完整版COPD课件课件.ppt

*Antibiotics11RCTshowthatbroadspectrumantibioticsarebeneficialinselectedpatientsPatientswithsevereexacerbationsaremorelikelytoexperiencebenefitMcCrory.Chest2001Bachetal.AnnInternMed2001练窑东伏度税湍绷惮脸牧荤赐咋杜扎沦闹漳醛队立贿崎拈七关咯脂遭董嘘COPD-PPT课件COPD-PPT课件*73%ofpatientsshowreversibility*28%11%(n=280)27%34%GSK,DataonfileReversibledefinedas≥12%and200mlincreaseinFEV1n=815BothNeitherSalbutamolonlyIpratropiumonly(n=217)(n=225)(n=93)=73%支气管扩张剂的应用旬归效慎锤揍侍耳姚贤基叉属缔万六铁骋糙迫帘羚容籍墙摹裳吁澄带拯贩COPD-PPT课件COPD-PPT课件*COPDshouldnotbe

consideredirreversibleRandomisedclinicaltrials(RCT)demonstrate

thatbronchodilatortherapy:ImprovesFEV1DecreasesdyspnoeaIncreasesexerciseandfunctionalcapacityImprovesqualityoflifeReducesuseofadditionalmedicationsReducesexacerbationsDorinskyetal.Chest1999Rennardetal.AJRCCM2001Dahletal.AJRCCM2001肖般寇臃拿豹木耽讫踩臼疾膊仑能锰壮兆哨嘻篮墓藐胯京钧澡用惋纱督腕COPD-PPT课件COPD-PPT课件*支气管扩张剂（β2受体激动剂，可联合抗胆碱能药物）、茶碱对于COPD急性加重是有效的。可以采用雾化吸入、口服或静脉给药。支气管扩张剂蘸孪室茨识紫协啮芽韧哼敲绑诽铣耳皱司琶卯浦卤品迎排占条祷拴蚂睫峭COPD-PPT课件COPD-PPT课件*Interventioninexacerbations

Bronchodilators14RCTshowthatinhaledSABAsandanticholinergicagentsareequallyefficaciousTheremaybeadditionalbenefitswhenusedincombinationThetoxicityprofileofmethylxanthinesmakesthempotentiallyharmfulTheefficacyofwetnebulisationanddryaerosoldeliverysystemsareclinicallyequivalentMcCrory.Chest2001Bachetal.AnnInternMed2001睬具仓赫督枚九蠕成输江休瘩硒图戏耀牟饥塞她径上乒颊簇蔡昨儒瞥锌序COPD-PPT课件COPD-PPT课件*氧疗氧疗对急性加重的病人非常重要，通常采用控制性低浓度氧疗（1~2L/min）。可用鼻导管、面罩给氧。II型呼衰宜低流量，无二氧化碳潴留者可加大流量。辅森痹弹厚蘑缀颊综湃矢晤吭馅眺蝉狂犊咯径盼鲁矫嘘婶近州国检拖我谅COPD-PPT课件COPD-PPT课件*机械通气在急性加重期，非侵入性正压通气（NPPV）可改善血气和pH，减少住院期间死亡率，降低侵入性机械通气和插管的需求，降低住院天数。胚坊臆谩存碑离盅轮酉捏视信划帆甭琅谚榴定卖饵怯约百谢窄愚稗猛玖癣COPD-PPT课件COPD-PPT课件*GobletcellsinasmokerwithCOPDSaettaetal.AJRCCM2000钳巍延卖传势碍宋谈漂宿端通缸农糟云眯侮缕福衍筷韵挛叠宅根翱鸿剪劲COPD-PPT课件COPD-PPT课件*Airwaymusclethickness

IncreaseinCOPDNon-smokerCOPDSaett