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[慢性阻塞性肺疾病(COPD)急性加重的治疗原则]

[Treatment principle of the chronic obstructive pulmonary disease (COPD) exacerbation].

作者信息

Musil J

机构信息

Pneumologická klinika 2. lékarské fakulty UK a FN Motol, Praha.

出版信息

Vnitr Lek. 2004 Sep;50(9):677-81.

Abstract

COPD is often accompanied with acute symptoms exacerbations. Patients in Ist stage: slide grade of COPD and IInd stage: middle grade of COPD suffer exacerbations accompanied with increased dyspnoea often together with increased cough and increased production of sputum. Patients in IIIrd stage (serious) and IVth stage (very serious) experience during exacerbations development of respiration insufficiency or its worsening and thus are usually treated in hospital. The most frequent causes of exacerbations are tracheobronchial tree infections and air pollution. The cause of approximately one third of serious exacerbations is not disclosed. Conditions which can resemble acute exacerbation are pneumonia, congestive heart failure, pneumothorax, pleural exudation, pulmonary embolism, and arrhythmia. Exacerbation treatment is symptomatic. Obstruction symptoms are treated with bronchodilatants and corticosteroids administration, hypoxemia with oxygen administration and signs of bacterial infection with antibiotics.

摘要

慢性阻塞性肺疾病(COPD)常伴有急性症状加重。第一阶段(轻度)和第二阶段(中度)的COPD患者症状加重时,常伴有呼吸困难加剧,通常还伴有咳嗽增加和痰液分泌增多。第三阶段(重度)和第四阶段(极重度)的患者在症状加重期间会出现呼吸功能不全或其恶化,因此通常需要住院治疗。症状加重最常见的原因是气管支气管树感染和空气污染。约三分之一的重度症状加重的病因不明。可能类似于急性加重的情况有肺炎、充血性心力衰竭、气胸、胸腔积液、肺栓塞和心律失常。症状加重的治疗是对症治疗。使用支气管扩张剂和皮质类固醇治疗阻塞症状,吸氧治疗低氧血症,使用抗生素治疗细菌感染迹象。

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