eISSN: 2450-4459
ISSN: 2450-3517
Lekarz POZ
Bieżący numer Archiwum Artykuły zaakceptowane O czasopiśmie Bazy indeksacyjne Prenumerata Kontakt Zasady publikacji prac
6/2018
vol. 4
 
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Postępowanie w kaszlu u osób dorosłych – rekomendacje dla lekarzy rodzinnych

Rafał Krenke, Joanna Chorostowska-Wynimko, Marta Dąbrowska, Przemysław Bieńkowski, Magdalena Arcimowicz, Elżbieta M. Grabczak, Agnieszka Mastalerz-Migas

Data publikacji online: 2018/12/28
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Kaszel jest jedną z najczęstszych dolegliwości, z jakimi pacjenci zgłaszają się do lekarza POZ. Najczęstszą przyczyną kaszlu ostrego są ostre zakażenia górnych dróg oddechowych, które zwykle wymagają jedynie leczenia objawowego. Przyczyną ostrego kaszlu mogą być także stany wymagające szybkiego i ukierunkowanego leczenia przyczynowego, takie jak zapalenie płuc, ciało obce w drogach oddechowych. Dlatego podstawowym zadaniem lekarza POZ jest przeprowadzenie diagnostyki różnicowej, która u znacznej większości chorych sprowadza się do wykluczenia stanów wymagających szybkiego leczenia przyczynowego. U chorych z kaszlem przewlekłym znaczenie leczenia objawowego jest raczej ograniczone, a dominującą rolę odgrywa leczenie przyczynowe. Należy przy tym podkreślić, że kaszel przewlekły może być trudnym wyzwaniem diagnostycznym, dlatego że spektrum chorób będących przyczyną kaszlu jest szerokie, a poza tym nierzadkie jest współistnienie kilku schorzeń powodujących kaszel.

Leczenie przyczynowe kaszlu powinno być prowadzone konsekwentnie (w odpowiedniej dawce i odpowiednio długo) i w zależności od przyczyny uwzględniać nie tylko farmakoterapię, lecz także modyfikację stylu życia, fizjoterapię i terapię logopedyczną. Należy mieć świadomość, że skuteczność leczenia przewlekłego kaszlu jest ograniczona, co może wynikać m.in. z niemożności ustalenia rzeczywistej przyczyny kaszlu, współistnienia kilku przyczyn, nieadekwatnego leczenia czy też nadwrażliwości odruchu kaszlu.
słowa kluczowe:

kaszel, dorośli, diagnostyka kaszlu, leczenie kaszlu

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