WEBVTT00:00:03.120 --> 00:00:05.880大家好今天和大家一起来聊一聊00:00:05.880 --> 00:00:08.260慢阻肺的自我检测指南00:00:08.760 --> 00:00:09.440在门诊呢00:00:09.440 --> 00:00:11.320我们经常会碰到一些患者啊00:00:11.320 --> 00:00:14.800因为咳嗽咳痰喘过来就诊啊00:00:14.800 --> 00:00:18.820也会咨询一些相关慢阻肺的问题00:00:18.840 --> 00:00:19.600那么今天呢00:00:19.600 --> 00:00:22.240就在这里和大家一起来聊一聊00:00:22.240 --> 00:00:24.980我们如何去掌握健康的主动权00:00:25.000 --> 00:00:26.580早发现早治疗00:00:28.480 --> 00:00:29.720今天分享的内容呢00:00:29.720 --> 00:00:30.920有三个部分00:00:30.920 --> 00:00:33.900第一慢性阻塞性肺病的基础知识00:00:33.960 --> 00:00:35.980第二自我检测的方法00:00:36.000 --> 00:00:37.980第三预防与管理00:00:38.640 --> 00:00:40.340首先我们来了解一下00:00:40.400 --> 00:00:42.940什么是慢性阻塞性肺病00:00:43.320 --> 00:00:44.920慢性阻塞性肺病呢00:00:44.920 --> 00:00:47.940它是一种慢性的呼吸系统疾病00:00:48.040 --> 00:00:51.140主要的表现呢就是气流的受阻00:00:51.160 --> 00:00:53.120那么它在临床上会表现为什么00:00:53.120 --> 00:00:55.880特征呢主要是包括咳嗽00:00:55.880 --> 00:00:58.780咳痰有些会伴有呼吸困难00:00:59.000 --> 00:01:00.700需要长期的管理00:01:01.320 --> 00:01:02.560慢性阻塞性肺病呢00:01:02.560 --> 00:01:03.880它严重的患者呢00:01:03.880 --> 00:01:06.340会影响到生活的质量00:01:06.400 --> 00:01:09.200需要早期啊重视啊00:01:09.200 --> 00:01:10.900积极的去干预治疗00:01:11.200 --> 00:01:12.880在全球的数据来看00:01:12.880 --> 00:01:14.280慢性阻塞性肺病呢00:01:14.280 --> 00:01:17.000是全球第三大的啊00:01:17.000 --> 00:01:18.940慢性致死性的疾病00:01:18.960 --> 00:01:21.100需要加强防御00:01:23.000 --> 00:01:24.880慢性阻塞性的肺病啊00:01:24.880 --> 00:01:26.500它有哪些诱因呢00:01:26.640 --> 00:01:28.120啊第一个诱因啊00:01:28.120 --> 00:01:30.240最重要的诱因就是吸烟啊00:01:30.240 --> 00:01:31.000我们知道啊00:01:31.000 --> 00:01:34.440吸烟它对于肺的影响是很大的啊00:01:34.440 --> 00:01:36.240吸烟它是慢阻肺的00:01:36.240 --> 00:01:38.500一个主要的一个危险因素00:01:38.560 --> 00:01:40.360所以一般确诊了啊00:01:40.360 --> 00:01:41.600慢阻肺的患者呢00:01:41.600 --> 00:01:45.260我们肯定是要尽量劝劝阻他吸烟的00:01:45.640 --> 00:01:46.560第二个原因呢00:01:46.560 --> 00:01:48.580就是空气的污染啊00:01:48.640 --> 00:01:51.720长期暴露在有污染的空气环境中呢00:01:51.720 --> 00:01:53.240会导致呃00:01:53.240 --> 00:01:55.700我们患病的风险会增加00:01:55.840 --> 00:01:58.000第三呢就是职业暴露啊00:01:58.000 --> 00:01:59.520有些啊朋友呢00:01:59.520 --> 00:02:03.040他是长期接触工业或者粉尘00:02:03.040 --> 00:02:05.080啊或者是一些化学物质的00:02:05.080 --> 00:02:08.340也容易罹患慢性阻塞性的肺病00:02:08.440 --> 00:02:09.320第四点呢00:02:09.320 --> 00:02:11.000是和遗传相关的啊00:02:11.000 --> 00:02:13.640有些是有一些家族病史的00:02:13.640 --> 00:02:16.200那么他患有慢阻肺的概率呢00:02:16.200 --> 00:02:17.460也会增加00:02:18.240 --> 00:02:21.940那如何去识别慢阻肺的常见症状呢00:02:22.280 --> 00:02:24.880第一最主要的就是一个慢性的咳嗽00:02:24.880 --> 00:02:27.920我们这里指的慢性咳嗽的定义是00:02:27.920 --> 00:02:30.040要超过3个月以上的00:02:30.040 --> 00:02:31.700一个慢性咳嗽00:02:31.880 --> 00:02:33.940同时会伴有一些咳痰00:02:34.240 --> 00:02:36.160那么咳痰量增多啊00:02:36.160 --> 00:02:39.500也是常常是这个慢阻肺的症状之一00:02:39.760 --> 00:02:41.200有些患者严重的呢00:02:41.200 --> 00:02:43.320会伴有呼吸困难啊00:02:43.320 --> 00:02:45.960同时会感到一些胸闷啊00:02:45.960 --> 00:02:47.540气喘这些症状00:02:48.640 --> 00:02:50.440慢阻肺肺对我们00:02:50.440 --> 00:02:53.680那么慢阻肺对于健康的危害啊00:02:53.680 --> 00:02:55.160是非常严重的00:02:55.160 --> 00:02:57.560那导致了患者的生活质量啊00:02:57.560 --> 00:02:59.220严重的下降啊00:02:59.240 --> 00:03:00.640动一动他就喘啊00:03:00.640 --> 00:03:03.400工作没有办法去应对啊00:03:03.400 --> 00:03:04.000第二呢00:03:04.000 --> 00:03:06.520它慢阻肺是需要长期治疗的啊00:03:06.520 --> 00:03:09.320因此会加重经济的负担啊00:03:09.320 --> 00:03:11.460所以我们要积极的进行预防00:03:11.560 --> 00:03:12.400第三呢00:03:12.400 --> 00:03:15.640慢阻肺它还会并发其他的疾病00:03:15.640 --> 00:03:19.200比如说肺源性的心脏病啊00:03:19.200 --> 00:03:22.240第四呢还会增加死亡的风险啊00:03:22.240 --> 00:03:23.480啊之前也提到00:03:23.480 --> 00:03:26.200慢阻肺是全球慢性病里面00:03:26.200 --> 00:03:27.960致死性是第三位的啊00:03:27.960 --> 00:03:30.740排位所以我们更需要去警惕00:03:32.720 --> 00:03:36.360慢阻肺有哪些自我检测方法呢00:03:36.360 --> 00:03:37.680我们需要掌握一些00:03:37.680 --> 00:03:40.260简单有效的自我检测手段00:03:40.640 --> 00:03:42.360通过症状来判断00:03:42.360 --> 00:03:44.220我们是否需要去就医00:03:44.680 --> 00:03:46.320首先我们要来了解啊00:03:46.320 --> 00:03:49.780自己可以记录一下症状发生的频率00:03:50.040 --> 00:03:50.600第二呢00:03:50.600 --> 00:03:53.480就是记录症状的严重程度啊00:03:53.480 --> 00:03:56.300比如说爬到几楼会出现气喘00:03:56.440 --> 00:03:58.860或者是说话说到几句00:03:59.040 --> 00:04:02.320大概什么长度的句子会出现气喘00:04:02.320 --> 00:04:03.240那么这个可以00:04:03.240 --> 00:04:05.520初步的判断这个气喘啊00:04:05.520 --> 00:04:07.540症状的一个严重程度00:04:07.640 --> 00:04:10.080第三呢就是症状的变化啊00:04:10.080 --> 00:04:13.340在什么情况下会出现症状的加重00:04:13.760 --> 00:04:16.400第四呢就是就医的指南啊00:04:16.400 --> 00:04:19.240出现在什么严重的状症状之时呢00:04:19.240 --> 00:04:22.020我们就必须要去就医检查了00:04:22.400 --> 00:04:24.520第四呢就是就医指南啊00:04:24.520 --> 00:04:25.800我们当我们出现00:04:25.800 --> 00:04:28.120什么样的严重症状的时候呢00:04:28.120 --> 00:04:32.300就提示我们必须要去就医检查了00:04:34.160 --> 00:04:36.160如果来医院就诊呢00:04:36.160 --> 00:04:37.960我们会推荐啊00:04:37.960 --> 00:04:40.140做肺功能的测试00:04:40.240 --> 00:04:42.220那么肺功能的测试呢00:04:42.320 --> 00:04:44.920啊它有包括简易的测试啊00:04:44.920 --> 00:04:46.700也有专业的检测00:04:47.040 --> 00:04:48.760那么在医院的专业检测00:04:48.760 --> 00:04:50.280就是我们说的啊00:04:50.280 --> 00:04:51.660肺功能啊00:04:51.680 --> 00:04:52.760简单的理解呢00:04:52.760 --> 00:04:55.740也可以理解为吹一个肺活量啊00:04:55.760 --> 00:04:57.680那么他可以判断00:04:57.680 --> 00:04:58.560这个患者的00:04:58.560 --> 00:05:01.040一个肺功能的一个情况啊00:05:01.040 --> 00:05:04.080我们根据吹出来的数据的比值00:05:04.080 --> 00:05:05.160我们来诊断00:05:05.160 --> 00:05:06.520他是否达到了00:05:06.520 --> 00:05:08.620慢性阻塞性肺病的诊断00:05:08.920 --> 00:05:11.280以及他的严重程度啊00:05:11.280 --> 00:05:12.380他的分级00:05:12.480 --> 00:05:13.720根据他的分级00:05:13.720 --> 00:05:17.340再给患者制定相对应的方案00:05:17.680 --> 00:05:20.560那么如果说确诊了慢阻肺的患者呢00:05:20.560 --> 00:05:21.820我们是推荐00:05:22.040 --> 00:05:26.120需要每年定期的去做肺功能的检测00:05:26.120 --> 00:05:27.200评估的啊00:05:27.200 --> 00:05:29.000如果说当中有变化00:05:29.000 --> 00:05:31.940我们可能还需要缩短这个频率00:05:32.920 --> 00:05:34.200在家中检测呢00:05:34.200 --> 00:05:35.600我们会推荐啊00:05:35.600 --> 00:05:39.000可以买一个家用的血氧饱和度检测00:05:39.000 --> 00:05:41.280啊就是监测手指啊00:05:41.280 --> 00:05:44.160这个血氧的饱和度检测方法呢00:05:44.160 --> 00:05:45.360比较简单啊00:05:45.360 --> 00:05:47.120有一个指脉氧仪啊00:05:47.120 --> 00:05:48.560这个网上都能买到00:05:48.560 --> 00:05:50.620或者是医药商店都能买到00:05:50.840 --> 00:05:51.960那么我们要了解啊00:05:51.960 --> 00:05:53.940一个正常的范围00:05:54.000 --> 00:05:56.040然后呢再去判断啊00:05:56.040 --> 00:05:59.360如果说出现了氧饱和度的下降啊00:05:59.360 --> 00:06:01.000我们就提示啊00:06:01.000 --> 00:06:03.160这个有可能就肺功能00:06:03.160 --> 00:06:05.140情况是有退化的00:06:08.960 --> 00:06:10.880接下来我们来了解一下00:06:10.880 --> 00:06:14.700慢性阻塞性肺病的风险因素的评估00:06:15.360 --> 00:06:17.800那第一我们会咨询患者啊00:06:17.800 --> 00:06:19.080了解一下病情00:06:19.080 --> 00:06:23.380他是否有一个长期慢性的吸烟史啊00:06:23.520 --> 00:06:25.040吸烟了多少时间00:06:25.040 --> 00:06:27.360接下来呢我们会啊00:06:27.360 --> 00:06:29.280接下来我们来了解一下啊00:06:29.280 --> 00:06:32.760怎么样去对患者是自身的评估00:06:32.760 --> 00:06:33.480对吧啊00:06:33.480 --> 00:06:34.000接下来00:06:34.000 --> 00:06:36.800我们来了解风险因素的评估00:06:36.800 --> 00:06:37.940这一块内容00:06:38.000 --> 00:06:39.600那么我们如何去评估00:06:39.600 --> 00:06:41.960自身是否患有慢阻肺呢00:06:41.960 --> 00:06:43.700的风险是多大呢00:06:44.680 --> 00:06:46.040我们来谈一谈啊00:06:46.040 --> 00:06:47.600如何评估自身00:06:47.600 --> 00:06:49.900患有慢阻肺的一个风险00:06:50.200 --> 00:06:51.720首先我们要了解啊00:06:51.720 --> 00:06:54.720是否有一个长期的吸烟史啊00:06:54.720 --> 00:06:56.640如果有长期吸烟史的00:06:56.640 --> 00:06:59.340这慢阻肺的概率呢就增加了00:06:59.520 --> 00:07:02.160第二呢就是一个环境因素啊00:07:02.160 --> 00:07:04.880是否长期暴露在一些空气00:07:04.880 --> 00:07:06.960比较污染的环境里面啊00:07:06.960 --> 00:07:10.020或者是有一些工业的尾气啊00:07:10.320 --> 00:07:11.800化工啊成分啊00:07:11.800 --> 00:07:12.720或者是粉尘啊00:07:12.720 --> 00:07:13.080这些的00:07:13.080 --> 00:07:16.120一个长期的一个职业病的接触史啊00:07:16.120 --> 00:07:18.780也是增加了慢阻肺的一个风险00:07:19.120 --> 00:07:19.600第三呢00:07:19.600 --> 00:07:23.740就是要问问患者是否有啊家族病史00:07:26.600 --> 00:07:29.440那么通过啊以上这些因素的评估啊00:07:29.440 --> 00:07:31.080我们可以了解到啊00:07:31.080 --> 00:07:33.880这个患者或者我们自我评估的时候00:07:33.880 --> 00:07:34.720能够了解到00:07:34.720 --> 00:07:37.160我患有慢性阻塞性肺病00:07:37.160 --> 00:07:39.040的风险有多大啊00:07:39.040 --> 00:07:41.540我们有专门的风险评估表00:07:42.400 --> 00:07:44.600那了解了患病的风险00:07:44.600 --> 00:07:45.960我们就应该啊00:07:45.960 --> 00:07:48.920去如何正确的预防与管理00:07:48.920 --> 00:07:50.880我们要去学习啊00:07:50.880 --> 00:07:53.060他的一个日常的一个护理00:07:55.000 --> 00:07:57.760首先我们要通过改变生活方式00:07:57.760 --> 00:07:59.340去预防慢阻肺00:07:59.880 --> 00:08:01.320第一重要的啊00:08:01.320 --> 00:08:03.340就是要戒烟啊00:08:03.560 --> 00:08:06.480如果说是这个患者有长期吸烟史的00:08:06.480 --> 00:08:07.840我们一定要劝阻他00:08:07.840 --> 00:08:09.180啊一定要戒烟00:08:09.440 --> 00:08:11.960第二呢就是要健康的饮食00:08:11.960 --> 00:08:13.600要增强免疫力啊00:08:13.600 --> 00:08:14.740预防感染00:08:14.840 --> 00:08:16.640因为一旦出现感染00:08:16.640 --> 00:08:17.320肺部感染00:08:17.320 --> 00:08:20.300他就会加重这个肺功能的恶化00:08:20.600 --> 00:08:23.940第三呢就是要做一些适当的运动00:08:24.000 --> 00:08:25.600那适当的运动呢00:08:25.600 --> 00:08:27.480啊包括一些呃00:08:27.480 --> 00:08:29.440强度不要那么大的啊00:08:29.440 --> 00:08:30.600比如说中等00:08:30.600 --> 00:08:32.480或者稍微偏低一点强度的00:08:32.480 --> 00:08:34.120一些有氧运动啊00:08:34.120 --> 00:08:37.540可以增加改善我们的心肺功能00:08:37.799 --> 00:08:40.879第四呢就是避免接触污染的环境00:08:40.879 --> 00:08:42.999空气啊一些尾气啊00:08:42.999 --> 00:08:44.119包括一些啊00:08:44.119 --> 00:08:45.120烧菜的油烟00:08:45.120 --> 00:08:46.520还有被动的吸烟00:08:46.520 --> 00:08:49.260这些我们都要尽量去避免的00:08:50.560 --> 00:08:51.240再其次呢00:08:51.240 --> 00:08:54.020就是需要定期的去体检了啊00:08:54.160 --> 00:08:56.560啊我们要需要定期的去做00:08:56.560 --> 00:08:58.160肺功能的检测啊00:08:58.160 --> 00:09:01.120同时还要做全面身体的评估啊00:09:01.120 --> 00:09:03.040了解身体的一个啊00:09:03.040 --> 00:09:05.100大致的一个健康状况00:09:05.440 --> 00:09:06.720那么体检的频率呢00:09:06.720 --> 00:09:08.780一般我们是推荐啊00:09:08.800 --> 00:09:11.120啊可以一年左右啊00:09:11.120 --> 00:09:12.720常规的做一次体检00:09:12.720 --> 00:09:13.880那像慢阻肺的患者00:09:13.880 --> 00:09:15.920如果说他发作频率比较高的00:09:15.920 --> 00:09:18.500我们可以适当的缩短他的频率00:09:19.520 --> 00:09:20.640在药物管理方面00:09:20.640 --> 00:09:22.520我们呀可以了解一下啊00:09:22.520 --> 00:09:25.000很多呢老病人他都知道啊00:09:25.000 --> 00:09:27.480最主要的管理慢阻肺的药物00:09:27.480 --> 00:09:29.500还有一个药物就是气雾剂00:09:29.680 --> 00:09:30.440那么气雾剂呢00:09:30.440 --> 00:09:32.280我们也分为很多种啊00:09:32.280 --> 00:09:34.380根据它的成分来分啊00:09:34.440 --> 00:09:37.280是单一的还是联合用药的啊00:09:37.280 --> 00:09:39.020是否含有激素类的00:09:39.040 --> 00:09:39.480这个呢00:09:39.480 --> 00:09:43.320是需要根据患者的肺功能的评估啊00:09:43.320 --> 00:09:45.200它的一个分级管理00:09:45.200 --> 00:09:45.560然后00:09:45.560 --> 00:09:49.080医生会制定出相应的一个方案啊00:09:49.080 --> 00:09:50.820一个药物的一个选择00:09:51.000 --> 00:09:53.440那么除除了气雾剂啊00:09:53.440 --> 00:09:54.400我们在使用00:09:54.400 --> 00:09:56.600除了在使用药物方面啊00:09:56.600 --> 00:09:57.440除了气雾剂00:09:57.440 --> 00:09:59.940我们还有一些常规的口服药物00:10:00.040 --> 00:10:02.920包括啊平时的止咳化痰啊00:10:02.920 --> 00:10:04.800平喘的一些药物啊00:10:04.800 --> 00:10:07.560如果说抵抗力比较差的人群啊00:10:07.560 --> 00:10:08.880容易反复感染的00:10:08.880 --> 00:10:10.500我们也会建议00:10:10.520 --> 00:10:13.200适当的用一些增加免疫的药物啊00:10:13.200 --> 00:10:14.860提高患者免疫力00:10:14.960 --> 00:10:17.620减少他患有感染的一个概率00:10:18.560 --> 00:10:20.100那如果说啊00:10:20.320 --> 00:10:21.680患了慢阻肺啊00:10:21.680 --> 00:10:23.580你一定要嗯00:10:24.520 --> 00:10:26.260如果确诊慢阻肺00:10:26.280 --> 00:10:29.780我们一定要严格的遵守医嘱啊00:10:30.000 --> 00:10:32.640并且按照医嘱的要求来00:10:32.640 --> 00:10:34.720进行规律的随访啊00:10:34.720 --> 00:10:35.040啊00:10:35.040 --> 00:10:38.400切记不能够自己随意的去停用药王00:10:38.400 --> 00:10:39.360有些患者呢00:10:39.360 --> 00:10:41.280他经过药物的积极治疗00:10:41.280 --> 00:10:42.240一段时间之后呢00:10:42.240 --> 00:10:43.960他自我感觉非常良好啊00:10:43.960 --> 00:10:46.840觉得气喘啊这些症状都消失了啊00:10:46.840 --> 00:10:49.520就自己把药物全部停用了啊00:10:49.520 --> 00:10:50.960那这样子的情况下呢00:10:50.960 --> 00:10:52.800他是非常容易复发的啊00:10:52.800 --> 00:10:54.920所以这个是很不推荐的00:10:54.920 --> 00:10:58.300我们一定要规范化的治疗和随访00:10:59.960 --> 00:11:01.600除了药物的治疗方面00:11:01.600 --> 00:11:03.600心理支持也是非常重要的啊00:11:03.600 --> 00:11:06.120我们还要重视心理健康00:11:06.120 --> 00:11:08.120在慢阻肺管理中的一个作用啊00:11:08.120 --> 00:11:10.200因为很多是老病人啊00:11:10.200 --> 00:11:11.640他随着他的年龄增长00:11:11.640 --> 00:11:13.340肺功能也有退化啊00:11:13.360 --> 00:11:15.440啊包括有一些感染的情况00:11:15.440 --> 00:11:17.760也会加重肺功能恶化00:11:17.760 --> 00:11:19.840那么他会出现症状加重啊00:11:19.840 --> 00:11:21.080一些胸闷啊00:11:21.080 --> 00:11:22.380气喘的情况00:11:22.400 --> 00:11:24.560那么对于这类患者来说啊00:11:24.560 --> 00:11:25.680我们一定要注重00:11:25.680 --> 00:11:27.520他们心理健康的情况00:11:27.520 --> 00:11:30.000要对他们进行及时的啊00:11:30.000 --> 00:11:31.680一个心理的一个辅导啊00:11:31.680 --> 00:11:33.420要有一个压力的管理00:11:33.560 --> 00:11:37.100包括社会上的支持以及家庭的支持00:11:39.640 --> 00:11:41.800那么对于慢阻肺的患者啊00:11:41.800 --> 00:11:42.560在家里00:11:42.560 --> 00:11:45.800进行一个自我的氧饱和度的监测00:11:45.800 --> 00:11:47.400是非常重要的啊00:11:47.400 --> 00:11:48.360之前也提到00:11:48.360 --> 00:11:48.880建议00:11:48.880 --> 00:11:52.160家中备有一个手指的指脉氧仪啊00:11:52.160 --> 00:11:53.000可以有效的00:11:53.000 --> 00:11:55.600监测那植脉氧的情况00:11:55.600 --> 00:11:58.040我们正常的植脉氧饱和度呢00:11:58.040 --> 00:12:02.280是在于95%到100%之间的啊00:12:02.280 --> 00:12:03.840如果说定义这个数值00:12:03.840 --> 00:12:05.200我们就要警惕了啊00:12:05.200 --> 00:12:09.420可以考虑在家中购置吸氧装置啊00:12:09.440 --> 00:12:10.600吸氧以后00:12:10.600 --> 00:12:13.360待腹侧再看看氧饱和度的情况00:12:13.360 --> 00:12:15.080是否有回升啊00:12:15.080 --> 00:12:17.960如果说吸氧以后没有任何的改善啊00:12:17.960 --> 00:12:19.720或者是胸闷啊00:12:19.720 --> 00:12:21.400气喘的情况啊00:12:21.400 --> 00:12:23.320症状有加重的啊00:12:23.320 --> 00:12:25.440或者是量饱和度啊00:12:25.440 --> 00:12:26.360继续下降00:12:26.360 --> 00:12:28.200跌至90%以下的00:12:28.200 --> 00:12:30.960那么像这种情况就是比较危急的了00:12:30.960 --> 00:12:34.440我们就建议尽快的去医院就诊啊00:12:34.440 --> 00:12:36.680进一步的完善一些检查00:12:36.680 --> 00:12:38.740比如说胸部的CT00:12:38.760 --> 00:12:40.160血里面的炎症指标00:12:40.160 --> 00:12:43.480来查一下是否存在了严重的感染啊00:12:43.480 --> 00:12:47.200或者有些是慢阻肺合并有肺大泡的00:12:47.200 --> 00:12:49.840出现了一个自发性的气胸破裂了00:12:49.840 --> 00:12:52.640也会导致阳保合度下降啊00:12:52.640 --> 00:12:54.600另外呢也推荐啊啊00:12:54.600 --> 00:12:55.960确诊慢阻肺的患者00:12:55.960 --> 00:12:57.760特别是中重度的患者啊00:12:57.760 --> 00:13:00.840可以在家中进行养疗啊00:13:00.840 --> 00:13:01.840这个氧疗的话呢00:13:01.840 --> 00:13:04.760不推荐从高浓度的氧流量啊00:13:04.760 --> 00:13:07.860我们推荐一个低流量的氧浓度00:13:08.080 --> 00:13:08.640而最好是00:13:08.640 --> 00:13:11.860每天能够有一个长时间的养料00:13:11.880 --> 00:13:13.440而如果时间中午的话00:13:13.440 --> 00:13:16.840我们可以推荐10到15个小时左右的00:13:16.840 --> 00:13:19.900一个长期的低流量的养料00:13:20.000 --> 00:13:21.440也是有助于00:13:21.440 --> 00:13:24.420改善患者的肺功能情况的00:13:25.680 --> 00:13:27.200慢阻肺患者呢00:13:27.200 --> 00:13:30.600啊什么季节容易急性发作呢00:13:30.600 --> 00:13:32.440一般是在冬季啊00:13:32.440 --> 00:13:34.840因为冬季非常的寒冷啊00:13:34.840 --> 00:13:37.440所以呢患者呢是容易啊00:13:37.440 --> 00:13:41.520呃在季节出现一些急性的发作00:13:41.520 --> 00:13:44.400甚至于一些并发严重的并发症00:13:44.400 --> 00:13:46.500比如说出现呼吸衰竭00:13:46.720 --> 00:13:49.060那对于这些急性00:13:49.240 --> 00:13:51.640对于如何减少急性发作呢00:13:51.640 --> 00:13:53.220我们也有一些建议00:13:53.360 --> 00:13:56.280首先我们要在日常生活中啊00:13:56.280 --> 00:13:58.600平衡均衡饮食啊00:13:58.600 --> 00:14:00.280提高一些免疫力啊00:14:00.280 --> 00:14:02.740让自己尽量减少患病00:14:03.520 --> 00:14:07.680嗯尽可能的少去人群聚众的地方00:14:07.680 --> 00:14:10.080特别是在空气不流动地方00:14:10.080 --> 00:14:12.760是很容易出现上呼吸道感染的00:14:12.760 --> 00:14:14.060一个传播的00:14:14.400 --> 00:14:14.840第二呢00:14:14.840 --> 00:14:18.680就是要积极的做一些适合的运动啊00:14:18.680 --> 00:14:20.680一些中等左右00:14:20.680 --> 00:14:24.400或者是在低点强度的有氧的活动啊00:14:24.400 --> 00:14:27.800可以让机体的抵抗力啊00:14:27.800 --> 00:14:28.800心肺功能呢00:14:28.800 --> 00:14:31.640得到提高和改善啊00:14:31.640 --> 00:14:34.760第三呢就是要积极的配合治疗00:14:34.760 --> 00:14:37.720规范的随访用药啊00:14:37.720 --> 00:14:38.160第四呢00:14:38.160 --> 00:14:40.720我们也要重视一个疫苗的接种啊00:14:40.720 --> 00:14:42.540特别是一些老年人群00:14:43.000 --> 00:14:44.440在秋季来临的时候呢00:14:44.440 --> 00:14:46.620就可以考虑去预约接种00:14:46.720 --> 00:14:49.560那包括像肺炎疫苗啊00:14:49.560 --> 00:14:51.360有些呢是流感疫苗啊00:14:51.360 --> 00:14:54.260这些呢都是可以有效的00:14:54.440 --> 00:14:56.560减少我们患有00:14:56.560 --> 00:14:59.580上呼吸道感染疾病的概率的00:15:01.840 --> 00:15:03.160慢阻肺的患者啊00:15:03.160 --> 00:15:07.800如果说出现了急性的咳痰喘加重啊00:15:07.800 --> 00:15:09.000或者是伴有发热00:15:09.000 --> 00:15:10.400我们就要警惕了00:15:10.400 --> 00:15:12.300这有可能就是一个00:15:12.320 --> 00:15:14.240慢阻肺的一个急性发作了啊00:15:14.240 --> 00:15:14.840第二个时候00:15:14.840 --> 00:15:16.940我们就要尽快的医院就诊00:15:17.120 --> 00:15:17.720就诊之后呢00:15:17.720 --> 00:15:19.560我们就会给患者啊00:15:19.560 --> 00:15:21.840完善相关的影像学啊00:15:21.840 --> 00:15:24.440非CT或者肺胸片的检查啊00:15:24.440 --> 00:15:26.640要查血里面的炎症指标啊00:15:26.640 --> 00:15:29.080评估患者目前的一个00:15:29.080 --> 00:15:31.100是否有感染的情况00:15:31.320 --> 00:15:32.580确诊之后呢00:15:32.640 --> 00:15:34.760我们就要积极的用药物治疗00:15:34.760 --> 00:15:37.960包括积极的抗炎抗感染治疗啊00:15:37.960 --> 00:15:41.880积极的用平喘药物止咳化痰啊00:15:41.880 --> 00:15:43.920同时也要加强护理呢00:15:43.920 --> 00:15:47.040预防这个进一步的交叉感染啊00:15:47.040 --> 00:15:48.940要提高患者的一个免疫力00:15:50.880 --> 00:15:51.320好的00:15:51.320 --> 00:15:54.040以上内容就为大家分享到这些00:15:54.040 --> 00:15:56.140谢谢大家