Speakman Lucy, Walthall Helen
Respiratory Nurse, Oxford Health NHS Foundation Trust.
Oxford Brookes university.
Br J Community Nurs. 2017 Sep 2;22(9):434-439. doi: 10.12968/bjcn.2017.22.9.434.
Interstitial lung disease (ILD) refers to a cluster of fibroinflammatory conditions. There are limited treatment options and most patients have severe dyspnoea. The prognosis is poor. This study aims to evaluate current literature on the assessment and management of refractory breathlessness in ILD. Few tools are available to assess dyspnoea in advanced respiratory disease. Holistic assessment requires a combination of tools but there are few disease specific tools. The role of opioids is well established in the reduction of breathlessness, but there is insufficient evidence that benzodiazepines are beneficial. Non-pharmcolological breathlessness intervention services can give patients mastery of their disease, reduced distress due to breathlessness and were more cost effective. More research on holistic interventions for use in advanced disease needs to be done. Patient-reported outcome measures could elicit valuable evidence to describe the benefit of breathlessness management services in advanced respiratory disease.
间质性肺疾病（ILD）指的是一组纤维炎性病症。治疗选择有限，大多数患者有严重的呼吸困难。预后较差。本研究旨在评估关于ILD中难治性呼吸困难评估与管理的现有文献。在晚期呼吸系统疾病中，用于评估呼吸困难的工具很少。全面评估需要多种工具结合使用，但针对特定疾病的工具很少。阿片类药物在减轻呼吸困难方面的作用已得到充分证实，但尚无足够证据表明苯二氮䓬类药物有益。非药物性呼吸困难干预服务可使患者掌握自身疾病情况，减轻因呼吸困难引起的痛苦，且更具成本效益。需要针对晚期疾病的全面干预措施开展更多研究。患者报告结局指标能够获取有价值的证据，以描述晚期呼吸系统疾病中呼吸困难管理服务的益处。
