支气管哮喘的急诊诊断与治疗

Q3 Medicine
Bingyan Chen, Meili Xu, Chaoqian Li
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引用次数: 0

摘要

支气管哮喘是一种异质性呼吸系统疾病,其急诊诊断和治疗面临多重挑战。本文根据国内外指南和共识的演变,结合急诊医学的临床特点,探讨目前哮喘急诊治疗的困惑和不足。鉴于“难治性哮喘”、“重度哮喘”等分类在急诊环境中的适用性有限,且诊断过程复杂,给临床操作带来困难,建议在急诊工作中将诊断术语统一为“支气管哮喘急性加重”(轻度、中度、重度、危重)。评价指标,如动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)、呼气峰流量(PEF)。简化了就是简化了。临床诊断和急诊管理应优先遵循中国支气管哮喘防治指南(基础版)。对于轻中度和重度恶化,建议采用分层治疗策略,重点是快速缓解症状,标准化使用糖皮质激素,并动态评估疗效。此外,迫切需要在支气管哮喘急诊诊断和治疗方面形成中国专家共识,同时促进多中心前瞻性研究,以优化急诊方案,改善患者预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Emergency diagnosis and treatment of bronchial asthma].

Bronchial asthma is a kind of heterogeneous respiratory disease, and its emergency diagnosis and treatment face multiple challenges. This article, based on the evolution of domestic and international guidelines and consensus, explores the current confusions and shortcomings in the emergency treatment of asthma, considering the clinical specifics of emergency medicine. Due to the limited applicability of classifications such as "refractory asthma" and "severe asthma" in emergency settings, as well as the complex diagnostic process that makes clinical operations difficult, it is proposed to unify the diagnostic terminology as "acute exacerbation of bronchial asthma" (mild, moderate, severe, critical severe) in emergency work. Assessment indicators, such as arterial oxygen partial pressure (PaO2), partial pressure of arterial carbon dioxide (PaCO2), arterial oxygen saturation (SaO2), peak expiratory flow (PEF). Simplified were simplified. The clinical diagnosis and emergency management should prioritize the approach outlined in the Chinese guidelines for the prevention and treatment of bronchial asthma (basic version). For mild-to-moderate and severe exacerbations, a tiered treatment strategy is recommended, focusing on rapid symptom relief, standardized glucocorticoid use, and dynamic efficacy assessment. Additionally, the urgent need for formulating a Chinese expert consensus on emergency diagnosis and treatment of bronchial asthma is highlighted, along with promoting multicenter prospective studies to optimize emergency protocols and improve patient prognosis.

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来源期刊
Zhonghua wei zhong bing ji jiu yi xue
Zhonghua wei zhong bing ji jiu yi xue Medicine-Critical Care and Intensive Care Medicine
CiteScore
1.00
自引率
0.00%
发文量
42
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