Lareau Suzanne, ZuWallack Richard, Nici Linda
College of Nursing, University of Colorado, Denver Anschutz Medical Campus, ED 2 North, 13120 East 19th Ave., Aurora, CO 80045, USA.
Pulmonary and Critical Care, Trinity Health of New England, St. Francis Hospital, 114 Woodland Street, Hartford, CT 06105, USA.
Life (Basel). 2025 May 7;15(5):750. doi: 10.3390/life15050750.
Goals of medical management of individuals with chronic obstructive pulmonary disease (COPD) should be to live better and live longer-in other words, improve health-related quality of life (HRQL) and survival. This narrative review summarizes the literature in these areas, with an emphasis on pulmonary rehabilitation (PR). Treatments that increase HRQL include pharmacologic agents, exercise training, physical activity promotion, lung volume reduction, PR, self-management training, and supplemental oxygen. Additionally, anything that reduces the frequency or impact of exacerbations substantially increases HRQL. With respect to survival in COPD, the list of beneficial interventions for this outcome is considerably more limited. Supplemental oxygen therapy for hypoxemic patients, smoking cessation interventions, influenza vaccination, and lung volume reduction procedures have the strongest evidence in survival benefit. PR, especially when provided following discharge for exacerbations, may improve survival. A nihilistic view of COPD treatment is unwarranted, as multiple interventions are available that improve HRQL, and likely increase survival for selected patients.
慢性阻塞性肺疾病（COPD）患者的医疗管理目标应该是生活得更好、更长久——换句话说，就是提高健康相关生活质量（HRQL）并延长生存期。这篇叙述性综述总结了这些领域的文献，重点是肺康复（PR）。提高HRQL的治疗方法包括药物、运动训练、促进身体活动、肺减容、PR、自我管理训练和补充氧气。此外，任何能大幅减少急性加重发作频率或影响的措施都能显著提高HRQL。关于COPD患者的生存期，对这一结果有益的干预措施清单要有限得多。对低氧血症患者进行补充氧气治疗、戒烟干预、流感疫苗接种和肺减容手术在生存获益方面有最有力的证据。PR，尤其是在因急性加重出院后进行时，可能会改善生存期。对COPD治疗持虚无主义观点是没有根据的，因为有多种干预措施可以提高HRQL，并且可能会提高特定患者的生存率。
