硫酸镁治疗慢性阻塞性肺疾病观察

近年来，我院对收治的慢性阻塞性肺疾病患者采用硫酸镁治疗，取得了较好的疗效，现报告如下。     

慢性阻塞性肺疾病治疗研究进展

现如今,慢性阻塞性肺疾病（COPD）的发病率越来越高,已经成为临床上的多发病。COPD属于一种慢性病,主要是指一种以气流受限为主的肺部疾病,多发于中老年人,预后效果不理想是导致此疾病治疗困难的主要因素。当前,临床上治疗COPD的原则为改善患者的临床症状,对病情的进展进行有效抑制,治疗方案一般包括手术治疗、药物治疗、机械通气治疗及辅助锻炼治疗等。为了实现对COPD的有效治疗,众多学者探讨此类患者在稳定期与加重期的具体治疗方式。通常情况下,对于稳定期患者,一般选择支气管扩张剂与氧疗等药物进行治疗。对于加重期的患者,治疗方式一般有氧疗、雾化吸入与机械通气治疗等,为了保证临床治疗的安全性与有效性,本文对此疾病的治疗方法研究进展进行了综述,以期为临床治疗COPD提供参考方案。     

慢性阻塞性肺疾病

文章对基层卫生人员必须掌握的慢性阻塞性肺疾病的诊治等内容进行介绍.     

慢性阻塞性肺疾病的治疗与护理

慢性阻塞性肺疾病简称慢阻肺（COPD）,是一种破坏性的肺部疾病,是以不完全可逆的气流受限为特征的疾病,严重影响着人们的身体健康和生活质量。本文结合实际简述慢性阻塞性肺疾病的治疗和护理,以期为实践提供参考依据。     

慢性阻塞性肺疾病肺康复治疗研究进展

慢性阻塞性肺疾病（COPD）是一种不完全可逆的气流受限,呈进行性发展,且可以预防和治疗的疾病,并与肺部对香烟烟雾等有害气体或有害颗粒的异常炎症应有关[1]。目前,COPD是全球慢性病发病与死亡的主要原因,其发病率和病死率均在上升嘲。它不仅表现为肺功能进行性下降,还可伴发全身型炎症、骨骼肌萎缩、体重下降等等,给患者身心带来严重伤害。     

慢性阻塞性肺疾病临床治疗分析

目的：分析慢性阻塞性肺疾病的临床治疗方法。方法：将40例慢性阻塞性肺疾病分为观察组和对照组各20例,对照组采取常规治疗,观察组雾化吸痰、心理、给氧等综合性治疗,对比两组患者治疗效果。结果：观察组与对照组治疗总有效率分别为90%、70%,观察组肺功能改善情况明显优于对照组（P<0.05）。结论：加强慢性阻塞性肺疾病的综合治疗,在常规治疗基础上联合给氧、雾化吸入、康复训练等治疗,临床效果显著,呼吸功能明显提高。     

慢性阻塞性肺疾病临床治疗分析

目的:分析慢性阻塞性肺疾病的临床治疗方法。方法:将40例慢性阻塞性肺疾病分为观察组和对照组各20例,对照组采取常规治疗,观察组雾化吸痰、心理、给氧等综合性治疗,对比两组患者治疗效果。结果:观察组与对照组治疗总有效率分别为90%、70%,观察组肺功能改善情况明显优于对照组(P<0.05)。结论:加强慢性阻塞性肺疾病的综合治疗,在常规治疗基础上联合给氧、雾化吸入、康复训练等治疗,临床效果显著,呼吸功能明显提高。     

慢性阻塞性肺疾病

本文介绍慢性阻塞性肺疾病的临床表现、诊断和治疗方法.     

慢性阻塞性肺疾病的临床治疗进展

慢性阻塞性肺疾病(COPD)是呼吸科临床上的常见病和多发病,指的是一种以气流受限为主要临床表现且伴随有肺功能降低的呼吸道疾病,也是目前导致患者死亡的主要疾病之一。目前在治疗慢性阻塞性肺疾病方面,临床的主要治疗措施包括辅助锻炼治疗、药物治疗以及机械通气治疗,慢性阻塞性肺疾病在治疗上更着重于患者症状的改善。笔者就目前慢性阻塞性肺疾病的临床治疗进展进行了综述。     

社区门诊慢性阻塞性肺疾病治疗体会

本文结合286例慢性阻塞性肺疾病病例,探讨社区门诊治疗方法。     

慢性阻塞性肺病的营养治疗

本世纪80年代以来,营养不良作为慢性阻塞性肺病(ＣＯＰＤ)常见的并发症,正受到越来越多的关注。营养不良可对ＣＯＰＤ患者产生有害影响。营养干预治疗可改善患者的营养状况,从而改善预后。本文从营养治疗的重要性、方法、疗效和并发症等方面介绍ＣＯＰＤ的营养治疗。1　营养不良是ＣＯＰＤ常见并发症ＣＯＰＤ患者常合并营养不良,主要表现为人体测量指标如体质量、肱三头肌皮褶厚度(ＴＳＦ)和上臂肌围(ＭＡＭＣ),身体构成指标体脂(ＢＦ)和无脂群(ＦＦＭ),血清内脏蛋白如白蛋白(Ａｌｂ)、前白蛋白(ＰＡｌｂ)、转铁蛋白(ＴＦＮ)和视黄醛结合蛋…     

Disease Management for Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a progressive chronic disease that is subject to acute exacerbations. Ideally, a patient with such a chronic disease should be provided with medical care that addresses these issues while empowering the patient to initiate rapid and definitive treatments to counter exacerbations. To do this, disease management for COPD must recognize that, as this disease is chronic and progressive, any intervention must be ongoing and progressive. As timely recognition of, and rapid intervention for, exacerbations is crucial, COPD disease management must be patient centered.The care offered to patients with COPD should include smoking cessation, regular vaccinations for influenza and pneumonia, and instruction on avoidance of respiratory irritants, as well as medications such as bronchodilators and corticosteroids. Daily exercise is essential and pulmonary rehabilitative tools should be employed. Patients with end-stage disease should be assisted in creating advance directives and should be provided with palliative care. The training of patients in the self-management skills of medication self-administration, secretion clearance, pursed lips breathing, walking exercise, and recognition and rapid treatment of exacerbations is integral to a successful COPD disease management program. Doctor’s therapeutic office visits guide and practice patients in performance of their daily routines to hone their skills, create habits, and develop positive living patterns. With practice, patients improve these skills over time — counter to the natural disease progression. Outcomes monitoring is necessary in order to evaluate the impact of the intervention, and to improve its efficacy.The Respiratory Disease Management Institute (RDMI) model for COPD is based on the aforementioned considerations. In a total of 1981 doctor’s therapeutic office visits over 6 years of this program, 744 exacerbations were identified, with a hospitalization rate of 3.2%. These results compare favorably with those of a previous study.COPD disease management is a systematic approach to the treatment of this chronic disease. When exacerbations are detected in their early stages, they are highly reversible and hospitalization may be avoided. The available data from the RDMI suggest that it is time for a multicenter study to evaluate this model of healthcare delivery for COPD.     

Patients with Chronic Obstructive Pulmonary Disease

For many years, chronic obstructive pulmonary disease (COPD) has been under-recognized and stigmatized. Misconceptions about this disease have led to under-treatment and under-funding, resulting in an increase in the burden of COPD.In 2005, the National Emphysema/COPD Association published the results of a set of national surveys of patients, primary care physicians, and pulmonologists. The findings of these surveys indicated that activity limitation was prevalent among patients with COPD, and that, although most physicians believed that effective therapy could slow the progression of COPD, their inadequate knowledge and poor adherence to practice guidelines had a negative impact on the care of patients with COPD.Patients with COPD may not be optimally treated by physicians. Greater attention needs to be paid to effective smoking cessation programs and self-management. Many physicians under-prescribe effective therapies, with some patients experiencing the ill effects of long-term systemic corticosteroids.Ambulatory oxygen is an effective therapy for COPD. However, the use of ambulatory oxygen can make daily living and leisure activities difficult for patients, and thus physicians have difficulty convincing patients to initiate this therapy. Attention needs to be paid to finding the right oxygen delivery system for the patient, and to educating patients on the correct use of this therapy, particularly when travelling. Another important issue surrounding oxygen therapy is sleep anxiety and the fear of breathlessness or dying in one’s sleep.COPD exacerbations have a major impact on quality of life; however, most therapies used to treat exacerbations have been designed for the treatment of asthma. Corticosteroids, antibacterials, and bronchodilators are routinely used for the treatment of exacerbations, but physicians often do not follow practice guidelines. Exacerbation management is too often ‘too little, too late.’ Another area of concern for patients is effective use of inhalers; incorrect inhaler technique is too common.It has been established that pulmonary rehabilitation programs should be an integral part of the management of COPD, particularly in patients with moderate or severe disease. Currently, the availability of pulmonary rehabilitation programs in the US is limited, as reimbursement is either inadequate or not available. In addition, many physicians do not refer patients to these programs when they are available.Medical advances notwithstanding, most patients with COPD demand therapies that are more effective, more enabling, and cause fewer adverse effects than current therapies. The challenge for medical science and the pharmaceutical industry is to bring about a qualitative change in therapy for the acute exacerbations of COPD as well as for the perpetual shortness of breath, which has such a devastating effect on quality of life. It is very encouraging that the medical community is beginning to recognize this challenge and is moving towards treating patients with COPD as ‘whole people’ and training them to self-manage at home. The overall success of these efforts is dependent on the recognition of COPD as a national health priority.     

Optimizing Disease Management of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. It is the fourth leading cause of chronic morbidity and mortality in the US, and is projected to rank seventh in burden of disease worldwide by 2020. In contrast with a number of chronic diseases, COPD is most often associated with one or more co-morbid conditions, and this requires a complexity of care that demands an even higher level of coordination of care. The coordination that characterizes disease management enables physicians to identify and treat all co-morbid conditions that, if not addressed, could seriously compromise the care of COPD. The requirements for high-quality 21st century care are stringent; some examples are (i) patient-centered care; (ii) adherence to evidence-based medicine that seeks standardization of care; (iii) integration of myriad medical disciplines and the care of multiple physicians; (iv) patient empowerment through collaborative self-management and shared decision making; (v) ongoing home monitoring and feedback to allow for early intervention; and (vi) formalized efforts to improve patient-physician and patient-nurse communication.The true value of disease management resides in its capacity to improve patient care, based as it is on heightened physician communication, evidence-based medicine, and adherence to guidelines, the principle of patient-centered care that facilitates collaborative self-management and concern with patient satisfaction. We provide evidence that patients want and respond to patient-centered care — care that is not technology, doctor, hospital, nor disease centered. Care that encourages patient participation in the establishment and implementation of care, respects the patient’s desire for information, seeks to understand and respond to patient emotional needs, and strengthens the patient-physician relationship.     

The Emerging Chronic Obstructive Pulmonary Disease Epidemic

The incidence and economic impact of chronic obstructive pulmonary disease (COPD) is escalating worldwide and is projected to remain on a positive trajectory for many years to come. At some point in this escalation, COPD may be regarded as a true epidemic. Unfortunately, the incidence among women is escalating more rapidly than in men, reflecting the social anthropology of changing smoking habits. This knowledge, coupled with the fact that the true disease prevalence is under-reported, suggests that we are facing a significant medical and economic crisis. The most preventable risks for COPD continue to be cigarette smoking and exposure to second-hand smoke. This is a particular problem for youth in their formative and critical growth years. Amalgamated with these alarming trends are the decline in air quality, occupational exposure to inhaled pollutants and pro-inflammatory materials, poor nutrition, lack of exercise, and increasing body mass index.There is a lack of patient and family understanding regarding this chronic disease process and its co-morbid conditions. First and foremost, smoking-cessation efforts must be increased, and protection from second-hand smoke needs to be emphasized. Spirometric testing to identify populations at risk and in the early stages of disease should be implemented on a large scale and should trigger implementation of appropriate preventive steps. Disease management processes and strategies used in alliance with educational-, nutritional-, and physical exercise-related interventions may hold the key to altering behavioral patterns of patients and their families. We need to provide patients with simple and definitive interventions that can be self-initiated at the earliest possible time. This may help us to integrate best medical practices early in the disease process. Thus, we can improve bodily function from a systemic perspective, while implementing coordinated disease surveillance and treatment plans for each affected individual. From an economic perspective, financial incentives can be provided by way of shifting costs from disease treatment to disease prevention and health enhancement. When the correct incentives and disease management strategies are embraced, a disease-oriented intervention can ameliorate the devastating impact of COPD on patients and their families while relieving the economic impact of the disease.In summary, numerous stakeholders will need to come together in order to identify and remove barriers for implementation of preventive measures, provide early intervention, modify the disease course, and minimize the economic impact of COPD. Strategies should be developed for populations, as well as individual patients, if we are to adequately address this emerging epidemic.