Urso Domenico Lorenzo, Luchetti Lucio
Recenti Prog Med. 2007 Mar;98(3):181-3.
Exacerbations of chronic obstructive pulmonary disease (COPD) are an important cause of both morbidity and mortality. Both infection of the tracheobronchial tree and air pollution are common causes of exacerbations. The guidelines comment that inhaled bronchodilators, theophyllines, systemic glucocorticoids, antibiotics (the latter if clinical signs of airways infection are present) are effective treatments for exacerbations of COPD. In severe exacerbations, non-invasive positive pressure ventilation is a useful adjunct to other medical therapy and improves blood gases and pH, reduces hospital-mortality, decreases the requirements for invasive mechanical ventilation and intubation and decreases the stay in hospital.
慢性阻塞性肺疾病(COPD)急性加重是发病和死亡的重要原因。气管支气管树感染和空气污染都是急性加重的常见原因。指南指出,吸入性支气管扩张剂、茶碱、全身性糖皮质激素、抗生素(如果存在气道感染的临床体征则使用后者)是治疗COPD急性加重的有效方法。在严重急性加重时,无创正压通气是其他药物治疗的有用辅助手段,可改善血气和pH值,降低医院死亡率,减少有创机械通气和插管的需求,并缩短住院时间。