(精选)【医学课件课件】哮喘教学课件.pptVIP

Differential diagnosis ? 1. Chronic obstructive pulmonary disease 2.?Congestive heart failure 3.?Cough secondary to drugs (such as angiotensin converting enzyme inhibitors) 4.?Mechanical obstruction of the airways (tumors, anatomic changes) ?? COMPLICATION（并发症）： Pneumothorax (气胸) Mediastinal emphysema (纵隔气肿) Atelectasis (肺不张)  Chronic bronchitis (慢性支气管炎)  Emphysema (肺气肿)  Interstitial pneumonia (间质性肺炎) Pulmonary fibrosis (肺纤维化) Cor pulmonale (肺原性心脏病) FULL and FINAL DIAGNOSIS: ● Need a differential diagnosis ● Need a category of degree of severity ● Any complication PREVENTION and TREATMENT（预防和治疗） PREVENTION and TREATMENT（预防和治疗）：原则：祛除病因、控制急性发作、巩固疗效、改善肺功能、防止复法及提高病人生活质量。一. 祛除病因：消除或避免接触过敏原和一些非特异性刺激。包括增强体质预防呼吸道感染等。二 .控制急性发作：解痉、抗炎、痰的引流、保持气道通畅、防止继发感染等。 Mechanisms of Asthma Risk Factors (for development of asthma) INFLAMMATION Airway Hyperresponsiveness Airflow Obstruction Risk Factors (for exacerbations) Symptoms Avoid Exposure to Risk Factors ● To reduce exposure to causes of asthma exacerbations (e.g. allergens, pollutants, foods and medications). ● Identify irritants in the workplace ● To reduce role of infections on asthma development, especially in children and young infants Pharmacologic Therapy （1）糖皮质激素(glucocorticosteroids)： （2）氨茶碱（Aminophylline):（3）拟肾上腺素药物(β2-agonists ) （4）抗胆碱能类药物(Anticholinergic) （5）白三烯受体拮抗剂（ Leukotriene modifiers ） （1）糖皮质激素(glucocorticosteroids)：  ●能抑制炎症，减少渗出和炎性细胞的浸润－ 减轻炎症. ●抑制导致气道痉挛的活性物质的合成,可以降 低支气管高度反应性. ●抑制支气管腺体的分泌--减少分泌物， 减少 气道阻力，改善基础通气量. ●有潜在的能力改变支气管哮喘的临床过程。 ASTHMA (BRONCHIAL ASTHMA) ? 哮喘 （支气管哮喘） Baoyuan Chen. M.D.FCCP. Division of Respiratory Medicine Department of Internal Medicine Tianjin General Hospital, Tianjin Medical University G INA lobal itiative for Sthma GINA创议 2004. The key points 1.Definition of Asthma 2.Diagnosis of Asthma CLINICAL M