COPD教学查房演练.pptxVIP

慢性阻塞性肺疾病　　　　　　　　　　　　　　　　;目录; CONTENTS;关键词 (Key Words);１、什么是慢性阻塞性肺疾病(COPD)？ ２、哪些人群更容易患COPD？ ３、作为医护人员，我们应该如何诊断、治疗？ ４、作为21世纪的新护士，我们应该如何提供护理？;;Chronic obstructive pulmonary disease: COPD, is a preventable and treatable disease. It is characterized by airflow limitation. The airflow limitation is not fully reversible and usually progressive.;二、COPD病案介绍;Clinical Case;体格检查;三、流行病学;1. 吸烟 ； Smoking 2. 职业性粉尘及化学物质； Occupational dusts and chemicals 3. 空气污染； Air pollution 4. 呼吸道感染； Respiratory tract infection 5. 其他 Others;四、病因与发病机制;五、临床表现：症状;?2. 咳痰 为白色粘液或浆液性泡沫痰，偶可带血丝。急性发作伴细菌感染时，痰量增多，可有脓性痰。 ? Sputum production There is a white mucus or serous frothy sputum, with blood occasionally. The sputum would be too much and purulent with bacterial infection.;?3. 气短或呼吸困难 仅在体力劳动或上楼等活动时出现，病情重时日常活动也能感到气促，是ＣＯＰＤ的标志症状。 ? Shortness of breath or dyspnea It only appears when laboring, going upstairs or doing other activities. Patient may feel unwell even in daily activities when it is worse, which is the signal symptoms of COPD.;?4. 喘息和胸闷 重度病人或急性加重时出现喘息和胸闷. ? Asthma and chest distress Critically serious patients may show asthma and chest distress in acute exacerbations.;五、临床表现：症状;视诊— 桶状胸，呼吸浅快，严重者可有缩唇呼吸。 Inspection Barrel-shaped chest, rapid and shallow breathing, severe cases may have pursed-lip breathing.;触诊— 触觉语颤减弱或消失。 Palpation Tactile fremitus is weakened or disappeared.;叩诊— 呈过清音，心浊音界缩小，肺下界和肝浊音界下降。 Percussion It sounds too voiceless, the border of cardiac dullness narrows, inferior boundary of lung and the border of hepatic dullness go down.;听诊— 两肺呼吸音减弱，呼气延长，部分病人可闻及干性啰音和（或）湿性啰音。 Auscultation Breath sounds reduces, expiratory sound extends, some patients can be heard wheezes or moist crackles.;I 级：轻度 Ⅱ级：中度 Ⅲ级：重度 IV级：极重度;Stage I: Mild Stage II: Moderate Stage III: Severe Stage IV: Very Severe ;六、COPD实验室检查;　　;4. 其他： 并发感染时痰涂片可见大量中性粒细胞，痰培养可检出各种病原菌。; 临床表现