《copd英文课》课件.ppt

* * * * * * * * * * * Non-pharmacotherapy treatment should be provided for your COPD patients. Rehabilitation, physiotherapy, exercise and muscle training are proven to increase exertional endurance, lessen dyspnea, clear secretions, and decrease hospital visits during exacerbations by improving and maintaining fitness of skeletal and respiratory muscles. This type of treatment will also encourage patients to stay mentally and physically active. Nutritional counselling is also important for those with COPD, especially for elderly or isolated patients. Malnutrition, which can lead to obesity or weight loss, is an independent risk factor for poor prognosis. Undernourished patients commonly suffer respiratory muscle dysfunction and increased mortality. Because COPD is a terminal and degenerative condition, it is important to prepare patients for dealing with emergency situations and panic attacks, and end-of-life planning. The three key elements of pulmonary rehabilitation are physical rehabilitation, nutritional therapy and counselling. Also very important is education and psychotherapy aimed at improving coping mechanisms and relaxation strategies (Canadian Respiratory Review Panel, 1998). LVRS appears to improve exercise capacity as well as quality of life in some patients. These effects can last more than 1 year. LVRS is usually reserved for patients with advanced COPD. Like LVR, lung transplantation is recommended only for patients with advanced COPD. There is considerable improvement in QoL after a lung transplant (GOLD Guidelines, 2001). * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * In industrialized countries, cigarette smoking accounts for most cases of COPD, In developing countries other environmental pollutants, such as particulates associated with cooking in confined spaces, are important causes. Air pollution (particularly with sulfur dioxide and particulates), exposure to certain occupational chemicals (such as cadmi