臨床醫(yī)學(xué)專業(yè)02級(jí)七年制《內(nèi)科學(xué)》教案

1、臨床醫(yī)學(xué)專業(yè)02級(jí)七年制內(nèi)科學(xué)教案姓名蔡映云業(yè)務(wù)職稱教授聘任授課職位教授授課題目Chronic Obstructive Pulmonary Diseases (COPD)學(xué)時(shí)數(shù)1授課班級(jí)04級(jí)八年制授課日期一、教學(xué)目的（掌握、熟悉、了解的具體內(nèi)容）1. Very important:Definition, clinical manifection and treatment of COPD2. Important:Cause and pathophysiology of COPD3. Less important:Pathology and pathogenesis of COPD二、執(zhí)行方案

2、：(一) 內(nèi)容及時(shí)間分配1. Chronic obstructive pulmonary disease (COPD) is a disease state characterized by airflow limitation that is not fully reversible. COPD is a very common disease around the world.2. Although many environmental factors have been implicated in the development of COPD, cigarette smoking re

3、mains the most important one.3. Main pathophysiological changes of COPD are airflow limitation, hyperinflation of lungs and disturbanced gas exchange.4. The three most common symptoms in COPD are cough, sputum production, and exceptional dyspnea.5. Only two interventions, smoking cessation and oxyge

4、n therapy in chronically hypoxemic patients, have been demonstrated to influence the natural history of patients with COPD.6. All other current therapies such as bronchodilators (anticholinergic agents, beta-agonists, and theophylline), inhaled or parenteral corticosteroids, mucolytic agents, and pu

5、lmonary rehabilitation, are directed at improving symptoms and decreasing the frequency and severity of exacerbations. 7. Lung voluime reduction surgery (LVRS) and lung transplantation may be considered in selected COPD patients.8. Exacerbations of COPD are episodes of increased dyspnes and cough an

6、d change in the amount and character of sputum. The approach to the patient experiencing an exacerbation includes an assessment of sputum. The approach to the patient experiencing an exacerbation includes an assessment of the severity of the patients illness, an attempt to identify the precipitating

7、 factor, and the institution of therapy.9. Treatment of acute exacerbation include the use of inhaled -agonist (often initially with nebulized therapy) together with an anticholinergic agent. GOLD guidelines recommend 30-40 mg of oral prednisolone or its equivalent for a period of 10-14 days and it

8、has been shown to reduce length of hospital stay, hasten recovery and reduce the change of subsequent exacerbation or relapse. Empirical antibiotics are usually applied in moderate to severe exacerbation and the choice should be based on the local patterns of antibiotics susceptibility of the usual

9、pathogens. The usual pathogens in acute exacerbation includes S pneumoniae H influenzae and Moraxella catarrhalis. Supplemental oxygen should be used to keep arterial saturation 90%. Ventilatory support may be required in those with severe respiratory distress despite initial therapy.1、慢性支氣管炎的定義及概述。

10、 3分鐘2、病因、發(fā)病機(jī)制、病理。 10分鐘3、臨床表現(xiàn)（癥狀和體征） 6分鐘4、輔助檢查（X線、肺功能、實(shí)驗(yàn)室檢查） 6分鐘5、診斷及其分型分期、鑒別診斷 5分鐘6、治療 13分鐘7、預(yù)防 2分鐘(二)重點(diǎn)和難點(diǎn)1、喘息性慢性支氣管炎與哮喘的鑒別2、根據(jù)慢支的分期進(jìn)行治療(三)中文和英文關(guān)鍵詞慢性支氣管炎 Chronic bronchitis(四)復(fù)習(xí)和思維題 1. How to treat the COPD patient with acute exacerbation?三、參考書及文獻(xiàn)目錄 陳灝珠主編實(shí)用內(nèi)科學(xué)第11版 北京人民衛(wèi)生出版社第1548-1550，2001年 朱元玨主編呼吸病

11、學(xué)第11版 北京人民衛(wèi)生出版社第877-891，2003年內(nèi)科學(xué)系制臨床醫(yī)學(xué)專業(yè)02級(jí)七年制內(nèi)科學(xué)教案姓名蔡映云業(yè)務(wù)職稱教授聘任授課職位教授授課題目阻塞性肺氣腫學(xué)時(shí)數(shù)1授課班級(jí)02級(jí)七年制授課日期一、教學(xué)目的（掌握、熟悉、了解的具體內(nèi)容）1、掌握阻塞性肺氣腫的臨床表現(xiàn)、診斷、治療。2、熟悉阻塞性肺氣腫的發(fā)病機(jī)制。二、執(zhí)行方案：(一) 內(nèi)容及時(shí)間分配1、定義與概述。 3分鐘2、病因和發(fā)病機(jī)制、病理、病理生理。 10分鐘3、臨床表現(xiàn)（癥狀和體征） 6分鐘4、輔助檢查（X線、CT、肺功能、血?dú)夥治觯?6分鐘5、診斷、鑒別診斷 5分鐘6、治療 13分鐘7、預(yù)防 2分鐘(二)重點(diǎn)和難點(diǎn)1、阻塞性肺氣腫的發(fā)作期和緩解期治療(三)中文和英文關(guān)鍵詞阻塞性肺氣腫 Ob