[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fxpgjKjqUCTG7rkpLxuX6Wv0QcIusQ_zRPU_Uv_awqAo":8},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":113},200,"操作成功",{"id":12,"name":13,"describes":6,"symptoms":6,"checkup":6,"treatment":6,"seoTitle":14,"seoKeywords":15,"seoDescription":16,"coverVertical":6,"coverAcross":6,"introduceClassifications":17,"departments":111},33,"结核"," 结核病的症状、预防和治疗"," 结核病, 结核症状, 结核预防, 结核治疗, 结核病因, 肺结核, 结核诊断, 结核病防治"," 了解结核病的症状、预防方法及治疗方案。结核病是一种具有高度传染性的疾病，及时的诊断和治疗至关重要。本文详细介绍了结核病的相关知识，帮助您全面了解并预防这种疾病。",[18,23,27,29,32,34,39,42,46,48,50,54,56,58,62,64,66,71,73,75,80,82,84,89,91,93,98,100,102,107,109],{"id":19,"classification":20,"description":21,"sort":22,"diseaseId":12},49357,"症状","\u003Cp>　　常见症状：劳力性呼吸困难、乏力、晕厥、心绞痛、胸痛、咯血、声音嘶哑、下肢水肿、肺动脉瓣区可听到喷射音、收缩期反流性杂音、肝肿大、颈静脉怒张\u003C/p>",0,{"id":24,"classification":25,"description":26,"sort":22,"diseaseId":12},54521,"概述","\u003Cp>　　葡萄球菌肺炎(staphylococcal pneumonia)是葡萄球菌所引起的急性化脓性肺炎，近年来，有逐渐增多的趋势。病情较重，常发生于免疫功能受损的病人，尤其对耐药的金黄色葡萄球菌的医院内感染已引起人们广泛注意。\u003C/p>",{"id":28,"classification":25,"description":26,"sort":22,"diseaseId":12},80137,{"id":30,"classification":20,"description":31,"sort":22,"diseaseId":12},48953,"\u003Cp>　　常见症状：腹痛、月经异常、盆腔包块、腹腔积血\u003C/p>",{"id":33,"classification":25,"description":26,"sort":22,"diseaseId":12},59707,{"id":35,"classification":36,"description":37,"sort":38,"diseaseId":12},48954,"检查","\u003Cp>　　检查项目：血尿常规、激素检查、B超、CT、肿瘤标志物检查、组织检查\u003C/p>",1,{"id":40,"classification":36,"description":41,"sort":38,"diseaseId":12},49358,"\u003Cp>　　检查项目：血液检查、肺活检、心电图、多普勒超声心动图、胸部平片、二维超声心动图、M型超声心动图（ME）、肺阻抗血流图、磁共振血管造影、心血管造影、心血管MRI检查、心音图检查\u003C/p>",{"id":43,"classification":44,"description":45,"sort":38,"diseaseId":12},54522,"病因","\u003Cp>　　葡萄球菌为革兰染色阳性球菌，有金黄色葡萄球菌(简称金葡菌)及表皮葡萄球菌两类。葡萄球菌的致病物质主要是毒素与酶，如溶血毒素、白细胞素、肠毒素等，具有溶血、坏死、杀白细胞及血管痉挛等作用。葡萄球菌致病力可用血浆凝固酶来测定，阳性者致病力较强。金葡萄为阳性，是化脓性感染的主要原因，但其他凝固阴性的葡萄球菌亦可引起感染并发症，随着医院内感染的增多，由凝固酶阴性葡萄球菌引起的肺炎亦有发现。医院内获得性肺炎中葡萄球菌感染占11%～25%。\u003C/p>",{"id":47,"classification":44,"description":45,"sort":38,"diseaseId":12},80138,{"id":49,"classification":44,"description":45,"sort":38,"diseaseId":12},59708,{"id":51,"classification":20,"description":52,"sort":53,"diseaseId":12},59709,"\u003Cp>　　常见症状：咳血痰、呼吸困难、高热、寒战、休克、脓痰、发绀、谵妄、昏迷、肺部啰音\u003C/p>\u003Cp>　　疾病起病多急骤，高热、寒战、胸痛，痰为脓性，量多，带血丝或呈粉红色乳状等全身毒血症表现。病情严重者可早期出现周围循环衰竭，院内感染者通常起病较隐袭，体温逐渐上升、脓痰。肺部X线显示肺段或肺叶实变，或呈小叶状浸润，其中有单个或多发的液气囊腔。X线阴影的易变性，表现为一处炎性浸润而在另一处出现新的病灶。或很小的单一病灶发展为大片阴影，此为金葡菌肺炎的另一重要特征。治疗有效时，病变消散，阴影密度逐渐减低，2～4周后病变完全消失，偶可遗留少许条索状阴影或肺纹理增多等。临床症状与肺炎球菌性肺炎的临床症状相似。\u003C/p>",2,{"id":55,"classification":20,"description":52,"sort":53,"diseaseId":12},80139,{"id":57,"classification":20,"description":52,"sort":53,"diseaseId":12},54523,{"id":59,"classification":36,"description":60,"sort":61,"diseaseId":12},59710,"\u003Cp>　　检查项目：白细胞计数（WBC）、胸部透视、痰液细菌涂片检查、痰液细菌培养、胸部平片\u003C/p>\u003Cp>　　根据全身毒血症状、咳嗽、脓血痰、白细胞计数增高、中性粒细胞比例增加、核左移并有中毒颗粒，X线表现片状阴影可伴有空洞及液平，即可作出初步诊断。近年来由于抗生素的使用，金葡萄肺炎的诊断不应过分依赖于痰和血培养阳性。而其他葡萄球菌肺炎由于症状多不典型，且与其他病原菌所致肺炎的症状颇为相似，给临床诊断带来困难，故其确诊仍需病原学证据。\u003C/p>\u003Cp>　　肺部X线显示肺段或肺叶实变，或呈小叶样浸润，其中有单个或多发的液气囊腔。\u003C/p>",3,{"id":63,"classification":36,"description":60,"sort":61,"diseaseId":12},54524,{"id":65,"classification":36,"description":60,"sort":61,"diseaseId":12},80140,{"id":67,"classification":68,"description":69,"sort":70,"diseaseId":12},59711,"鉴别","\u003Cp>　　细菌学检查是确诊葡萄球菌肺炎的依据。痰液涂片检查可见大量脓细胞、成堆革兰阳性球菌，白细胞内可见到革兰阳性球菌。痰液、鼻咽拭子、浆膜腔液、下呼吸道分泌物、肺穿刺物及血液培养应及早进行，抗菌药物使用之前即应留取标本。由于正常人鼻咽部可带菌，因此，咳痰培养前必须清洁口腔，并作多次培养，成人痰培养阳性率高达87%～95%，血培养的阳性率较低。应在高热时多次(2～3次，每隔1/2～1小时1次)或自两处不同部位采血，成人血标本量应 ≥10ml。表皮葡萄球菌血培养需要2次阳性才能确认有意义。除胸液、肺穿刺物和血培养分离到葡萄球菌具有肯定诊断价值，其他标本包括下呼吸道防污染技术所采集到的标本培养到葡萄球菌，其诊断价值需结合临床(如迅速发展的坏死性肺炎)进行判断。\u003C/p>",4,{"id":72,"classification":68,"description":69,"sort":70,"diseaseId":12},54525,{"id":74,"classification":68,"description":69,"sort":70,"diseaseId":12},80141,{"id":76,"classification":77,"description":78,"sort":79,"diseaseId":12},54526,"并发症","\u003Cp>　　如治疗不及时，可并发菌血症，心内膜炎，脑膜炎等。\u003C/p>",5,{"id":81,"classification":77,"description":78,"sort":79,"diseaseId":12},59712,{"id":83,"classification":77,"description":78,"sort":79,"diseaseId":12},80142,{"id":85,"classification":86,"description":87,"sort":88,"diseaseId":12},54527,"预防","\u003Cp>　　尽管葡萄球菌感染后可出现多种后继免疫反应，并且曾经尝试制造葡萄球菌菌苗，葡萄球菌类毒素等免疫制剂，但至今尚未证明任何一种免疫性预防措施是有效的。\u003C/p>\u003Cp>　　有人主张治疗带菌者，用鼻咽拭子采样后培养结果阳性的人可予每天口服利福平0.45～0.6g，连服5天，或与其他敏感的抗菌药物合用可明显地减少葡萄球菌的感染，在6～12周后根据个体的具体情况，必要时重复一个疗程，亦有应用抗生素如杆菌肽或新霉素滴鼻液，莫匹罗星或杆菌肽软膏搽鼻前庭部局部治疗的报道，医护人员应严格无菌操作技术，做好病区内消毒隔离，接触每一病人后要洗手。\u003C/p>\u003Cp>　　对于有葡萄球菌感染病灶者，尤其是感染医院内耐药菌株者应进行隔离，阻断传染源和传播途径，相关医护人员同时行鼻咽拭子培养，若培养出同一型细菌，则医护人员亦属医院内葡萄球菌感染有关的带菌者，必要时应更换工作岗位。\u003C/p>",6,{"id":90,"classification":86,"description":87,"sort":88,"diseaseId":12},59713,{"id":92,"classification":86,"description":87,"sort":88,"diseaseId":12},80143,{"id":94,"classification":95,"description":96,"sort":97,"diseaseId":12},54528,"治疗","\u003Cp>　　1.抗菌治疗\u003C/p>\u003Cp>　　(1)经验性治疗：根据感染来源(社区或医院)和本地区近期药敏资料选择药物。社区获得性肺炎考虑可能为葡萄球菌所致时，不宜选用青霉素，而应选用苯唑西林和头孢唑林等第一代头孢菌素;若效果不好，在进一步进行病原学诊断相关检查时可考虑换用糖肽类抗生素治疗。住院病人若怀疑医院获得性葡萄球菌肺炎，首选糖肽类抗生素治疗。在经验治疗过程中，应尽各种可能获得病原菌，并根据其药敏情况及时修改治疗方案。\u003C/p>\u003Cp>　　(2)针对性治疗：培养并确认病原菌为葡萄球菌时，应根据其药敏结果选药。如为甲氧西林敏感菌株，可选用苯唑西林、氯唑西林、头孢唑林或头孢噻吩等;若分离菌对甲氧西林耐药，首选糖肽类抗生素，并根据药敏结果可加用磷霉素、磺胺甲?唑/甲氧苄啶(SMZ-TMP)、利福平等。糖肽类抗生素目前国内应用的有：①万古霉素，成人剂量2.0g/d，分2次缓慢静滴;②去甲万古霉素，成人1.6g/d，分2次缓慢静滴;③替考拉宁，成人0.4g加入液体中静脉滴注，首3次剂量每12小时1次给药，以后维持剂量0.4g，每天给药1次。本品亦可肌内注射。肾功能减退患者应调整剂量。疗程不少于3周。国外近年新上市的抗革兰阳性球菌新型抗生素如链阳霉素、?唑烷酮等对葡萄球菌包括耐药株有良效，但也已出现耐药现象。\u003C/p>\u003Cp>　　2.引流 脓(气)胸应及早胸腔置管引流。肺脓肿应嘱病人按病变部位和全身情况作体位引流。金黄色葡萄球菌呼吸机相关肺炎患者亦应加强湿化吸痰，并严格执行无菌操作。\u003C/p>\u003Cp>　　3.其他 营养支持、心肺功能维护等均十分重要。伴随葡萄球菌心内膜炎患者，在抗菌治疗症状有所改善时应即早进行心脏赘生物的手术治疗。\u003C/p>",7,{"id":99,"classification":95,"description":96,"sort":97,"diseaseId":12},80144,{"id":101,"classification":95,"description":96,"sort":97,"diseaseId":12},59714,{"id":103,"classification":104,"description":105,"sort":106,"diseaseId":12},54529,"饮食","\u003Cp>　　1、葡萄球菌肺炎吃哪些食物对身体好：可吃营养丰富、容易消化、清淡的食物，多吃水果、蔬菜，多饮水。\u003C/p>\u003Cp>　　2、葡萄球菌肺炎最好不要吃哪些食物：\u003C/p>\u003Cp>　　·忌用酸性药物和食品。\u003C/p>\u003Cp>　　·忌喝茶\u003C/p>\u003Cp>　　·忌生冷食物。　不过食西瓜、冰淇淋、冰冻果汁、冰糕、冰棒、冷饮、香蕉、生梨等生冷食物。\u003C/p>\u003Cp>　　·忌油腻厚味。不宜吃鱼肝油、松花蛋黄、蟹黄、凰尾鱼、鲫鱼子，以及动物内脏等厚味食品。\u003C/p>\u003Cp>　　·忌高蛋白饮食。\u003C/p>\u003Cp>　　·忌食多糖之物。\u003C/p>\u003Cp>　　·忌辛辣食物。在膳食中不宜加入辣油、胡椒及辛辣调味品。\u003C/p>\u003Cp>　　(以上资料仅供参考，详情请咨询医生。)\u003C/p>",8,{"id":108,"classification":104,"description":105,"sort":106,"diseaseId":12},80145,{"id":110,"classification":104,"description":105,"sort":106,"diseaseId":12},59715,[112],"感染科",true]