临床医学专业02级七年制《内科学》教案

1、临床医学专业02级七年制内科学教案姓名蔡映云业务职称教授聘任授课职位教授授课题目Chronic Obstructive Pulmonary Diseases (COPD)学时数1授课班级04级八年制授课日期一、教学目的（掌握、熟悉、了解的具体内容）1. Very important:Definition, clinical manifection and treatment of COPD2. Important:Cause and pathophysiology of COPD3. Less important:Pathology and pathogenesis of COPD二、执行方案

2、：(一) 内容及时间分配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、慢性支气管炎的定义及概述。

10、 3分钟2、病因、发病机制、病理。 10分钟3、临床表现（症状和体征） 6分钟4、辅助检查（X线、肺功能、实验室检查） 6分钟5、诊断及其分型分期、鉴别诊断 5分钟6、治疗 13分钟7、预防 2分钟(二)重点和难点1、喘息性慢性支气管炎与哮喘的鉴别2、根据慢支的分期进行治疗(三)中文和英文关键词慢性支气管炎 Chronic bronchitis(四)复习和思维题 1. How to treat the COPD patient with acute exacerbation?三、参考书及文献目录 陈灏珠主编实用内科学第11版 北京人民卫生出版社第1548-1550，2001年 朱元珏主编呼吸病

11、学第11版 北京人民卫生出版社第877-891，2003年内科学系制临床医学专业02级七年制内科学教案姓名蔡映云业务职称教授聘任授课职位教授授课题目阻塞性肺气肿学时数1授课班级02级七年制授课日期一、教学目的（掌握、熟悉、了解的具体内容）1、掌握阻塞性肺气肿的临床表现、诊断、治疗。2、熟悉阻塞性肺气肿的发病机制。二、执行方案：(一) 内容及时间分配1、定义与概述。 3分钟2、病因和发病机制、病理、病理生理。 10分钟3、临床表现（症状和体征） 6分钟4、辅助检查（X线、CT、肺功能、血气分析） 6分钟5、诊断、鉴别诊断 5分钟6、治疗 13分钟7、预防 2分钟(二)重点和难点1、阻塞性肺气肿的发作期和缓解期治疗(三)中文和英文关键词阻塞性肺气肿 Ob