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慢性阻塞性肺疾病:面向姑息治疗临床医生的标志性特征叙述性综述

Chronic obstructive pulmonary disease: A narrative synthesis of its hallmarks for palliative care clinicians.

作者信息

D'Andria Ursoleo Jacopo, Bottussi Alice, Sullivan Donald R, D'Andria Corrado, Smirnova Natalia, Rosa William E, Nava Stefano, Monaco Fabrizio

机构信息

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. Electronic address: https://twitter.com/JDAndriaUrsoleo.

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. Electronic address: https://twitter.com/abottussi.

出版信息

Eur J Intern Med. 2025 Mar;133:25-34. doi: 10.1016/j.ejim.2024.12.033. Epub 2025 Jan 9.

DOI:10.1016/j.ejim.2024.12.033
PMID:39794226
Abstract

Chronic obstructive pulmonary disease (COPD) is a life-limiting condition and the third leading cause of death worldwide. People with COPD experience physical and psychological symptoms and functional limitations that impair their quality of life. Their caregivers face adverse clinical outcomes due to personal, social, and financial demands. As such, recent emphasis has been placed on early referral to palliative care services to enhance prognostic awareness, clarify goals of care, and manage symptoms. In this narrative synthesis of key aspects of COPD care, we propose practical, evidence-based strategies to integrate palliative care principles with conventional disease-directed treatments throughout the illness trajectory. We emphasize the importance of equipping clinicians caring for people with COPD with a thorough understanding of both the inherent disease complexities and the cornerstones of its multimodal management, including palliative care, to address the unique psychosocial and physical needs of this patient population.

摘要

慢性阻塞性肺疾病(COPD)是一种危及生命的疾病,是全球第三大死因。慢性阻塞性肺疾病患者会出现身体和心理症状以及功能受限,这会损害他们的生活质量。由于个人、社会和经济需求,他们的护理人员面临不良临床结局。因此,最近人们强调早期转诊至姑息治疗服务,以提高预后意识、明确护理目标并管理症状。在本次对慢性阻塞性肺疾病护理关键方面的叙述性综述中,我们提出实用的、基于证据的策略,以便在整个疾病过程中将姑息治疗原则与传统的疾病导向治疗相结合。我们强调,让护理慢性阻塞性肺疾病患者的临床医生深入了解疾病的内在复杂性及其多模式管理的基石(包括姑息治疗)非常重要,以便满足这一患者群体独特的心理社会和身体需求。

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本文引用的文献

1
Spiritual Care in Palliative Medicine and End of Life: A Bibliometric Network Analysis.姑息医学与生命末期的精神关怀:文献计量网络分析
J Palliat Med. 2025 Feb;28(2):265-279. doi: 10.1089/jpm.2024.0007. Epub 2024 Aug 2.
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European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness.欧洲呼吸学会关于重症成年呼吸系统疾病患者症状管理的临床实践指南。
Eur Respir J. 2024 Jun 28;63(6). doi: 10.1183/13993003.00335-2024. Print 2024 Jun.
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The National Prevalence of Supplemental Oxygen Use in Persons with Chronic Obstructive Pulmonary Disease: A Comparison of Claims-based and Self-reported Supplemental Oxygen Use.
慢性阻塞性肺疾病患者补充氧气使用的全国患病率:基于索赔数据和自我报告的补充氧气使用情况比较
Ann Am Thorac Soc. 2024 May;21(5):838-840. doi: 10.1513/AnnalsATS.202311-949RL.
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COPD and multimorbidity: recognising and addressing a syndemic occurrence.COPD 与多种共病:识别和应对综合征发生。
Lancet Respir Med. 2023 Nov;11(11):1020-1034. doi: 10.1016/S2213-2600(23)00261-8. Epub 2023 Sep 8.
5
National Prevalence of Social Isolation and Loneliness in Adults with Chronic Obstructive Pulmonary Disease.慢性阻塞性肺疾病患者中社会隔离和孤独的全国流行率。
Ann Am Thorac Soc. 2023 Dec;20(12):1709-1717. doi: 10.1513/AnnalsATS.202304-288OC.
6
Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary.全球慢性阻塞性肺疾病倡议 2023 年报告:GOLD 执行摘要。
Eur Respir J. 2023 Apr 1;61(4). doi: 10.1183/13993003.00239-2023. Print 2023 Apr.
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Improving the wellbeing of caregivers of patients with COPD using a home-based pulmonary rehabilitation programme.通过一项居家肺康复计划改善慢性阻塞性肺疾病患者照护者的健康状况。
ERJ Open Res. 2022 Dec 12;8(4). doi: 10.1183/23120541.00255-2022. eCollection 2022 Oct.
8
Effect of Regular, Low-Dose, Extended-release Morphine on Chronic Breathlessness in Chronic Obstructive Pulmonary Disease: The BEAMS Randomized Clinical Trial.定期、低剂量、延长释放吗啡对慢性阻塞性肺疾病慢性呼吸困难的影响:BEAMS 随机临床试验。
JAMA. 2022 Nov 22;328(20):2022-2032. doi: 10.1001/jama.2022.20206.
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Patient-Centered Discussions About Disease Progression, Symptom, and Treatment Burden in Chronic Obstructive Pulmonary Disease Could Facilitate the Integration of End-of-Life Discussions in the Disease Trajectory: Patient, Clinician, and Literature Perspectives: A Multimethod Approach.以患者为中心讨论慢性阻塞性肺疾病的疾病进展、症状和治疗负担可以促进在疾病进程中纳入终末期讨论:患者、临床医生和文献的观点:一种多方法途径。
J Palliat Med. 2023 Mar;26(3):353-359. doi: 10.1089/jpm.2022.0028. Epub 2022 Oct 12.
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Palliative Care Early in the Care Continuum among Patients with Serious Respiratory Illness: An Official ATS/AAHPM/HPNA/SWHPN Policy Statement.严重呼吸系统疾病患者的照护延续链中的舒缓医疗:美国胸科学会/美国临终关怀与姑息医学学会/美国护士麻醉师协会/世界卫生组织姑息治疗联盟政策声明。
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