英文精品课件chronic obstructive pulmonary disease （35p）

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1、CHRONICOBSTRUCTIVEPULMONARYDISEASECLINICALPRACTICEGUIDELINESREVIEWWEEK1:DIAGNOSISAMBULATORYINTERNALMEDICINEGROUPPRACTICEUNIVERSITYHEALTHNETWORK/MSHSEPTEMBER2007Preparedby:Dr.D.PaniskoCOPD:GuidelinesforthisSeminarStandardsforthediagnosisandtreatmentofp

2、atientswithCOPD:asummaryoftheATS/ERSpositionpaper.CelliBRetal.EurRespirJ2004;23:932-46.Fulldocument,withupdates,availableat:www.thoracic.org,accessedSept2007CanadianThoracicSocietyrecommendationsforthemanagementofchronicobstructivepulmonarydisease-2003

3、.O’DonnellDEetal.CanRespirJ2003;10(SupplA):11A-33AGlobalInitiativeforChronicObstructiveLungDisease.(GOLD).AcollaborativeoftheNIHandWHO.UpdatedNov2006,accessedSept2007.Availableatwww.goldcopd.comCOPDDiagnosis:ObjectivesAfterthisseminaryoushould:beawareo

4、fdiagnosticclinicalpracticeguidelinesforstablechronicCOPDbeabletodefineCOPDandasthmaandoutlineadifferentialdiagnosisbeablelistimportanthistoricalandlaboratorydiagnosticfeaturesofCOPDbeabletodescribetheevidence-basedphysicalexaminationforCOPDandairflowl

5、imitationCOPDI:DIAGNOSISCASE:A61yearoldmancomestoyourclinicasanewpatient.HehadjustbeenadmittedtohospitalforhisfirstexacerbationofCOPD.Hehascompleteda10dayantibioticcourseand10daysoforalPrednisone.Heisnowonlyonanipratropiumpuffer,2puffsqid.HowisCOPDdefi

6、ned?Whatisemphysema?Whatisasthma?WhyisitimportanttomakeadiagnosisofCOPD(asopposedtoasthma)inthispatient?COPDI:DIAGNOSISCOPDDefinition:Apreventableandtreatablediseasestatecharacterizedbyairflowlimitationthatisnotfullyreversible.Theairflowlimitationisusu

7、allyprogressiveandassociatedwithanabnormalinflammatoryresponseofthelungstonoxiousparticlesorgases,primarilycausedbycigarettesmoking.AlthoughCOPDaffectsthelungs,italsoproducessignificantsystemicconsequences.ImpliespostbronchodilatorFEV1/FVC<0.7ATS/ERSpo

8、sitionpaperCOPDI:DIAGNOSISCOPD:traditionallyunderstoodasaspectrum-componentsofchronicbronchitisoremphysema.ThelattermaytakeonrevitalizedsignificancebecauseofanewapproachthatconsiderstheimportanceofdifferentphenotypesofCOPD.EMPHYSEMA:Abn