COPD规范化诊断与治疗.ppt

* 思力华治疗可以显著提高COPD患者的运动耐量 * 气体陷闭引起呼吸困难，进而使运动耐量减退，最终导致生活质量下降 This Air Trapping Slide Kit contains PowerPoint slides, including some animated slides, with accompanying notes. * 肺泡完全充气，在正常的呼气过程中，肺泡收缩；吸气时，肺泡再次充气膨胀 The animation begins with the alveolus fully inflated. Over the course of a normal exhalation, the alveolus fully deflates. With inhalation, the alveolus re-inflates. * 同正常人相比，COPD的不可逆性表现在肺泡壁的破坏，肺泡失去弹性；胆碱能的收缩引起气道陷闭 因而，呼气变得缓慢，肺泡在呼气过程中只能部分放气 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. * 气体陷闭影响COPD患者，导致胸腔扩张，从而使呼吸肌处于机械不利 气体陷闭会限制病人扩张潮气量（在运动时需要增加潮气量），这就会使病人感到呼吸困难。 过度充气可以引起气体陷闭，可以通过X光观察到 这张图可以看到COPD患者的脉的空间非常广阔，这是由于气体陷闭而引起的 Air trapping affects patients with COPD. It results in an expansion of the chest wall, which places the respiratory muscles at a mechanical disadvantage.1 Air trapping limits the ability of patients to expand tidal volume when required, for example, during activity. This makes the patient feel breathless or dyspneic. Hyperinflation, resulting from air trapping, can be observed on standard X-rays. Note the wide intercostal spaces in this patient with COPD, which are caused by air trapping. ODonnell DE, Webb K. The etiology of dyspnea during exercise in COPD. Pulmonary and Critical Care Update 14, Lesson 15./downloads/education/online/Vol14_13_18.pdf. Accessed 24 February 2004. * 气体陷闭与肺部过度充气的总结 * 这是一张COPD患者肺过度充气的图，通过使用支气管扩张剂后，肺容量增加 * 这张图比较正常人和COPD患者的肺容量 COPD患者由于气体陷闭和肺过度充气，残气量增加，深吸气量减少 肺容量 TLC; 肺总量 – 肺完全