慢性阻塞性肺部疾病的诊断和门诊治疗:一篇评论
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
概括
慢性阻塞性肺病 (COPD) 的治疗正在发展. 主要治疗方法包括长效支气管扩展剂,吸入性皮质类固醇,肺复原治疗和氧气治疗,改善患者的治疗结果.
科学领域:
- 肺部医学
- 内部医学
背景情况:
- 慢性阻塞性肺病 (COPD) 影响了3000万美国成年人,是导致死亡的主要原因,
- 主要医疗保健医生诊断和管理COPD,因为其可变的临床特征和治疗反应而面临挑战.
- 在COPD诊断和治疗方面取得的快速进展需要最新的知识来提供最佳的患者护理.
研究的目的:
- 审查目前对COPD诊断和治疗的认识和最新进展.
- 强调基于证据的治疗策略对于改善患者的结果的重要性.
主要方法:
- 诊断依赖于螺旋测量来评估不完全可逆的呼气流量限制.
- 治疗是根据疾病的严重程度,症状 (喘息,咳,吐) 和恶化的频率进行的.
- 主要干预措施包括戒烟,接种疫苗,长效支气管扩展剂,吸入的皮质类固醇,肺部康复和补充氧气.
主要成果:
- 长效支气管扩展剂,吸入性皮质类固醇和肺部康复疗法有效减少症状,改善功能,减少恶化.
- 补充氧气治疗静止低氧症 (Spo2 < 89%) 已被证明可以改善存活率.
- 肺部康复治疗虽然未得到充分利用,
结论:
- 慢性肺炎是一种复杂的疾病,
- 适当使用支气管扩展剂,吸入皮质类固醇,肺部康复和氧气治疗显著改善了生命质量和存活率.
- 针对特定患者的高级疗法可用,这强调了持续临床更新的必要性.
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