Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
BMC Med. 2013 Nov 20;11:247. doi: 10.1186/1741-7015-11-247.
Exacerbations of chronic obstructive pulmonary disease (COPD) are one of the commonest causes of hospital admission in Europe, Australasia, and North America. These adverse events have a large effect on the health status of the patients and impose a heavy burden on healthcare systems. While we acknowledge the contribution of pharmacotherapies to exacerbation prevention, our interpretation of the data is that exacerbations continue to be a major burden to individuals and healthcare systems, therefore, there remains great scope for other therapies to influence exacerbation frequency and preservation of quality of life. In this review, the benefits and limitations of pulmonary rehabilitation, non-invasive ventilation, smoking cessation, and long-term oxygen therapy are discussed. In addition, supported discharge, advanced care coordination, and telehealth programs to improve clinical outcome are reviewed as future directions for the management of COPD.
慢性阻塞性肺疾病（COPD）恶化是欧洲、澳大拉西亚和北美最常见的住院原因之一。这些不良事件对患者的健康状况有很大影响，并给医疗保健系统带来沉重负担。虽然我们承认药物治疗在预防恶化方面的作用，但我们对数据的解释是，恶化仍然是个人和医疗保健系统的主要负担，因此，仍然有很大的空间可以通过其他治疗方法来影响恶化的频率和生活质量的保持。在这篇综述中，讨论了肺康复、无创通气、戒烟和长期氧疗的益处和局限性。此外，还讨论了支持性出院、高级护理协调以及改善临床结果的远程医疗计划，作为 COPD 管理的未来方向。
