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浅议我国《慢性阻塞性肺疾病诊治指南》 总被引:6,自引:0,他引:6
2001年4月美国国立心、肺、血液研究所(NHLBI)和世界卫生组织(WHO)发表了新的《慢性阻塞性肺疾病(COPD)全球倡议》(GOLD)。继此,中华医学会呼吸病学分会慢性阻塞性肺疾病学组参照GOLD的有关内容,在1997年制定的《中国慢性阻塞性肺疾病诊治规范(草案)》(简称《草案》)的基础上进行了修订,并于2002年发表了《中国慢性阻塞性肺疾病诊治指南》(简称《指南》)。该指南是一个既结合我国国情又与国际接轨的指导性件。 相似文献
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吴昊 《中华结核和呼吸杂志》2007,30(11):873-874
《慢性阻塞性肺疾病诊治指南(2007年修订版)》(简称《指南2007年版》),是近年来有关慢性阻塞性肺疾病(COPD)研究成果的充分体现。学习后收获很大,对加深该病的认识和指导临床工作均有切实作用,但同时笔者认为对COPD进行分型(即分解成几个亚型)的条件已经成熟,应该不失时机地开展相关工作。现分析如下。 相似文献
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慢性阻塞性肺疾病(COPD)是一种具有气流受限特征的疾病,气流受限不完全可逆、呈进行性发展,与肺部对有害气体或有害颗粒的异常炎症反应有关。2002年世界卫生组织(WHO)将COPD列为世界疾病经济负担的第五位,并且其患病率及致死率由逐年上升之势[1]。早在2001年4月美国国立心、肺血液研究所(NHLBI)和世界卫生组织(WTO)就共同发表了《慢性阻塞性肺疾病全球创议》(Globalinitiativeforchronicobstructivelung disease,GOLD)。我国参照GOLD并结合我国1997年制定的《COPD诊治规范》于2002年8月制定了慢性阻塞性肺疾病诊治指南,在指南… 相似文献
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编辑同志 :贵刊 2 0 0 2年 11期刊登的《慢性阻塞性肺疾病诊治指南》(以下简称指南 ) [1] 是在 1997年《慢性阻塞性肺疾病 (COPD)诊治规范 (草案 )》[2 ] 的基础上参照《慢性阻塞性肺疾病全球倡议 (GOLD)》的有关内容修订的 ,对我们正确认识COPD及规范临床治疗有很大帮助。我们在学习过程中发现了一些问题 ,请有关专家给予解答并指正 :1.《指南》中认为 :如患者只有慢性支气管炎和 (或 )肺气肿 ,而无气流受限 ,则不能诊断COPD。我们认为这种说法值得商榷 ,单纯型慢性支气管炎可以没有气流阻塞 ,GOLD曾指出 ,肺气肿作为一个病理学术… 相似文献
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随着支气管哮喘(简称哮喘)、慢性阻塞性肺疾病(简称COPD)的发病率及患病率的逐年上升,哮喘、COPD诊断与治疗已引起医学界的高度重视。支气管哮喘防治指南(简称哮喘指南)和慢性阻塞性肺疾病诊治指南(简称COPD指南)的及时推出,提高了广大医师对哮喘、COPD的认识,规范了治疗方案,肯定了肺功能在哮喘、COPD的诊断、病情分级和指导用药等方面的作用。笔者根据“哮喘指南”和“COPD指南”的内容结合自己的认识体会, 相似文献
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2001年发表的“慢性阻塞性肺疾病全(COPD)球防治创议(GOLD)”和2002年我国发表的“慢性阻塞性肺疾病诊治指南”为COPD制定了新的定义,认为COPD是一种以气流受限为特征的疾病,气流受限通常呈进行性发展,不完全可逆,多与肺部对有害颗粒或有害气体的异常炎症反应有关。该定义突出了不完全可逆的气流受限和气道的炎症特征,当各种有害颗粒或气体进入气道后,首先引发气道上皮的防御反应,导致多种炎症细胞的集聚活化,并通过自分泌和旁分泌方式释放各种炎性介质,作用于各种气道结构细胞,包括上皮细胞、平滑肌细胞。 相似文献
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张珍祥 《中华结核和呼吸杂志》2005,28(1):69-69
感谢张洋、高广富对《慢性阻塞性肺疾病诊治指南(COPD)》(以下简称指南)的关注,现就他们提出的几个问题谈谈我本人的看法,供参考。 相似文献
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关注慢性阻塞性肺疾病诊治指南的发表 总被引:2,自引:0,他引:2
1995年 ,欧美等国相继制定了“慢性阻塞性肺疾病 (COPD)诊治指南”以规范COPD的诊断和治疗 ,加强对COPD的研究工作。 1 997年中华医学会呼吸病学分会制定了我国的“慢性阻塞性肺疾病(COPD)诊治规范 (草案 )”。近年 ,美国国立心肺血管研究所和世界卫生组织组织多国有关专家制定了“慢性阻塞性肺疾病防治全球创议 (GOLD)”(我刊于2 0 0 1年第 7期刊登了“慢性阻塞性肺疾病全球创议简介”) ,就COPD的定义、机制、诊断及治疗进行了全面阐述。参照GOLD的有关内容 ,在广泛汲取我国呼吸病学专家意见的基础上 ,中华医… 相似文献
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《Respirology (Carlton, Vic.)》2009,14(S2):S38-S40
• Judging the effect of treatment for hospital-acquired pneumonia is difficult using only inflammatory parameters or findings from chest radiography.
• Preferably, treatment effects should be judged comprehensively from body temperature, findings of chest radiography, inflammatory parameters, status of purulent discharge, bacteriological findings and oxygenation.
• In VAP, the parameter most closely correlated with prognosis is trend in PaO2 /FiO2 .
• Clinical improvements are normally seen within 72 h. Antimicrobials thus should not be changed until the third day unless a dramatic deterioration in symptoms is seen.
• With the exception of pneumonia from microbes that tend to possess strong resistance, such as Pseudomonas aeruginosa , a treatment period of 7–10 days is adequate if the early-stage drugs are effective.
• If no improvements in the course are achieved by 3 days after starting treatment, an investigation should be made into whether treatment should be continued or changed to a different antimicrobial agent. 相似文献
• Preferably, treatment effects should be judged comprehensively from body temperature, findings of chest radiography, inflammatory parameters, status of purulent discharge, bacteriological findings and oxygenation.
• In VAP, the parameter most closely correlated with prognosis is trend in PaO
• Clinical improvements are normally seen within 72 h. Antimicrobials thus should not be changed until the third day unless a dramatic deterioration in symptoms is seen.
• With the exception of pneumonia from microbes that tend to possess strong resistance, such as Pseudomonas aeruginosa , a treatment period of 7–10 days is adequate if the early-stage drugs are effective.
• If no improvements in the course are achieved by 3 days after starting treatment, an investigation should be made into whether treatment should be continued or changed to a different antimicrobial agent. 相似文献
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Temple RJ 《American heart journal》2003,146(4):565-567
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Fabre O Guesnier L Renaut C Gautier L Geronimi H Jasaitis L Strauch K 《Annales de cardiologie et d'angeiologie》2005,54(6):332-338
Acute type A aortic dissection is a surgical emergency. Treatment is based on dissected ascending aortic replacement and correction of an associated aortic insufficiency. Catheterization of the axillary artery, open distal anastomosis and systematic resection of the intimal tear are the main surgical evolutions of the last years. They allowed to significantly reduce intraoperative mortality rate particularly due to bleeding. Thirty days mortality rate of operated aortic dissection is about 20 to 30%. Visceral malperfusion syndromes induced by aortic dissection represent an important cause of postoperative death. An early diagnosis and treatment appears necessary. Thoracoabdominal CT scan allows understanding mechanisms inducing malperfusion. Aortography and an emergency endovascular procedure allow restoring arterial blood flow before renal or mesenteric irreversible ischemia. Collaboration between radiologist, anesthesiologist and surgeon is necessary to optimize survival of acute type A aortic dissection. 相似文献
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Lehmann P 《Deutsche medizinische Wochenschrift (1946)》2004,129(6):259-66; quiz 267-70
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Nevéus T Läckgren G Tuvemo T Hetta J Hjälmås K Stenberg A 《Scandinavian journal of urology and nephrology. Supplementum》2000,(206):1-44
Nocturnal urinary continence is dependent on 3 factors: 1) nocturnal urine production, 2) nocturnal bladder function and 3) sleep and arousal mechanisms. Any child will suffer from nocturnal enuresis if more urine is produced than can be contained in the bladder or if the detrusor is hyperactive, provided that he or she is not awakened by the imminent bladder contraction. Urine production is regulated by fluid intake and several interrelated renal, hormonal and neural factors, foremost of which are vasopressin, renin, angiotensin and the sympathetic nervous system. Detrusor function is governed by the autonomic nervous system which under ideal conditions is under central nervous control. Arousal from sleep is dependent on the reticular activating system, a diffuse neural network that translates sensory input into arousal stimuli via brain stem noradrenergic neurons. Disturbances in nocturnal urine production, bladder function and arousal mechanisms have all been firmly implicated as pathogenetic factors in nocturnal enuresis. The group of enuretic children are, however, pathogenetically heterogeneous, and two main types can be discerned: 1) Diuresis-dependent enuresis - these children void because of excessive nocturnal urine production and impaired arousal mechanisms. 2) Detrusor-dependent enuresis - these children void because of nocturnal detrusor hyperactivity and impaired arousal mechanisms. The main clinical difference between the two groups is that desmopressin is usually effective in the former but not in the latter. There are two first-line therapies in nocturnal enuresis: the enuresis alarm and desmopressin medication. Promising second-line treatments include anticholinergic drugs, urotherapy and treatment of occult constipation. 相似文献
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胃泌素瘤是一种神经内分泌肿瘤, 异位分泌胃泌素, 导致卓-艾综合征。大部分胃泌素瘤为散发病例, 20%~25%患者作为多发性内分泌腺瘤综合征1型(MEN1)临床表现之一存在。因为散发胃泌素瘤及MEN1治疗策略不同, 所以临床上需要将其加以区分。胃泌素瘤药物治疗主要分为控制高胃泌素血症相关症状和控制肿瘤生长两类。散发病例的手术治愈率为20%~40%, 而对于MEN1人群是否进行手术治疗尚存在争议。本文对近年来胃泌素瘤诊断及治疗相关临床进展进行阐释, 以期为临床工作提供参考。 相似文献
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类鼻疽病(Melioidosis)是由类鼻疽伯克霍尔德菌(B.pseudomallei)感染所致的人兽共患地方性传染病,主要因接触污染的土壤或水而感染,本病一般散发,无明显季节性。肺类鼻疽病是类鼻疽最常见临床类型,是类鼻疽伯克霍尔德菌急性感染的肺部表现形式,临床表现多样化,常累及肺外器官,易合并败血症,病死率高。 相似文献
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