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A Society of General Internal Medicine Position Statement on the Internists' Role in Social Determinants of Health.普通内科医学协会关于内科医生在健康的社会决定因素中作用的立场声明。
J Gen Intern Med. 2020 Sep;35(9):2721-2727. doi: 10.1007/s11606-020-05934-8. Epub 2020 Jun 9.
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Association Between Initiation of Pulmonary Rehabilitation After Hospitalization for COPD and 1-Year Survival Among Medicare Beneficiaries.COPD 住院后启动肺康复治疗与 Medicare 受益人的 1 年生存率之间的关联。
JAMA. 2020 May 12;323(18):1813-1823. doi: 10.1001/jama.2020.4437.
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Pharmacologic Management of Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guideline.慢性阻塞性肺疾病的药物治疗。美国胸科学会临床实践指南。
Am J Respir Crit Care Med. 2020 May 1;201(9):e56-e69. doi: 10.1164/rccm.202003-0625ST.
4
Effectiveness of Tai Chi for health promotion for adults with health conditions: a scoping review of Meta-analyses.太极拳对患有健康问题的成年人促进健康的有效性:一项Meta分析的范围综述
Disabil Rehabil. 2021 Oct;43(21):2978-2989. doi: 10.1080/09638288.2020.1725916. Epub 2020 Feb 18.
5
Clinical course and management of idiopathic pulmonary fibrosis.特发性肺纤维化的临床病程与管理
Multidiscip Respir Med. 2019 Dec 2;14:35. doi: 10.1186/s40248-019-0197-0. eCollection 2019.
6
Diagnostic approach to chronic dyspnoea in adults.成人慢性呼吸困难的诊断方法。
J Thorac Dis. 2019 Oct;11(Suppl 17):S2117-S2128. doi: 10.21037/jtd.2019.10.53.
7
Effect of inhaler drug education on fatigue, dyspnea severity, and respiratory function tests in patients with COPD.吸入器药物教育对 COPD 患者疲劳、呼吸困难严重程度和呼吸功能测试的影响。
Patient Educ Couns. 2020 Apr;103(4):709-716. doi: 10.1016/j.pec.2019.11.003. Epub 2019 Nov 5.
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Dyspnea in COPD: New Mechanistic Insights and Management Implications.COPD 患者呼吸困难:新的发病机制见解与管理意义。
Adv Ther. 2020 Jan;37(1):41-60. doi: 10.1007/s12325-019-01128-9. Epub 2019 Oct 30.
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A Randomized, Double-Blind, Multisite, Pilot, Placebo-Controlled Trial of Regular, Low-Dose Morphine on Outcomes of Pulmonary Rehabilitation in COPD.一项关于常规低剂量吗啡对慢性阻塞性肺疾病患者肺康复结局影响的随机、双盲、多中心、试点、安慰剂对照试验。
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Management of Chronic Respiratory Failure in Interstitial Lung Diseases: Overview and Clinical Insights.间质性肺疾病慢性呼吸衰竭的管理:概述与临床见解。
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难治性呼吸困难的管理:普通内科医生的综述。

Management of Refractory Breathlessness: a Review for General Internists.

机构信息

Division of Hospital Medicine, Emory University School of Medicine, Atlanta, GA, USA.

, Atlanta, USA.

出版信息

J Gen Intern Med. 2021 Apr;36(4):1035-1040. doi: 10.1007/s11606-020-06439-0. Epub 2021 Jan 19.

DOI:10.1007/s11606-020-06439-0
PMID:33469757
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8041955/
Abstract

Internists frequently care for patients who suffer from breathlessness in both the inpatient and the outpatient settings. Patients may experience chronic refractory breathlessness despite thorough evaluation and management of their underlying medical illnesses. Left unmanaged, chronic breathlessness is associated with worsened quality of life, more frequent visits to the emergency room, and decreased activity levels, as well as increased levels of depression and anxiety. This narrative review summarizes recent research on interventions for the relief of breathlessness, including both non-pharmacologic and pharmacologic options.

摘要

内科医生经常在住院和门诊环境中照顾患有呼吸困难的患者。尽管对患者的基础疾病进行了彻底的评估和管理,但他们仍可能会持续存在难治性呼吸困难。如果不加以管理,慢性呼吸困难会导致生活质量下降、急诊就诊次数增加、活动水平降低,以及抑郁和焦虑程度增加。本综述总结了近期关于缓解呼吸困难干预措施的研究,包括非药物和药物治疗选择。