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终末期肺病的姑息治疗

Palliative Care in End-Stage Lung Disease.

作者信息

Park So Young

机构信息

Department of Pulmonary, Allergy, and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.

出版信息

J Hosp Palliat Care. 2025 Mar 1;28(1):25-29. doi: 10.14475/jhpc.2025.28.1.25.

Abstract

The prevalence of chronic obstructive pulmonary disease (COPD) is increasing, and the condition is associated with a high mortality rate. For patients with COPD, the reality of a life-limiting illness causing severe breathlessness is often daunting. Unlike cancer, the progression of COPD is less predictable, making its prognosis challenging for clinicians. Patients with COPD in the intensive care unit (ICU) present a unique set of challenges characterized by persistent respiratory distress, dependence on ventilator support, and complex medical needs. Therefore, palliative care is vital for ICU patients with COPD, as it offers a compassionate, patient-centered approach that emphasizes symptom relief, quality of life, and alignment of care with patient values. However, palliative care for these patients is extremely difficult in Korea. Discussion of end-of-life care for non-cancer patients is particularly difficult in Korean society. One reason for this is that hospice palliative care is perceived as termination of treatment by the public. Additionally, because Korean society has a Confucian cultural background, people are usually reluctant to discuss death. Moreover, lack of attention among medical professionals is another key factor that makes implementing palliative care difficult for patients with end-stage COPD. This review aimed to explore ways to provide a meaningful and dignified life for patients with COPD in the ICU by administering palliative care.

摘要

慢性阻塞性肺疾病(COPD)的患病率正在上升,且该疾病与高死亡率相关。对于COPD患者而言,一种导致严重呼吸困难的、危及生命的疾病的现实情况往往令人望而生畏。与癌症不同,COPD的进展较难预测,这使得临床医生对其预后的判断颇具挑战性。重症监护病房(ICU)中的COPD患者面临着一系列独特的挑战,其特点包括持续的呼吸窘迫、对呼吸机支持的依赖以及复杂的医疗需求。因此,姑息治疗对于ICU中的COPD患者至关重要,因为它提供了一种富有同情心、以患者为中心的方法,强调症状缓解、生活质量以及使护理与患者价值观保持一致。然而,在韩国,为这些患者提供姑息治疗极其困难。在韩国社会,讨论非癌症患者的临终护理尤其困难。原因之一是临终关怀姑息治疗被公众视为终止治疗。此外,由于韩国社会具有儒家文化背景,人们通常不愿谈论死亡。而且,医疗专业人员缺乏关注是另一个关键因素,这使得为晚期COPD患者实施姑息治疗变得困难。本综述旨在探讨通过实施姑息治疗,为ICU中的COPD患者提供有意义且有尊严生活的方法。

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本文引用的文献

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Depression and anxiety in patients with COPD.慢性阻塞性肺疾病患者的抑郁和焦虑
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Noninvasive ventilation in acute respiratory failure.急性呼吸衰竭中的无创通气
Int J Chron Obstruct Pulmon Dis. 2014 Aug 11;9:837-52. doi: 10.2147/COPD.S42664. eCollection 2014.

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