移动医疗在呼吸系统疾病患者药物吸入管理中的应用进展

掌握正确吸入技术是呼吸系统疾病患者接受吸入治疗的前提,移动医疗可以促进呼吸系统疾病患者正确掌握吸入技术。该文介绍了移动医疗在呼吸系统疾病患者药物吸入技术管理中的应用形式、应用效果,分析应用过程中存在的不足与挑战,以期为国内开发相应的移动医疗设备或应用程序提供借鉴。     

COPD患者雾化吸入治疗的应用进展

慢性阻塞性肺疾病（COPD）是严重危害人类健康的疾病,也是呼吸系统的常见病、多发病。雾化吸入对于呼吸道疾病的治疗有确切的疗效,其优点是药物作用直接,疗效迅速、全身副反应小。近年来,雾化吸人治疗对于呼吸系统疾病在临床上的应用日趋广泛,特别是对于COPD患者在如何选择雾化器、雾化药物,不同雾化吸入方式的临床效果以及雾化吸入的护理等方面做了一些研究,现综述如下。     

雾化吸入药物在治疗呼吸系统疾病中的进展

雾化吸入药物治疗呼吸系统疾病在临床上应用日趋广泛,近年来,采用雾化吸入途径对难治性呼吸系统疾病,特别是对慢性阻塞性肺疾病(COPD)、支气管哮喘、肺癌、肺动脉高压(PH)、间质性肺疾病(ILD)等方面的治疗有了新的尝试与进展,现综述如下.……     

一次性雾化吸入器在临床中的应用

雾化吸入是通过压缩雾化吸入装置对患呼吸系统疾病的病人将药物吸入深呼吸道内，进行有效的治疗。我科于2006年开始应用一次性雾化吸入器，用此方法治疗慢性阻塞性肺疾病、哮喘等病人，用此方法治疗患者265例，均收到良好效果。因为其操作简便、经济、真正做到一位患者一个仪器，避免院内交叉感染的危险，同时也避免了医疗护理纠纷的发生。     

儿童雾化吸入依从性的研究综述

正雾化吸入是通过物理手段将雾化液冲击成小气溶胶药物颗粒,高浓度的雾状药物经口鼻部直接作用于支气管和肺部病变部位,具有无痛苦、无创伤、疗效快、全身不良反应少等特点,是呼吸系统疾病的主要治疗手段,适用范围包括哮喘、支气管扩张症、儿童呼吸系统疾病、围术期气道管理等[1]。患者依从性差或操作方法不当是雾化吸入治疗失败的重要因素。研究[2-5]显示,目前儿童雾化吸入依从性较差的问题较为突出。多个调     

雾化吸入药物在治疗呼吸系统疾病中的进展

雾化吸入药物治疗呼吸系统疾病在临床上应用日趋广泛，近年来，采用雾化吸入途径对难治性呼吸系统疾病，特别是对慢性阻塞性肺疾病（COPD）、支气管哮喘、肺癌、肺动脉高压（PH）、间质性肺疾病（ILD）等方面的治疗有了新的尝试与进展，现综述如下。[第一段]     

支气管哮喘中医药研究概况

支气管哮喘是呼吸系统常见的一种疾病,目前吸入型糖皮质激素仍然是西医治疗支气管哮喘的首选药物,但长期激素治疗会有许多不良反应,如口腔念珠菌病感染等。近年来,中药治疗、膏方治疗、穴位敷贴、针灸治疗等联合治疗逐渐成为支气管哮喘治疗的热点,发挥其独特的优势。     

浅析呼吸科疾病氧气雾化吸入的治疗及护理

雾化吸入疗法是各种呼吸道疾病常用的给药方法,操作简单、见效快、无不良反应。临床上对急性、慢性呼吸系统疾病治疗有一定疗效,使用氧气雾化吸入药物辅助治疗,配合体位、吸入的方式、翻身叩背、助痰排出等措施,可明显地减轻疾病症状。     

雾化吸入法在电子支气管镜检查中的应用与护理

超声雾化吸入法是应用超声波声能,把药液变成细微、温暖、舒适的气雾,随着深而慢的吸气由呼吸道吸入到终末支气管及肺泡,从而达到治疗目的。电子气管镜检查是呼吸系统疾病及肺部肿瘤最常用和最重要的诊断检查,能为呼吸系统疑难病病人的诊断和治疗提供科学的依据,有着非常重要的意义。     

雾化吸入沙丁胺醇致过敏反应

雾化吸入沙丁胺醇是临床辅助治疗呼吸系统疾病的常用方法,其作用直接、起效快、全身不良反应少,可有效缓解患者咳嗽、咳痰、气喘及呼吸困难等临床不适症状。沙丁胺醇虽为雾化途径给药,但与其他药物一样,亦会发生过敏等不良反应。现将我科1例应用此药雾化吸入治疗后发生过敏反应的病例报告如下。     

Clinical aspects, diagnosis and treatment of obstructive lung diseases among the population of Afghanistan

The authors analyzed 504 case histories of inhabitants of Afghanistan treated for chronic obstructive pulmonary diseases in a Kabul hospital, investigated the results of a study of function of the external respiratory system in 87 patients with chronic obstructive bronchitis, bronchial asthma and pulmonary emphysema, and the results of determination of efficacy of bronchodilators with different mechanisms of action in 134 patients, and described clinical symptoms and the main principles of therapy of patients in Afghanistan. A two-stage system of medical care of patients with pulmonary diseases was recommended.     

电阻抗断层成像技术在呼吸系统肺功能成像中的应用

电阻抗断层成像技术（EIT）作为一项新兴的功能性成像技术，具有无损伤、便携、图像监护等突出特点。其中肺功能成像为目前EIT最主要的应用领域，可以实现肺通气及血流灌注的实时动态监测。本文介绍肺EIT在呼吸系统常见疾病如急性呼吸窘迫综合征、慢性阻塞性肺疾病、肺栓塞等疾病中的基础及临床研究进展，为未来EIT技术的进步及临床应用提供帮助。     

Process of pulmonary rehabilitation and program organization

Pulmonary rehabilitation programs are highly directed to return patients suffering from chronic lung diseases to a state of self-help. These programs are largely organized as temporary interventions in a highly fragmented delivery care system for patients with chronic respiratory conditions. In an optimal health care organizational structure, pulmonary rehabilitation needs to be considered as an essential part of an individualized, integrated care process, organized from the vantage point of the patient and the patients'health continuum. Pulmonary rehabilitation programs need to become organized as patient-centered care, respectful of and responsive to individual patient preferences, needs and values. Partnering and communication skills are considered as drivers for successful rehabilitation. Assessment is considered as the cornerstone to evaluate the individual needs and problems in order to develop an individualized intervention. Pulmonary rehabilitation programs need to move away from a supply-driven functional organizational structure towards integrated structures, including the full range of medical expertise, technical skills and specialized facilities needed to compete on added value in the management of patients with chronic respiratory diseases.     

Effect of chronic nonspecific lung diseases on the detectability and course of tuberculosis

Chronic nonspecific diseases of the respiratory organs frequently develop after clinical cure of tuberculosis, particularly in persons with ample residual changes which, in their turn, contribute to the development of a recurrence of tuberculosis. Recurrences were mainly detected during consultations in medical institutions. Therefore improved work with patients of the 7th registration group in antituberculous centers as well as with patients with chronic nonspecific diseases of the respiratory organs in the general medical network will contribute to a decrease in the number of tuberculosis recurrences or their earlier detection.     

Extracorporeal membrane oxygenation in adults: a nursing challenge

ECMO is an aggressive treatment for selected patients who are unresponsive to conventional therapy for respiratory failure. Although its use in neonates is well documented, the number of successful reports in adults is limited. Venovenous ECMO represents a therapeutic option for adult patients with severe respiratory failure that has not responded to diuresis, high oxygen flows, and positive end-expiratory pressure. As medical centers obtain more experience with and resources for adult ECMO, critical care nurses will need to develop more familiarity with this technology.     

Hemophilus influenzae bronchitis and pneumonia

Hemophilus influenzae is increasingly recognized as an important pathogen in a wide spectrum of diseases in adults. It is often implicated in the infectious exacerbation of chronic bronchitis, and it is a frequent cause of pneumonia in adults. The recent recognition of ampicillin-resistant strains should be a reminder to obtain beta-lactamase or antibiotic susceptibility testing when H. influenzae is isolated in specimens from patients with lower respiratory infections.     

High prevalence of bronchiectasis in adults: analysis of CT findings in a health screening program

Bronchiectasis is one of the common chronic respiratory diseases and associated with respiratory morbidity and mortality. However, neither its prevalence nor its etiology is well-defined. We aimed to estimate the prevalence and risk factors of bronchiectasis in adults. In a retrospective study, we analyzed radiologic findings on chest computed tomography (CT) images performed as part of a health-screening program. From January to December 2008, 1,409 (24.6%) of 5,727 participants in the screening program of a health promotion center at a university hospital underwent chest CT scans based on the subject's decision. Bronchiectasis was diagnosed, if there was abnormal bronchial dilatation in any area of both lungs on chest CT. Respiratory symptoms, smoking status, and past medical history were also analyzed to define clinical characteristics and risk factors of bronchiectasis. Of 1,409 patients (aged 23-86 years), who were screened for respiratory diseases using chest CT for one year in a health promotion center, 129 patients (9.1%) were diagnosed with bronchiectasis. The prevalence of bronchiectasis was higher in females than in males (11.5% vs. 7.9%, p = 0.022) and increased with age. Respiratory symptoms were reported in 53.7% of subjects. Previous history of tuberculosis (TB) (OR 4.61, 95% CI 2.39-8.88, p = 0.001) and age (OR 2.49, 95% CI 1.56-3.98, p = 0.001) were significantly associated with bronchiectasis. This retrospective analysis of chest CT findings in health screening examinees revealed a very high prevalence of bronchiectasis in adults. Previous TB infection is one of the major causes of bronchiectasis.     

江西省永新县芦溪乡卫生院2010年住院疾病与费用构成情况调查

目的调查2010年江西省永新县芦溪乡镇卫生院住院疾病构成及费用情况,了解当地疾病负担,为进一步研究提供基线数据。方法收集2010年该院住院病例资料,根据国际疾病分类编码(ICD-10)对出院记录的第一诊断进行疾病标化和系统归类,运用EXCEL 2003和SPSS 13.0等统计软件整理分析住院患者一般情况,出院诊断、医疗费用及使用基本药物情况等。结果①2010年芦溪乡院住院病例925人次,男女性别比为0.8;②住院系统疾病可分为17类,占ICD-10标准分类的81%;③前5类疾病依次为呼吸、消化、损伤中毒和外因、循环及泌尿生殖系统疾患,累计占82.27%;④前15位单病种依次为上呼吸道感染、骨折、慢性阻塞性肺病、慢性胃肠炎、脑血管病、泌尿系结石、类风湿性关节炎、椎间盘疾患、胆囊结石伴胆囊炎、心脏病、生殖器官疾病、损伤和中毒、肺炎、高血压及消化性溃疡;⑤上呼吸道感染和肺炎患者年龄均主要集中于≥65岁和<5岁;除了泌尿系结石和消化性溃疡外,其余8种慢性病患者的年龄均主要集中在≥65岁;⑥前15种单病种中,慢性病患者平均住院日及次均住院费用低于急性病(4.8天vs.11.6天;439.1元vs.666.9元);⑦芦溪乡镇卫生院住院费用虽逐年增加,但仍远低于全国乡院平均水平(542.3元vs.1 004.6元)。结论①2010年芦溪乡镇卫生院住院病例前3位系统疾病是呼吸、消化及损伤和中毒,其中前2种系统疾病均为女性多于男性;急性病多集中于感染和骨折。②前15位单病种中除类风湿性关节炎、胆囊结石伴胆囊炎、心脏病、生殖器官疾病和消化性溃疡外,其余10种单病种与四川永安乡院基本相同。③呼吸系统、损伤和中毒以急性病为主;消化、循环、泌尿生殖及肌肉骨骼和结缔组织系统以慢性病为主。④急慢性病在35岁以后年龄段患者呈显著增加趋势,且女性多于男性;≤15岁和≥35岁急性病患者的疾病负担均较重。⑤上呼吸道感染和肺炎患者均主要集中于老年人和儿童。⑥与甘肃新添乡院(基本型)相比,芦溪乡院骨折患者平均住院日长(43.7天vs.9天),次均住院费用高(1 948.0元vs.1 646.3元),疾病负担重(8.11%vs.4.85%)。⑦急性病患者平均住院日远高于四川永安(小康型)和甘肃新添(基本型)乡院(11.6天vs.3.7天、6.2天),但次均住院费用却远低于两院(666.9天vs.850.4元、906.85元)。     

肺表面活性物质联合鼻塞式持续气道正压通气治疗新生儿呼吸窘迫综合征的临床分析

目的评价鼻塞式持续气道正压通气（NCPAP）联合肺表面活性物质（猪肺磷脂注射液,固尔苏）对新生儿呼吸窘迫综合征（NRDS）的治疗作用。方法27例NRDS的患儿经气管滴入固尔苏[100mg／（kg·次）],然后拔管予NC—PAP呼吸支持治疗,作为NCPAP组。25例常规机械通气病例作为对照组（VT组）,比较两组患儿的临床症状体征、血气变化、并发症、住院时间以及住院费用。结果治疗后1h,两组患儿症状体征明显好转;6h、12h及24h,两组患儿的血气较治疗前显著改善,两组比较,无明显差异;NCPAP组肺部感染及慢性肺部疾病的发生率明显低于VT组;NCPAP组的氧疗及住院时间明显少于VT组,住院费用也较低。结论NCPAP及固尔苏联合应用能有效地治疗NRDS,与常规机械通气比较,具有肺部感染、慢性肺部疾病发生率低、住院时间短、住院费用少等特点。