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COPD 2016:海基会分类对慢性阻塞性肺疾病(COPD) Management_Md Rashidul Hassan_胸部疾病研究所&医院,达卡,孟加拉国

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慢性阻塞性肺疾病(COPD)是最常见的呼吸道疾病中遇到的医生。慢性阻塞性肺疾病(COPD)可能是一种慢性炎症性肺疾病导致阻塞气流从肺部。症状包括呼吸困难、咳嗽、痰(痰)生产和喘息。通常是由于长期接触刺激性气体或颗粒,从烟最频繁。慢性阻塞性肺病的人患心脏病的风险增加,癌和其他疾病的传播。肺气肿和支气管炎2常见条件导致慢性阻塞性肺病。这两种情况通常发生在一起,在严重COPD患者中可能会有所不同。支气管炎是班轮的支气管的炎症,携带空气的肺气囊(肺泡)。它的特点是每天咳嗽和痰(痰)生产。肺气肿可能条件在顶部的肺泡的小小气道(肺细支气管)被破坏的结果损害暴露在香烟烟雾和其他刺激性气体和微粒。 This disease may be a burden for both developed and developing countries. In 2007, a study on COPD referred to as BOLD-BD (Burden of Obstructed Lung Disease in Bangladesh) revealed the prevalence of COPD generally population to be 4.32% Chronic Obstructive Lung Diseases (COPD) may cause significant inflammation and narrowing of small airways which isn't reflected alright by FEV1. Moreover, FEV1 correlated well with exertional dyspnea, not with chronic productive cough even with wheeze. Patients with chronic productive cough are more susceptible to exacerbations than emphysema patient, so management of Chronic Obstructive Lung Diseases (COPD) depends on both symptoms and exacerbations besides FEV1. GOLD classification ABCD sub-classification isn't friendly for GPs. Considering limitations of FEV1, presence of complications (respiratory failure, other comorbidities), frequency of exacerbations and impact of disease on patients’ life a replacement management plan for Chronic Obstructive Lung Diseases (COPD) patients is formulated which is simpler than Gold management plan. So, a modified staging and management of Chronic Obstructive Lung Diseases (COPD) is formulated which is predicated on symptoms (S) frequency of exacerbations (E) and performance (Lung Function= FEV1) and counting on these three parameters, SEF (symptom, exacerbation and Function) classification has been made. consistent with SEF classification, COPD patients are dividing into four stages on the idea of FEV1 and every stage is again sub-classified on the idea of symptoms and exacerbation. Methodology: SEF trial of COPD was conducted from July 2011 to December 2012. it had been a prospective case control; cross over trial over one-year period. Results: We recruited 153 as control patients in SEF Study. 12 patients excluded from case series as investigation demonstrated primary disease wasn't COPD. 111 (72.6%) patient skilled treatment and 27 (17.6%) patient not skilled treatment and three (2.0%) patient died during treatment 1 patient died thanks to cerebral stroke, 1 patient died thanks to taking treatment of Osteoporosis after infusion of Zolendronic Acid and died thanks to high fever and respiratory failure in ICU 2 days after infusion and 1 patient died thanks to Exacerbation of COPD in ICU of NIDCH. Conclusion SEF classification could also be an efficient tool that it are often an honest guide for a Generalist and Pulmonologist to optimize selection of drugs in COPD Patient. But needs further study to validate the result. Md Rashidul Hassan

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