哮喘的英语作文

篇一：哮喘英语讲稿

Asthma

1 Definition

Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning. These episodes are usually associated with widespread, but variable, airflow obstruction within the lung that is often reversible either spontaneously or with treatment.

2 Do you know … (asthma facts)

? Asthma is one of the most common chronic diseases worldwide.

? An increasing prevalence of asthma and incorrect treatment increase the mortality of

asthma.

3 Etiology and Pathogenesis (what cause asthma?)

(1) Etiology

Host factors

?

? Genetic predisposition Obesity

? Sex

Environmental factors ( Factors that Exacerbate Asthma)

Environmental factors include allergens, respiratory infections, diet, drugs, and exercises.

(2) Pathogenesis

?

?

?

? 变态反应 allergic reaction 气道炎症airway inflammation 气道高反应性airway hyperresponsiveness AHR 神经-受体平衡失调neuroceptor dysequilibrium

4 Clinical findings

(1) Symptoms

The typical symptoms of asthma are recurrent episodes of cough, worse particularly at night; shortness of breath, chest tightness, wheezing (means there are high-pitched whistling sounds

when breathing out, especially in children), and sputum production. These symptoms occur or worsen at night or in the early morning, awakening the patient. That is often reversible either spontaneously or with treatment.

? cough-variant asthma 咳嗽变异性哮喘

? exercise-induced bronchoconstriction 运动性哮喘

(2) Physical examination

The most common physical finding in asthma is diffusing, expiratory wheezing, an increased respiratory rate and prolonged expiration.

寂静胸（silent chest）:occasionally, in severe asthma exacerbations, wheezing may be absent owing to severely reduced airflow and ventilation.

5 Laboratory examination

(1 )Measurement of lung function

PEF↓ FEV1↓

diumal variation in PEF >20%

bronchial provocation test :＞20% decrease in FEV1 15 minutes after inhalation of a specific agents or after 6 minutes of exercise.

bronchial relaxation test :＞15% increase in FEV1 15 minutes after inhalation of short acting β2 agonist .

(2 )Measurement of allergic status

Skin tests with allergens or measurement of specific IgE in serum: The presence of allergies increases the probability of a diagnosis of asthma, and can help to identify risk factors that cause asthma symptoms in individual patients.

(3) Other laboratory examinations

Arterial blood gas analysis

Sputum studies

Chest X-ray

6 Diagnosis

(1) Asthma diagnosis

? History and patterns of symptoms

? Physical examination

? Spirometry to demonstrate reversibility

? Exclude other causes of wheezing

(2) Asthma staging

? Acute Asthma Exacerbation 急性发作期

? Chronic asthma persistent 慢性持续期

? Asthma paracmasis 缓解期

7 并发症（ Complication ）

Complications of asthma include airway infection, exhaustion, cor pulmonale肺源性心脏病/呼吸衰竭respiratory failure、气胸pneumothorax等

8 Therapy

? allergen avoidance

? main curative

Medications to treat asthma can be divided into two categories: relievers and controllers. Inhaled glucocorticosteroids are the most effective controller medications currently

available.

（1） β2-agonist 通过对气道平滑肌表面的β 2 受体的兴奋，舒张气道平滑肌。控制哮喘急性发作的首选药物。

short-Acting β2 -Agonists：5－10分钟起效，维持 4－6小时。如沙丁胺醇

（salbutamol）、特布他林（terbutaline）

Long-Acting β2 -Agonists：可维持12小时。如福莫特罗（furm(转载于:www.Zw2.cN 爱 作 文 网)oterol）、沙美特罗（ salmaterol）、班布特罗（bambuterol）

（2） Theophylline 抑制磷酸二酯酶，提高平滑肌细胞内的 cAMP 浓度外；刺激肾上腺分泌肾上腺素，增加呼吸肌的收缩；增强气道纤毛清除功能和抗炎作用。aminophylline氨茶碱 sustained-release theophylline缓释茶碱（controller）

（3） Anticholinergics降低迷走神经的张力，解除支气管痉挛

溴化异丙托品（ ipratropium bromide ）噻托溴铵(tiotropium bromide)

（4 ）Glucocorticosteroids

controlling airway inflammation

? decreasing airway hyperresponsiveness ?

systemic glucocorticosteroids：甲基强的松龙methylprednisolone、地塞米松dexamethasone、氢化可的松hydrocortisone、泼尼松prednisone、强的松prednisone. inhaled gulcocorticosteroids(ICS)：倍氯米松（beclomethasone.BDP）、布地奈德budesonide、氟替卡松fluticasone.

（5） Sodium Cromoglycate

（6）Leukotriene Modifier

扎鲁司特（zafirlukast安可来）、孟鲁司特（montelukast顺尔宁）

? treatment of Asthma exacerbation

The aims of treatment are to relieve airflow obstruction and hypoxemia as quickly as

possible, and to plan the prevention of future relapses. Early intervention may lessen the severity and duration of an exacerbation. The primary therapies for exacerbations include, depending on severity, repetitive or continuous administration of an inhaled short-Acting β2 -Agonists, early introduction of systemic glucocorticosteroids to patients with moderate to severe asthma exacerbations , and oxygen supplementation.

? treatment of asthma paracmasis

Depending on the patients’ current level of asthma control and current treatment , each

patients is assigned to one of five “treatment steps”. For example, if asthma is not controlled on the current treatment regimen, treatment should be stepped up until control is achieved. If control has been maintained for at least three months, treatment can be stepped down. At each treatment step ,reliever medication should be provided for quick relief of symptoms as needed. At step 2 to 5, patients also require one or more regular controller medications, which keep symptoms and attacks from starting.

9 Nursing diagnosis

? impaired gas exchange

related to increased airway resistance, airway inflammation, and airway spasm

? ineffective airway clearance

related to bronchospasm, ineffective cough, excessive mucus production, tenacious

secretions, and fatigue

? knowledge deficit

related to knowledge deficits of MDIs

10 nursing implemention

?

?

?

?

?

?

?

?

? reduce exposure to risk factors avoid food allergies, lay off alcohol and somking provide comfortable position, such as orthopnea monitoring conditions, especially at night or in the early morning keeping airway clear, and oxygen is given by mask or nasal prongs teach clients effective coughing techniques teach client to breathe deeply through the nose and exhale 2-3 times through pursed lips decrease the clients’ anxiety and panic teach clients the correct administration of medications, especially how to use inhaler

devices and monitoring the side effects.

Medicine care

? glucocorticosteroids

Oral candidiasis ,hoarseness, irritated throat and dry cough are local adverse effects caused by inhalation of corticosteroids. These problems can be reduced or prevented by mouth washing; take oral medicine after meals to reduce stimulation of gastrointestinal. It should never be abruptly discontinued but tapered gradually over time to prevent adrenal insufficient.

? β2 agonists

? short-acting inhaledβ2 agonist should be used only on an as-needed basis at the lowest

dose and frequency required, not for long-term, regular, single, and large-dose use ? control the drip rate while using salbutamol, and monitor adverse systemic effects, such as tremor and tachycardia.

? methylxanthines

? the main problem with theophylline is the relatively high incidence of side effects, which

include gastrointestinal symptoms, cardiac arrhythmias, low blood pressure, and even death.

? Side effects can be reduced by careful dose selection and monitoring the serum

concentration of theophylline.

? pay attention to concentration and speed while iv.drip ，>10min

? theophylline administration requires monitoring of its serum concentrations for safe and

effective use.

? liver disease, congestive heart failure, and certain drugs including cimetidine, some

quinolones, and some macrolides increase the risk of toxicity.

11 Heath education

篇二：(英文摘要)BiPAP治疗重症哮喘致呼吸衰竭38例分析11

BiPAP治疗重症哮喘致呼吸衰竭38例分析 湖北省中山医院呼吸科王新卫 刘新年 张维

【摘要】 目的：探讨BiPAP救治重症哮喘致呼吸衰竭的疗效。方法：选择38例重症哮喘致呼吸衰竭病例应用BiPAP治疗，比较BiPAP治疗前后2h的心率、呼吸频率、动脉血气分析的结果。结果：心率、呼吸频率、动脉血气分析BiPAP后2h较BiPAP前2h对比，P<0.05，均具有统计学差异。38例患者，经过常规治疗及BiPAP治疗，38例重症哮喘患者症状均得到缓解，有l例需气管插管，进行有创通气，无一例死亡。结论：BiPAP提高了对重症哮喘并发呼吸衰竭的抢救成功率。

【关键词】 哮喘/并发症；呼吸功能不全/治疗；正压呼吸

Clinical Analysis of BiPAP Ventilation for Severe Asthma Merge Respiratory Failure

Xingwei Wang, Department of Respiratory Medicine, The Zhongshan Hospital of Hubei, Wuhan, 430032

【Abstract】Objective To discuss the clinical effect of bilevel positive airway pressure (BiPAP) in the treatment of severe asthma merge respiratory failure. Methods 38 cases of respiratory failure caused by severe asthma were underwent BiPAP ventilation therapy, the Heart Rate、Respiratory Frequency、Arterial blood gas analysis changes before and 2h after therapy were observed and compared. Only one patients required Tracheal intubation and Invasive ventilation, with no deaths. Results All of the parameters was showed statistically significant difference between before and after treatment(P<0.05). Conclusion The success rate of severe asthma merge respiratory failure were improved through the use of BiPAP Ventilation.

【Key words】Asthma/Complication, Respiratory Insufficiency/Treatment, Positive-Pressure Respiration

目前经罩Bipap治疗重症哮喘致II型呼吸衰竭己得到了临床广泛应用，疗效确切。我科。2004-03／2009-05应用Bipap治疗重症哮喘致II型呼吸衰竭38例，分析如下。 l 临床资料

1.l 一般资料 本组男24例，女14例，平均（37±15）岁。本组均有：（1）典型支气管哮喘病史；（2）临床表现：呼吸窘迫、呼吸频速、端坐呼吸、发绀、两肺哮鸣音、床边X线胸片呈肺气肿征象或合并肺部感染；（3）面罩吸氧4～6 L/min，SaO2＜90%；（4）神志清楚能配合治疗；（5）血气分析：PaO2＜60mmHg且PaCO2≥50mmHg。除外面部创伤、畸形、神经肌肉疾病。神志不清不能配合、合并气胸及纵膈气肿、血流动力学不稳定、呼吸道分泌物过多等均不纳入此标准。所有病例均符合第7版内科学“支气管哮喘急性发作期危重症”的诊断标准[1]。

1.2 方法 本组患者行BiPAP治疗，采集BiPAP治疗前后2h的心率、呼吸频率、动脉血气分析，进行统计学处理。

1.2.1 治疗方法 本组入院后给予抗炎、解痉、平喘、糖皮质激素应用、吸氧等常规治疗，同时进行BiPAP治疗。采用美国伟康公司生产的BiPAP呼吸机，选用合适的面罩通气，头

高位或平卧位，S/T模式工作，吸气相压力（IPAP）由6 cm H2O开始，逐渐升至16～20 cm H2O，呼气相压力（EPAP）由4cm H2O开始，根据实际情况调至6～8 cmH2O，调节氧浓度，使SpO2≥90％。

1.2.2 观察方法 入院时的一般情况包括：性别、年龄、哮喘病程、吸烟指数、生命体征、血常规和生化检查、血气分析及糖皮质激素应用情况等，无创正压通气所使用的机型、通气模式、通气参数，使用时间和不良反应，使用无创正压通气前2h及后2h的生命体征及血气分析变化情况最后转归。

2 结果

心率、呼吸频率、动脉血气分析BiPAP后2h较BiPAP前2h对比，P＜0.05，均具有统计学差异。见表2。38例患者，经过常规治疗及BiPAP治疗，4l例重症哮喘患者症状均得到缓解，有l例需气管插管，进行有创通气，无一例死亡。

3 讨论

以上证明：BiPAP的早期应用可有效地改善哮喘患者的通气和氧合状况，纠正缺氧及CO2潴留，纠正呼吸性酸中毒，有效地降低呼吸频率及心率，解除呼吸肌疲劳[2 - 4]。BiPAP并发症少，对于尚未达到插管上机标准的重症患者，尤其是伴有CO2潴留而无使用BiPAP的禁忌证者，甲期使用BiPAP对于改善患者病理生理状况，避免病情的进一步加重，赢得药物治疗的时间，避免气管插管，有着积极的意义[5]。其作用机理：（1）扩张支气管，降低气道阻力，提高肺泡通气量，并通过增加残气量抵消内源性PEEP，从而改善哮喘的呼吸力学异常；（2）通过前述作用技持续气道正压，可使肺泡中的氧向血液弥散，纠正低氧，缓解呼吸困难；（3）减少呼吸功，使呼吸肌得到休息而缓解呼吸肌疲劳；（4）萎陷的肺泡重新扩张，并促进分泌物排出；（5）减轻由于胸内负脏过度波动对血流动力学的不良影响；（6）改善肿的顺应性[6]。有创通气需建立人工气道，由于人工气道的存在易于产生下呼吸道感染及呼吸机相关性肺炎，使治疗过程反复，撤机困难，甚至产生呼吸机依赖。BiPAP操作简便，疗效确切，可以避免患者气管插管或气管切开所带来的痛苦，危险及并发症，患者易于接受，可早期应用，以免贻误抢救时机；不增加气管感染机会；对患者说话、进食、咳嗽等生理活动影响较小[7]，易于脱机，不产生呼吸机依赖。BiPAP提高了对重症哮喘并发呼吸衰竭的抢救成功率，避免了人工气道和有创通气相关性并发症的发生，缩短了住院时间，节省了医疗费用。

【参考文献】

[1] 陆再英，钟南山。内科学[ M ]7版。北京：人民卫生出版社，2008：69-78。

[2] 陈灏珠，廖履坦，杨秉辉。实用内科学[ M ]12版。北京：人民卫生出版社，2005：1647。

[3] 王辰，商鸣宇。有刨与无创序贯性机械通气治疗慢性阻塞性肺疾病所致严重呼吸衰竭

的研究[ J ]。中华结核和呼吸杂志，2000，23（4）：212。

[4] 俞森洋。现代机械通气的理论与实践[ M ]。北京：中国协和医科学出版社，2000：211

—386。

[5] 崔德健。重症支气管哮喘发作的机械通气治疗[ J ]。中华结核和呼吸杂志，1994，17（6增刊）：44 —47。

[6] 朱元珏，陈文彬。呼吸病学[ M ]11版。北京：人民卫生出版社，2003：612。

[7] 中华医学会呼吸病学分会临床呼吸生理及ICU学组，无创正压通气临床应用中的几点建议[ J ]，中华结核和呼吸杂志，2002，25（2）：130—134。

作者简介

王新卫，男，46岁，医学硕士，从事呼吸临床专科十余年，现任中华医学会湖北省呼吸专业委员会委员，湖北省防痨协会理事，武汉市老年医学会理事委员，现任湖北省中山医院呼吸科科主任，具有丰富的医学临床经验。

篇三：关于雾霾的英语作文

关于雾霾的英语作文

Haze is air pollution in which is mixed up with dust, smoke and other dry particles ,and it obscure the clarity of the sky and interacts with the natural environment. 雾霾是空气污染和灰尘,烟雾和其他干燥粒子,它掩盖了清晰的天空,与自然环境进行交互。

雾霾原因

This kind of air pollutant come from a variety of natural and manmade sources. Natural sources can include windblown dust, and soot from wildfires. Manmade sources can include motor vehicles, and industrial fuel burning, and manufacturing operations. The one of the main cause that touches off haze is manufacturing operations. Many factories were over measure produced the smog that had over the standard and the smog seriously influence the air become air pollution.这种空气污染物来自各种自然和人为来源。天然来源可以包括风沙、烟尘从森林大火。人为来源可以包括机动车辆、工业燃料燃烧和制造业务。触动了烟雾的主要原因之一是制造业务。许多工厂测量产生的烟雾对标准和烟雾严重影响空气成为空气污染。

雾霾危害

The components that make up haze may have negative effect on people's health especially that of the children and the elderly. Also not excluded are those who have certain diseases such as asthma, allergy, and pneumonia and lung disease. Workers working in the open air have a high risk in their health.组件构成烟雾可能对人们的健康有负面影响特别是儿童和老人。也不排除是某些疾病如哮喘、过敏、肺炎和肺部疾病。工人工作在露天有很高的风险在他们的健康。

解决方法

One of effective solutions to help eliminate haze is to make some chemistry changes during the manufacturing process,so it could reduce harmful emissions which are produced by

manufacturing operations一个有效的解决方案,帮助消除烟雾是让一些化学变化在制造过程中,所以它能减少有害排放产生的制造业务。

关于 雾霾 的英语作文（篇1）

Recently,haze weather has become a daily one right here in large part of China.People are forced to wear the mask to avoid breathing poisonous air.So it is necessary to find out the reason why leads to that and work out the resolution.If we trace the cause for haze weather ,the main points are as follows ,first,china 's air quality standards are rather lax and evaluation factors are limited,so you will see that current air appraisal system has defects.Second,some people just go for economic interests instead of turning out products according to relevant law and regulations.They tend to use obsolete equipment in which they are high likely to emit a great deal of wasted air.

Third,across our society ,relevant protection awareness has not built up so that people havent formed a habit of using green product and saving energy as much as possible.Just for the sake of convience to go out,people rely more and more on travelling and working by car while car is the main cause for the haze weather

To settle this problem,a series of meaures should be taken as follows.First ,we should strengthen air monitor to lower the levels of small particulate pollutants.Second,we should enact more strict laws and regulations and keep perfecting our current law on environmental protection to regulate people 's daily action and the industrial production and punish those factories that ignore the protection and keep emitting dangerous material that cause haze.

Third,we should develop green and energy-saving energy to lower the emission of haze and improve air quality.As far as i am concerned ,if we work together to be able to do such measures ,our environment will getting better and better and haze weather will vanish completely. 关于 雾霾 的英语作文（篇3）

During the 15 days from New Year’s Eve to Lantern Festival, Beijing was affected by smog for more than half the time, because of which people suffered a lot. On the road people drove slowly because they could not see clearly. People also suffered from many illnesses caused by smog.

The smog in Beijing has been caused by many factors, in which the increase of cars in the city area plays an important role. The carssend off a lot of poisonous gases, which in turn adds to the already seriousair pollution.

In my opinion, the number of cars should be limited.We should call on the people to use more public transport. Only in this way canwe expect to have more sunny days.

关于 雾霾 的英语作文（篇4）

Dear Bill,

I’m glad to receive your letter,thank you for your caring for the weather and my health.Now I’d like to tell you something about the smog.

Since the winter last year,the smog has occurred a lot of times.it has done great harm to our daily life.many traffic accidents happened just because of the heavy smog weather,more and more people have to go to see the doctor because the serious disease caused by the smog,quite a lot of flights have to be put off,a great number of people have to stay at home for fear of the poisonous air caused by the smog.

People have realized the great harm caused by the smog and the importance of protecting the environment.people all over the country are taking measures to reduce the smog weather.the government suggests people go to work or school with the public traffic, such as the bus and the underground.Also we should plant more trees.

According to me, I will go to school by bike or on foot, and I won’t throw the waste anywhere.in addition, I will tell the people I meet to protect the environment as possible as they can.would you like to tell me some good ideas?i’m looking forward to your reply.

Yours,

Li Hua