(Disclaimer: This article is for scientific use only, and relevant information in the following content has been processed to protect patient privacy)
Abstract: Bronchial asthma is a category of asthma, which belongs to chronic respiratory diseases and often manifests as recurrent episodes of wheezing, shortness of breath, chest tightness, and so on. As in this case patient, he came to the hospital with cough and chest tightness 1 month before admission, which was aggravated by activity, and the effect of self-medication was not good. The diagnosis of bronchial asthma was clearly made by pulmonary function tests and bronchodilator tests. After 7 days of hospitalization, the patient’s condition was controlled and his lung function returned to normal.
Basic information】Male, 35 years old
Disease Type】Bronchial asthma
Hospital】The First Hospital of Harbin Medical University
Time of consultation】May 2022
Treatment plan】Medication (budesonide suspension for inhalation, ipratropium bromide solution for inhalation, doxorubicin injection, methylprednisolone sodium succinate for injection, budesonide formoterol powder inhalation, montelukast sodium tablets)
Treatment period】7 days of inpatient treatment, outpatient follow up
Treatment effect] The disease has been controlled and the lung function has returned to normal.
I. Initial consultation
One month before admission, the patient developed cough and chest tightness, and the symptoms worsened after activity, and she felt short of breath when she went up two floors. Occasional dry cough with nasal congestion and facial skin pruritus during the course of the disease, no fever, acid reflux, heartburn, postnasal drip, etc. The patient visited the outpatient clinic for cough. Pulmonary function tests: FEV1% was 67.5%, suggesting moderate obstructive ventilatory dysfunction; no abnormalities were seen on lung CT. The patient had a past history of allergic rhinitis and intermittent chest tightness, which could be relieved by itself and was not taken seriously.
II. Treatment process
After admission, the patient underwent bronchodilator test, nitric oxide test, blood gas analysis, blood routine, calcitoninogen, liver and kidney function, immunoglobulin and other tests. The results showed that the bronchial diastolic test was positive; nitric oxide value was high; immunoglobulin IgE >1000 IU/ml. Combined with the patient’s clinical manifestations, the patient was in the moderate severity of bronchial asthma acute attack classification, and the patient and his family were explained the condition. After admission, inhalation budesonide suspension and inhalation ipratropium bromide solution were given as nebulized inhalation to help dilate the airway and improve airway inflammation, and doxorubicin injection and methylprednisolone sodium succinate for injection were given intravenously.
(Pulmonary function test)
III. Treatment effect
After the patient was admitted to the hospital, after active and standardized treatment with nebulized inhalation bronchodilator and application of theophylline drug and hormone intravenous drip treatment, the patient responded well to treatment and the symptoms of shortness of breath were relieved; lung function, blood gas analysis, and blood immunoglobulin indexes returned to normal. After 7 days of hospitalization, the patient was discharged successfully. Before discharge, the patient was advised to continue to apply budesonide formoterol powder inhalation therapy and oral montelukast sodium tablets after going home.
IV. Precautions
We are glad that the patient’s symptoms of chest tightness and shortness of breath were relieved after treatment. However, the patient should effectively monitor and manage his condition after discharge, learn to use the peak flow rate meter correctly and record the asthma diary, through which he can assess his response to treatment, level of control and severity of asthma, and the patient should improve the testing of allergens at an optional date after discharge. In life, proper weight loss and control of weight can be adhered to far movement, such as jogging and playing ball; strict cessation of smoking to avoid recurrence of asthma symptoms.
V. Personal insight
Although bronchial asthma cannot be cured, long-term standardized treatment can achieve good or complete clinical control of asthma and prevent the occurrence of future risks. After diagnosis, patients need to reduce their exposure to risk factors. Acute exacerbations of bronchial asthma are mostly seen in patients with poor treatment compliance and poor control, but also in well-controlled patients. Therefore, if symptoms such as chest tightness and shortness of breath occur, they should seek medical attention without delay and be given correct and aggressive treatment under the guidance of a physician. Patients should also maintain an optimistic attitude and standardize their medication to help improve their quality of life.