epoc-grupal.docx

8/19/2019 EPOC-GRUPAL.docx

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UNIVERSIDAD NACIONALAUTÓNOMA DE MÉXICO

FACULTAD DE ESTUDIOS SUPERIORES ZARAGOZA

ÁREA CIENCIASCIENCIAS MÉDICO BIOLÓGICAS

MÉDICO CIRUJANO

EPIDEMIOLOGÍA

ENFERMEDAD PULMONAROBSTRUCTIVA CRÓNICA

(EPOC)

ALUMNOS DE EQUIPO 2 ORGANIZADOR:

• Alcántara González Lizette Guaalu!e

• "a#ac$o So%a Al#a Patricia

• "ar!intero Menoza "ecilia In&%

• "ort&% E'an(eli%ta Diana Aie&

• "ruz "a#!o% )a*iola +anet$

• )ernánez "ano O,elia Paolina

• Ror-(uez .ara/a% I0c$el Guaalu!e

GRUPO: 1301

PROFESOR TITULAR: ROCIO PANIAGUA HERNÁNDEZ

FEBRERO, 201

ENFERMEDAD OBSTRUCTIVA CRÓNICA (EPOC)


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DEFINICIÓN

L! "#$"%&"'!' ()*&+#!% +-.%)/.! /%#/! EPOC4 "- )#! "#$"%&"'!'(%""#*" 5 .%!.!*" 6)" -" /!%!/."%7! (+% )#! +-.%)//# '"* $*)8+ !9%"+6)" #+ "- /+&(*".!&"#." %""%-*" A-+/!'! ! )#! %"!//# #$*!&!.+%!()*&+#!% ("%--."#." (%#/(!*&"#." $%"#." !* ;)&+ '"* .!!/+ 5 *"("/.+%!/#4,">!/"%!/+#"-, "$"/.+- ">.%!?()*&+#!%"- 5 "#$"%&"'!'"-/+#/+&.!#."- 34 2@4 24 1@4

EPIDEMIOLÓGICA:

L! "#$"%&"'!' ()*&+#!% +-.%)/.! /%#/! "- )#! (!.+*+=! '" !*.!(%"!*"#/! ! #"* &)#'!* 1@ '" *! (+*!/# &)#'!*4, '" /+#'/#(%+%"-! 5 '"."%+%+ -#$/!.+ "# *! /!*'!' '" '!, 6)" ."#" %!# &(!/.+

"/+#&/+ "# *!- ("%-+#!- 5 *+- --."&!- '" -!*)'104 34

E- &- $%"/)"#." "# ("%-+#!- &!5+%"- '" @ !!/"%!/+#"- 5 *!/+&+%*'!' /+#.%)5"# ! *! %!"'!' *+!* "# *+- (!/"#."- #'')!*"- 144410414

L! E#$"%&"'!' P)*&+#!% O-.%)/.! C%#/!- EPOC4, "-. /+#-..)'! (+% *!%+#6).- /%#/! 5 "* "#$-"&! ()*&+#!% 1@4

ETIOLÓGICA:

E* (%#/(!* $!/.+% '" %"-+ !-+/!'+ !* '"-!%%+**+ '" *! EPOC "- "* ;)&+ '"*.!!/+, (+% *+ 6)" -" '"" ')'!% '"* '!#-./+ - #+ ">-." "-." !#."/"'"#."'" ">(+-/# L! #;!*!/# '" +.%!- (!%.=/)*!- (%+/"'"#."- '" *! (+*)/#!&"#.!* + '" !&"#."- +/)(!/+#!*"- (+'%=!# ."#"% /"%.+ (!("* !'.+ E-(+-*" 6)" ">-.!# $!/.+%"- "#9./+- !# '"-/+#+/'+- 6)" ()"'!# ">(*/!% (+% 6)9 -*+ )# 2@ '" *+- $)&!'+%"- '"-!%%+**!# *! EPOC, !)#6)" "* #/+/+#+/'+ "- "* '9$/. ;"%"'.!%+ '" !*$!?1?!#..%(-#!, )# #;'+% '" (%+."!-!-


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-9%/!- /)5! $!*.! (%++/! "#$-"&! ()*&+#!% 5 "- %"-(+#-!*" #/!&"#." '")# 1 '" *+- "#$-"&!- 14 1@4

E- )#! #$*!&!/# /%#/! '"* "(."*+ %+#6)!*, 6)" (%+')/" ;("%-"/%"/#,%+#6)+*+- /+# +-.%)//# 5 $%+-- *! !//# (%+."+*=./! "- %"-(+#-!*" '"*! '"-.%)//# '" *!- (!%"'"- !*"+*!%"- 5 /!(*!%"-, (%+')/"#'+ '*!.!/# '"*+- "-(!/+- !9%"+- /+# '$"%"#."- .(+- '" "#$-"&!, (!#!/#!% 5/"#.%+!/.+#!%114

L! *&.!/# /%#/! '"* $*)8+ '" !%", /!%!/."%=-./! '" EPOC, "- +/!-+#!'! (+% )#! /+&#!/# '" "#$"%&"'!' '" *!- =!- !9%"!- ("6)"

S" /!%!/."%7! (+% #$*!&!/# /%#/! '" *! =! !9%"! '"* (!%9#6)&! ()*&+#!% 5 '" *!- !%."%!- ()*&+#!%"-

L!- /9*)*!- 5 &"'!'+%"- #$*!&!.+%+- #+*)/%!'+- -+#: &!/%$!+- !*"+*!%"-,(+*&+%$+#)/*"!%"-, *#$+/.+- T CD4 5 /9*)*!- "(."*!*"- E#.%" *+- &"'!'+%"--" "#/)"#.%! "* $!/.+% '" #"/%+-- .)&+%!* !*$!, *")/+.%"#+- B, #."%*")/#! 5$!/.+% 6)&+././+ '" *+- #").%$*+- O.%+- (%+/"-+- 6)" #."%"#"# -+# "*

'"-"6)*%+ "#.%" (%+."!-!- 5 !#.(%+."!-!- 5 "* "-.%9- +>'!#."

14

L! '-&#)/# '"* $*)8+ "-(%!.+%+ "- *! !#+&!*=! $)#/+#!* 6)" '"$#" ! *!EPOC E- "* %"-)*.!'+ '" *!- !*."%!/+#"- !#!.&/!- '" *+- %+#6)+*+-, 6)"+/!-+#!# )# !)&"#.+ '" *! %"--."#/! !* $*)8+ !9%"+, 5 '"* (!%9#6)&! !*"+*!%,6)" (%+')/"# )#! '-&#)/# '" *! "*!-./'!' ()*&+#!% E-.!- !*."%!/+#"-.!&9# +/!-+#!# !#+&!*=!- "# "* #."%/!&+ !-"+-+ 5 ()"'"# (%++/!% /!&+- "# *! &"/#/! "#.*!.+%!, *! ;"&+'#&/! ()*&+#!% 5 *! %"-()"-.! !*"8"%//+ 14

CONSTRUCTO

E- )#! "#$"%&"'!' #$*!&!.+%! /%#/! '"* (!%9#6)&! ()*&+#!% 5'" *!- !%."%!- ()*&+#!%"-, "- (%""#*" 5 .%!.!*", -" /!%!/."%7!

(+% *! +-.%)//# ("%--."#." !* $*)8+ !9%"+ 5 -" '"" ! *!


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'-&#)/# '"* $*)8+ !-"+-+ ()*&+#!% *+ /)!* +"'"/" ! '$"%"#."-(!."#+- E- '" /)%-+ (%+%"-+ /+# %"-()"-.! #$*!&!.+%!

!#+%&!* '" *+- ()*&+#"-, !$"/.! !* 1@ '" *! (+*!/# &)#'!*, 6)"()"'" "-.!% + #+ ! !/+&(!

">("/.+%!/#, ">!/"%!/+#"-, "$"/.+- ">.%! ()*&+#!%"- 5

"#$"%&"'!'"- /+#/+&.!#."-

CLASIFICACIÓN

P!%! $#"- "')/!.+- -" %"/+&"#'! )#! /*!-$/!/# -&(*" "# /)!.%+ "-.!'=+-

E* &!#"8+ '"* EPOC "- (%#/(!*&"#." )!'+ (+% *+- -=#.+&!-, 5 /+&+ ">-.")#! (+%" /+%%"*!/# "#.%" *! *&.!/# !* $*)8+ !9%"+ 5 *! (%"-"#/! '"-=#.+&!-, *! /*!-$/!/# "- &- )# !+%'!8" (%/./+ 5 '"" "%-" /+&+ )#!;"%%!&"#.! "')/!.! 5 )#! #'/!/# &)5 "#"%!* (!%! "* &!#"8+ 4

4

A-=, *! )=! GOLD 2011 6)" /*!-$/! *! EPOC "# *+- "-.!'+- GOLD1, 2, 3 5

+-.%)//# *"", &+'"%!'!, %!" 5 &)5 %!"4 6)" ."#" "# /)"#.! *+-

-=#.+&!- 5 "* %"-+ '" ">!/"%!/+#"-

● A:GOLD 1?2,5K+ 0?1 ">!/"%!/#K!!/"%!/+#"- K!!/"%!/+#"-,

%"-()"-.! !* .%!.!&"#.+ , "*+/'!' '" (%+%"-# '" *! "#$"%&"'!', + &)"%."4?

L+- $"#+.(+- /*=#/+- -"# G"-EPOC -+#:


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● T(+ A:EPOC #+ !)'7!'+% /+# "#$-"&! + %+#6).- /%#/!

● T(+ B: EPOC &>.+ /+# !-&!, ."#! + #+ !)'7!/+#"- $%"/)"#."-

● T(+ C: EPOC !)'7!'+% /+# "#$-"&!

● T(+ D: EPOC !)'7!'+% /+# %+#6).- /%#/!124

2, , 1, 234

E# $)#/# '" *+- !*+%"- '" *! FE1 (+'"&+- /*!-$/!% *! EPOC "#:

LEE: FE1 /+&(%"#''+ "#.%" "* 0 5 "* 0 '" *+- !*+%"- '" %"$"%"#/!

MODERADA: FE1 "#.%" "* 0 5 "* @ '" *+- !*+%"- '" %"$"%"#/!

GRAE: FE1 &"#+% '"* 0 '" *+- !*+%"- '" %"$"%"#/!

E-.! '-# "- .* (!%! +%"#.!% "* .%!.!&"#.+ 5 (!%! +(.&7!% *+- %"/)%-+--!#.!%+- 34

14

FACTORES DE RIESGO (3,20,2 4

MODIFICABLES NO MODIFICABLES

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P+*)/# !&"#.!*

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POSTULADOS DE HANLON

MAGNITUD:L! EPOC +/)(! *+- (%&"%+- @ *)!%"- '" &+%*'!' 5 &+%.!*'!' "# "* &)#'+

D" !/)"%'+ ! *!- "-.!'=-./!- 6)" %"(+%.! "* INEGI, ">-." "'"#/! 6)" *!&+%.!*'!' "# *! EPOC -" ! #/%"&"#.!'+ "# "* !/+, "* INER, -" )/ "# "* *)!% "# *! .!*! '" &+%?&+%.!*'!'!#)!* A/.)!*&"#." *! EPOC +/)(! "* /)!%.+ *)!% "# /)!#.+ ! &+%.!*'!' ! #"*&)#'!*, "# M9>/+ -" )/! "#.%" "* 5 "* 134

E# "* 2020 -" "-("%! 6)" +/)(" "* ."%/"% *)!% /+&+ /!)-! '" &+%.!*'!'"#"%!*

E# .9%&#+- '" &+%*'!' .%!#-.!%! '"* /)!%.+ !* ."%/"% *)!% ! #"* &)#'!* 5*! /!)-! '"* !)&"#.+ '" *! &+%*'!' 5 &+%.!*'!' -" '"" (%#/(!*&"#." ! *!

"('"&! 4 : A/.)!*&"#." *+- '!.+- &)"-.%!# )#! !*.! (%"!*"#/! '" *!"#$"%&"'!' "# "'!' *!+%!*, '+#'" "* 0 '" *+- (!/"#."- -+# &"#+%"- '" @!


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TENDENCIA SECULAR:

E* #/%"&"#.+ "# *! &+%.!*'!' ;! -'+ -)-.!#/!* "# *+- (%&"%+ .%"#.! !"#.! '" "%%+%"- 3@4

L! "-(%+&".%=!, ()"'" '!#+-./!% 5 &"8+%!% "* .%!.!&"#.+ (%"/+7 24

R> '" .%!> PA 5 *!."%!*, 6)" '""%# %"(".%-" "# /!-+- '"">!/"%!/+#"- (!%! '"-/!%.!% /+&(*/!/+#"- $%"/)"#."- /+&+-+%"#$"//+#"- + #")&+.%!>334

E* "-.)'+ %!'+*/+, &)"-.%! )# '!$%!&! !(*!#!'+, *!- -+&%!-%+#/+!-/)*!%"- #+ !*/!#7!# *! ("%$"%! '"* ()*&# 334

G!-+&".%=! 334


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VIABILIDAD:

G)=! (!%! "* '!#-./+ 5 "* .%!.!&"#.+ '" *! "#$"%&"'!' ()*&+#!% +-.%)/.! /%#/!

A."#/# #."%!* !* (!/"#." /+# E#$"%&"'!' O-.%)/.! C%#/! '"-'"

*! !."#/# (%&!%! ! *! "-("/!*7!'! 4

D"-'" 200, "* M#-."%+ '" S!#'!' 5 P+*=./! S+/!*, ! .%!9- '"* P*!#'" C!*'!' '"* S-."&! N!/+#!* '" S!*)' SNS4 5 *! E-.%!."! "#EPOC, ;! "-.!'+ .%!!8!#'+ (!%! %"')/% "* #&"%+ '" ("%-+#!- /+#EPOC 5 (!%! '"#.$/!% *! &!#"%! '" &"8+%!% *! !."#/# 5 *! /!*'!' '"'! '" *!- ("%-+#!- 6)" *! -)$%"# 24

FACTIBILIDAD:

A'"&- '" *! /!%! '" &+%.!*'!' 5 &+%*'!', *! EPOC /+#**"! !*.+- /+-.+-

"/+#&/+- %"-)*.!#."- '" *+- /+-.+- '%"/.+- '" *! !."#/# (!%! *! -!*)' 5 *+-/+-.+- #'%"/.+- %"*!/+#!'+- /+# *+- /)'!'+- 5 *! (9%''! '" *! (%+')/.'!''"* (!/"#." 4

MEDIDAS PREVENTIVAS 1° !° " #° NIVEL DE ATENCIÓN

1$ (PROMOCIÓN A LA SALUD " PROTECCIÓN ESPECÍFICA) A'&#-.%!/# '" *! !/)#! (!%! "* %)- '" *! #$*)"#7! )#! "7 !* !

-")&"#.+ '"

(!/"#."- /!#''!.+- ! /%)=! '" EPOC, #/*)5"#'+ %"')//# ()*&+#!%,

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!$ (DX TEMPRANO " TX OPORTUNO)

E* '!#-./+ '" EPOC '"" /+#-'"%!%-" "# /)!*6)"% (!/"#." 6)" ."#"-=#.+&!- '" .+-, (%+')//# '" "-().+ + '-#"! 5K+ ."#" ;-.+%! '" ">(+-/#

! $!/.+%"- '" %"-+ (!%! *! "#$"%&"'!'4


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LIMITACIÓN DEL DA%O#$ (REHABILITACIÓN)

E#.%"#!&"#.+ &)-/)*!%, #).%/#, $-+."%!(!, "')/!/#, !(+5+

(-/+*/+ 5 +>"#+."%!(! ! *!%+ (*!7+ E8"%//+- "# //*".! 5 !#'!

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R> P?A 5 L!. '" .%!>

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)#! +(/# '" .%!.!&"#.+ (*!#."!'! "- !/)#!%*+ /+#.%! *! #$*)"#7! 5

#")&+/+/+ )#! "7 !* !


11/21

C)!#'+ -" "#/)"#.%! !!#7!'+ "- /+&# *! (9%''! '" ("-+ 5 *!/!6)">!14

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!+*'+, %!/+#"- +/!*"- '-&#)'!-, ()"'" ;!"% -*!#/!- 134

SIGNOS DE ALARMA

R"-(%!.+%+-: A)&"#.+ '" *! '-#"!, !)&"#.+ '" *! .+-, !)&"#.+ '"* +*)&"#'"* "-().+, !)&"#.+ '" *! ()%)*"#/! '"* "-().+, %"-(%!/# %('! 5 -)("%$/!*5 -*!#/!-

S-.9&/+-: F"%", .!6)/!%'!, "'"&! '" &"&%+- #$"%+%"-, !*."%!/# '"*"-.!'+ &"#.!* 24

L! EPOC -" !-+/! ! '+- "#$"%&"'!'"- $)#'!&"#.!*&"#.":

HQPERLIN ;..(:KK"-("'!+%KKE#$-"&!V()*&+#!%E#$-"&!()*&+#!% : E- "* !%!#'!&"#.+ ("%&!#"#." '" *+- %+#6)+*+- ."%&#!*"-,/+# '"-.%)//# '" *! (!%"' !*"+*!% , ()'"#'+ + #+ (%"-"#.!%-" $%+--E-.+ (%++/! "* /+*!(-+ '" *!- =!- %"-(%!.+%!- S" -)"*" "'"#/!% "# *!/*=#/! (+% (+*(#"! 5 .!6)(#"!, ("%+ /+# '-&#)/# '"* &)%&)**+ "-/)*!%

! *! !)-/)*.!/# 5, (+% !)&"#.+ '"* "-(!/+ %".%+"-."%#!* "# *! %!'+%!$=!*!."%!* 76)"%'! '"* .%!>E* ("%$* '" *+- (!/"#."- /+# "#$-"&! P"%$* Pink Puffer 4 "-: !-."#!, !*%"'"'+% '" 0 !("/.+%!/#, '-#"!(%"/+7, *"" !*."%!/# '" *! '$)-# '" !-"-, -#+- %!'+*/+- '";("%#-)$*!/# 5 )**!-, &)5 !8! /!(!/'!' '" '$)-# '" CO 5 )#!%"--."#/! '" *! =! !9%"! (+/+ !*."%!'! +/!-+#!*&"#." "*"!'!4

E-.+- (!/"#."- +."#"# (+/! &"8+%=! /*=#/! /+# "* )-+ '"

http://es.wikipedia.org/wiki/Enfisema_pulmonarhttp://es.wikipedia.org/wiki/Enfisema_pulmonarhttp://es.wikipedia.org/wiki/Enfisema_pulmonarhttp://es.wikipedia.org/wiki/Bronquioloshttp://es.wikipedia.org/wiki/Alv%C3%A9olo_pulmonarhttp://es.wikipedia.org/wiki/Fibrosishttp://es.wikipedia.org/wiki/Polipneahttp://es.wikipedia.org/wiki/Enfisema_pulmonarhttp://es.wikipedia.org/wiki/Enfisema_pulmonarhttp://es.wikipedia.org/wiki/Bronquioloshttp://es.wikipedia.org/wiki/Alv%C3%A9olo_pulmonarhttp://es.wikipedia.org/wiki/Fibrosishttp://es.wikipedia.org/wiki/Polipnea


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%+#/+'*!.!'+%"- 5 (+% *+ "#"%!* (%+%"-!# '"-$!+%!*"&"#." /+# "* (!-+'"* ."&(+

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E.-,/+ 0*2: E# *! EPOC ()"'"# (%"-"#.!%-" '"%-+- -=#.+&!- "-("/=$/+-

6)" #+%&!*&"#." #+ -" ;!/"# "'"#."- ;!-.! 6)" ;!5! +/)%%'+ )# '!/*)5" "* '!#-./+

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E3',/&'*- : 4,&-25+ -4 0467 -8'/

D"" %"!*7!%-" "-(%+&".%=! "# /)!*6)"% (!/"#." 6)" -" -+-("/;" EPOCP!%! *+%!% '"#.$/!% (!/"#."- "# $+%&! ."&(%!#! "# "* /)%-+ '" *!"#$"%&"'!', *! "-(%+&".%=! '"" %"!*7!%-" "# #'')+- 6)" ."#"# .+- /%#/!5 ">("/.+%!/# !)#6)" #+ (%"-"#."# '-#"!, ;!9#'+-" '"-/!%.!'+


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#/!*&"#." (+% !/*+-/+(=!- *! (+-*'!' '" )#! .)"%/)*+-- !/.! 4

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

A-&! B%+#6)"/.!-!- I#-)$/"#/! /!%'!/! 104 O.%!- "#$"%&"'!'"- /+# *!- 6)" -" ;! '" %"!*7!% "* '!#-./+

'$"%"#/!* -+# *! .)"%/)*+--, *! +-.%)//# '" *! =! !9%"! -)("%+%, *!$%+-- 6)=-./!, *! #")&+/+#+-- 5 *! %+#6)+*.- +*."%!#." 34

24

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T!*! 2 D!#-./+ D$"%"#/!* '" *! EPOC 04D!#-./+ C!%!/."%=-./!- O%"#.!'+%!-W

EPOC

I#/+ "# *! "'!' &"'! '" *! '!S=#.+&!- *"#.!&"#." (%+%"-+-

A#."/"'"#."- '" .!!6)-&+ /%#/+ + ">(+-/# ! .(+ '" ;)&+-

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