基于2021年GOLD《COPD诊断、治疗与预防全球策略》解析慢性阻塞性肺疾病稳定期非药物管理策略

Analysis of Non-pharmacological Management Strategies for Stable Chronic Obstructive Pulmonary Disease Based on 2021 GOLD's Global Strategy for the Diagnosis,Management,and Prevention of Chronic Obstructive Pulmonary Disease

目前,慢性阻塞性肺疾病(COPD)是世界第三大死因,仅次于缺血性心脏病和卒中。但面对这个可防、可治的重大公共卫生问题,我国临床诊疗仍存在诸多如健康教育不足、随访缺失、临床管理不规范等问题,以上均可能是病情加重的重要原因,致使后期治疗效果欠佳、难度增大,以及社会经济负担增加等。故加快促进临床管理的规范化,提高诊疗精度和效度具有重要的现实意义。本文基于2021年慢性阻塞性肺疾病全球倡议(GOLD)《COPD诊断、治疗与预防全球策略》指南,结合我国临床诊疗现状和疾病研究进展,针对COPD稳定期非药物管理策略进行解析,包括肺功能测定和评估、减少危险因素暴露、肺康复、氧疗、无创通气和外科治疗,以期为我国临床医师的实践工作提供参考,优化临床疗效。

Chronic obstructive pulmonary disease(COPD)is now the third leading cause of death in the world,after ischemic heart disease and stroke.However,in the face of this preventable and curable major public health problem,there are still many problems in clinical diagnosis and treatment in China,such as insufficient health education,missing follow-up data,and non-standardized clinical management,which may be important causes of the deterioration of conditions,leading to increased difficulties in treating and higher possibility of poor outcome after late treatment as well as increased social and economic burden of COPD.Therefore,it is of great practical significance to accelerate the standardization of prevention,diagnosis and management of COPD to improve the accuracy and effectiveness of diagnosis and treatment of COPD.To provide a reference for emergency and respiratory clinicians to better treat COPD patients clinically,in view of domestic diagnosis,treatment and studies regarding COPD,we comprehensively analyzed the non-pharmacological treatment of stable COPD based on the updated GOLD's Global Strategy for the Diagnosis,Management,and Prevention of Chronic Obstructive Pulmonary Disease,mainly including pulmonary function measurement and assessment,smoking cessation,pulmonary rehabilitation,oxygen therapy,ventilatory support and surgical interventions.