临床医学专业02级七年制《内科学》教案讲解.docxVIP

临床医学专业 02 级七年制《内科学》教案 姓 名 蔡映云 业务职称 教授 聘任授课职位 教授 授课题目 授课班级 Chronic Obstructive Pulmonary Diseases (COPD) 04 级八年制 学时数 1 授课日期 一、教学目的（掌握、熟悉、了解的具体内容） Very important: Definition, clinical manifection and treatment of COPD Important: Cause and pathophysiology of COPD Less important: Pathology and pathogenesis of COPD 二、执行方案： (一) 内容及时间分配 Chronic obstructive pulmonary disease (COPD) is a disease state characterized by airflow limitation that is not fully reversible. COPD is a very common disease around the world. Although many environmental factors have been implicated in the development of COPD, cigarette smoking remains the most important one. Main pathophysiological changes of COPD are airflow limitation, hyperinflation of lungs and disturbanced gas exchange. The three most common symptoms in COPD are cough, sputum production, and exceptional dyspnea. Only two interventions, smoking cessation and oxygen therapy in chronically hypoxemic patients, have been demonstrated to influence the natural history of patients with COPD. All other current therapies such as bronchodilators (anticholinergic agents, beta-agonists, and theophylline), inhaled or parenteral corticosteroids, mucolytic agents, and pulmonary rehabilitation, are directed at improving symptoms and decreasing the frequency and severity of exacerbations. Lung voluime reduction surgery (LVRS) and lung transplantation may be considered in selected COPD patients. Exacerbations of COPD are episodes of increased dyspnes and cough and change in the amount and character of sputum. The approach to the patient experiencing an exacerbation includes an assessment of sputum. The approach to the patient experiencing an exacerbation includes an assessment of the severity of the patient’s illness, an attempt to identify the precipitating factor, and the institution of therapy. Treatment of acute exacerbation include the use of inhaled ?-agonist (often initially with nebulized therapy) together with an anticholinergic agent. GOLD