慢性阻塞性肺病(COPD)的诊断和治疗指南
授权机构:Institute for Clinical Systems Improvement 临床系统改进协会
COPD (chronic obstructive pulmonary disease) includes both emphysema and chronic obstructive bronchitis. COPD is the fourth leading cause of death in the United States and is the only common chronic illness for which mortality rates, social burden and economic burden continue to increase (Global Initiative for Chronic Obstructive Lung Disease, 2011 [Guideline]).
Historically viewed as a man's disease, more women have died of COPD than men each year since 2000 (National Center for Health Statistics, 2004). Cigarette smoking is the cause of 80-90% of COPD cases, with occupational exposure accounting for 10-20% and Alpha 1-antitrypsin deficiency accounting for 3-4% (American Thoracic Society, 2003 [Guideline]; American Thoracic Society, 1995 [Guideline]). Early diagnosis and treatment, including pulmonary rehabilitation and pharmacologic intervention, can improve the quality of life in COPD patients (Lacasse, 1996 [Meta-analysis]). Smoking cessation and oxygen for severe hypoxemia can prolong life (Global Initiative for Chronic Obstructive Lung Disease, 2011 [Guideline]). Therefore, COPD should be considered a preventable and treatable illness.
Given the large burden COPD places on the individual patient and the population, the goal of the guideline is threefold. The first is to improve population health through education, awareness, prevention and evidence-based treatment. Secondly, the guideline should improve patient care experience and quality of care. The final area is to improve affordability through appropriate diagnosis and treatment that leads to decreasing COPD per-capita costs.
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