chronic obstructive pulmonary disease (COPD)
It is a disease characterized by airflow limitation that can be prevented and treated, but airflow limitation is not completely possible.
Inverse,
Gradual development,
It is related to the abnormal inflammatory response of the lungs to harmful gases or harmful particles (such as cigarette smoke)
Close.
chronic obstructive pulmonary disease (COPD)
It mainly involves the lungs and can also cause the whole body.
(
Or extrapulmonary
)
The adverse effects.
Second, avoid environmental pollution.
Avoid all kinds of pathogenic factors, especially smoking, environmental pollution, colds and so on. , and avoid dust and irritating gases.
Inhalation; Pay attention to keep warm, change the unhealthy lifestyle, and improve the living environment if possible.
Third, medication.
1
Bronchial relaxants: compared with oral drugs, inhalants have fewer adverse reactions, so inhalation therapy is the first choice.
2
Glucocorticoid: This treatment can reduce the frequency of acute exacerbation and improve the quality of life. Combined inhalation of sugar peel
Hormones and hormones
β2
Receptor agonists,
It's better than using them alone.
correct
chronic obstructive pulmonary disease (COPD)
Patients are not advised to take sugar orally for a long time.
Corticosteroid therapy.
three
Other drugs:
( 1)
Phlegmatic
(
Mucolytic agent
)(2)
Oxidation inhibitor
(3)
immunomodulator
(4)
vaccine
(5)
Chinese medicine treatment.
Fourth, long-term family oxygen therapy.
Long-term home oxygen therapy is very important for people with hypoxia.
Lack of oxygen requires replenishment of oxygen,
When is hypoxia?
When to replenish oxygen.
Blood oxygen saturation is lower than
90%
Long-term home oxygen therapy is necessary,
lower than
9 1-95%
It is best to have long-term home oxygen therapy. Long-term home oxygen therapy generally takes oxygen through nasal catheter.
1.0
~
2.0L
/
Minimum (
Listen to the doctor's advice.
)
The duration of oxygen inhalation covers the anoxic period, and oxygen inhalation must be taken during sleep. Changjiujia
Hospital oxygen therapy should use oxygen therapy machine for oxygen therapy, not ordinary oxygen therapy machine.
Five, ventilator treatment
When there is
carbon dioxide
The partial pressure of carbon dioxide is too high or respiratory support is needed to improve respiratory distress and reduce heart load.
Conditions, or sleep apnea syndrome (snoring), you can use non-invasive two-stage reserve frequency.
Ventilator treatment,
Reducing the partial pressure of carbon dioxide,
If you only have sleep apnea syndrome,
(Snoring)
,
Oxygen inhalation alone can not improve the problem of hypoxia during sleep.
In this case, a single-stage ventilator can be used,
solve
Hold your breath and lack oxygen, so as to control and stabilize the disease.
Seven. rehabilitation
Rehabilitation treatment can improve the activity ability of patients with progressive airflow limitation, severe dyspnea and low activity.
Force, improve the quality of life, is
chronic obstructive pulmonary disease (COPD)
An important treatment for patients. It includes respiratory physiology therapy,
Muscle training,
Nutritional support,
Psychotherapy and education measures.
In terms of respiratory physiotherapy, including
Help the patient cough,
Exhale forcefully to promote secretion clearance;
Relax the patient,
Breathe with contracted lips to avoid
Avoid rapid shallow breathing to help overcome acute dyspnea and other measures.
Muscle training requires systematic luck.
Exercise and respiratory muscle exercise, the former includes walking, climbing stairs, pedaling and so on. And the latter includes abdominal breathing exercises. exist
In terms of nutritional support,
Reach the ideal weight as required;
At the same time, avoid excessive carbohydrate diet and high calories.
Take pictures to avoid producing too much carbon dioxide.
Eight, regular hospital examination
Extracurricular knowledge of COPD 1. Extracurricular knowledge
/20040 1/ca 362 17 1
A smattering of science and technology ※
Chinese and foreign famous clocks (1)
Chinese and foreign famous clocks (2)
Chinese and foreign famous clocks (3)
Chinese and foreign famous clocks (4)
Chinese and foreign famous clocks (5)
Chinese and foreign famous clocks (6)
Chinese and foreign famous clocks (7)
Chinese and foreign famous clocks (8)
Chinese and foreign famous clocks (9)
Chinese and foreign famous clocks (10)
Biography of scientists ※
Bradley, the discoverer of distortion
Laplace, master of celestial mechanics
Father of Russian Physiology
Microscopic observation and study of Gru plants
Immunologist-Chen Weifeng
Chest surgeon-Huang Jiasi
Physiologist-Cai Qiao
Entomologist-Yin Xiangchu
Experimental embryologist-Tong Dizhou
Neil armstrong
Yuri gagarin
Wang Ganjun, the first Chinese astronaut to go into space.
2. What health education should be given to patients with chronic obstructive pulmonary disease?
The contents of health education include: (1) Quitting smoking: improving the living environment, repeatedly emphasizing non-smoking and quitting smoking, not only understanding the harm of smoking, but also guiding patients to quit smoking.
(2) Enhance physical fitness: prevent acute respiratory infection, and insist on cold-resistant exercises such as washing your face with cold water, wiping your body or taking a bath. (3) Strengthen nutrition intake and improve nutritional status.
(4) Insist on full-body exercise and breathing training: Patients should take appropriate full-body activities, such as walking, playing Tai Ji Chuan, breathing exercises, jogging, etc. , improve skeletal muscle and cardiopulmonary function, regulate mood and increase exercise endurance. (5) Home oxygen therapy guidance: ltot can improve the prognosis of COPD patients and improve their quality of life, and should provide knowledge and skills in purchase, use and maintenance.
(6) Psychological counseling: Patients at home often have obvious loneliness, and the incidence of depression is high. Therefore, family and friends should not only provide physical care, but also give psychological care and help.
3.3 What are the common complications? Chronic obstructive pulmonary disease?
The details are as follows: (1) Cardiovascular diseases (such as ischemic heart disease, atrial fibrillation, heart failure and hypertension): Cardiovascular diseases are the most common and important complications of COPD.
Cardiac selective beta blockers should not be banned in patients with chronic obstructive pulmonary disease. (2) Osteoporosis: Osteoporosis is the main complication of COPD, which is related to the impaired health status and poor prognosis of patients, but it is often missed in clinic.
Compared with other subtypes of COPD, osteoporosis is more closely related to emphysema. COPD patients with osteoporosis are usually accompanied by body mass index and low fat-free weight.
(3) Anxiety and depression: Anxiety and depression are also important complications of COPD, which are related to poor prognosis. It is usually associated with youth, female, smoking, low FEVi, cough, high SGRQ score and history of cardiovascular disease.
(4) Lung cancer: It is found that lung cancer is the main cause of death in patients with mild COPD. (5) Infection: COPD patients often have serious infections, especially respiratory infections.
(6) Metabolic syndrome and diabetes. (7) Bronchiectasis: airflow limitation has been recognized as a characteristic manifestation of some patients with bronchiectasis.
With the increasing application of CT scanning technology in the management of COPD patients, more and more COPD patients have been found to have imaging changes of bronchiectasis, from mild tubular bronchiectasis to more serious varicose changes, and cystic bronchiectasis is rare. Bronchiectasis is associated with prolonged acute exacerbation and increased mortality in patients with chronic obstructive pulmonary disease.
(8) Cognitive impairment.
4. how to 4. Do COPD patients do breathing exercises?
Patients with anxiety and dyspnea often breathe shallow and fast, which leads to the increase of ventilation dead space. In addition, the airflow passes through the narrow airway, which increases the breathing power consumption. Therefore, patients with chronic airflow obstruction often change the way of using respiratory muscles, so that the most effective ventilation pressure is generated in intercostal inspiratory muscles rather than diaphragm.
Breathing control technology can help reverse these trends. The methods are as follows: ① Abdominal breathing exercise: the patient takes supine position, semi-supine position or sitting position, with one hand on the abdomen and the other hand on the chest. The patient inhales deeply through the nasal cavity and bulges up the abdomen at the same time, so that the hand placed on the abdominal wall feels movement.
Put your hands on your chest and keep your chest movement to a minimum. A small weight can be placed in the abdomen for resistance training to improve the patient's attention. When exhaling, the abdominal muscles and hands press down on the abdominal cavity at the same time, and the lips can be contracted to exhale slowly.
Start twice a day, each time 10 ~ 15 minutes. Gradually increase the frequency and time in the future and strive to become a natural breathing habit; ② Breathing with contracted lips: After inhaling through the nose, the patient slowly contracts his lips and exhales (such as whistling), generally inhaling for 2 seconds and exhaling for 4-6 seconds.
The expiratory flow rate should be such that the candle flame at a distance of 0/5 ~ 20 cm from the oral lip/kloc-can be tilted without extinguishing. Abdominal breathing combined with lip contraction and exhalation can reduce respiratory frequency, increase tidal volume, reduce functional residual volume, improve alveolar ventilation, reduce respiratory power consumption, coordinate breathing and relieve dyspnea.
5. What are the common complications of COPD in clinical gerontology?
The common complications of COPD are: (1) Cardiovascular disease is the most important complication of COPD patients and the leading cause of death.
Common cardiovascular complications include ischemic cardiomyopathy, heart failure, atrial fibrillation and hypertension. Ok (2) Osteoporosis is the main complication of COPD, which is often missed.
Osteoporosis can exist in the early stage of COPD. Systemic hormone therapy will increase the risk of osteoporosis, and repeated use of hormone therapy should be avoided in the acute exacerbation of COPD.
3) Lung cancer is common in COPD patients and is the most common cause of death in patients with mild COPD. (4) There is a correlation between nasal symptoms or nasal inflammatory diseases and the aggravation and deterioration of COPD patients.
(5) Acute and chronic lower respiratory tract infection Lower respiratory tract infection is an important complication of COPD patients and an important factor affecting the progress of COPD patients. The clinical symptoms of the elderly are often atypical or mild, while the extrapulmonary symptoms such as drowsiness, confusion, anorexia, nausea and vomiting are more prominent, which can often lead to respiratory failure quickly.
(6) Pulmonary hypertension is a common complication of COPD, which is not only the cause of pulmonary hypertension, but also the common cause of chronic pulmonary heart disease. (7) Venous thromboembolic disease AECOPD is often complicated with venous thromboembolic disease.
The possibility of pulmonary embolism should be considered when patients with severe AECOPD have refractory hypoxemia. (8) COPD patients with pulmonary fibrosis and emphysema often have pulmonary fibrosis. The lung volume of these patients is relatively normal, but the diffusion ability is obviously reduced, and the incidence of pulmonary hypertension is high.
(9) Skeletal muscle weakness is common in COPD patients and can be earlier than cachexia. Systemic inflammation is an important cause of weight loss and muscle atrophy in COPD patients.
(10) Depression is also a common complication, suggesting a poor prognosis.
6. What should I pay attention to when diagnosing COPD in the elderly?
At present, an important limitation of the definition of chronic obstructive pulmonary disease is that the degree of airflow limitation related to each age group cannot be accurately determined.
This problem is particularly important for the elderly. With the increase of age, the elastic contractility of their lungs decreases and the incidence of airway obstruction increases. If the same standard is used, for example, the ratio of forced expiratory volume to forced vital capacity in the first second (FEV/FVC) is less than 70%, it may be overdiagnosed.
Therefore, it is very important to choose a specific age FEV/FVC ratio among the elderly. Underdiagnosis is common among the elderly because they often ignore these symptoms or think they are related to other diseases.
The incidence of airflow obstruction increases with age. The incidence rate is 8.2% over 40 years old, and the highest incidence rate is 65 ~ 85 years old. Except for patients aged 85 and above who may be unable to have lung function examination due to different mortality or disability rates, the incidence of lung function decline in other patients is getting higher and higher with age.
What should COPD patients pay more attention to? What living habits contribute to the rehabilitation of COPD? Patients with chronic obstructive pulmonary disease need long-term disease control, because patients with chronic obstructive pulmonary disease usually have symptoms of excessive phlegm and cough all the time, which affects their normal life. But this is not serious, it is acute for copd patients. Acute attack will aggravate the original symptoms, and it will also lead to severe dyspnea and even suffocation. Therefore, it is urgent for patients to reduce the number of acute attacks, maintain good living habits and help the disease recover gradually. How to reduce the number of acute attacks in copd patients?
The key to reduce the acute attack of copd is to avoid risk factors. The risk of acute exacerbation includes exacerbation of expectoration and asthma, recurrent attacks and hospitalization at least once a year in the past six months to one year. Treatment needs to combine non-drug therapy with drug therapy, such as quitting smoking and respiratory function exercise. Drug treatment should be early and reasonable, and appropriate inhalers should be selected according to the situation and degree of airflow limitation. What living habits contribute to the rehabilitation of COPD? Improving the lifestyle of copd includes exercise and diet. Don't exercise too hard. Jogging and Tai Ji Chuan can enlarge small airways and improve lung function through lip contraction, slow exhalation and diaphragm movement. Pay attention to ensure adequate nutrition in diet, and eat more meat and other high-quality protein.
In addition, it is necessary to strengthen physical health, improve respiratory muscle strength and help expectoration. Good exercise and eating habits can prevent the acute exacerbation of COPD. It is very important for patients with chronic obstructive pulmonary disease to adjust their living habits, because there are too many factors in life that can easily stimulate the lungs and lead to chronic obstructive pulmonary disease, even if it is not an acute attack, it will have a great impact on the body. Therefore, it is necessary to maintain good and healthy living habits in daily life. Patients can adjust their diet, exercise and life rules under the guidance of doctors. As long as you are healthy and do not stimulate the lungs and digestive tract, you can reduce the number of acute attacks.
In order to determine whether there is copd, it can be combined with blood gas testing to understand. Due to the adverse symptoms caused by airflow obstruction and the influence of oxygen during the onset of copd, it may lead to hypoxemia, acid-base balance disorder, hypercapnia and so on. Blood gas test can prompt the development, degree and better response of the disease, actively cooperate with the treatment, and gradually restore the health of the body.