(精选)【COPD英文精品课件】World COPD Day教学课件.pptVIP

A diagnosis of COPD should be considered in any patient who has cough, sputum production, or dyspnea and/or a history of exposure to risk factors. The diagnosis is confirmed by spirometry. To help identify individuals earlier in the course of disease, spirometry should be performed for patients who have chronic cough and sputum production even if they do not have dyspnea. Spirometry is the best way to diagnose COPD and to monitor its progression and health care workers to care for COPD patients should have assess to spirometry. Global Strategy for Diagnosis, Management and Prevention of COPD Definition, Classification Burden of COPD Risk factors Pathogenesis, pathology, pathophysiology Management Practical Considerations Revised 2006 Four Components of Care Assess and Monitor Disease Reduce Risk Factors Manage Stable COPD Manage Exacerbations Relieve symptoms Prevent disease progression ? Improve exercise tolerance ? Improve health status ? Prevent and treat complications ? Prevent and treat exacerbations ? Reduce mortality GOALS of COPD MANAGEMENT VARYING EMPHASIS WITH DIFFERING SEVERITY DIAGNOSIS AND RISK FACTORS Bronchodilator testing no longer mandatory Post-bd FEV1 still the preferred outcome Symptom assessment, e.g., MRC dyspnoea Co-morbid pathology to be documented New therapy for smoking cessation More emphasis on indoor pollution IV: Very Severe III: Severe II: Moderate I: Mild Therapy at Each Stage of COPD FEV1/FVC 70% FEV1 80% predicted FEV1/FVC 70% 50% FEV1 80% predicted FEV1/FVC 70% 30% FEV1 50% predicted FEV1/FVC 70% FEV1 30% predicted or FEV1 50% predicted plus chronic respiratory failure Add regular treatment with one or more long-acting bronchodilators (when needed); Add rehabilitation Add inhaled glucocorticosteroids if repeated exacerbations Active reduction of risk factor(s); influenza vaccination Add short-acting bronchodilator (when needed) Add long term oxygen if chronic respira