慢性閉塞性肺疾患の診断と外来治療: レビュー
Craig M Riley1, Frank C Sciurba1
1Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
JAMA
|February 27, 2019
まとめ
慢性閉塞性肺疾患 (COPD) の治療は進化しています 主要な治療法は,長時間作用する支氣管拡張剤,吸入用コルチコステロイド,肺リハビリテーション,低酸素症に対する酸素療法で,患者のアウトカムを改善します.
科学分野:
- 肺医学
- 内科 医学
背景:
- 慢性閉塞性肺疾患 (COPD) は アメリカで3千万人の成人に 影響し,主要な死因であり,医師の診察を多く行う原因となっています.
- 主要医療従事者はCOPDの診断と管理に困難に直面し,その臨床的特徴と治療への反応が変化するからです.
- 慢性肺炎の診断と治療の急速な進歩により 最適な患者ケアのための最新の知識が必要になります
研究 の 目的:
- COPDの診断と管理における現在の理解と最近の進歩をレビューする.
- 患者の治療結果を改善するために 根拠に基づいた治療戦略の重要性を強調する.
主な方法:
- 診断はスピロメトリーによるもので,不完全で逆戻り可能な排気流の制限を評価する.
- 治療は,疾患の重症度,症状 (呼吸不全,咳,唾液),および悪化の頻度によって導かれます.
- 重要な介入には 禁煙,ワクチン接種,長時間作用する支氣管拡張剤,吸入用コルチコステロイド,肺リハビリテーション,補充酸素が含まれます.
主要な成果:
- 長期にわたって作用する支柱管拡張剤,吸入用コルチコステロイド,肺リハビリテーションは症状を効果的に軽減し,機能を改善し,悪化を軽減します.
- 休息時の低酸素症 (Spo2 < 89%) の補充酸素は生存率を向上させることが証明されています.
- 肺のリハビリテーションは 十分に活用されていないが 症状と運動耐性を高めます
結論:
- COPDは複雑で,集中的で個別的な治療が必要です.
- 呼吸器拡張剤,吸入用コルチコステロイド,肺リハビリテーション,酸素療法による適切な使用は,生活の質と生存率を大幅に改善します.
- 先進的な治療法は特定の患者プロファイルで利用可能であり,継続的な臨床更新の必要性を強調しています.
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