肺炎预防主要针对致病病原体,通过接种疫苗及管理与疾病发生相关风险得以实现。
主要预防措施是让高危人群接种肺炎链球菌和流感疫苗以及戒烟。[1]Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.
https://thorax.bmj.com/content/64/Suppl_3/iii1.long
http://www.ncbi.nlm.nih.gov/pubmed/19783532?tool=bestpractice.com
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Is there randomized controlled trial evidence to support the use of vaccines for preventing pneumococcal infection in adults?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.388/full展示答案
在疫苗接种方面,英国卫生安全局(UK Health and Security Agency, UKHSA)建议:[60]UK Health Security Agency. Complete routine immunisation schedule. Feb 2022 [internet publication]
https://www.gov.uk/government/publications/the-complete-routine-immunisation-schedule/the-complete-routine-immunisation-schedule-from-february-2022#the-routine-immunisation-schedule-from-february-2022
肺炎球菌疫苗
65 岁或以上的成年人和风险人群:接种单剂 23 价肺炎链球菌多糖疫苗(23-valent pneumococcal polysaccharide vaccine, PPV23)。风险人群是指存在以下情况的人群:[60]UK Health Security Agency. Complete routine immunisation schedule. Feb 2022 [internet publication]
https://www.gov.uk/government/publications/the-complete-routine-immunisation-schedule/the-complete-routine-immunisation-schedule-from-february-2022#the-routine-immunisation-schedule-from-february-2022
无脾畸形或脾功能异常
患有慢性呼吸系统、心脏、肝脏疾病,或神经系统疾病
4 期或 5 期慢性肾脏病(包括血液透析)
糖尿病
由疾病或者治疗而引起的免疫抑制
耳蜗植入物
补体异常。
应抓住一切机会(如接种流感疫苗时或常规诊疗时)为风险患者接种肺炎球菌疫苗,尤其在患者出院时。
流行性感冒疫苗接种
有关英国的疫苗、疫苗接种程序、特殊患者人群和当前疫苗接种时间表,如需了解更多信息,请参阅英国卫生安全局最新的疫苗接种计划。
UKHSA complete routine immunisation schedule.
Opens in new window 疫苗接种计划因地而异;请咨询当地指导建议。
戒烟对于所有患者都很重要,但对于肺炎和流感高危人群尤为重要。应根据国家戒烟指南提供建议。[1]Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.
https://thorax.bmj.com/content/64/Suppl_3/iii1.long
http://www.ncbi.nlm.nih.gov/pubmed/19783532?tool=bestpractice.com
NICE: stop smoking interventions and services
Opens in new window
主动和被动吸烟都是 CAP 的公认独立危险因素。[1]Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.
https://thorax.bmj.com/content/64/Suppl_3/iii1.long
http://www.ncbi.nlm.nih.gov/pubmed/19783532?tool=bestpractice.com
缺乏足够证据,无法确认补充维生素 C 或 D 对于预防(或治疗)肺炎的效果。[61]Padhani ZA, Moazzam Z, Ashraf A, et al. Vitamin C supplementation for prevention and treatment of pneumonia. Cochrane Database Syst Rev. 2021 Nov 18;(11):CD013134.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013134.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/34791642?tool=bestpractice.com
[62]Public Health England. Insufficient evidence for vitamin D preventing or treating ARTIs. Jul 2020 [internet publication].
https://www.gov.uk/government/news/insufficient-evidence-for-vitamin-d-preventing-or-treating-artis
对于所有吸烟的 CAP 患者,根据国家戒烟指南提供建议。
NICE: stop smoking interventions and services
Opens in new window 向患者说明,吸烟会破坏人体清除病原体和碎片的天然防御机制。[1]Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.
https://thorax.bmj.com/content/64/Suppl_3/iii1.long
http://www.ncbi.nlm.nih.gov/pubmed/19783532?tool=bestpractice.com