Chronic Obstructive Pulmonary Disease (COPD)

慢性阻塞性肺病(COPD)是一种进行性的慢性肺病,使人呼吸困难. COPD的两种主要类型是慢性支气管炎和肺气肿. 这是一种非常常见的疾病,也是美国的第三大死亡原因.  

慢性阻塞性肺病主要是由于长期接触刺激肺部的物质而引起的. Cigarette smoking is the leading cause of COPD. 其他刺激物包括空气污染、化学烟雾和灰尘. 

At first COPD may have no signs or symptoms. As the disease gets worse, symptoms become more severe. Symptoms include:

  • A cough that produces a lot of mucus
  • Shortness of breath, especially with physical activity
  • Wheezing
  • Chest tightness
COPD symptoms usually worsen gradually overtime. However, they can worsen suddenly. 例如,感冒、流感或肺部感染可能会导致你的症状迅速恶化. You may have a much harder time catching your breath. You may also experience chest tightness, more coughing, changing in color or amount of your spit, or a fever. Call your doctor right away if your symptoms worsen suddenly. They may prescribe antibiotics to treat the infection. Some severe symptoms may require treatment in a hospital.

Vaccines

流感和肺炎会给慢性阻塞性肺病患者带来严重的问题. 关于流感疫苗和肺炎球菌疫苗,与你的医生或药剂师交谈是很重要的. 流感疫苗可以降低患流感的风险,减轻症状. 肺炎球菌疫苗可以降低你患肺炎及其并发症的风险. 患有慢性阻塞性肺病的人比没有慢性阻塞性肺病的人患肺炎的风险更大.

  • Normal Lungs vs COPD
  • Treatment
  • Lifestyle Changes
  • Medical

How Normal Lungs Work

在正常的肺里,当你呼吸时,你的气道(支气管)充满了空气. 气道分支成数千个更小更细的细支气管. These tubes end in tiny round air sacs called alveoli. 被称为毛细血管的小血管沿着气囊壁流动. When air reaches the air sacs, 氧气通过气囊壁进入毛细血管中的血液. 与此同时,二氧化碳(CO2)气体从毛细血管进入气囊. 这个过程(气体交换)将氧气带入体内,并去除二氧化碳. The airways and air sacs are elastic or stretchy. When you breath in, the air sac fills with air. When you breath out, it deflates and the air leaves your body.

How COPD Hinders The Lungs

在慢性阻塞性肺病中,由于以下一种或多种原因,进出气道的空气减少:

  • The airways and air sacs lose their elastic quality
  • The walls between many of the air sacs are destroyed
  • The walls of the airways become thick and inflamed
  • The airways make more mucus than usual and can become clogged

There is no cure for COPD. However, 生活方式的改变和治疗可以帮助缓解症状,减缓疾病的发展.

The goals of COPD treatments include:

  • Relieving your symptoms
  • Slowing the progress of the disease
  • 提高你的运动耐力或保持活跃的能力
  • Preventing and treating complications
  • Improving your overall health

Quit smoking and avoid lung irritants

戒烟是你可以采取的战胜慢性阻塞性肺病的最重要步骤. 和你的医生谈谈可以帮助你戒烟的项目和产品.  Try to avoid secondhand smoke and places with dusts, fumes, 或者其他你可能吸入并刺激肺部的有毒物质.

COPD, especially severe forms, 可能会导致你因呼吸短促和疲劳而进食困难. This may cause you to not get enough calories and nutrients, 哪些会加重你的症状,增加你被感染的风险. 和你的医生谈谈你的饮食计划,以满足你的营养需求. 你的医生可能会建议少吃多餐,吃饭前休息.

People with COPD may find it hard to stay physically active. 和你的医生谈谈什么样的活动对你来说是安全的. 体育活动可以增强帮助你呼吸的肌肉,改善你的整体健康状况.

Medication

医生可以给患有慢性阻塞性肺病的人开几种不同类型的药物.  Depending on the severity of your symptoms, your doctor may have you use a combination of medications. 

Bronchodilators 放松气道的肌肉,帮助打开气道,让呼吸更容易. 支气管扩张剂有两种:短效和长效支气管扩张剂. 短效时间约4-6小时,需时使用. 长效支气管扩张剂持续时间约12小时或更长,每天使用. 

Most bronchodilators are taken using an inhaler. This allows the medicine to go straight to your lungs. Not all inhalers are used the same, 所以一定要问你的医生或药剂师告诉你使用吸入器的正确方法. If your COPD is mild, 当症状出现时,医生可能会给你开短效支气管扩张剂. If you have moderate to severe COPD, 你可能需要定期服用短效和长效支气管扩张剂.

支气管扩张联合吸入糖皮质激素(类固醇) 

Steroids help reduce airway inflammations. 通常单独使用吸入类固醇不是首选的治疗方法. If your COPD is severe or if you symptoms flare up often, 医生可能会给你开支气管扩张剂和吸入类固醇的联合用药. 

Oxygen Therapy

If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. Oxygen is delivered through nasal prongs or a mask. 你可能只在某些时候或所有时间需要额外的氧气. 氧气可以帮助患有严重慢性阻塞性肺病的人在经历较少症状的情况下进行任务或活动, protect their heart and organs from damage, sleep better, and live longer. 

Surgery

Some people with COPD may benefit from surgery. 对于药物治疗不能改善症状的人来说,这通常是最后的手段. Surgeries for people with COPD mainly relate to emphysema. 肺移植可能是患有严重慢性阻塞性肺病的人的一种选择.

Types of Surgery

Bullectomy: 当气囊壁被破坏,更大的空气空间被称为大泡形成. 这些空气空间会变得很大,影响呼吸. 在大疱切除术中,从肺中取出一个或多个非常大的大疱.

Lung Volume Reduction Surgery (LVRS): 为了帮助肺部更好地工作,外科医生将受损的组织从肺中移除. 在精心挑选的患者中,LVRS可以改善呼吸和生活质量. 

Lung Transplant: 肺移植可以改善非常严重的COPD患者的肺功能和生活质量. 外科医生切除受损的肺,用捐赠者的健康的肺替换. 肺移植有很多风险,包括感染和移植肺的排斥反应. 

Source: American Lung Association

Resources

Links to various resources on the topics discuss on this page. 

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