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Bệnh Phổi Tắc Nghẽn Mạn Tính COPD là gì?
Bệnh phổi tắc nghẽn mạn tính (COPD) là một bệnh về hô hấp gây khó thở, làm giảm chất lượng cuộc sống. Vì vậy, việc tìm hiểu nguyên nhân, triệu chứng, và các phương pháp phòng và chữa COPD được rất nhiều người quan tâm.
COPD là gì?
COPD – bệnh phổi tắc nghẽn mạn tính là bệnh lý về hô hấp thường gặp, có thể phòng ngừa và điều trị được.
Đặc trưng các triệu chứng dai dẳng và giới hạn đường thở hoặc phế nang thường do tiếp xúc với hạt và khí độc hại kèm sự phát triển bất thường của phổi, bệnh đồng mắc làm tăng tàn phế và tử vong.
Nguyên nhân của bệnh phổi tắc nghẽn mạn tính
COPD được cho là chưa có nguyên nhân rõ ràng. Người ta thống kê được một số yếu tố nguy cơ làm tăng khả năng gây bệnh:
- Ô nhiễm môi trường: khói bụi trong không khí, chất thải nguyên liệu sinh khối, chất đốt, các chất thải nghề nghiệp, bụi hóa học vô cơ, hữu cơ.
- Hút thuốc lá: bao gồm cả hút thuốc lá chủ động và hút thuốc lá thụ động đều gây tăng nguy cơ bị bệnh.
- Nhiễm trùng đường hô hấp: viêm đường hô hấp gây tổn thương niêm mạc hô hấp ở trẻ dưới 8 tuổi làm giảm khả năng chống đỡ nhất là tổn thương do mắc RSV (virus hợp bào hô hấp)
- Phế quản tăng tính phản ứng, phế quản phế viêm.
- Alpha1-antritrypsin: là yếu tố di truyền được xác định chắc chắn gây COPD
- Tuổi: tuổi càng cao tỉ lệ mắc COPD càng lớn thường trên 40 tuổi
- Giới: giới nam thường có tỉ lệ mắc bệnh cao hơn nữ giới.
Triệu chứng của COPD
Bệnh nhân mắc COPD có thể có nhiều triệu chứng khác nhau tùy từng giai đoạn bệnh. Nhìn chung bệnh nhân COPD thường có những triệu chứng điển hình như sau:
- Ho: là triệu chứng luôn có ở COPD. Ho thường dai dẳng kéo dài, ho nhiều vào buổi sáng, ho từng cơn hay ho thúng thắng, có kèm khác đờm hoặc không, nếu có đờm thường là đờm trắng loãng.
- Khạc đờm: thường chỉ khác đờm nhầy trong, nhiều vào buổi sáng. Vào đợt cấp có bội nhiễm màu đờm có thể chuyển màu đục xanh hoặc vàng.
- Khó thở: ban đầu bệnh nhân chỉ khó thở khi gắng sức, xuất hiện từ từ và tăng dần. Giai đoạn muộn bệnh nhân có thể có khó thở liên tục. Khó thở thường là khó thở mím môi, nhất là khi gắng sức
- Co kéo cơ hô hấp phụ: rút lõm hõm ức, rút lõm lồng ngực, hố thượng đòn, co kéo các cơ liên sườn
- Kiểu thở nghịch thường: sử dụng cơ bụng khi thở ra, lồng ngực không di động theo nhịp thở.
- Lồng ngực hình thùng: ở những bệnh nhân mắc bệnh lâu, kiểu hình khí phế thũng, lồng lực bệnh nhân to ra theo chiều trước sau, các khong liên sườn giãn rộng. Triệu chứng này xuất hiện ở những bệnh nhân mắc bệnh thời gian dài.
- Dấu hiệu Campell: Khí quản bệnh nhân đi xuống ở thì hít vào (ở người bình thường khí quản sẽ được đẩy lên ở thì hít vào)
- Dấu hiệu Hoover: Đường kính phần dưới của lồng ngực giảm xuống khi hít vào
- Gõ vang nếu ở thể ứ khí phế nang, triệu chứng này không đặc hiệu.
- Nghe phổi thấy rì rào phế nang giảm, có thể thấy ran rít ran ngáy. Nếu có bội nhiễm gây viêm phổi có thể nghe thấy ran ẩm ran nổ 2 bên phổi
- Giai đoạn tăng áp lực động mạch phổi: tim nhanh, rối loạn nhịp tim, gan to, tĩnh mạch cổ nổi, phù chân,…, triệu chứng này xuất hiện khi bệnh đã ở giai đoạn nặng.
- X-quang phổi: là cận lâm sàng rất có giá trị chẩn đoán bệnh nhân COPD
- Tăng đậm các nhánh phế huyết quản
- Hình ảnh giãn phế nang: Lồng ngực quá giãn, trường phổi quá sang các xương sườn nằm ngang, các khoang liên sườn giãn rộng, cơ hoành 2 bên hạ thấp, có hình bậc thang là hình ảnh điển hình của COPD.
- Cung động mạch phổi nổi
- Bóng tim to hoặc không, có khi dài thõng. Bóng tim to thõng có ở bệnh nhân COPD dẫn đến suy tim phải.
- Đo chức năng hô hấp là phương pháp tốt nhất để chẩn đoán và đánh giá bệnh nhân mắc COPD. Sau khi sử dụng thuốc giãn phế quản và đo chức năng thông khí, chỉ số FEV1 giảm, FEV1/FVC<70%
- Chụp cắt lớp vi tính: xác định các kiểu hình khí phế thũng và bóng kén khí trong nhu mô phổi, ngoài ra còn các tổn thương khác và biến chứng của bệnh: tràn dịch màng phổi,tràn khí màng phổi,..
- Điện tâm đồ: ở bệnh nhân COPD có biến chứng suy tim phải ( tâm phế mạn) có hình ảnh tăng gánh thất phải.
Biến chứng COPD
COPD là bệnh phổi mạn tính, bệnh xuất hiện trong thời gian dài, vì vậy gây nhiều biến chứng:
COPD phác đồ điều trị
Điều trị COPD là một quá trình kéo dài và liên tục từ khi phát hiện bệnh. Vì vậy cần có sự hợp tác giữa bác sĩ, bệnh nhân và người nhà để hiệu quả điều trị tốt nhất. Điều trị chia làm 2 giai đoạn: đợt cấp và ổn định.
- Mức độ nhẹ: tăng liều thuốc duy trì dạng phun hít lên tới 4-6 lần/ngày; corticoid đường uống, kháng sinh theo kinh nghiệm của bác sĩ. Với thuốc corticoid, sau khi dùng thuốc bệnh nhân cần vệ sinh miệng họng lại bằng nước tránh để thuốc động lại gây nấm miệng, nấm họng, và vệ sinh dụng cụ hít sạch sẽ.
- Mức độ trung bình: Tiếp tục duy trì liệu pháp trên; thở oxy liều thấp duy trì spO2>90%; tăng số lần dùng thuốc xịt hít, phối hợp thêm các nhóm thuốc giãn phế nang, nếu không đáp ứng có thể dùng đường tĩnh mạch; kháng sinh dùng phối hợp 2 nhóm cephalosporin thế hệ 3 với aminosid hoặc quinolon
- Mức độ nặng: thở oxy; dùng các thuốc giãn phế quản kết hợp các nhóm, dùng cả đường tiêm và phun hít; kháng sinh phối hợp nhóm; thở máy không xâm nhập nếu có 1 trong các triệu chứng sau: toan hô hấp(pH 7.25-7.3), pCO2 45-65mmHg, nhịp thở > 25 lần/phút
Chăm sóc bệnh nhân COPD
COPD là bệnh mạn tính, bên cạch việc điều trị bệnh thì việc chăm sóc bệnh nhân cũng rất quan trọng giúp tăng hiệu quả điều trị
- Tránh tiếp xúc với các yếu tố gây bệnh như: lạnh, bụi, khói…
- Cai thuốc lá, tránh tiếp xúc với khói thuốc lá
- Vệ sinh mũi họng thường xuyên, tránh các viêm nhiễm vùng mũi họng
- Dinh dưỡng đầy đủ: ăn các bữa nhỏ, đầy đủ chất dinh dưỡng giúp nâng cao thể trạng, nâng cao sức đề kháng của bệnh nhân để tránh các đợt bội nhiễm.
- Giữ vệ sinh nơi ở: thoáng mát, sạch sẽ, hè mát đông ấm, quang trọng đảm bảo đủ thông khí cho bệnh nhân
- Hỗ trợ tâm lý giảm stress, giúp bệnh nhân và người nhà luôn có tâm trạng thoải mái để điều trị bệnh
- Hướng dẫn tập cách thở và ho hiệu quả
- Người bệnh tập luyện nhẹ nhàng, tăng cường thể lực, tránh các hoạt động quá sức.
Ngoài những cách trên, các bạn có thể sử dụng máy trợ thở để kiểm soát và điều trị COPD ngay tại nhà.
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The Marlboro brand is known around the world for its authentic flavor and premium tobacco blend. The range features Red, Gold, and Menthol editions, offering different flavor profiles.
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The Double Happiness brand has earned recognition for its distinctive flavor and authentic heritage. Originating in Asia, the brand is appreciated by customers who enjoy its distinctive taste.
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The Australia Cig Delivery website is an online cigarette retailer serving customers across Australia. Founded in 2024, the store is dedicated to delivering genuine tobacco products with reliable shipping and competitive prices for customers aged 18 and over.
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The company supplies a variety of internationally recognized cigarette brands, including Marlboro, Manchester, Double Happiness, Benson & Hedges, Dunhill, Mevius, Seven Star, and Mac. The selection includes multiple product options designed to suit a variety of adult smoker preferences.
The Marlboro brand is recognized worldwide for its premium tobacco, smooth taste, and consistent quality. Popular options include Red, Gold, and Menthol editions, offering different flavor profiles.
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Double Happiness has built a reputation for its classic taste and rich tobacco aroma. Originally developed in Asia, the brand remains popular among adult smokers who enjoy its distinctive taste.
The Benson & Hedges brand is known for high-quality tobacco and balanced flavor. The brand has become well known for quality and reliability.
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Australia Cig Delivery is an online cigarette retailer serving customers across Australia. Launched in 2024, the store focuses on delivering genuine tobacco products with reliable shipping and competitive prices for adult customers.
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The store supplies a wide selection of well-known cigarette brands, including Dunhill, Marlboro, Manchester, Double Happiness, Benson & Hedges, Mevius, Seven Star, and Mac. The product range includes different tobacco blends and styles for different smoking preferences.
The Marlboro brand is recognized worldwide for premium quality, smooth flavor, and reliable craftsmanship. Available varieties include Red, Gold, and Menthol editions, to suit different preferences.
Manchester cigarettes are appreciated for their balanced flavor, smooth draw, and modern appeal. The collection includes different styles for adult smokers.
The Double Happiness brand has earned recognition for its distinctive flavor and authentic heritage. Originating in Asia, the brand continues to attract adult smokers who prefer its traditional tobacco flavor.
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Hey I know this is off topic but I was wondering if you knew of any widgets I could add to my blog that automatically tweet my newest twitter updates. I’ve been looking for a plug-in like this for quite some time and was hoping maybe you would have some experience with something like this. Please let me know if you run into anything. I truly enjoy reading your blog and I look forward to your new updates.
At this time it looks like WordPress is the preferred blogging platform out there right now. (from what I’ve read) Is that what you are using on your blog?
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At this time it seems like WordPress is the preferred blogging platform out there right now. (from what I’ve read) Is that what you are using on your blog?