Ismail T S
Faculty of Medicine, Universiti Teknologi MARA, Level 11, Hospital Selayang, Lebuhraya Kepong Selayang, 68100 Batu Caves, Selangor Darul Ehsan, Malaysia.
Med J Malaysia. 2009 Sep;64(3):250-5; quiz 256.
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are important events in COPD patients and place a large burden on healthcare resources. COPD patients with frequent exacerbations have accelerated decline in lung function, poorer health status and are at higher risk of mortality. The mainstay of treatment includes increasing short acting bronchodilator therapy and systemic glucocorticosteroids with or without antibiotics. Non invasive ventilation is indicated in those with respiratory failure with acidosis or hypercapnia. Preventive strategies to reduce exacerbations include smoking cessation, immunisation against influenza and S. pneumonia, chronic maintenance inhaled pharmacotherapy, pulmonary rehabilitation and self management education.
慢性阻塞性肺疾病（COPD）急性加重是COPD患者的重要事件，给医疗资源带来巨大负担。频繁急性加重的COPD患者肺功能下降加速，健康状况较差，死亡风险更高。治疗的主要方法包括增加短效支气管扩张剂治疗以及使用或不使用抗生素的全身糖皮质激素。对于伴有酸中毒或高碳酸血症的呼吸衰竭患者，建议使用无创通气。减少急性加重的预防策略包括戒烟、接种流感疫苗和肺炎链球菌疫苗、长期维持吸入药物治疗、肺康复和自我管理教育。
