Jouneau S, Dres M, Guerder A, Bele N, Bellocq A, Bernady A, Berne G, Bourdin A, Brinchault G, Burgel P R, Carlier N, Chabot F, Chavaillon J M, Cittee J, Claessens Y E, Delclaux B, Deslée G, Ferré A, Gacouin A, Girault C, Ghasarossian C, Gouilly P, Gut-Gobert C, Gonzalez-Bermejo J, Jebrak G, Le Guillou F, Léveiller G, Lorenzo A, Mal H, Molinari N, Morel H, Morel V, Noel F, Pégliasco H, Perotin J M, Piquet J, Pontier S, Rabbat A, Revest M, Reychler G, Stelianides S, Surpas P, Tattevin P, Roche N
Groupe de travail des recommandations de la SPLF sur la prise en charge des exacerbations de BPCO, Société de pneumologie de langue française, 75006 Paris, France; IRSET UMR 1085, service de pneumologie, hôpital Pontchaillou, université de Rennes 1, CHU de Rennes, 35033 Rennes, France.
Unité de réanimation médicale et surveillance continue, service de pneumologie et réanimation médicale, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
Rev Mal Respir. 2017 Apr;34(4):282-322. doi: 10.1016/j.rmr.2017.03.034. Epub 2017 May 25.
Chronic obstructive pulmonary disease (COPD) is the chronic respiratory disease with the most important burden on public health in terms of morbidity, mortality and health costs. For patients, COPD is a major source of disability because of dyspnea, restriction in daily activities, exacerbation, risk of chronic respiratory failure and extra-respiratory systemic organ disorders. The previous French Language Respiratory Society (SPLF) guidelines on COPD exacerbations were published in 2003. Using the GRADE methodology, the present document reviews the current knowledge on COPD exacerbation through 4 specific outlines: (1) epidemiology, (2) clinical evaluation, (3) therapeutic management and (4) prevention. Specific aspects of outpatients and inpatients care are discussed, especially regarding assessment of exacerbation severity and pharmacological approach.
慢性阻塞性肺疾病(COPD)是一种慢性呼吸道疾病,在发病率、死亡率和医疗成本方面给公共卫生带来了最重要的负担。对于患者而言,COPD是导致残疾的主要原因,因为它会引起呼吸困难、限制日常活动、病情加重、慢性呼吸衰竭风险以及呼吸外系统性器官功能障碍。法国呼吸学会(SPLF)之前关于COPD加重的指南于2003年发布。本文件采用GRADE方法,通过4个具体大纲对COPD加重的当前知识进行了综述:(1)流行病学,(2)临床评估,(3)治疗管理,(4)预防。文中讨论了门诊和住院患者护理的具体方面,特别是关于加重严重程度的评估和药物治疗方法。