Health Science Museum | Do you know chronic obstructive pulmonary disease?
Chronic obstructive pulmonary disease is a Chronic bronchitis and/or emphysema characterized by airflow obstruction can further develop into a common chronic disease of pulmonary heart disease and respiratory failure. It is related to the abnormal inflammatory reaction of harmful gases and harmful particles, and the morbidity rate and mortality rate are very high. The incidence rate of over 40 years old in the world has reached 9% to 10%.
Chronic obstructive pulmonary disease (COPD) is a common disease that can be prevented and treated with persistent airflow limitation, airflow restricted development, and airway It is associated with an increase in the chronic inflammatory response of toxic particles or gases to the lungs.
Gao Hongmei, director of the Department of Respiratory Medicine, Shenyang Tenth People’s Hospital, said that chronic obstructive pulmonary disease (hereinafter referred to as chronic obstructive pulmonary disease) is commonly known as “old slow gas” or “tracheitis, lung emphysema”. It is a group of diseases characterized by airflow limitation, and the airflow limitation is reversible and progressive. But it can be prevented.
1. Cause chronic obstructive pulmonary disease Causes of the disease:
If you want to prevent it, you need to know what causes chronic obstructive pulmonary disease:
1. Personal susceptibility factors: such as congenital α1-antitrypsin deficiency .
3. Contact with occupational dust and chemicals.
4. Air pollution.
5. Repeated bronchial infection and so on.
We know that the cause can be targeted prevention, such as: smoking cessation, tobacco control; workers exposed to occupational dust to do occupational prevention; weathering heavy weather to reduce outdoor activities, or wear well Anti-pollution masks will travel again; patients who are susceptible to bronchial infections should pay attention to cold and warmth, prevent “cold”, and regularly inoculate influenza vaccines and epidemic bacterial vaccines.
Second, how do you know that you have May have chronic obstructive pulmonary disease?
First, patients with chronic obstructive pulmonary disease may exhibit the following symptoms:
1. Chronic cough, recurrent or perennial, obvious in the morning or early in the morning.
2. Cough, white sputum-based, more in the morning, there may be purulent sputum in acute exacerbation.
3. Difficulty breathing or shortness of breath. When the patient is tired at the beginning of the illness, it can be obviously short of breath when resting.
4. Wheezing and chest tightness, seen in patients with acute exacerbation or severe chronic obstructive pulmonary disease. The patient himself may find that the thorax becomes a round barrel, which is different from the oblate shape of an ordinary person.
The above performance highlights the chronic course of disease, mostly more than 2 years.
3. What tests may you give to you with chronic obstructive pulmonary disease?
If you suspect that you have a chronic obstructive pulmonary disease and that your doctor has this consideration, what tests may the doctor give you?
1. Lung CT: In addition to its diagnostic significance, this test is more important than other diseases, such as the exclusion of bronchiectasis, bronchial lung cancer, tuberculosis and other diseases.
2. Lung function: This is a mandatory item for the diagnosis of chronic obstructive pulmonary disease. And it may be repeated several times because it is not only the basis for diagnosis, but also the standard for grading disease severity, an important indicator for prognosis and efficacy judgment.
3. Others: Blood tests, sputum culture, etc. will be performed during acute attacks. In order to determine whether respiratory failure and pulmonary heart disease are combined, blood gas analysis, electrocardiogram, and echocardiography will be performed. Some questionnaires will be done, and a 6-minute walk test will be conducted to determine the severity of the illness.
IV. Chronic obstructive pulmonary common concurrency Symptoms:
1. Chronic respiratory failure: As the lung function declines progressively, the lungs inhale oxygen to eliminate carbon dioxide, and the lips appear purple, lethargy and other respiratory failure.
2. Chronic pulmonary heart disease: This is a heart disease secondary to lung disease, which is characterized by lower extremity edema, loss of appetite, indigestion, etc. The focus of treatment is on lung disease, which should be breathing. Seek medical attention.
3. Spontaneous pneumothorax: patients with chronic obstructive pulmonary disease are prone to lung bullae, and rupture can induce pneumothorax. The performance is sudden aggravation of breathing difficulties, and there is cyanosis. You should seek medical advice promptly and re-examine chest X. line.
5. Treatment of chronic obstructive pulmonary disease :
The treatment of chronic obstructive pulmonary disease is divided into several categories: acute exacerbation treatment and stable disease treatment.
1. Acute attack treatment: If the patient has a worse cough, cough, or wheezing than usual, consider entering the acute exacerbation period. The hospital should be treated or hospitalized. The treatment plan is decided by the doctor. The possible treatments are: oxygen, antibiotics, hormones, expectorants, and antiasthmatics. If combined with respiratory failure, pulmonary heart disease, it is also possible to use non-invasive ventilation, or tracheal intubation with invasive ventilation.
2. Stable period treatment: It is required to be the patient’s own focus, and is completed under the guidance of a doctor.
Quitting smoking: Avoid occupational dust exposure and reduce exposure to air pollution.
Diet: Patients with wasting are mainly high-calorie, high-protein diets, and obese patients should lose weight.
Drug use: Patients with chronic obstructive pulmonary disease need to improve their dyspnea symptoms for long-term use, including the following drugs:
1 bronchodilator: salbutamol aerosol, salmeter Luo, formoterol, indacaterol, theophylline, ipratropium bromide, and thiophanate, these drugs have good effects, small side effects, long-term application, requiring patients to learn the correct use of inhalation devices.
2 peony drugs such as ambroxol hydrochloride, carboxymethacetin and the like.
3 hormones are used in patients with severe and very severe conditions. Inhaled dosage form, often combined with long-acting bronchodilators, such as fluticasone /salmeterol, budesonide /formoterol, because of its small side effects, can be used for a long time.
Home Oxygen Therapy: For patients with respiratory failure and pulmonary heart disease, secondary polycythemia, low-flow oxygen, more than 15 hours a day.
Home Noninvasive Ventilation Therapy: Benefits for patients with severe respiratory failure, pulmonary heart disease, and those requiring exercise rehabilitation.
Pulmonary rehabilitation: including breathing training, sputum training; stretching training; resistance training; exercise therapy: including walking, treadmill, upper limb training, etc.
[This issue of experts ]
Gao Hongmei, director of the Department of Respiratory Medicine, Shenyang Tenth People’s Hospital, chief physician, master’s degree. Good at respiratory disease treatment. Member of the Ninth Committee of the Respiratory Diseases Branch of Liaoning Medical Association, member of the Respiratory Physiology Committee of the Provincial Cell Biology Society, member of the Provincial Medical Association Medical Appraisal Experts, and Youth Committee of the Pulmonary Rehabilitation Professional Committee of the China Disabled Persons Rehabilitation Association.