COPD讲课祥解.ppt

急性加重期COPD的治疗原则 抗感染： 根据病原菌类型及药物敏感选用抗生素。 糖皮质激素：AECOPD推荐使用泼尼松40mg /d，疗程5天。机械通气:无创或有创机械通气。 防治并发症：呼吸衰竭、肺源性心脏病、心力衰竭，具体治疗方法可参阅有关章节治疗内容。 其他对症支持治疗 总结 COPD 药物 肺功能FEV1%/FVC70% 症状 危险因素 稳定期 急性 发作期 C D A B 分级 分期 戒烟 症状评分 肺功能锻炼 流感疫苗 治疗 诊断 急性发作 次数 肺功能 I级门诊 II级 住院 III级住ICU 总结 慢支、肺气肿、COPD的概念和相互间关系 COPD稳定期的评估 COPD稳定期的治疗目标 谢谢！ * ATS/ERS 指南 目的在于为患者提供美好前景， 鼓励我们医务人员采取更积极的态度，同时采取更有效的治疗手段 三部分；全身系统疾病 ? M Saetta * In COPD, irreversible damage causes the alveolar walls and supports to lose elasticity compared with the normal condition. The airways are partly collapsed and occluded, an effect made worse by reversible cholinergic constriction.1 As a result, deflation is slower, and so the alveolus only partly deflates over the course of an exhalation. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO workshop report. 2001. /workshop/toc.html. Accessed: 14 November 2003. * In COPD, irreversible damage causes the alveolar walls and supports to lose elasticity compared with the normal condition. The airways are partly collapsed and occluded, an effect made worse by reversible cholinergic constriction.1 As a result, deflation is slower, and so the alveolus only partly deflates over the course of an exhalation. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO workshop report. 2001. /workshop/toc.html. Accessed: 14 November 2003. * COPD patients suffer from reduced expiratory flow. As a result, the lungs may not fully empty before the next breath begins. This is particularly likely if the patient has to breathe faster as a result of physical activity.1 Because the lungs do not fully empty, they become progressively over inflated with each breath. This process is known as air trapping, which leads to hyperinflation.1 Air trapping reduces th