Diagnosis and general approaches to the treatment of chronic obstructive pulmonary disease

Dmitry S. Gubanov, Kseniya M. Gubanova
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Abstract

We consider the causes of chronic obstructive pulmonary disease, the stages of its development with concomitant diseases, methods for its diagnosis and treatment. Chronic obstructive pulmonary disease is a total chronic disease of the human respiratory system. The process of formation of pathological changes in the lungs is primarily associated with the impact of harmful chemicals – tobacco and smoke on the epithelium of the respiratory tract. The increase in life expectancy in recent decades allows most people to reach the age of high probability of chronic obstructive pulmonary disease and related pathologies. According to various sources, chronic obstructive pulmonary disease is in third or fourth place among the causes of death. The purpose of this review is to systematize practical methods for diagnosing and treating patients with chronic obstructive pulmonary disease on an outpatient basis. Materials and methods. The research methods involve the systematization of materials describing the identified problem, the collection and classification of medical facts about it, the assessment of existing scientific and practical approaches to solving the problem under consideration. Results. The prognosis for chronic obstructive pulmonary disease in terms of complete recovery and increased life expectancy is generally unfavorable. Therefore, it is important to take into account all the possibilities to eliminate any factors provoking deterioration of the condition, the patient's readiness for treatment, as well as the social and economic conditions of his residence. Conclusion. Treatment for chronic obstructive pulmonary disease is determined by the severity of the obstruction, symptoms, and the risk of exacerbation with escalation of therapy to control persistent symptoms or further exacerbations. The severity of an exacerbation varies according to the site of treatment: moderate exacerbations are treated on an outpatient basis with oral corticosteroids, antibiotics, or both, and severe exacerbations require hospitalization or emergency care.
慢性阻塞性肺疾病的诊断和一般治疗方法
我们考虑慢性阻塞性肺疾病的原因,其发展阶段与伴随疾病,其诊断和治疗方法。慢性阻塞性肺疾病是一种完全慢性的人体呼吸系统疾病。肺部病理变化的形成过程主要与有害化学物质-烟草和烟雾对呼吸道上皮的影响有关。近几十年来预期寿命的增加使大多数人达到了患慢性阻塞性肺疾病和相关病理的高概率年龄。根据各种资料来源,慢性阻塞性肺病在死亡原因中排名第三或第四位。本综述的目的是系统化门诊诊断和治疗慢性阻塞性肺疾病的实用方法。材料和方法。研究方法包括系统化描述已确定问题的材料,收集和分类有关问题的医学事实,评估现有的科学和实用的解决问题的方法。结果。慢性阻塞性肺疾病在完全康复和预期寿命增加方面的预后通常是不利的。因此,重要的是要考虑到所有可能性,以消除导致病情恶化的任何因素、患者对治疗的准备情况以及其居住地的社会和经济条件。结论。慢性阻塞性肺疾病的治疗取决于梗阻的严重程度、症状和随着治疗的升级而加重的风险,以控制持续症状或进一步加重。急性加重的严重程度因治疗部位而异:中度急性加重可在门诊使用口服皮质类固醇、抗生素或两者同时治疗,严重急性加重则需要住院或急诊治疗。
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