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--> 00:05.071\n慢阻肺日常防护指南。\n\n00:06.844 --> 00:07.045\n嗯。\n\n00:12.086 --> 00:12.211\n好，\n\n00:12.211 --> 00:15.885\n我们这个这次分五个部分讲一下。\n\n00:15.885 --> 00:17.885\n第一部分是认识慢阻肺，\n\n00:18.236 --> 00:20.436\n第二部分是远离诱因，\n\n00:20.736 --> 00:22.635\n第三部分是科学用药，\n\n00:22.736 --> 00:24.510\n第四部分是康复锻炼，\n\n00:24.510 --> 00:26.436\n第五部分是饮食与环境。\n\n00:27.638 --> 00:28.187\n第一部分，\n\n00:28.288 --> 00:29.788\n认识慢阻肺。\n\n00:30.695 --> 00:31.746\n慢阻肺是什么呢？\n\n00:32.096 --> 00:34.320\n慢阻肺的定义慢阻肺呢，\n\n00:34.320 --> 00:37.195\n是一种常见的慢性气道疾病，\n\n00:37.296 --> 00:40.745\n以持续的呼吸道症状和气流受限为特征，\n\n00:40.895 --> 00:42.120\n其进展缓慢，\n\n00:42.120 --> 00:43.495\n但可预防和治疗。\n\n00:44.894 --> 00:52.144\n慢阻肺患者常表现为慢性咳嗽、咳痰以及进行性加重的气短或呼吸困难，\n\n00:52.194 --> 00:54.594\n这些症状严重影响日常生活。\n\n00:56.383 --> 01:00.383\n可以将慢阻肺的气道比作逐渐被阻塞的吸管，\n\n01:00.883 --> 01:02.383\n呼吸时阻力增大，\n\n01:02.383 --> 01:03.734\n导致呼吸困难，\n\n01:03.734 --> 01:06.433\n形象的说明了疾病对呼吸的影响。\n\n01:08.336 --> 01:11.311\n我们怎么样才能远离这个慢阻肺的诱因呢？\n\n01:12.096 --> 01:12.646\n第一步，\n\n01:12.646 --> 01:13.070\n第一，\n\n01:13.070 --> 01:14.146\n一定要戒烟，\n\n01:14.295 --> 01:15.646\n戒烟刻不容缓。\n\n01:16.375 --> 01:18.676\n烟草是慢阻肺的主要病因，\n\n01:18.676 --> 01:21.551\n长期吸烟会严重损害肺部功能，\n\n01:21.551 --> 01:22.875\n加速病情恶化。\n\n01:23.529 --> 01:26.279\n戒烟是延缓肺功能下降最有效措施，\n\n01:26.279 --> 01:27.805\n能显著改善症状，\n\n01:27.805 --> 01:29.180\n提高生活质量，\n\n01:29.279 --> 01:32.279\n是慢阻肺患者必须迈出的关键一步。\n\n01:34.425 --> 01:37.300\n第二步是减少环境刺激物空气污染。\n\n01:37.300 --> 01:38.875\n雾霾天应减少外出，\n\n01:38.875 --> 01:42.224\n必要时佩戴PM2.5防护口罩，\n\n01:42.224 --> 01:44.925\n以降低空气污染对呼吸道的刺激。\n\n01:46.305 --> 01:46.980\n职业防护。\n\n01:46.980 --> 01:49.855\n从事粉尘或化学物质相关职业的患者，\n\n01:49.855 --> 01:51.980\n应严格做好职业防护，\n\n01:51.980 --> 01:53.805\n避免有害物质的吸入。\n\n01:55.209 --> 01:57.410\n厨房油烟也是一个很大方面，\n\n01:57.610 --> 02:00.084\n烹饪的时候要开启强力抽油烟机，\n\n02:00.084 --> 02:01.260\n保持厨房通风，\n\n02:01.360 --> 02:03.459\n减少油烟对呼吸道的刺激。\n\n02:04.281 --> 02:04.482\n嗯，\n\n02:04.681 --> 02:06.482\n还有避免使用柴草。\n\n02:07.353 --> 02:09.804\n煤炭等生物燃料取暖做饭，\n\n02:09.804 --> 02:12.804\n寒冷天气外出时戴好口罩或围巾，\n\n02:12.804 --> 02:14.354\n温暖吸入的空气。\n\n02:15.419 --> 02:17.718\n那么慢阻肺怎样科学用药呢？\n\n02:18.718 --> 02:19.192\n首先呢，\n\n02:19.192 --> 02:20.268\n我们要遵医嘱，\n\n02:20.317 --> 02:23.367\n患者必须严格遵循医生的用药建议，\n\n02:23.417 --> 02:25.242\n不可自行停药或减量，\n\n02:25.242 --> 02:26.718\n以确保病情稳定。\n\n02:27.067 --> 02:29.218\n正确用药是稳定的基石。\n\n02:30.354 --> 02:30.554\n嗯，\n\n02:30.753 --> 02:32.128\n慢阻肺药物分类，\n\n02:32.128 --> 02:35.904\n慢阻肺的药物分为维持用药和应急药物。\n\n02:35.904 --> 02:37.854\n维持用药需长期规律使用，\n\n02:37.854 --> 02:40.604\n应急药物则在急性发作时按需使用。\n\n02:41.003 --> 02:44.404\n吸入装置要学会正确使用吸入装置。\n\n02:45.322 --> 02:47.248\n可有效的提高药物疗效，\n\n02:47.248 --> 02:48.673\n减少不良反应。\n\n02:49.876 --> 02:50.376\n第四步，\n\n02:50.477 --> 02:51.326\n第四部分，\n\n02:51.326 --> 02:52.376\n康复锻炼。\n\n02:53.531 --> 02:56.281\n我们首先要学会呼吸的艺术。\n\n02:57.085 --> 02:57.460\n首先，\n\n02:57.460 --> 02:58.785\n第一个是缩唇呼吸。\n\n02:59.134 --> 03:01.785\n缩唇呼吸可延长呼气时间，\n\n03:02.134 --> 03:04.434\n减少呼吸耗能、功耗。\n\n03:04.634 --> 03:06.660\n患者应掌握其正确方法，\n\n03:06.660 --> 03:07.785\n并坚持练习。\n\n03:08.636 --> 03:08.936\n第二步，\n\n03:08.936 --> 03:10.986\n第二种方法是腹式呼吸。\n\n03:11.136 --> 03:13.936\n腹式呼吸能有效增强膈肌功能，\n\n03:13.936 --> 03:15.386\n改善呼吸效率，\n\n03:15.386 --> 03:18.236\n是慢阻肺患者重要的康复训练方法。\n\n03:19.845 --> 03:20.595\n动则有益，\n\n03:20.595 --> 03:21.595\n量力而行。\n\n03:21.895 --> 03:22.845\n运动原则，\n\n03:22.895 --> 03:26.945\n患者应遵循循序渐进、持之以恒的运动原则，\n\n03:27.095 --> 03:30.046\n根据自身情况选择合适的运动方式。\n\n03:30.395 --> 03:34.046\n推荐步行、太极拳、瑜伽等运动。\n\n03:35.940 --> 03:37.740\n这些适合慢阻肺的患者，\n\n03:37.789 --> 03:40.589\n可有效改善身体机能和生活质量。\n\n03:42.798 --> 03:45.147\n再一个是要加强上肢的力量训练。\n\n03:46.356 --> 03:49.356\n提举小杠铃、小哑铃、弹力带等。\n\n03:50.119 --> 03:50.470\n练习。\n\n03:51.548 --> 03:55.548\n上肢力量训练可以增强患者的身体素质。\n\n03:55.748 --> 03:57.147\n下肢力量训练，\n\n03:57.197 --> 04:01.748\n坐位、抬腿、原地踏步等下肢力量训练和提高患者的活动耐力。\n\n04:03.042 --> 04:04.367\n慢阻肺的第五部分，\n\n04:04.367 --> 04:05.442\n饮食与环境。\n\n04:07.906 --> 04:08.257\n饮食，\n\n04:08.457 --> 04:09.531\n吃出健康，\n\n04:09.531 --> 04:10.382\n吃出力量。\n\n04:10.382 --> 04:11.406\n饮食原则，\n\n04:11.457 --> 04:13.906\n慢阻肺患者应遵循高蛋白。\n\n04:14.781 --> 04:17.432\n高维生素、高热量的饮食原则，\n\n04:17.432 --> 04:19.981\n以满足身体对营养的需求。\n\n04:21.585 --> 04:24.985\n饮食禁忌就是少吃产气食物和油腻食物，\n\n04:24.985 --> 04:26.485\n避免加重呼吸困难。\n\n04:26.835 --> 04:32.860\n推荐多吃瘦肉、鱼、蛋、奶、豆制品及新鲜蔬蔬菜水果，\n\n04:32.860 --> 04:34.436\n有助于增强体质。\n\n04:35.028 --> 04:35.803\n其他的时候，\n\n04:35.803 --> 04:38.329\n其他多喝水可以稀释痰液，\n\n04:38.329 --> 04:39.278\n利于咳出，\n\n04:39.678 --> 04:43.229\n少食多餐可避免饱胀压迫膈肌。\n\n04:44.032 --> 04:45.082\n家庭的呼吸支持。\n\n04:47.458 --> 04:49.757\n这个推荐就是长家庭长期氧疗，\n\n04:50.007 --> 04:51.882\n那么我们会医生呢，\n\n04:51.882 --> 04:55.708\n会根据患者的血氧饱和度决定是否需要长期家庭氧疗。\n\n04:56.493 --> 05:01.042\n氧疗的原则就是家庭需氧疗需遵循持续低流量的原则，\n\n05:01.342 --> 05:04.042\n每日吸氧时间应超过15个小时。\n\n05:06.361 --> 05:07.361\n家庭环境，\n\n05:07.361 --> 05:09.437\n保持室内空气清新湿润，\n\n05:09.437 --> 05:10.187\n定期打扫，\n\n05:10.187 --> 05:11.437\n避免灰尘和螨虫。\n\n05:11.437 --> 05:13.312\n秋冬季节可使用加湿器。\n\n05:14.471 --> 05:16.020\n识别急性加重信号，\n\n05:16.071 --> 05:17.170\n当出现咳嗽，\n\n05:17.170 --> 05:18.371\n咳痰明显加重，\n\n05:18.371 --> 05:19.670\n呼吸困难加剧，\n\n05:19.821 --> 05:20.471\n发热，\n\n05:20.520 --> 05:21.571\n下肢浮肿。\n\n05:23.194 --> 05:25.644\n精神食欲变差等情况时，\n\n05:25.644 --> 05:27.769\n可能是慢阻肺急性加重的信号，\n\n05:27.769 --> 05:28.843\n需及时就医，\n\n05:29.044 --> 05:30.044\n定期复查。\n\n05:31.536 --> 05:32.510\n即使病情稳定，\n\n05:32.510 --> 05:35.335\n患者也应每3.6个月进行一次定期复查，\n\n05:35.335 --> 05:37.485\n包括肺功能检查和医生评估。\n\n05:37.686 --> 05:38.635\n疫苗接种，\n\n05:38.786 --> 05:44.460\n每年接种流感疫苗和肺炎球菌疫苗可有效预防感染，\n\n05:44.460 --> 05:46.085\n降低急性加重的风险。\n\n05:46.335 --> 05:47.210\n医患合作，\n\n05:47.210 --> 05:49.885\n患者应与医生建立良好的合作关系，\n\n05:49.985 --> 05:52.385\n共同制定和调整治疗方案。\n\n05:53.337 --> 05:53.437\n好，\n\n05:53.437 --> 05:54.187\n感谢观看。\n\n05:55.687 --> 05:55.937\n嗯。\n\n05:57.335 --> 05:59.635\n希望大家能在以后，\n\n05:59.985 --> 06:00.385\n嗯。\n\n06:01.372 --> 06:02.571\n把慢阻肺控制好，\n\n06:02.821 --> 06:06.071\n我们重点要讲一下慢阻肺的缩唇呼吸。\n\n06:07.738 --> 06:13.937\n多唇呼吸是慢性阻塞性肺疾病的一个常用的呼吸训练方法，\n\n06:14.138 --> 06:15.988\n能帮助改善通气效率。\n\n06:16.868 --> 06:18.192\n缓解气短症状。\n\n06:19.309 --> 06:22.359\n具体操作步骤就是用鼻子缓慢吸气。\n\n06:23.687 --> 06:25.036\n感觉腹部微微鼓起，\n\n06:25.486 --> 06:27.786\n吸气时间保持2.3秒，\n\n06:27.986 --> 06:31.786\n然后嘴唇像吹口哨吹口哨一样缩成小口状。\n\n06:35.330 --> 06:37.031\n缓慢均匀的呼气，\n\n06:37.430 --> 06:40.430\n呼气时间是吸气时间的2.3倍，\n\n06:40.480 --> 06:41.830\n比如吸气3秒，\n\n06:41.830 --> 06:43.131\n呼气6.9秒。\n\n06:44.188 --> 06:45.539\n第三步就是重复练习，\n\n06:45.539 --> 06:47.338\n每次训练5.10分钟，\n\n06:47.688 --> 06:50.389\n每天可进行3.4次练习。\n\n06:50.639 --> 06:51.864\n这个方法的核心呢，\n\n06:51.864 --> 06:55.338\n是通过缩唇延长呼吸呼气时间，\n\n06:55.438 --> 06:57.088\n减少气道塌陷，\n\n06:57.239 --> 06:59.938\n让肺内残留的废气更充分的排出，\n\n07:00.088 --> 07:02.489\n从而减轻呼吸费力的感觉。\n\n07:03.364 --> 07:04.815\n这些操作方法就是。\n\n07:06.816 --> 07:07.066\n嗯。\n\n07:09.768 --> 07:09.967\n好。\n\n07:11.630 --> 07:12.130\n这就是。\n\n07:13.160 --> 07:13.684\n慢阻肺，\n\n07:13.684 --> 07:15.809\n一个很重要的呼吸训练方法。\n\n07:16.842 --> 07:17.492\n再一个。\n\n07:19.040 --> 07:20.490\n慢阻肺是一种，\n\n07:20.591 --> 07:28.890\n它其实是一种持续气流受限的特征为特征的可预防、可治疗的呼吸系统慢性疾病。\n\n07:30.338 --> 07:31.287\n气流受限呢。\n\n07:32.865 --> 07:36.966\n构呈进行性发展与气道和肺组织。\n\n07:37.898 --> 07:43.048\n对烟草、烟雾等有害气体或有害颗粒的慢性炎症反应增强有关。\n\n07:44.774 --> 07:49.274\n核心症状包括慢性咳嗽、咳痰、气短或者是呼吸困难。\n\n07:50.110 --> 07:50.860\n部分患者呢，\n\n07:50.860 --> 07:53.460\n还会出现喘息和胸闷。\n\n07:53.510 --> 07:54.835\n病情进展到后期，\n\n07:54.835 --> 07:58.510\n也可能伴随体重下降、食欲减退等全身症状。\n\n07:59.575 --> 08:03.174\n诊断上肺功能检查是金标准，\n\n08:03.475 --> 08:05.263\n吸入支气管舒畅气，\n\n08:05.263 --> 08:11.424\n气后第一秒用力呼气容积与用力肺活量的比值小于0.7即可确诊。\n\n08:11.424 --> 08:12.975\n存在持续气流受限。\n\n08:13.614 --> 08:17.463\n治疗和和管理的关键在于戒烟。\n\n08:18.882 --> 08:21.433\n这个是延缓病情进展的首要措施，\n\n08:21.833 --> 08:22.558\n同时呢，\n\n08:22.558 --> 08:24.233\n要配合规律的使用。\n\n08:27.464 --> 08:30.714\n支气管舒张剂、糖皮质激素等药物，\n\n08:30.765 --> 08:32.590\n以及进行肺康复训练，\n\n08:32.590 --> 08:36.114\n接种流感和肺炎疫苗来预防急性加重。\n\n08:37.846 --> 08:42.096\n戒烟门诊也是我们慢阻肺的一个重要的部分啊，\n\n08:42.596 --> 08:43.421\n戒烟的话，\n\n08:43.421 --> 08:45.445\n我们推荐是一个叫透皮贴。\n\n08:47.741 --> 08:48.466\n戒烟有一个，\n\n08:48.466 --> 08:51.390\n现在有一种叫尼古丁透皮贴。\n\n08:56.945 --> 08:59.546\n它的今天它的核心呢，\n\n08:59.546 --> 09:01.046\n是要结合这个。\n\n09:03.508 --> 09:07.158\n结合这个意志力干预和科学辅助手段，\n\n09:07.508 --> 09:09.859\n双管齐下能大幅提高成功率。\n\n09:09.859 --> 09:10.359\n以下。\n\n09:11.460 --> 09:12.960\n就是首先呢，\n\n09:12.960 --> 09:14.460\n要制定明确的计划。\n\n09:16.041 --> 09:18.692\n制定设定具体的戒烟日期，\n\n09:18.942 --> 09:21.242\n建议一到两周内不宜拖延，\n\n09:21.291 --> 09:24.091\n提前告知家人朋友寻求监督，\n\n09:24.242 --> 09:28.192\n同时清理身边的香烟、打火机、烟灰缸等相关物品。\n\n09:29.705 --> 09:32.406\n在第二个重要方面就是行为心理调节。\n\n09:32.455 --> 09:33.955\n烟瘾发作的时候。\n\n09:34.663 --> 09:36.263\n大概通常持续3.5分钟，\n\n09:36.513 --> 09:38.862\n用替代行为转移注意力，\n\n09:38.862 --> 09:43.312\n比如嚼无糖口香糖、喝水、散步、做缩唇呼吸训练等。\n\n09:43.562 --> 09:45.713\n避开容易触发吸烟的场景，\n\n09:45.913 --> 09:47.513\n如酒局、熬夜。\n\n09:47.713 --> 09:48.737\n若感到烦躁，\n\n09:48.737 --> 09:50.963\n可以通过深呼吸冥想缓解。\n\n09:52.661 --> 09:53.861\n再一个就是药物辅助，\n\n09:54.211 --> 09:55.911\n一个是尼古丁替代疗法，\n\n09:56.161 --> 09:58.711\n如尼古丁贴片、口香糖、吸入剂等，\n\n09:58.711 --> 10:01.012\n逐步降低身体对尼古丁的依赖，\n\n10:01.012 --> 10:03.562\n避免突然戒断引发强烈不适。\n\n10:04.442 --> 10:04.742\n嗯，\n\n10:04.742 --> 10:05.268\n再一个，\n\n10:05.268 --> 10:07.393\n有一些非尼古丁类的处方药，\n\n10:07.543 --> 10:10.043\n如伐尼克兰、安非他酮等，\n\n10:10.043 --> 10:11.942\n需在医生指导下使用。\n\n10:12.093 --> 10:15.242\n前者能阻断尼古丁受体并减轻戒断反应，\n\n10:15.393 --> 10:18.643\n后者可缓解戒烟时的烦躁焦虑。\n\n10:19.814 --> 10:21.513\n再一个是寻求专业支持。\n\n10:21.763 --> 10:24.963\n拨打戒烟热线或前往医院的戒烟门诊，\n\n10:25.213 --> 10:27.939\n医生会根据个人情况制定个性化方案，\n\n10:27.939 --> 10:29.864\n同时加入戒烟互助小组，\n\n10:30.064 --> 10:31.539\n和同伴互相鼓励，\n\n10:31.539 --> 10:33.463\n能提升坚持下去的动力。\n\n10:35.281 --> 10:35.481\n嗯，\n\n10:36.181 --> 10:36.830\n所以说，\n\n10:36.830 --> 10:38.031\n得了慢阻肺的话，\n\n10:38.031 --> 10:39.531\n肯定是不能吸烟的。\n\n10:39.531 --> 10:40.531\n一定要戒烟，\n\n10:40.781 --> 10:41.505\n戒烟呢，\n\n10:41.505 --> 10:44.231\n它可以延缓这个肺功能的下降。\n\n10:48.322 --> 10:49.822\n能显著的改善症状，\n\n10:49.921 --> 10:51.221\n提高生活质量，\n\n10:51.421 --> 10:54.822\n是慢阻肺患者必须迈出的关键的一步。\n\n10:59.007 --> 11:00.158\n还有这个用药，\n\n11:00.158 --> 11:01.408\n慢阻肺的用药，\n\n11:01.807 --> 11:04.033\n慢阻肺的这种维持用药，\n\n11:04.033 --> 11:06.507\n我们现在用的最多的是一个叫。\n\n11:08.241 --> 11:09.690\n慢阻肺用药都是一些吸入，\n\n11:09.690 --> 11:11.491\n吸入剂就是提前。\n\n11:13.049 --> 11:13.598\n提前弄好，\n\n11:13.598 --> 11:16.499\n提前准备好的那种雾化剂。\n\n11:20.273 --> 11:21.448\n吸入剂常见的，\n\n11:21.448 --> 11:25.023\n比如说是那个支气管舒张剂。\n\n11:26.328 --> 11:26.528\n嗯，\n\n11:26.677 --> 11:28.578\n最常用的吸入剂，\n\n11:28.978 --> 11:31.403\n它能松弛气道平滑肌，\n\n11:31.403 --> 11:32.203\n扩张气道，\n\n11:32.203 --> 11:34.627\n快速改善气短、喘气等症状。\n\n11:34.728 --> 11:36.828\n短效的白塔受体阻滞剂。\n\n11:37.643 --> 11:40.143\n代表药物是沙丁胺醇和特布他林，\n\n11:40.443 --> 11:42.093\n它们的特点是起效快，\n\n11:42.093 --> 11:43.494\n数分钟内就起效，\n\n11:43.593 --> 11:45.693\n大概持续4.6个小时，\n\n11:45.693 --> 11:49.593\n都用于缓解急性胸闷气短的抢救急救。\n\n11:49.994 --> 11:52.244\n再一个是长效的白塔二受体，\n\n11:52.244 --> 11:53.968\n主动是激动机GL，\n\n11:53.968 --> 11:55.494\n我们常说的LADA。\n\n11:56.471 --> 11:59.820\n常代表药物就是沙美特罗或者是福莫特罗，\n\n12:00.070 --> 12:02.820\n它的优点是能持续12.24个小时，\n\n12:02.820 --> 12:03.895\n需要规律使用，\n\n12:03.895 --> 12:05.921\n用于长期控制日常症状。\n\n12:06.070 --> 12:09.370\n福莫特罗兼具短效起效特性。\n\n12:10.965 --> 12:14.815\n再一种常见的吸入剂药物是抗胆碱能药物，\n\n12:15.015 --> 12:15.739\n短效的，\n\n12:15.739 --> 12:17.140\n比如说是异丙吸入，\n\n12:17.140 --> 12:18.265\n用异丙托溴铵。\n\n12:18.994 --> 12:21.093\n它持续时间是6.8个小时，\n\n12:21.093 --> 12:22.943\n常与沙丁胺醇联合使用。\n\n12:23.093 --> 12:27.893\n长效的就是赛托溴铵、格隆溴铵持续24小时，\n\n12:27.893 --> 12:30.044\n能有效减少急性加重的频率。\n\n12:30.794 --> 12:33.544\n再一个是吸入糖皮质激素。\n\n12:34.252 --> 12:38.302\n它需要跟那个支气管舒张剂联合使用，\n\n12:38.552 --> 12:43.052\n代表药物就是吸入用布地奈德或者是氟替卡松。\n\n12:43.353 --> 12:45.203\n优点是需要与。\n\n12:46.765 --> 12:51.015\n长效白塔二受体阻滞剂联合制成复合制剂，\n\n12:51.015 --> 12:54.664\n如布地奈德福莫特罗、氟地卡、松沙美特罗。\n\n12:54.664 --> 12:59.015\n仅适用于气道存在明显炎症频繁急性加重的。\n\n12:59.831 --> 13:02.206\nCOPD患者可减轻气道炎症，\n\n13:02.206 --> 13:03.831\n降低急性加重风险，\n\n13:03.981 --> 13:07.932\n不可单独用于CAPCOPD的治治疗。\n\n13:10.507 --> 13:13.906\n第三种就是现在是常用的是三联复合制剂，\n\n13:13.906 --> 13:18.856\n代表药物是福布地、奈德福、莫特罗格隆、溴格隆溴铵。\n\n13:19.937 --> 13:20.387\n或者是。\n\n13:21.226 --> 13:23.802\n氟替卡松沙美特罗乌美溴铵。\n\n13:23.802 --> 13:25.726\n它的特点是同时包含了。\n\n13:27.018 --> 13:28.343\n同时包含吸入性糖皮质激素，\n\n13:28.343 --> 13:29.568\n长效白塔受体激动剂，\n\n13:29.669 --> 13:30.068\n嗯，\n\n13:30.068 --> 13:31.068\n还有长效的。\n\n13:31.830 --> 13:32.880\n抗胆碱能药物。\n\n13:34.741 --> 13:38.091\n三种成分能全面覆盖气道扩张和炎性控制，\n\n13:38.091 --> 13:43.966\n适用于中重度的慢阻肺患者的控制或还有或者是反复急性加重的患者，\n\n13:43.966 --> 13:45.041\n可以显著提升。\n\n13:46.468 --> 13:47.268\n生活质量。\n\n13:48.169 --> 13:48.669\n就是。\n\n13:49.568 --> 13:51.718\n这些药物需要在医生的指导下。\n\n13:53.559 --> 13:55.158\n根据病情选择药物，\n\n13:55.408 --> 13:57.609\n不可自行更换或停药。\n\n13:57.859 --> 14:00.258\n第二个是正确掌握吸入装置。\n\n14:01.885 --> 14:03.335\n的使用方法。\n\n14:04.211 --> 14:05.312\n否则会影响药效。\n\n14:08.132 --> 14:08.932\n第三个就是。\n\n14:09.948 --> 14:11.499\n吸入后要及时漱口，\n\n14:11.499 --> 14:13.148\n避免口腔真菌感染，\n\n14:13.148 --> 14:15.348\n尤其是含糖皮质激素的药物。\n\n14:15.598 --> 14:19.448\n第四个是部分药物可能会出现口干、心悸等副作用，\n\n14:19.499 --> 14:21.148\n若这种明症状明显，\n\n14:21.148 --> 14:23.549\n需及时调整就医方案。\n\n14:28.392 --> 14:30.992\n这个常见的这种吸入装置，\n\n14:31.392 --> 14:33.242\n它的这个分布操作啊。\n\n14:34.164 --> 14:34.364\n嗯。\n\n14:35.578 --> 14:37.679\n这个好多病人都不太了解，\n\n14:37.679 --> 14:38.328\n需要。\n\n14:39.763 --> 14:41.838\n需要大家需要讲注意一下啊，\n\n14:41.838 --> 14:44.713\n一个就是像那种压力定量气雾剂，\n\n14:45.062 --> 14:46.862\n如沙丁胺醇气雾剂，\n\n14:47.263 --> 14:52.288\n这个吸入装置分布操作哈第一步要取下气雾剂的盖子，\n\n14:52.288 --> 14:53.562\n用力摇匀药物。\n\n14:53.612 --> 14:55.812\n用力摇匀药物10.15秒，\n\n14:55.812 --> 14:57.513\n确保药液混合均匀。\n\n14:58.791 --> 14:59.041\n第二步，\n\n14:59.041 --> 15:01.541\n要轻轻的呼气至不能再呼，\n\n15:01.692 --> 15:03.541\n然后将喷嘴放入口中，\n\n15:03.841 --> 15:05.892\n双唇紧紧包住喷嘴，\n\n15:06.142 --> 15:07.367\n保持头部后仰，\n\n15:07.367 --> 15:08.242\n身体直立。\n\n15:09.307 --> 15:09.807\n第三步，\n\n15:09.908 --> 15:11.632\n缓慢深吸气的同时，\n\n15:11.632 --> 15:13.007\n按压气雾剂阀门，\n\n15:13.007 --> 15:13.857\n释放药物，\n\n15:14.007 --> 15:16.908\n吸气时间至少持续3.5秒。\n\n15:17.627 --> 15:17.976\n第四步，\n\n15:17.976 --> 15:19.927\n要屏住呼吸10秒，\n\n15:19.927 --> 15:21.976\n让药物充分沉积在气道，\n\n15:22.077 --> 15:23.827\n之后缓慢呼气。\n\n15:24.711 --> 15:25.211\n第五步，\n\n15:25.211 --> 15:27.111\n若需要吸入第二剂，\n\n15:27.262 --> 15:29.812\n间隔一分钟后重复上述步骤。\n\n15:31.030 --> 15:33.380\n第六步是食用后及时要漱口。\n\n15:35.195 --> 15:38.244\n那么还有一种慢阻肺药物使用，\n\n15:38.494 --> 15:40.395\n就是像叫准纳期，\n\n15:40.645 --> 15:44.270\n如氟地卡、松沙美特罗准纳器就是这种，\n\n15:44.270 --> 15:45.520\n这种是需要你的，\n\n15:45.520 --> 15:47.794\n就是一个手握住准纳器外壳，\n\n15:47.895 --> 15:49.645\n另一手向外推动滑盖，\n\n15:49.645 --> 15:50.945\n只是听到咔嗒声，\n\n15:51.145 --> 15:52.794\n表明装饰已备好药物。\n\n15:53.666 --> 15:57.166\n那么同样的方法就是呼气至不能再呼。\n\n15:58.346 --> 16:00.296\n注意不要对着吸嘴呼气啊，\n\n16:00.296 --> 16:01.945\n将吸嘴放入口中，\n\n16:02.245 --> 16:04.596\n深深深平稳的吸气，\n\n16:04.596 --> 16:06.445\n吸气后要屏住呼吸10秒。\n\n16:07.692 --> 16:08.942\n最后缓慢的呼气，\n\n16:08.942 --> 16:10.291\n然后关闭准纳器，\n\n16:10.392 --> 16:12.242\n就推动滑杆复位即可。\n\n16:13.043 --> 16:14.893\n也是使用后要及时漱口。\n\n16:17.530 --> 16:18.130\n还有一种，\n\n16:18.530 --> 16:20.080\n还有一种叫能贝乐，\n\n16:20.080 --> 16:23.080\n是赛托溴铵软物吸入器。\n\n16:23.429 --> 16:25.104\n它这个是打开防尘帽，\n\n16:25.104 --> 16:26.130\n拔出药瓶，\n\n16:26.429 --> 16:29.280\n将药瓶插入吸入器并卡紧，\n\n16:29.280 --> 16:30.880\n直到听见咔嗒声。\n\n16:31.935 --> 16:34.786\n第二步是按压吸入器侧面的针刺按钮。\n\n16:35.539 --> 16:36.763\n刺破药瓶密封膜，\n\n16:36.763 --> 16:37.789\n然后松开按钮。\n\n16:38.903 --> 16:40.028\n后面的方法就一样了，\n\n16:40.028 --> 16:41.528\n就是呼气至不能再呼，\n\n16:41.528 --> 16:43.578\n然后将吸嘴放入口中，\n\n16:43.578 --> 16:46.278\n双唇包紧用力且深长的吸气，\n\n16:46.278 --> 16:48.703\n同时按压吸入器顶部的剂量按钮，\n\n16:48.804 --> 16:50.504\n持续吸气至肺部充满。\n\n16:51.265 --> 16:54.640\n最后就是屏住呼吸10秒后缓慢呼气，\n\n16:54.640 --> 16:57.114\n取出吸入器及食用后及时漱口，\n\n16:57.114 --> 16:59.065\n用过的药品需要及时丢弃。\n\n17:00.411 --> 17:00.611\n嗯，\n\n17:01.210 --> 17:03.611\n这是常见的这种药物，\n\n17:03.611 --> 17:06.860\n就是学会要正确的使用这种吸入装置。\n\n17:07.779 --> 17:07.879\n嗯，\n\n17:07.879 --> 17:10.879\n好多病人他不太会就是用，\n\n17:10.879 --> 17:11.479\n比如说。\n\n17:12.697 --> 17:14.072\n要塞嘴里好多人，\n\n17:14.072 --> 17:15.546\n这个这鼻子这个地方，\n\n17:15.546 --> 17:17.847\n这个这个都是一些错误的操作方法。\n\n17:19.602 --> 17:20.901\n再一个是康复锻炼。\n\n17:22.864 --> 17:24.515\n包括锻炼刚才也讲过了，\n\n17:24.765 --> 17:27.114\n还有推荐运动。\n\n17:29.104 --> 17:30.279\n还有长期家庭氧疗，\n\n17:30.279 --> 17:34.854\n长期家庭氧疗这也是一个很重要的治疗慢阻肺的一个方法。\n\n17:36.173 --> 17:36.423\n嗯，\n\n17:36.423 --> 17:38.249\n这里也展开讲一下啊，\n\n17:38.249 --> 17:39.548\n长期家庭养疗呢，\n\n17:39.548 --> 17:40.323\n一般需要。\n\n17:41.760 --> 17:43.560\n准备一个制氧机。\n\n17:44.848 --> 17:45.272\n制氧机，\n\n17:45.272 --> 17:46.272\n准备一个制氧机，\n\n17:46.272 --> 17:48.848\n然后它是一个改善这种中重度，\n\n17:48.848 --> 17:53.098\n慢性阻塞性肺疾病的一个重要的治疗手段。\n\n17:53.447 --> 17:54.897\n主要是适用于。\n\n17:56.036 --> 18:00.385\n它是需要维持在动脉血氧分压是90.93，\n\n18:00.735 --> 18:01.385\n然后。\n\n18:02.338 --> 18:03.488\n无需追求百分之百。\n\n18:05.472 --> 18:09.121\n然后这个每日持持续吸氧要大于15个小时，\n\n18:09.421 --> 18:10.921\n大于等于十五个小时。\n\n18:12.512 --> 18:13.437\n要低流量吸氧，\n\n18:13.437 --> 18:15.113\n就是一到两升每分钟。\n\n18:15.412 --> 18:15.812\n嗯，\n\n18:15.812 --> 18:16.613\n那好的。\n\n18:16.762 --> 18:17.463\n同时呢，\n\n18:17.463 --> 18:19.963\n这个这个慢阻肺是种慢性病啊，\n\n18:20.062 --> 18:22.613\n需要和我们和医生做朋友，\n\n18:22.662 --> 18:24.887\n就是要定期复查疫苗接种，\n\n18:24.887 --> 18:25.713\n医患合作，\n\n18:25.713 --> 18:26.863\n医患合作是。\n\n18:28.000 --> 18:30.949\n制定调整治疗方案的一个很重要的方面，\n\n18:30.949 --> 18:32.650\n也是控制疾病一个重要方面。\n\n18:33.286 --> 18:33.536\n嗯，\n\n18:33.686 --> 18:34.135\n好的，\n\n18:34.135 --> 18:34.760\n就到这里，\n\n18:34.760 --> 18:35.485\n谢谢大家。\n\n","v0247cg10004d767p72ljht5p4f5cal0",1120,717,"2026-01-28 10:12:04","慢阻肺定义、诱因、治疗、康复","常见的慢性气道疾病，以持续的呼吸道症状和气流受限为特征， 其进展缓慢， 但可预防和治疗。","2026-06-11 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