4.4 : 慢性阻塞性肺病 IV：评估和诊断研究

Assessment of COPD involves reviewing the patient's medical history, focusing on chronic cough, sputum production, dyspnea, history of exacerbations, smoking history, exposure to harmful agents, and family history of genetic lung diseases.

The physical examination involves observing the patient's breathing pattern, checking for cyanosis or use of accessory muscles, lung auscultation for wheezes, reduced sounds, or crackles, and inspecting the chest for signs of emphysema and barrel chest.

Next, the diagnostic process involves pulmonary function tests, with spirometry being the primary test used to measure Forced Vital Capacity or FVC, and Forced Expiratory Volume in 1 second, or FEV1, focusing on the FEV1/FVC ratio less than 70% to identify airflow obstruction.

Arterial blood gas analysis is conducted to determine oxygen and carbon dioxide levels.

Additionally, chest X-rays assess lung hyperinflation and diaphragm shape.

A CT scan also provides detailed lung images to detect structural changes and differentiate COPD from other lung diseases.

Lastly, sputum tests check for bacteria during exacerbations.