Universitat Autònoma de Barcelona, Equip d'Atenció Primària Chafarinas, SAP Muntanya, Barcelona, Spain.
Ther Adv Respir Dis. 2011 Dec;5(6):369-75. doi: 10.1177/1753465811416698. Epub 2011 Sep 15.
To describe the approach to asthma exacerbations in a primary care centre in comparison with current guidelines and to ascertain the resolution of the episodes.
A cross-sectional, descriptive study was performed in asthmatic patients over 14 years old who were consulting for asthma exacerbations in a primary care centre during a 6-month period. The treatment given and the resolution obtained were evaluated.
One hundred and twenty-three asthma exacerbations were registered, corresponding to 96 patients. A total of 74% were mild exacerbations, 24.4% moderate and 1.6% severe. The severity of asthma correlated directly with the severity of exacerbations. The frequency of resolution was 98.4%, with an average duration of medical attention of 30 min (SD 16.5). According to guidelines, 60.2% of the mild exacerbations were well treated, as were 26.7% of the moderate exacerbations and none of the severe episodes. Peak expiratory flow was measured in 54.5% of patients. In 82 cases (66.6%) salbutamol was given with a large-volume spacer chamber. Treatment after discharge was correct in 27.3% of the mild and 23.3% of the moderate exacerbations. A total of 23 (23.9%) patients presented more than one exacerbation during the study period.
Most exacerbations seen in primary care are mild. Administration of salbutamol was sufficient for the resolution of these exacerbations. However, treatment after discharge was not compliant with guidelines in most cases. The primary care team was able to resolve most of the asthma exacerbations.
描述基层医疗中心治疗哮喘急性发作的方法，并与当前指南进行比较，确定发作的缓解情况。
这是一项横断面、描述性研究，在基层医疗中心因哮喘急性发作就诊的 14 岁以上哮喘患者中进行，在 6 个月的时间内评估他们的治疗方法和缓解情况。
共登记了 123 例哮喘急性发作，涉及 96 名患者。轻度发作占 74%，中度发作占 24.4%，重度发作占 1.6%。哮喘严重程度与发作严重程度直接相关。缓解率为 98.4%，平均医疗关注时间为 30 分钟（SD 16.5）。根据指南，60.2%的轻度发作得到了良好的治疗，26.7%的中度发作得到了良好的治疗，而重度发作无一例得到了良好的治疗。在 54.5%的患者中测量了呼气峰流速。在 82 例（66.6%）患者中使用了沙丁胺醇大剂量储雾罐。轻度发作中 27.3%、中度发作中 23.3%的患者出院后治疗正确。在研究期间，共有 23 名（23.9%）患者出现了一次以上的发作。
在基层医疗中看到的大多数急性发作都是轻度的。沙丁胺醇的使用足以缓解这些发作。然而，在大多数情况下，出院后的治疗并不符合指南。基层医疗团队能够解决大多数哮喘急性发作。
