!n *k#-@+ enekn ,!#-e- ,ee!-")n ("/k e!.%n

-e7! n#!% -e)"n$$ *k*- "n" nk (e!("*n4 B"% )% "n" (e!./" e!n

*k#- kn (e!n$-n$ /n *k*- kn /"ke%*!kn /en$n (eknn "n(! ()#!k% /n

"n(! /#"n% n$ ("n$$"+ /"(*kkn */! ke%*! /en$n k-e%e!-" $ 7e,( e-e!(

e -ek!e( *k*- n$ (e!("*n (/"4 M*k*- (e!-e*( kn ke%*! -e$"

-,*(*4 S,*(* n$ /"ke%*!kn #%e) -e#!n$ ,-"en )en/kn /,( /"e>%*-"

-*e!+ !n+ >#%*e /n k#n-"-(en-"n+ k#n/"-" -,*(* "-n e,e!%")(kn

-e7! -,e-""k ,!#-e- ke./"n ,(#%#$"k ,/ ,een(*kn -,*(* "(* -en/"!" ?P!"7e

W"%-#n+ 2011@4 D)k e!!n 7#ke%( -e!"n$ /"k"(kn /en$n #!n$#!n$ n$

e!#k#k4 B"% (*k+ k kn (e!- /)k e!(ek-(*! k-!4 In" e!!(" e!7,*!

/en$n /e* /n en/ -"n$ k"( ke!*-kn -"%"4 U*n /"(" ,/ ,-"en

/en$n PPOK ?,enk"( ,!* #-(!*k(" k!#n"k@4 ="k e!#k#k (e!%%* nk+ !n

/)k kn e!!n 7#ke%( k!en !e-"n (* (! ene,e%4 =*$+ #!n$#!n$ n$

(e%) en$)"!*, nk /e* /n -,+ *n$k"n en$%" (*k e!/)k 7#k%(4 In"

.*$ *n$k"n e!*,kn (n/ /!" !#nk"("- k!#n"-+ (e!*( ,/ ,e!#k#k e!(4

54 P(#ekn"-e M*% M*n()

M*% /n *n() (e!./" k"( !n$-n$n ,*-( *n() /" e/*%% #%#n$(4

M*n() /,( (e!./" (n, /"/)*%*" *% /n /,( e!-"( ,!#ek("%4

M*% /n *n() /,( /"n$$, -e$" -*(* e#en n$ (e!./" /% 3

-(/"*: 1@ *%+ 2@ Re(7)"n$ ?$e!kn /n -*! -ee%* *n()@+ 3@ /n *n()4

S(/"* ,e!(+ *%+ /,( /".e%-kn -e$" -*(* ,e!-n n$ -n$( ("/k enk

/"$"n e%kn$ (en$$#!#kn /n e,"$-(!"*+ -e!"n$ enekn *n()4 Te!/,(


18/32

e!$" ,e!*)n k(">"(- -%*!n 7e!n n$ e!k"(n /en$n *%+ -e,e!("

en"n$k(n -%">-"+ en*!*nn (#n*- %*n$ /n ,e!"-(%("k4 Pen"n$k(n (#n*-

/*#/e* /n .e.en* enekn (e!./"n !e%*k- /*#/en* ke %*n$4 N*n

/e"k"n+ ("/k (e!/,( *k(" n$ en$e-nkn ) )% "n" enekn *%4e.% /n (n/ *% -e!"n$k%" /%) ,*7(+ en"n$k(n -%">-"+ )en/k *n()+

)en/k ,"n$-n+ e!ke!"n$(+ /n (k"k!/"4 Re(7)"n$+ /%) -*(* *-) "n>#%*n(e!

*n(*k *n()+ -e!"n$k%" ene!(" *% /n (e!./" -ee%* *n()+ (e!/"!" (- $e!kn

,e!n,-n -,-#/"k e%n $%#("- /n $e!kn "n-,"!-" /"n/"n$ // /n /"!$4

K#n(!k-" #(#( /#en -( ek-,"!-" en$en/%"kn $e!kn "n-,"!-"4 P"%#!*- /n

n(!* /"-(% e!k#n(!k-" -( *n/*- e!e%k--"4

S(/"* k)"!+ *n()+ /"/e"n"-"kn -e$" -*(* !e%ek- n$ enekn

/#!#n$n ek-,*%-" "-" %*n$ (* *-*- (* ke/*n ke *%*(4 P*-( *n()

ene!" -*kn /!" k#!(ek- -e!e!%+ #!$n >e-("*%!+ /e!) ,e7* ke#!e-,(#!

?7)e#!e7e,(#! (!"$$e! G#ne+ CT@+ /n -e!*( e!en+ (e!-*k /!" -"-(e

$-(!#"n(e-("n%4 M*n() (e!./" k"( !n$-n$n ,/ ,*-( *n()+ n$ (e!%e(k /"

/e!) ,#-(!e e/*%% #%#n$( /" /-! >en(!"ke% kee,(4 M*n() /,( /"!n$-n$

e%%*" .%*! -! e!en #%e) !n$-n$n ne!>*- >$*- /n -",("- (* #%e)

!n$-n$n ee(k n$ en"*%kn *n() /en$n k(">-" CT4 =%*! ee!en

ene!" -"n% n$ enekn (e!./"n $e!kn ek-,*%-" #(#( /#en+

$-(!#"n(e-("n%+ /n ,e!n,-n n$ (e!k##!/"n-" /en$n e,"en#en ee("kn$

ene!(" /"-e*( *n()4 P*-( *n() -e7! n(#"- e!/ /" /ek( ,*-( -%">-"

/n ,e!n,-n+ -e)"n$$ ,/ k(* *n() -e!"n$ (e!./" )",e!-%">-" /n $e!kn

,e!n,-n4

4 P(#ekn"-e -(!"7 Re%*k-

P(#$ene-"- :

14 T!n-"en( LES !e%8("#n ?TLESR-@

Re%k--" -,#n(n+ ("/k /",en$!*)",!#-e- ene%n+ /"e/"-" !e%e8 >$*-

n$ /"-e!(" !e%k--" 7!*! /"!$


19/32

Me!*,kn en#en !e%*k- "-"#%#$"- ,/ #!n$ -e)( (e(," e!%n$-*n$

%e") % ? 10 -e7@ /"-n/"n$ !e%*k- ene%n ? ; -e7 @

P/ **n TLESR- e!*,kn ekn"-e *( !e%*k- ,/ ERD

24 H",#(en-">e (* "nk#,e(en-" LES

H",#(en-">e (eknn 10 H$

Ink#,e(en-" 5 H$ /" (- (eknn /% %*n$

Te!./" en#en !e%*k- e- k"( (eknn "n(! /#"n% n$ ("("

en"n$k( "-%n ,/ (*k .#n$k#k

P/ )",#(en-">e (* "nk#,e(en LES+ n#ne!#-">e ERD %e") -e!"n$

/"(e*kn

Mknn n$ k"( k#n-*-" -een(! kn /"-",n ,/ %*n$4 Se(e%) k"(

en$*n) knn /n /"(e%n kn -*k ke ke!#n$k#n$n /n e-*k" %*n$4

D"$"n (- %*n$ (e!/,( -e7 ,"n(* -*k *n(*k knn /n "n*n

e!*, 7"n7"n #(#( -,)"n7(e! n$ -e7! #(#("- kn en*(*, /n e*k ke("k

knn /"(e%n4

Se(e%) knn -*k ke %*n$+ ,e!*( kn e,!#/*k-" - /n enG" *n(*k

en(* ,en7e!nn knn4 O!n$ n$ en$%" ken"kn - %*n$

"-n /"-ekn k!en %e)n #(#( -,)"n7(e! n$ ("/k /,( en*(*, /en$n

!,( -e)"n$$ ,/ ke/n (e!(en(* knn n$ (e%) k"( (e%n kn n"k ke%" ke

ke!#n$k#n$n4

Mknn n$ (e%) (e!7,*! /en$n G( - /n n"k ke ke!#n$k#n$n kn

en"*%kn !- ,)"( (* - /" %"/) -e!( -en--" (e!k! /" // /n *%* )("

n$ enekn e!( ke("k en$"% n-4

64 H**n$n Peke!.n /n $e.% ,/ -7en!"#


20/32

De* "n/*-(!"? !n$+-een+ /%%@e!*k*!n ke7"% /"("*n ,/ ,!* ,!%"-"- -"%"

)",e!-ek!e-" & )",e!(!#" ke%en.! *7*- !en(n (e!)/, "nek-" /n "n%-"

;4 Mekn"-e O( An(""#("k /n O( S",(#("k ,/ -7en!"#

• O( n(""#("k :*n(*k en7e$)en$*!n$" "nek-"+ keke%n (**)

• O( -",(#("k:Un(*k en$)"%n$kn $e.% /!" -*(* ,enk"( D"n

,ee!"n #(#(n "n" )n -eke/! en./"kn $e.% ,enk"( $! ("/k

/"%" %$"+ (e(," #(#(n "n" ("/k /,( ee!"kn -*(* ,ene*)n

n$ -een!n (* ("/k kn /,( en"/kn ke%*)nke%*)n

/% .n$k k(* n$ 7*k*, %4


21/32

e.% %#k% "(* (*k %e") /!" - /en$n 2 "n$$*+ )e#,("-"-+ -e-k

n,- /n ne!" //4 e.% -"-(e("k "(* /e+ %"-e+ ke!"n$(

%+ n#!ek-" /n e!( /n en*!*n4

Pee!"k-n "-"-

P/ ,ee!"k-n TB /"(e*kn -*! n,- !#nk"%+ #!"k+ -*! n,-

e%e)+ (* !#nk" -)4 P/ ,-"en /en$n %"/en"("- TB (e!/,(

,ee-!n KB -ek"(! %e)e! /n ke("k4 P/ ,-"en ,%*e!"("- TB k!en

/ 7"!n+ )-"% ,e!k*-" en./" ,ekk /n *-k*%(-" e%e) )"n$$ ("/k

(e!/en$! ,/ (e,( n$ / 7"!n4Pee!"k-n k(e!"#%#$"

D""% /!" -,e-"en : /)k+ 7"!n ,%e*!+ 7"!n -e!e!#-,"n%+ "%-n

!#nk*- /n %*n$+ !#n7#%>e#%! %>$e+ "#,-"4 Un(*k ,en$"%n

-,e-"en /)k /"%k*kn 3 k%" "(* -ek(*+ ,$"+ -ek(* (* -e(",

,$" -e% 23 )!" e!(*!*( (*!*(4 Pee!"k-n -,e-"en "n" /"%k*kn

-e7! "k!#-k#,"- /n "kn4 In(e!,!e(-" )-"% /)k :

BTA ?@ : 38 ,#-"(" (* 28 ,#-"("+ 18 ,#-"("

BTA ?@ : 38 ne$("

="k )-"% 18 ?@+ 28 ?@ /"*%n$ ,ee!"k-n BTA 38 %$"+ "%

)-"%:

18 ,#-"(" /n 28 ne$(" ?BTA ,#-"("@38 ne$(" ?BTA ne$("@

In(e!,!e(-" ,e7n /en$n "k!#-k#, /en$n -k% IUATLD :

T"/k / BTA /% 100 %,n$ ,n/n$+ ne$(" D"(e*kn 1' BTA /% 100 %,n$ ,n/n$ + /"(*%"- .*%)

k*n n$ /"%")(

D"(e*kn 10'' BTA /% 100 %,n$ ,n/n$+ 1

D"(e*kn 110 BTA /% 1 %,n$ ,n/n$+ 2

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,"k% /n ,#-(e!"#!+ %#*- ) -e$en ,#-(e!"#! K>"(-

Be!7k "%"e!

E*-" ,%e*! *n"%(e!% ?"-n@


22/32

Pee!"k-n ,en*n.n$ %"nn

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!en/)

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B4 PPOK ?PENAKIT PARU OBSTRUKTIF KRONIK@

• De"n"-"

PPOK e!*,kn ,enk"( n$ /,( /"7e$) /n /"#("+ /en$n k!k(e!"-("k

)(n %"!n */! ene(, /n ,!#$!e-" n$ /"-e!(" /en$n ,en"n$k(n

!e-,#n "n%-" k!#n"- ,/ -%*!n n,- /n ,!* (e!)/, ,!("ke% e!)4

•

e.% K%"n"-Se-k n,- k!#n"k+ (*k ,!#/*k(" k!#n"k+ */) %e%)4

• Fk(#! !e-"k#

• P.nn -, !#k#k

• P#%*-" */! /"/% !*n$n -e,e!(" )n "#- *n(*k e-k /n

en-kn


23/32

• Peke!.n+ n$ e!k"(n /en$n ,,!n )n k"" /n ,!("ke% n$

% /n (e!*- ene!*-

• P#%*-" */! /"%*! !*n$n

• ene("k /"ke()*" e!,e!n /% (e!./"n PPOK "(* /e"-"en-"

n("(!",-"n % 1• M-%) ,/ ,!* n$ (e!./" -( - $e-(-" (* -( nknk ?e!(

/n %)"! (en/)+ "nek-" ,e!n,-n@ .*$ e!,#(en-" en"n$k(kn

!"-"k# (e!./"n PPOK4

• D"$n#-"-

Anne-"-

="k ,-"en en$%" $e.% -e-k n,-+ (*k k!#n"-+ ,!#/*k-" -,*(*

k!#n"-+ /n (e!/,( ,,!n k(#! !e-"k#+ /"$n#-"- k%"n"- PPOK /,(

/",e!("n$kn4 Se-k n,- ,/ ,-"en PPOK e!-"( ene(, /n

e*!*k /en$n #%)!$ (* k(""(-4 Se/n$kn (*k k!#n"- e!"(

"n(e!"((en /n *n$k"n *n,!#/*7(">e4

Pee!"k-n "-"-

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!#nk#>-k*%! en"n$k(+ .n(*n$ ,en/*%*

S,"!#e(!"

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PPOK+ -n$( /"n.*!kn *n(*k /"%k*kn (e- -,"!#e(!" Se(e%) ,en$$*nn !#nk#/"%(#!+ )-"% VEP1 (* KVP ;0J

en.e%-kn ) ,-"en en$%" PPOK4 ="k )-"% %e") /!"

- /en$n ;0+ e!!(" *kn PPOK

• T( Lk-n PPOK S("%

T( %k-n PPOK /"$" en./" (e!," n#n!k#%#$" /n !k#%#$"4Un(*k (( %k-n n#n!k#%#$" ,/ ,-e"n PPOK e!/-!kn ,en"%"n

ek--e!-" /n $e.%+ "(* :

P-"en ke%#,#k A : k#n-e%"n$ (e!," ,en$$n(" n"k#("n+ k(">"(- "-"k

P-"en ke%#,#k B+ C+ D : k#n-e%"n$ (e!," ,en$$n(" n"k#("n+ !e)"("-"

,*%#n%+ /n k(">"(- "-"k4

NB : k!k(e!"-("k ke%#,#k ,-"en


24/32

• P-"en ke%#,#k A : !"-"k# !en/)+ $e.% -e/"k"(

• P-"en ke%#,#k B : !"-"k# !en/)+ $e.% nk

• P-"en ke%#,#k C : !"-"k# ("n$$"+ $e.% -e/"k"(

• P-"en ke%#,#k D : !"-"k# ("n$$"+ $e.% nk

Un(*k (( %k-n !k#%#$" ,/ ,-"en PPOK "(* :

!*, ,-"en Rek#en/-" ,"%")n ,e!( Te!," %"nn n$

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ke!. 7e,(

Te#"%"n

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ke!. %

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(* n("k#%"ne!$"k ke!.

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K!#-"-(e"n+B2 $#n"-

ke!. 7e,( /n (*

n("k#%"ne!$"k ke!. 7e,(+

(e#"%"n


25/32

C4 PNEUMONIA

• Deen"-"

Pne*#n" /%) ,e!/n$n n$ en$en" ,!enk" ,!*+ /"-(% /!"

!#nk"#%*- (e!"n%"- n$ en7k*, !#nk"#%*- !e-,"!-(#!"*-+ /n %>e#%"+ -e!(en"*%kn k#n-#%"/-" .!"n$n ,!* /n $n$$*n ,e!(*kn $- -e(e,(4

• E,"/e"#%#$"

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/n -(* (* %e") ,enk"( /-! n$ en$$n$$* / ()n (**)4

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,enk"( !(e!" k#!#ne!+ ke$n-n+ "n-*"-"en-" !en%+ ,enk"( -! k!#n"k+ /n

,enk"( )(" k!#n"k4

Fk(#! ,!e/"-,#-"-" :• Ke"-n e!#k#k

• P-7 "nek-" >"!*-

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• Ke%"nn (* ke%e)n -(!*k(*! #!$n //

• Pen*!*nn ke-/!n

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- %"n4 In(e!k-" "n" enen(*kn k%-""k-" /n en(*k n"e-(-" /!"

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,ene ISNBA k"( /n ,e!*)n ke/n ,-"en -e,e!(" $n$$*n

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("/k (e,( n$ en"*%kn ,e!*)n k!k(e!"-("k k*n4

• P(#$ene-"- ,ne*#n" k#*n"(-


26/32

Fk(#! ,e!*) n$ en"n$k(kn !e-"k# "nek-" #%e) ,(#$en (e!(en(* ,/

PK

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e!(+ ("n/kn e/)+ ,ee!"n n(""#("k+ #(#(n %"n /n ("n/kn

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n$ ("/k "- /"!*) "(* e!k"(n /en$n "nn$ ?-ek- ,!"+ ,enk"(

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??"n(*-" (* -%n$ n-#$-(!"k@4

• E("#%#$"

• Pne*#n" k#*n"(-


27/32

P(#$en n$ -e!"n$ /".*," ,/ k(#! !e-"k# (e!(en(* "-%n H4

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k!/"#,*%#n% (* .k+ (* ,-7 (e!," n(""#("k -,ek(!* %*-4

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28/32

Ce,(+ k*( /en$n !*-( 7#%#*!e/ -,*(* ?S4 Pne*#n"e@ ,e!%)n+

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29/32

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