{"id":1381,"date":"2017-05-04T10:28:44","date_gmt":"2017-05-04T07:28:44","guid":{"rendered":"http:\/\/www.bulentsekerel.com\/?page_id=1381"},"modified":"2017-05-04T10:40:57","modified_gmt":"2017-05-04T07:40:57","slug":"astim-hakkinda-sik-sorulan-sorular","status":"publish","type":"page","link":"https:\/\/bulentsekerel.com\/index.php\/astim-hakkinda-sik-sorulan-sorular\/","title":{"rendered":"Ast\u0131m Hakk\u0131nda S\u0131k Sorulan Sorular"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_image-98f28eb690880195188c7db82008649b\">\n.avia-image-container.av-av_image-98f28eb690880195188c7db82008649b img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-av_image-98f28eb690880195188c7db82008649b .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-av_image-98f28eb690880195188c7db82008649b av-styling- avia-align-center  avia-builder-el-0  el_before_av_heading  avia-builder-el-first '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" class='wp-image-1383 avia-img-lazy-loading-not-1383 avia_image ' src=\"https:\/\/bulentsekerel.com\/wp-content\/uploads\/2017\/05\/DSC_7984-300x199.jpg\" alt='ast\u0131m hakk\u0131nda s\u0131k sorulan sorular' title='ast\u0131m hakk\u0131nda s\u0131k sorulan sorular'  height=\"199\" width=\"300\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/bulentsekerel.com\/wp-content\/uploads\/2017\/05\/DSC_7984-300x199.jpg 300w, https:\/\/bulentsekerel.com\/wp-content\/uploads\/2017\/05\/DSC_7984-768x510.jpg 768w, https:\/\/bulentsekerel.com\/wp-content\/uploads\/2017\/05\/DSC_7984-1030x683.jpg 1030w, https:\/\/bulentsekerel.com\/wp-content\/uploads\/2017\/05\/DSC_7984-1500x995.jpg 1500w, https:\/\/bulentsekerel.com\/wp-content\/uploads\/2017\/05\/DSC_7984-705x468.jpg 705w, https:\/\/bulentsekerel.com\/wp-content\/uploads\/2017\/05\/DSC_7984-450x299.jpg 450w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/div><\/div><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-efa8ac45ff180f47319ae92805ed0ffb\">\n#top .av-special-heading.av-av_heading-efa8ac45ff180f47319ae92805ed0ffb{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-av_heading-efa8ac45ff180f47319ae92805ed0ffb .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-efa8ac45ff180f47319ae92805ed0ffb .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-efa8ac45ff180f47319ae92805ed0ffb av-special-heading-h1  avia-builder-el-1  el_after_av_image  el_before_av_textblock '><h1 class='av-special-heading-tag'  itemprop=\"headline\"  >Ast\u0131m Hakk\u0131nda S\u0131k Sorulan Sorular<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n<section  class='av_textblock_section av-av_textblock-0366cc7376be6c9e82a3e9cc8987b64f'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>Anne baban\u0131n sigara i\u00e7mesinin \u00e7ocukta ast\u0131m geli\u015fimine etkisi nedir?<\/strong><\/p>\n<p>Bug\u00fcnk\u00fc anlay\u0131\u015f\u0131m\u0131z; sigaran\u0131n hem ast\u0131m\u0131n olu\u015fumunda hem de varolan hastal\u0131\u011f\u0131n k\u00f6t\u00fcle\u015fmesinde sorumlu olabilece\u011fi y\u00f6n\u00fcndedir. Sigaran\u0131n bilinen pek \u00e7ok olumsuz yan etkisi vard\u0131r, ancak sigara duman\u0131na maruz kalanlarda en iyi g\u00f6sterilmi\u015f yan etki solunum sistemi yak\u0131nmalardaki belirgin art\u0131\u015ft\u0131r. Benzer \u015fekilde gebelerin sigaraya maruz kalmalar\u0131 durumunda, bebeklerinin akci\u011ferlerinde yetersiz b\u00fcy\u00fcme ve geli\u015fme oldu\u011fu g\u00f6sterilmi\u015ftir. Sigara ast\u0131m\u0131n geli\u015fiminde su\u00e7lanm\u0131\u015fsada, bu etkiyi ve mekanizmay\u0131 ortaya koyan bir ara\u015ft\u0131rma mevcut de\u011fildir. Ancak sigara maruziyetinin en iyi bilinen etkilerinden biri kronik obstr\u00fcktif akci\u011fer hastal\u0131\u011f\u0131 geli\u015fimine olan katk\u0131s\u0131d\u0131r.<\/p>\n<p><strong>\u00c7ocukluk \u00e7a\u011f\u0131 ast\u0131m\u0131n tipleri nelerdir?<\/strong><\/p>\n<p>\u00c7ocukluk \u00e7a\u011f\u0131 ast\u0131m\u0131n bilinen en klasik tipleri alerjik olan ve olmayan hastal\u0131k formlar\u0131d\u0131r. Ancak bu s\u0131n\u0131flaman\u0131n bug\u00fcn i\u00e7in pek bir anlam\u0131 kald\u0131\u011f\u0131n\u0131 s\u00f6ylemek m\u00fcmk\u00fcn de\u011fildir. Alerjik durumun ortaya konmas\u0131 daha \u00e7ok hastal\u0131\u011f\u0131 k\u00f6t\u00fcle\u015ftiren fakt\u00f6rlerin tan\u0131nmas\u0131 a\u00e7\u0131s\u0131ndan \u00f6nemlidir. Bug\u00fcnk\u00fc alg\u0131lay\u0131\u015f\u0131m\u0131za g\u00f6re; ast\u0131m\u0131 art\u0131k tek bir hastal\u0131k olarak de\u011fil de daha \u00e7ok bir \u201csendrom\u201d olarak tan\u0131ml\u0131yoruz. \u0130\u00e7inde klinik g\u00f6r\u00fcn\u00fcm, do\u011fal seyir ve tedavi yan\u0131t\u0131 a\u00e7\u0131s\u0131ndan farkl\u0131 tiplerin oldu\u011funu biliyoruz. \u00dcst\u00fcne \u00fcstelik bu tiplerin aras\u0131ndaki s\u0131n\u0131rlar net de\u011fil veya bir tak\u0131m klinik ve laboratuar bulgular\u0131na dayanarak bu s\u0131n\u0131rlar\u0131 \u00e7iziyor ve hastan\u0131n tedavisi izlemini buna g\u00f6re planl\u0131yoruz. \u00a0\u00d6zetle her h\u0131\u015f\u0131lt\u0131l\u0131 \u00e7ocuk ast\u0131m olmad\u0131\u011f\u0131 gibi her h\u0131\u015f\u0131lt\u0131l\u0131 \u00e7ocu\u011funda ast\u0131ml\u0131 gibi tedavi edilmesine kar\u015f\u0131y\u0131m. Bu de\u011fi\u015fik tiplerin do\u011fru olarak alg\u0131lanmas\u0131n\u0131n hem hastan\u0131n do\u011fru bilgilendirilmesi hem de uygun tedavinin planlanmas\u0131 a\u00e7\u0131s\u0131ndan \u00f6nemli oldu\u011fu kabul edilmektedir.<\/p>\n<p><strong>Alerjinin pediatrik ast\u0131mdaki yeri nedir?<\/strong><\/p>\n<p>Ast\u0131m tan\u0131s\u0131 koydu\u011fumuz hastalara bakt\u0131\u011f\u0131m\u0131zda ortalama %70 hastada bir ya da birden \u00e7ok alerjinin e\u015flik etti\u011fini biliyoruz. Bu durum san\u0131r\u0131m, ast\u0131m\u0131n neden baz\u0131 hekimlerce hala \u201calerjk bron\u015fit\u201d olarak tan\u0131mland\u0131\u011f\u0131 a\u00e7\u0131k\u00e7a g\u00f6steriyor. Ast\u0131ml\u0131 bir hastada alerjik durumun ortaya konmas\u0131 bir\u00e7ok a\u00e7\u0131dan \u00f6nem arzediyor. Bir yandan hastaya nelerden ka\u00e7\u0131nmas\u0131 gerekti\u011finin \u00f6\u011fretmemiz a\u00e7\u0131s\u0131ndan bu bilgiye ihtiyac\u0131m\u0131z var, di\u011fer yandan da alerjinin e\u015flik etmesi daha farkl\u0131 bir seyre i\u015faret ediyor. Alerjik olan ast\u0131ml\u0131larda ilerleyen ya\u015fla k\u00fcr geli\u015fme olas\u0131l\u0131\u011f\u0131 alerjisi olmayanlara g\u00f6re farkl\u0131d\u0131r. Ayr\u0131ca, nadir de olsa baz\u0131 alerjik ast\u0131ml\u0131lara tedavi olarak alerjen imm\u00fcnoterapisi uygulanabiliyor. Yani alerjik durum di\u011fer bir yandan da tedavinin nas\u0131l yap\u0131laca\u011f\u0131n\u0131 belirleyebiliyor.<\/p>\n<p><strong>Ast\u0131m \u00e7ocukluk \u00e7a\u011f\u0131nda hangi hastal\u0131klarla s\u0131k birliktelik g\u00f6sterir? Refl\u00fc ile ili\u015fkisi eri\u015fkindeki gibi midir?<\/strong><\/p>\n<p>Ast\u0131m alerjik hastal\u0131klardan biridir. Alerjik hastal\u0131klar dendi\u011finde ise ast\u0131m\u0131n yan\u0131s\u0131ra; alerjik rinit, atopik dermatit ve besin alerjisi anla\u015f\u0131l\u0131r. Bunun anlam\u0131 \u015fudur: \u201cAlerjik hastal\u0131klardan birini bar\u0131nd\u0131ran bir ki\u015fide di\u011fer alerjik hastal\u0131klar\u0131n geli\u015fme riski sa\u011fl\u0131kl\u0131 ba\u015fka bir k\u015fiye g\u00f6re daha fazlad\u0131r. Ayr\u0131ca ailenizde alerjik hastal\u0131klardan biri varsa sizde de alerjik hastal\u0131klardan birinin geli\u015fme riski olduk\u00e7a y\u00fcksektir.\u201d Bu sebeple ast\u0131m tan\u0131s\u0131 konan her hastan\u0131n di\u011fer alerjik hastal\u0131klar a\u00e7\u0131s\u0131ndan de\u011ferlendirilmesi gerekir.<\/p>\n<p>Ayr\u0131ca, baz\u0131 hastal\u0131klar ast\u0131ma e\u015flik edebilir. Bunlar aras\u0131nda sinuzit, burun polibi, a\u011fr\u0131 kesici-ate\u015f d\u00fc\u015f\u00fcr\u00fcc\u00fc ila\u00e7lara duyarl\u0131l\u0131k ve refl\u00fc say\u0131labilir. Refl\u00fc di\u011fer hastal\u0131klara g\u00f6re biraz farkl\u0131d\u0131r. \u015e\u00f6yleki; bir yandan ast\u0131m ataklar\u0131 refl\u00fcye yol a\u00e7arken di\u011fer yandan da refl\u00fcn\u00fcn kendiside ba\u015fta \u00f6ks\u00fcr\u00fck olmak \u00fczere ast\u0131m yak\u0131nmalar\u0131na benzer bulgulara neden olabilir. Bu ba\u011flamda refl\u00fc-ast\u0131m ili\u015fkisi \u201cTavuk mu yumurtadan \u00e7\u0131kar, yumurta m\u0131 tavuktan\u201d \u00f6zdeyi\u015fini \u00e7a\u011fr\u0131\u015ft\u0131r\u0131r.<\/p>\n<p><strong>\u00c7ocuklarda ast\u0131m tan\u0131s\u0131 nas\u0131l konur?<\/strong><\/p>\n<p>Ast\u0131m tan\u0131s\u0131 koyduran bir test yoktur. Tan\u0131 daha \u00e7ok klinik bulgulara ve hastal\u0131k \u00f6yk\u00fcs\u00fcne dayand\u0131r\u0131l\u0131r. Ancak laboratuvar bulgular\u0131 ve tedavi yan\u0131tlar\u0131 da tan\u0131 koymada yard\u0131mc\u0131d\u0131r. Yak\u0131nmalar\u0131n ba\u015flang\u0131\u00e7 ya\u015f\u0131, niteli\u011fi, tedaviye verdi\u011fi yan\u0131tlar ve seyri tan\u0131 i\u00e7in \u00e7ok \u00f6nemli iken, ki\u015fisel ve ailesel alerji \u00f6yk\u00fcs\u00fc tan\u0131 i\u00e7in her zaman aranmas\u0131 gereken desteklerdir. Benzer \u015fekilde laboratuvar testleri de daha \u00e7ok tan\u0131y\u0131 destekleyici niteliktedir. Bunlardan solunum fonksiyonlar\u0131 hem tan\u0131 koymada hem de hasta izleminde en \u00f6nemli konuma sahiptir. Hatta bu sebeple \u201cAst\u0131ml\u0131 hasta izlemi solunum fonksiyonu \u00f6l\u00e7\u00fclmeden yap\u0131lmaz\u201d diyenler vard\u0131r. \u00a0Uygun teknikler ve aletler kullan\u0131ld\u0131\u011f\u0131nda \u00fc\u00e7 ya\u015f\u0131n \u00fczerindeki \u00e7o\u011fu \u00e7ocukta solunum fonksiyonlar\u0131 \u00f6l\u00e7\u00fcm\u00fc yap\u0131lablir. Solunum fonksiyon testleri hem tan\u0131 koymada hem de izlemde \u00e7ok yard\u0131mc\u0131d\u0131rlar. Solunum fonksiyon testleri yap\u0131lamayan \u00e7ocuklarda, tan\u0131 ve tedavi hekimin deneyim ve bilgisine daha \u00e7ok dayan\u0131r.<\/p>\n<p><strong>\u00c7ocuklarda ast\u0131m belirtileri nelerdir?<\/strong><\/p>\n<p>S\u00fcrekli veya ataklar halinde gelen \u00f6ks\u00fcr\u00fck, tekrarlayan h\u0131r\u0131lt\u0131 (h\u0131\u015f\u0131lt\u0131), nefes darl\u0131\u011f\u0131 ve g\u00f6\u011f\u00fcsde s\u0131k\u0131\u015fma hissinden her hangi biri ast\u0131m\u0131 d\u00fc\u015f\u00fcnd\u00fcrmelidir. Ast\u0131m \u00f6ks\u00fcr\u00fc\u011f\u00fc kuru, inat\u00e7\u0131 ve tekrarlay\u0131c\u0131d\u0131r. N\u00f6betler halinde gelir, s\u0131kl\u0131kla gece ve sabaha kar\u015f\u0131 ba\u015flay\u0131p hastay\u0131 uykudan uyand\u0131rabilir. H\u0131\u015f\u0131lt\u0131 ast\u0131m\u0131n en karekteristik bulgusudur. \u00d6zellikle nefes verirken g\u00f6\u011f\u00fcsten \u0131sl\u0131k sesine benzer bir ses duyulur. Ancak her h\u0131\u015f\u0131lt\u0131 duyulan \u00e7ocuk ast\u0131ml\u0131 de\u011fildir. \u00d6zellikle ya\u015fam\u0131n ilk iki y\u0131l\u0131nda bebeklerde solunum yolu infeksiyonlar\u0131 s\u0131kt\u0131r ve bu hastal\u0131klar h\u0131\u015f\u0131lt\u0131l\u0131 bir seyir g\u00f6sterir. Bu nedenlerle, \u00f6zellikle tekrarlayan h\u0131\u015f\u0131lt\u0131l\u0131 \u00e7ocuklarda ast\u0131m mutlaka akla getirilmelidir. Nefes darl\u0131\u011f\u0131 ise s\u0131k nefes al\u0131p-verme ve bebeklerde karn\u0131n, \u00e7ocuklarda g\u00f6\u011fs\u00fcn k\u00f6r\u00fck gibi inip kalkmas\u0131 ile kendini belli edebilir.<\/p>\n<p><strong>\u00c7ocuklarda ast\u0131m hangi hastal\u0131klarla kar\u0131\u015f\u0131r?<\/strong><\/p>\n<p>Ast\u0131m bir \u00e7ok hastal\u0131kla kar\u0131\u015fabilir. Pratikte okul \u00f6ncesi ya\u015f grubunda tekrarlayan h\u0131\u015f\u0131lt\u0131s\u0131 olan \u00e7ocuklar &#8220;H\u0131\u015f\u0131lt\u0131l\u0131 \u00c7ocuk&#8221; olarak isimlendirilir ve bunlar\u0131n \u00e7o\u011fu ast\u0131m de\u011fildir ve ilerleyen ya\u015fla birlikte hastalar yak\u0131nmas\u0131z hale gelirler. Ast\u0131m ise daha kal\u0131c\u0131 veya yineleyici olma \u00f6zelli\u011findedir. Ast\u0131ml\u0131lar\u0131n tedavisinde daha yo\u011fun ila\u00e7lar uygulanmas\u0131 gerekirken ast\u0131m\u0131 olmayan H\u0131\u015f\u0131lt\u0131l\u0131 \u00c7ocuklara yo\u011fun tedaviler uygulanmas\u0131 yarars\u0131zd\u0131r\/gereksizdir ve y\u00fcksek doz ila\u00e7lar kullanmak \u00e7ocuklar\u0131 tedaviye ba\u011fl\u0131 risklerle kar\u015f\u0131 kar\u015f\u0131ya b\u0131rak\u0131r.<\/p>\n<p>Ast\u0131m ayr\u0131ca alt solunum yolu infeksiyonlar\u0131 ile kar\u0131\u015fmakta ve bu nedenle bir\u00e7ok hasta yerli yersiz antibiotik tedaviler almaktad\u0131r. Yineleyen solunum sistemi yak\u0131nmalar\u0131na neden olan ba\u015fka hastal\u0131klarda (larenjit, geniz eti, sinuzit, geniz ak\u0131nt\u0131s\u0131 gibi ) solunum yolu sorunlar\u0131n\u0131n da ast\u0131m ile kar\u0131\u015fabilece\u011fini her zaman ak\u0131lda tutmak gerekir.<\/p>\n<p><strong>\u00c7ocuklarda ast\u0131m\u0131n do\u011fal seyri nas\u0131ld\u0131r? \u00c7ocu\u011fumun ast\u0131m\u0131 ge\u00e7er mi?<\/strong><\/p>\n<p>\u00c7ocukluk ya\u015f grubunda ast\u0131m tan\u0131s\u0131 konan hastalar\u0131n yakla\u015f\u0131k yar\u0131s\u0131n\u0131n gen\u00e7 eri\u015fkin d\u00f6nemde yak\u0131nmas\u0131z hale geldiklerini g\u00f6sterdik. Avrupa ve Amerika k\u00f6kenli ara\u015ft\u0131rmalarda bir hastada ilerde yak\u0131nmalar\u0131n kaybolaca\u011f\u0131n\u0131n en \u00f6nemli g\u00f6stergelerinin hastal\u0131k \u015fiddeti, alerjinin e\u015flik edip etmemesi, solunum fonksiyonlar\u0131, bron\u015f a\u015f\u0131r\u0131 duyarl\u0131l\u0131\u011f\u0131 ve cinsiyet oldu\u011fu kabul edilmektedir. \u00dclkemiz hastalar\u0131nda da genelde bu de\u011fi\u015fkenlerin do\u011fal seyrin nas\u0131l olaca\u011f\u0131n\u0131 yans\u0131tt\u0131\u011f\u0131 s\u00f6ylenebilir, ancak Hacettepe de y\u00fcr\u00fct\u00fclen bir ara\u015ft\u0131rmam\u0131zda, erken ya\u015fta saptanan baz\u0131 kan de\u011ferlerinin de do\u011fal seri \u00f6ng\u00f6rmede bir belirte\u00e7 olarak kullan\u0131labilece\u011fini g\u00f6stermi\u015ftir. Hastalar\u0131n gen\u00e7 eri\u015fkin d\u00f6nemde yak\u0131nmas\u0131z hale gelmesi her zaman ast\u0131m\u0131n k\u00fcr oldu\u011funu g\u00f6stermez, \u00e7\u00fcnk\u00fc ileri ya\u015flarda yak\u0131nmalr geri gelebilece\u011fi bilinir.<\/p>\n<p><strong>Ast\u0131m krizini tetikleyen fakt\u00f6rler nelerdir? Ast\u0131ml\u0131 \u00e7ocuklar\u0131n sak\u0131nmas\u0131 gereken \u00f6nemli durumlar nelerdir?<\/strong><\/p>\n<p>Ast\u0131ml\u0131 bir ki\u015fide yak\u0131nmalar\u0131 ba\u015flatan en s\u0131k neden \u00fcst solunum yolunun infeksiyonlar\u0131d\u0131r. Bunu alerjenler, yo\u011fun duman\/kokular ve baz\u0131 ila\u00e7lar izler. Ast\u0131ma en s\u0131k yol a\u00e7an alerjenler pollenler, ev tozu akar\u0131, hayvanlar, baz\u0131 k\u00fcf mantarlar\u0131 ve hamam b\u00f6ce\u011fidir. \u00dcst solunum yolunun her t\u00fcrl\u00fc infeksiyonu ast\u0131m yak\u0131nmalar\u0131n\u0131 ba\u015flatmaz. En fazla sorumlu olan viral (virusla ili\u015fkili) infeksiyonlard\u0131r. \u00d6rne\u011fin nezle virusu \u00a0ast\u0131m ataklar\u0131na en s\u0131k neden olan ajand\u0131r. Genelde bakterilerin neden oldu\u011fu \u00fcst solunum yolu infeksiyonlar ast\u0131m\u0131 tetiklememekle birlikte sin\u00fczit ast\u0131m\u0131 tetikler\/k\u00f6t\u00fcle\u015ftirebilir. \u00dclkemizde en s\u0131k ast\u0131ma yol a\u00e7an alerjenler pollen ve ev tozu akar alerjisidir. Pollenlerden de en s\u0131k alerji g\u00f6r\u00fcleni ise \u00e7ay\u0131r pollenleri yani \u00e7im pollenidir. Akar ise ev tozu i\u00e7inde ya\u015fayan ve g\u00f6zle g\u00f6r\u00fclemeyecek derecede k\u00fc\u00e7\u00fck olan bir b\u00f6cektir ve \u00f6zellikle de tekstil \u00fcr\u00fcnlerin \u00fczerinde bulunur. Rutubetli ve \u0131l\u0131man iklim ya\u015famas\u0131 i\u00e7in en uygun ortam\u0131 sa\u011flar. Ku\u015f t\u00fcy\u00fc ve y\u00fcn yatak yorganlar en s\u0131k bulundu\u011fu yerlerdir. Hayvanlardan ise en s\u0131k alerji yapt\u0131\u011f\u0131 bilinen kedidir. Yo\u011fun kimyasal madde koku ve dumanlar\u0131 her ki\u015fide baz\u0131 yak\u0131nmalara neden olur. Ancak ast\u0131ml\u0131larda her zaman bu yak\u0131nmalar daha fazla olur. Sigara ve soba duman\u0131, yo\u011fun parf\u00fcm, naftalin, boya vernik kokusu, egzos duman\u0131, so\u011fuk ve kuru hava solumak yak\u0131nmalar\u0131 ba\u015flat\u0131r. Egzersizin ast\u0131m yak\u0131nmalar\u0131 ba\u015flatt\u0131\u011f\u0131 iyi bilinen bir durumdur. Ancak burada sorumlu olan egzersizin kendisi de\u011fil egzersiz s\u0131ras\u0131nda a\u011f\u0131zdan solunum yap\u0131lmas\u0131 yani \u0131s\u0131nmam\u0131\u015f ve nemlenmemi\u015f havan\u0131n solunmas\u0131d\u0131r. \u0130la\u00e7lardan en s\u0131k ast\u0131ma yol a\u00e7an a\u011fr\u0131 kesici\/ate\u015f d\u00fc\u015f\u00fcr\u00fcc\u00fc ila\u00e7lard\u0131r. Eri\u015fkin ast\u0131ml\u0131lar\u0131n %10-20sinde ve \u00e7ocuk ast\u0131ml\u0131lar\u0131n %5-10\u2019nunda bu ila\u00e7lara kar\u015f\u0131 a\u015f\u0131r\u0131 hassasiyet mevcuttur ve bu durumlarda hassas olunan ila\u00e7lar kesinlikle kullan\u0131lmamal\u0131d\u0131r. Bunun d\u0131\u015f\u0131nda hipertansiyon, kalp hastal\u0131klar\u0131 ve baz\u0131 g\u00f6z hastal\u0131klar\u0131nda kullan\u0131lan ila\u00e7larda ast\u0131m\u0131 k\u00f6t\u00fcle\u015ftirebilece\u011finden her ast\u0131ml\u0131n\u0131n ba\u015fvurdu\u011fu hekimi ast\u0131m\u0131 oldu\u011fu hakk\u0131nda bilgilendirmesi gerekir.<\/p>\n<p><strong>\u00c7ocuklarda ast\u0131m tedavisinde neler kullan\u0131lmaktad\u0131r? Anne-babalara tavsiyeleriniz nedir, aile e\u011fitiminin \u00f6nemi nedir?<\/strong><\/p>\n<p>Mevcut tedaviler hastal\u0131\u011f\u0131 kontrol alt\u0131nda tutarak hasta ki\u015finin sa\u011fl\u0131kl\u0131 ki\u015filer benzer kaliteli ya\u015fam s\u00fcrmesine olanak sa\u011flar. Temel ama\u00e7lar spor dahil normal ya\u015fant\u0131n\u0131n devam ettirilmesi ve ast\u0131m krizlerini \u00f6nlemektir. Bu ama\u00e7lara ula\u015fabilmek i\u00e7in ast\u0131m erken d\u00f6nemde tan\u0131nmal\u0131 ve tedaviye erken d\u00f6nemde ba\u015flanmal\u0131d\u0131r. Ast\u0131m k\u0131sa s\u00fcrede gelip ge\u00e7en bir hastal\u0131k de\u011fildir. Bu nedenle hastan\u0131n yak\u0131nmas\u0131 olmasa da d\u00fczenli doktor kontrol\u00fc gereklidir. Ast\u0131m\u0131 k\u00fcr eden (tamamen ortadan kald\u0131ran) bir tedavi \u015fekli hen\u00fcz mevcut de\u011fildir. \u0130yi bir ast\u0131m tedavisi m\u00fcmk\u00fcn olan en az ve en d\u00fc\u015f\u00fck doz ile hastan\u0131n m\u00fcmk\u00fcn olan en iyi durumda tutulmas\u0131n\u0131 ama\u00e7lar. \u00dclkemizde gerekli tedavilerin \u00f6nerilmedi\u011fi bir \u00e7ok hasta yan\u0131nda gereksiz yere a\u015f\u0131r\u0131 ve y\u00fcksek dozlar ile tedavi edilen hastalar\u0131n oldu\u011fu g\u00f6r\u00fclmektedir. Yerli yersiz a\u011f\u0131zdan veya enjeksiyon \u015feklinde kortizon kullanmak hastalar\u0131 ila\u00e7lara ba\u011fl\u0131 yan etkilerin olu\u015fmas\u0131 riski ile kar\u015f\u0131 kar\u015f\u0131ya b\u0131rakmaktad\u0131r. Bu durumun en \u00f6nemli nedenleri\u00a0ast\u0131ml\u0131 hastalar\u0131n yo\u011fun poliklinik ko\u015fullar\u0131nda k\u0131sa s\u00fcrede tedavi edilmeye \u00e7al\u0131\u015f\u0131l\u0131yor olunmas\u0131, hasta izleminde solunum fonksiyonlar\u0131 gibi objektif testlerin neredeyse hi\u00e7 kullan\u0131lmamas\u0131, hasta-hekim ve ebeveyn dialo\u011funun yetersiz kurulmas\u0131 en dikkati \u00e7eken nedenlerdir. Ast\u0131m tedavisi kabaca \u00fc\u00e7 a\u015famada incelenebilir. \u0130lk a\u015fama tetikleyicilerden (infeksiyonlar, allejenler, yo\u011fun ve keskin kokular ve baz\u0131 ila\u00e7lar) sak\u0131nmad\u0131r. Sak\u0131nma \u00f6nlemleri yak\u0131nmalar\u0131n olu\u015fmas\u0131n\u0131 b\u00fcy\u00fck oranda kontrol edebilirse de \u00e7o\u011fu hastada t\u00fcm\u00fcyle ortadan kald\u0131ramaz. Bu takdirde yak\u0131nmalar\u0131n d\u00fczenli veya gerektik\u00e7e kullan\u0131lan de\u011fi\u015fik ila\u00e7lar ile kontrol alt\u0131nda al\u0131nmas\u0131 gerekir. Hekimler hastal\u0131\u011f\u0131n \u015fiddeti, hasta ya\u015f\u0131, kolay kullan\u0131labilirli\u011fi ve maliyet gibi fakt\u00f6rlerin g\u00f6z \u00f6n\u00fcnde tutarak her hasta i\u00e7in \u00f6zg\u00fcn tedaviler \u00f6nerirler. \u0130la\u00e7 tedavilerinde koruyucu ve rahatlat\u0131c\u0131 olmak \u00fczere iki grup ila\u00e7 vard\u0131r. Koruyucu ila\u00e7lar\u0131n s\u00fcrekli olarak kullan\u0131lmas\u0131 gerekirken rahatlat\u0131c\u0131 ila\u00e7larda gerektik\u00e7e devreye girerler. Koruyucu ila\u00e7lar aras\u0131nda inhale kortikosteroidler, l\u00f6kotrien antagonistleri, uzun etkili bronkodilat\u00f6rler ve teofilin say\u0131labilir. \u0130la\u00e7 tedavilerinin \u00f6nerilen \u015fekilde uygulamas\u0131 ile hastalar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011funda yak\u0131nmalar giderilebilir ve hastan\u0131n ya\u015fam kalitesi artt\u0131r\u0131labilir. \u0130lk iki a\u015fama tedavileri uygulamas\u0131na kar\u015f\u0131n yeterli yarar\u0131 g\u00f6rmeyen k\u00fc\u00e7\u00fck bir hasta grubunda ise, hastalar\u0131n \u00e7o\u011funlukla \u201ca\u015f\u0131\u201d olarak and\u0131klar\u0131, imm\u00fcnoterapi tedavisi uygulanabilir. \u0130mm\u00fcnoterapi tedavisinde hastaya duyarl\u0131 oldu\u011fu alerjen giderek artan dozlarda verilerek ba\u011f\u0131\u015f\u0131kl\u0131k sisteminde verilen tepkilerin azalt\u0131lmas\u0131 ama\u00e7lan\u0131r. Bu tedavi bi\u00e7imi genelde hastal\u0131k kontrol\u00fcni artt\u0131rsa bile k\u00fcr edemez (ortadan kald\u0131ramaz). \u0130mm\u00fcnoterapi yap\u0131lma karar\u0131 ve nas\u0131l yap\u0131laca\u011f\u0131 konu hakk\u0131nda uzmanl\u0131k(ihtisas) e\u011fitimi alm\u0131\u015f alerjistler taraf\u0131ndan verilir.<\/p>\n<p>Hastalar\u0131n s\u0131k atak ge\u00e7irmesi, \u00f6ks\u00fcr\u00fck ve h\u0131r\u0131lt\u0131 ile uyanmas\u0131, egzersizle \u00f6ks\u00fcr\u00fck olmas\u0131, egzersiz kapasitesinde k\u0131s\u0131tlanma olmas\u0131 ve rahatlat\u0131c\u0131 ila\u00e7 gereksiniminde art\u0131\u015f olmas\u0131 ast\u0131m tedavisinin yetersiz oldu\u011funu g\u00f6sterir. Bu durumda tedavi \u015femas\u0131 tekrardan g\u00f6zden ge\u00e7irilmesi i\u00e7in hekim ile temas kurulmal\u0131d\u0131r.<\/p>\n<p><strong>Bunun d\u0131\u015f\u0131nda eklemek istedikleriniz nelerdir?<\/strong><\/p>\n<p>Ast\u0131m korkulacak bir hastal\u0131k de\u011fildir. Korkulmas\u0131 gereken varolan hastal\u0131\u011f\u0131n hafife al\u0131nmas\u0131 veya g\u00f6rmezden gelinmesi veya hastalar\u0131n kortizon y\u00fckleyerek tedavi edilmeleridir. Bilin\u00e7li bir hekim ve hasta\/hasta yak\u0131n\u0131 ile \u00e7o\u011fu hastada sa\u011fl\u0131kl\u0131 bir insanda oldu\u011funa yak\u0131n bir kontrol seviyesine ula\u015fmak s\u0131kl\u0131kla m\u00fcmk\u00fcnd\u00fcr. Ancak bu hekim-hasta\/hasta yak\u0131n\u0131 aras\u0131nda g\u00fcven zemininde olu\u015fturulacak bir i\u015fbirli\u011fine gereksinim duyar. Hekimlerimizi bilgi ve becerilerini artt\u0131rmaya, hastalar\u0131m\u0131z\u0131da hekimleri ile ortak karar almaya ve bu kararlar\u0131 uygulamaya davet etmek istiyorum.<\/p>\n<p><em>Dikkat: Bu yaz\u0131 Dr B\u00fclent \u015eekerel taraf\u0131ndan haz\u0131rlanm\u0131\u015f olup kaynak g\u00f6sterilmeden kullan\u0131lamaz.<\/em><\/p>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ast\u0131m Hakk\u0131nda S\u0131k Sorulan Sorular - Prof. Dr. B\u00fclent Enis \u015eekerel<\/title>\n<meta name=\"description\" content=\"Prof. Dr. B\u00fclent Enis \u015eekerel&#039;in haz\u0131rlad\u0131\u011f\u0131, &quot;ast\u0131m hakk\u0131nda s\u0131k sorulan sorular&quot; ba\u015fl\u0131kl\u0131 yaz\u0131 ve \u00e7ocuk sa\u011fl\u0131\u011f\u0131 ile ilgili daha fazla bilgi bu sayfada.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/bulentsekerel.com\/index.php\/astim-hakkinda-sik-sorulan-sorular\/\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ast\u0131m Hakk\u0131nda S\u0131k Sorulan Sorular - Prof. Dr. B\u00fclent Enis \u015eekerel\" \/>\n<meta property=\"og:description\" content=\"Prof. Dr. B\u00fclent Enis \u015eekerel&#039;in haz\u0131rlad\u0131\u011f\u0131, &quot;ast\u0131m hakk\u0131nda s\u0131k sorulan sorular&quot; 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