Hōʻike ʻia kahi meta-analysis i paʻi ʻia ma Internal Medicine e pili ana nā antibiotics a me nā glucocorticoids systemic me ka liʻiliʻi o ka mālama ʻana i nā poʻe mākua meCOPDexacerbations i hoʻohālikelike ʻia me ka placebo a i ʻole ka hana therapeutic.

No ka hoʻokō ʻana i kahi loiloi ʻōnaehana a me ka meta-analysis, ua loiloi ʻo Claudia C. Dobler, MD, Bond University, Australia, a me nā mea ʻē aʻe i 68 mau hoʻāʻo i hoʻopaʻa ʻia, me 10,758 mau maʻi maʻi me nā exacerbations acute.COPDi mālama ʻia ma ka haukapila a i ʻole ma waho.Ua hoʻohālikelike ka haʻawina i nā hana lāʻau lapaʻau me kahi placebo, mālama maʻamau a i ʻole nā ​​​​hana lāʻau lapaʻau ʻē aʻe.

Nā pōmaikaʻi o nā lāʻau antibiotic a me nā glucocorticoids systemic

Ma kahi hoʻohālikelike o nā lā 7-10 o nā lāʻau antibiotic systemic a me ka placebo a i ʻole ka mālama maʻamau no nā maʻi maʻi maʻi a i ʻole nā ​​​​maʻi maʻi maʻi, ma ka hopena o ka mālama ʻana, pili nā lāʻau antibiotic i ke kala ʻana o ka exacerbation acute o ka maʻi, akā ʻaʻohe mea pili i ka ka paʻakikī o ka exacerbation a me ke kaiapuni lapaʻau (OR = 2.03; 95% CI, 1.47- -2.8; kūlana haʻahaʻa o nā hōʻike).Ma hope o ka pau ʻana o ka therapeutic intervention, i ke aʻo ʻana i nā maʻi ma waho me nā exacerbations maʻemaʻe, hiki i ka ʻōnaehana antibiotic therapy ke hoʻemi i ka nui o ka hiki ʻole o ka mālama ʻana (OR = 0.54; 95% CI, 0.34-0.86; ikaika hōʻike kūpono).ʻO nā maʻi maʻi a me nā maʻi ma waho me nā exacerbations haʻahaʻa a haʻahaʻa a haʻahaʻa paha, hiki i nā lāʻau antibiotic ke hōʻemi i ka pilikia o ka hanu, ka ʻū a me nā hōʻailona ʻē aʻe.

Pēlā nō, no nā maʻi inpatient a me nā maʻi maʻi waho, hoʻohālikelike ʻia nā glucocorticoids systemic me kahi placebo a i ʻole ka mālama maʻamau.Ma hope o 9-56 mau lā o ka mālama ʻana, ʻoi aku ka liʻiliʻi o nā glucocorticoids systemic (OR = 0.01; 95% CI, 0-0.13; haʻahaʻa ka maikaʻi o nā hōʻike), me ka nānā ʻole i ke ʻano o ka mālama ʻana a i ʻole ke kiʻekiʻe o ka exacerbation acute.I ka pau ʻana o nā lā 7-9 o ka mālama ʻana, ua hoʻomaha ʻia nā maʻi me nā exacerbations haʻahaʻa a koʻikoʻi i loko o ke keʻena maʻi outpatient a me ka haukapila.Eia nō naʻe, pili nā glucocorticoids systemic me ka hoʻonui ʻana i ka nui o nā hopena ʻino a me ka endocrine.

Manaʻo nā mea noiʻi e pili ana i kā lākou ʻike, pono e hōʻoia nā kauka a me nā hoa hana e hoʻohana ʻia nā lāʻau antibiotic a me nā glucocorticoids systemic i nā exacerbation acute.COPD(ʻoiai inā he haʻahaʻa).I ka wā e hiki mai ana, hiki iā lākou ke hoʻoholo maikaʻi i ka poʻe maʻi e pōmaikaʻi nui mai kēia mau lapaʻau a ʻaʻole paha e pōmaikaʻi nā mea maʻi (e pili ana i nā biomarkers, me ka protein C-reactive a i ʻole procalcitonin, nā eosinophils koko).

Pono e hōʻike hou aku

Wahi a nā mea noiʻi, aia ka nele o ka ʻikepili hoʻoholo e pili ana i ka makemake o nā antibiotics a i ʻole glucocorticoid therapy, a me nā hōʻike o ka hoʻohana ʻana i nā lāʻau lapaʻau ʻē aʻe, me ka aminophylline, magnesium sulfate, nā lāʻau anti-inflammatory, inhaled corticosteroids, a me nā bronchodilators pōkole.

Ua ʻōlelo ka mea noiʻi e hōʻemi ʻo ia i nā kauka mai ka hoʻohana ʻana i nā lāʻau lapaʻau ʻole, e like me ka aminophylline a me ka magnesium sulfate.Manaʻo ka poʻe noiʻi ʻoiai he nui nā haʻawina e pili ana i ka COPD, ʻaʻole lawa nā hōʻike he nui nā lāʻau lapaʻau no ka mālama ʻana i nā exacerbations acute o COPD.No ka laʻana, i ka hana lapaʻau, hoʻohana mau mākou i nā bronchodilators pōkole e hoʻomaha i ka dyspnea i ka wā o ka exacerbations o COPD.ʻO kēia mau mea e pili ana i nā antagonists muscarinic receptor antagonists (ipratropium bromide) a me nā agonists beta receptor agonists (salbutamol).

Ma waho aʻe o ka noiʻi kiʻekiʻe kiʻekiʻe, ka noiʻi hilinaʻi e pili ana i nā lāʻau lapaʻau, ua kuhikuhi pū nā mea noiʻi e pono ke aʻo ʻia nā ʻano hana ʻē aʻe.

"Ke hōʻike nei ka nui o nā hōʻike hōʻike i kekahi mau lāʻau lapaʻau non-pharmacological, ʻoi aku ka poʻe e hoʻomaka ana e hoʻomaʻamaʻa i ka wā exacerbation, hiki ke hoʻomaikaʻi i ka exacerbations haʻahaʻa a koʻikoʻi o nā maʻi COPD i ka haukapila.ʻO ka American Thoracic Society/European Respiratory Conference ma 2017 ʻO nā alakaʻi i hoʻopuka ʻia e pili ana i nā ʻōlelo aʻoaʻo kūlana (haʻahaʻa haʻahaʻa loa o nā hōʻike) i ka wā o ka hoʻokipa ʻana i nā exacerbations acute o COPD, mai hoʻomaka i ka hoʻoponopono pulmonary, akā ua puka mai kekahi mau hōʻike hou mai ia manawa e pono ai mākou He nui nā hōʻike kiʻekiʻe o ka hoʻomaʻamaʻa mua i ka wā o ka exacerbation acute o COPD e hōʻoia i ka pono o ka hoʻomaʻamaʻa mua no ka exacerbation acute o COPD.