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--> 00:05.395\n各位老师，\n\n00:05.395 --> 00:06.096\n大家下午好，\n\n00:06.096 --> 00:09.845\n我们今天分享的题目是急性细支气管炎的疾病概述。\n\n00:11.552 --> 00:12.201\n那首先来看一下，\n\n00:12.201 --> 00:16.351\n急性细支是急性细支气管炎的定义。\n\n00:16.351 --> 00:17.476\n医学的专业定义呢，\n\n00:17.476 --> 00:19.302\n就是急性细支管炎呢，\n\n00:19.302 --> 00:23.302\n是一种主要累积直径小于两毫米的细支气管的急性炎症。\n\n00:26.041 --> 00:27.441\n多由病毒感染引发。\n\n00:28.520 --> 00:31.971\n病变主要主要侵犯呼吸性细支气管肺泡管。\n\n00:33.057 --> 00:34.057\n以及肺泡等部位，\n\n00:34.257 --> 00:34.608\n嗯，\n\n00:34.608 --> 00:36.158\n通俗的理解来说呢，\n\n00:36.307 --> 00:36.708\n嗯，\n\n00:36.908 --> 00:39.958\n就像我们身体里很很小的一个通风管道，\n\n00:40.108 --> 00:40.783\n细支管，\n\n00:40.783 --> 00:42.257\n细支气管发炎了。\n\n00:44.914 --> 00:48.863\n这些管道从空气负责，\n\n00:48.863 --> 00:50.613\n把空气运到肺的各个角落，\n\n00:50.613 --> 00:52.738\n发炎以后就会影响空气的正常流通。\n\n01:03.036 --> 01:05.486\n我们来看一下疾病的流行病学特点。\n\n01:06.806 --> 01:07.906\n发病季节特点呢？\n\n01:07.906 --> 01:10.806\n急性细支气管炎具有明显的一个季节季节性，\n\n01:11.056 --> 01:13.257\n在冬春季节发病率比较高。\n\n01:13.457 --> 01:14.707\n例如在我国的北方，\n\n01:14.806 --> 01:16.707\n冬季寒冷且空气干燥，\n\n01:16.857 --> 01:20.656\n每年11月至次月至次年的3月期间，\n\n01:20.656 --> 01:23.906\n急性性支气管炎就诊的患儿数量明显增多。\n\n01:24.946 --> 01:25.772\n年龄分布呢，\n\n01:25.772 --> 01:28.571\n该疾病主要好发于两岁以内的婴幼儿，\n\n01:28.671 --> 01:29.722\n尤其是六个类，\n\n01:29.722 --> 01:32.772\n6个月以以下的这个婴婴儿更为常见。\n\n01:32.772 --> 01:33.421\n据统计，\n\n01:33.571 --> 01:36.459\n在因急性支气管炎住院的患儿中，\n\n01:36.459 --> 01:39.972\n六六个月以下的婴儿比例可达50%.60%。\n\n01:43.308 --> 01:44.384\n它流行病学特点呢，\n\n01:44.384 --> 01:46.259\n具有不同的地域差异，\n\n01:46.259 --> 01:49.683\n在不同的地域差异有差异性也比较大。\n\n01:49.683 --> 01:50.808\n在一些寒冷气，\n\n01:50.808 --> 01:52.083\n在一些寒气候，\n\n01:52.083 --> 01:53.833\n寒冷空气污染比较重的地方，\n\n01:53.933 --> 01:55.183\n发病率稍微高一点，\n\n01:55.283 --> 01:56.759\n如一些工业城市，\n\n01:56.759 --> 01:58.134\n由于空气污染比较多，\n\n01:58.183 --> 01:59.583\n急性气管炎的发病。\n\n02:00.295 --> 02:03.746\n几率要比空气新鲜的沿海城市高出20%.30%。\n\n02:05.480 --> 02:09.154\n经细支气管炎的危害主要是一个对呼吸功能的一个影响，\n\n02:09.154 --> 02:12.654\n经细支管炎会导致细气管黏膜的肿胀，\n\n02:12.654 --> 02:13.429\n分泌物增多，\n\n02:13.429 --> 02:14.330\n使气道狭窄，\n\n02:14.330 --> 02:15.179\n影响气体交换，\n\n02:15.179 --> 02:17.404\n严重时可出现呼吸急促，\n\n02:17.404 --> 02:18.929\n喘息、发绀的症状，\n\n02:19.229 --> 02:20.830\n甚至引发呼吸衰竭，\n\n02:20.979 --> 02:21.580\n例如。\n\n02:22.587 --> 02:23.811\n部分病情较重的患儿，\n\n02:23.811 --> 02:28.537\n呼吸频率可高达百分之可可可可可达50.80次每分，\n\n02:28.537 --> 02:29.886\n明显高于正常水平。\n\n02:30.669 --> 02:31.445\n对于心血管系统呢，\n\n02:31.445 --> 02:32.770\n也有十分重要的影响，\n\n02:32.919 --> 02:34.445\n由于呼吸功能受到影响，\n\n02:34.445 --> 02:36.244\n身体缺氧会加重心脏的负担，\n\n02:36.244 --> 02:40.270\n可导致各种心律失常、心力衰竭等心血管系统的并发症。\n\n02:40.270 --> 02:41.270\n研究表明呢。\n\n02:42.768 --> 02:45.042\n10%.15%的急性气管炎的患儿呢，\n\n02:45.042 --> 02:47.192\n在疾病严重时会出现不同程度的。\n\n02:49.492 --> 02:50.391\n心血管功能异常。\n\n02:52.759 --> 02:53.910\n性息食管炎的危害呢，\n\n02:53.910 --> 02:55.559\n主要是一个对生长发育的危害。\n\n02:55.559 --> 02:57.360\n反复的急性息食管炎呢，\n\n02:57.360 --> 03:00.860\n会影响患儿的营养摄入和睡眠质量，\n\n03:01.059 --> 03:03.535\n进而对生长发育产生不利的影响。\n\n03:03.535 --> 03:05.634\n长期患病的患儿，\n\n03:05.634 --> 03:07.960\n身高体重可能会落后于同龄人，\n\n03:08.110 --> 03:10.110\n智力发育也可能受到一定的影响。\n\n03:14.830 --> 03:17.380\n急性细支管炎的病因与发病机制，\n\n03:17.380 --> 03:18.330\n急性细支管炎呢，\n\n03:18.330 --> 03:20.229\n常常用于这些感染导致的。\n\n03:21.302 --> 03:22.402\n病毒类的病原体，\n\n03:22.453 --> 03:24.828\n病毒是引发急性细气管炎的主要病，\n\n03:24.828 --> 03:25.703\n主要病原体。\n\n03:25.802 --> 03:26.477\n其中呢，\n\n03:26.477 --> 03:28.277\n呼吸道合胞病毒是最为常见的，\n\n03:28.277 --> 03:30.203\n70%的病例由其引发。\n\n03:30.402 --> 03:30.852\n例如，\n\n03:30.852 --> 03:33.544\n在多个地区的临床研究中发现，\n\n03:33.544 --> 03:36.652\n在急性气管炎的患儿样本检测里，\n\n03:36.652 --> 03:38.552\n呼吸道合胞病毒检测率很高。\n\n03:38.852 --> 03:39.477\n此外，\n\n03:39.477 --> 03:40.128\n鼻病毒，\n\n03:40.128 --> 03:40.802\n流感病毒，\n\n03:40.802 --> 03:42.602\n副流感病毒也是比较常见的。\n\n03:42.703 --> 03:44.402\n这些病毒在不同的季节。\n\n03:45.776 --> 03:46.876\n的感染比例有所差异，\n\n03:46.876 --> 03:53.300\n如流感病毒在流感高发季节导致急性细支气管炎的病病例会明显增多。\n\n03:53.300 --> 03:54.501\n细菌类的病原体呢，\n\n03:54.501 --> 03:56.725\n也是也也是一个比较。\n\n03:58.216 --> 03:59.516\n比比较比较多见的一个，\n\n03:59.617 --> 04:02.817\n虽然叫病毒类的病原体比较少见，\n\n04:03.167 --> 04:03.742\n但是呢，\n\n04:03.742 --> 04:06.917\n某些细菌也可以在病毒的基础上合并感染，\n\n04:07.016 --> 04:08.042\n如肺炎链球菌，\n\n04:08.042 --> 04:09.266\n金黄色葡萄球菌，\n\n04:09.367 --> 04:11.817\n在一些免疫力低下的儿童患儿中呢，\n\n04:11.817 --> 04:13.417\n这这些细菌可能趁虚而入，\n\n04:13.417 --> 04:14.117\n加重病情。\n\n04:14.417 --> 04:15.141\n研究表明，\n\n04:15.141 --> 04:19.592\n在部分住院治疗的急性细支气管炎的患儿中，\n\n04:19.592 --> 04:22.316\n15%.20%的细菌合并感染的情况。\n\n04:28.628 --> 04:29.829\n支原体病原体呢，\n\n04:29.829 --> 04:33.829\n也是一个比较重要的一个支气管炎的一个致病菌，\n\n04:34.128 --> 04:35.729\n致病的一个病原体啊。\n\n04:35.729 --> 04:36.579\n肺炎支原体呢，\n\n04:36.579 --> 04:39.979\n也系支气管炎的致病病原体之一，\n\n04:39.979 --> 04:42.329\n尤其是稍大一点的儿童中更为多见。\n\n04:42.378 --> 04:44.354\n在学校幼儿园的场所呢，\n\n04:44.354 --> 04:46.128\n肺炎支原体容易引起传播。\n\n04:46.479 --> 04:47.428\n据有关调查呢，\n\n04:47.428 --> 04:49.979\n在5.15岁儿童细支气管炎的病例中，\n\n04:50.128 --> 04:53.329\n肺炎支原体的比例可到达10%.15%。\n\n04:56.565 --> 04:57.940\n感染引发的病理生理过程呢，\n\n04:57.940 --> 05:00.065\n主要是一个病毒入侵与免疫反应。\n\n05:00.515 --> 05:00.864\n嗯，\n\n05:00.864 --> 05:05.015\n当病毒入侵侵入细支管炎上皮细胞后，\n\n05:05.015 --> 05:06.515\n会引发机体免疫反应。\n\n05:06.614 --> 05:08.415\n免疫系统识别病原，\n\n05:08.565 --> 05:10.015\n识别识别病原体。\n\n05:11.869 --> 05:15.119\n抗原激活T淋巴细胞B淋巴细胞的免疫细胞，\n\n05:15.220 --> 05:18.720\n例如呼吸道合胞病毒感染时会刺激机体产生特异性的抗体。\n\n05:18.720 --> 05:19.820\n在整个过程中呢。\n\n05:22.123 --> 05:24.748\n免免疫细胞释放细胞因子的物质，\n\n05:24.748 --> 05:28.523\n可能会导致细支气管炎的黏膜炎症反应加剧，\n\n05:28.574 --> 05:30.023\n引起黏膜水肿等等。\n\n05:30.324 --> 05:33.623\n炎症介质的释放也是一个比较重要的一个病理生理过程。\n\n05:33.623 --> 05:34.748\n在感染过程中呢，\n\n05:34.748 --> 05:37.473\n炎症炎症细胞会释放多种的炎症介质，\n\n05:37.473 --> 05:39.023\n例如组胺、白三烯等。\n\n05:39.023 --> 05:42.123\n这些炎症介质会使得细血管平滑肌收缩，\n\n05:42.174 --> 05:43.223\n导致气道狭窄。\n\n05:43.223 --> 05:44.123\n以主干为例，\n\n05:44.123 --> 05:45.773\n它能够增加血管的通透性，\n\n05:45.973 --> 05:48.023\n使呼吸道分泌物增多，\n\n05:48.023 --> 05:49.074\n进一步阻塞气道，\n\n05:49.074 --> 05:50.873\n引发喘息、咳嗽等症状。\n\n05:56.151 --> 05:57.651\n感染引发的病理生理过程呢？\n\n05:57.651 --> 06:00.200\n气体气道阻塞与气体交换。\n\n06:00.351 --> 06:01.501\n随着炎症的发展，\n\n06:01.550 --> 06:02.450\n细支气管。\n\n06:04.332 --> 06:04.907\n粘膜肿胀，\n\n06:04.907 --> 06:05.606\n分泌物增多，\n\n06:05.606 --> 06:07.082\n加上粘液栓形成，\n\n06:07.182 --> 06:08.582\n会造成气道阻塞，\n\n06:08.631 --> 06:10.032\n气体进出受限，\n\n06:10.032 --> 06:12.682\n导致气导致通气与血流比例失调，\n\n06:13.182 --> 06:14.381\n影响气体交换。\n\n06:14.532 --> 06:15.032\n比如，\n\n06:15.032 --> 06:21.432\n在影像影像学中检查可以发现病变部位的病变部位的肺组织通气不足，\n\n06:21.432 --> 06:22.981\n氧气无法进入血液，\n\n06:22.981 --> 06:24.282\n二氧化碳排出受阻，\n\n06:24.332 --> 06:26.932\n进而引起机体缺氧和二氧化碳潴留。\n\n06:31.846 --> 06:33.846\n宿主因素对发病的影响，\n\n06:33.996 --> 06:35.346\n年龄因素，\n\n06:35.346 --> 06:37.395\n年龄是重要的宿主因素。\n\n06:37.395 --> 06:39.446\n婴幼儿的气道相对狭窄，\n\n06:39.645 --> 06:41.196\n免疫功能尚未完善。\n\n06:41.295 --> 06:41.770\n例如，\n\n06:41.770 --> 06:43.145\n6个月以下的婴儿呢，\n\n06:43.145 --> 06:45.145\n体内的免疫球蛋白水平比较低，\n\n06:45.246 --> 06:47.145\n尤其是分泌型的IGA不足，\n\n06:47.346 --> 06:50.170\n引起病原体的抵抗力较为薄弱，\n\n06:50.170 --> 06:51.571\n容易容易感染，\n\n06:51.571 --> 06:53.545\n引起急性细支管炎，\n\n06:53.596 --> 06:55.846\n且婴幼儿咳嗽反射较弱，\n\n06:55.895 --> 06:57.196\n难以有效的咳出。\n\n06:58.539 --> 07:01.139\n呼吸道分泌物也增加了发病的风险，\n\n07:01.338 --> 07:04.588\n过敏体质也是一个比较重要的一个营养因素。\n\n07:04.639 --> 07:06.614\n就过敏体质的儿童呢，\n\n07:06.614 --> 07:08.588\n更容易患有急性细气管炎。\n\n07:08.739 --> 07:10.664\n过敏体质患者呢，\n\n07:10.664 --> 07:14.063\n接触过过敏原之后会引发气道的过敏反应，\n\n07:14.063 --> 07:15.789\n使气道处于高反应状态。\n\n07:16.188 --> 07:18.213\n如对尘螨、花粉过敏的儿童呢，\n\n07:18.213 --> 07:20.088\n在接触相应的过敏原之后呢。\n\n07:21.282 --> 07:23.282\n气道黏膜更容易出现一些炎症反应，\n\n07:23.433 --> 07:24.632\n一旦感染病原体，\n\n07:24.632 --> 07:25.683\n病情往往较重，\n\n07:25.782 --> 07:27.583\n且更容易出现喘息的症状。\n\n07:27.683 --> 07:28.757\n其发病几率呢，\n\n07:28.757 --> 07:31.782\n比非过敏体质的儿童要高出30%.50%。\n\n07:38.790 --> 07:39.440\n同时呢，\n\n07:39.640 --> 07:42.714\n宿主的一些疾病的影响也是比较重要的。\n\n07:42.714 --> 07:49.915\n比如某些患儿具有先天性心脏病、慢性肺、慢性肺、肺部疾病、免疫缺陷病等基础病的儿童，\n\n07:49.915 --> 07:52.239\n由于其基础身体情况较差，\n\n07:52.390 --> 07:53.339\n抵抗力低下，\n\n07:53.440 --> 07:55.364\n更容易受到病病原体的入侵，\n\n07:55.364 --> 07:57.339\n引发急性细支气管炎。\n\n07:57.440 --> 07:57.864\n例如，\n\n07:57.864 --> 07:58.989\n先天性心脏病的话，\n\n07:59.089 --> 08:02.515\n心脏功能异常常会导致肺部循肺部血液循环，\n\n08:02.515 --> 08:03.290\n导致肺淤血，\n\n08:03.290 --> 08:04.290\n增加感染风险。\n\n08:05.611 --> 08:07.687\n且患儿患病后进情，\n\n08:07.687 --> 08:09.161\n病情进展可能更快，\n\n08:09.212 --> 08:10.611\n治疗难度也相对较大。\n\n08:16.434 --> 08:18.885\n接下来分享一下急性期支管炎的临床表现。\n\n08:20.484 --> 08:21.859\n典型的症状一个是咳嗽，\n\n08:21.859 --> 08:23.959\n喘息咳嗽呢，\n\n08:23.959 --> 08:25.660\n急性吸支管炎的常见症状，\n\n08:25.660 --> 08:26.684\n初期多为干咳，\n\n08:26.684 --> 08:27.984\n之后可出现咳痰。\n\n08:29.566 --> 08:29.717\n例如，\n\n08:29.717 --> 08:30.617\n在疾病早期，\n\n08:30.617 --> 08:32.416\n患儿常表现为刺激性干咳，\n\n08:32.416 --> 08:33.666\n随着病情的发展呢，\n\n08:33.716 --> 08:34.867\n痰液逐渐增多，\n\n08:35.017 --> 08:37.067\n为白色的黏痰或黄色的浓痰，\n\n08:37.416 --> 08:39.466\n咳嗽时一般较为频繁，\n\n08:39.466 --> 08:41.267\n尤其在夜间或清晨时加重，\n\n08:41.466 --> 08:43.367\n影响患儿的睡眠和日常生活。\n\n08:43.466 --> 08:44.242\n喘息呢，\n\n08:44.242 --> 08:45.692\n也为该病的重要症状之一，\n\n08:45.692 --> 08:48.617\n表现为呼吸时发现高调的效能音，\n\n08:48.617 --> 08:49.817\n这是由于气道狭窄，\n\n08:49.916 --> 08:51.466\n气流通过受阻所致。\n\n08:51.567 --> 08:55.666\n多数患儿在活动或哭闹后喘息的症状更为加重。\n\n08:55.666 --> 08:56.067\n明显。\n\n08:56.632 --> 08:57.031\n严重时，\n\n08:57.031 --> 08:59.731\n即使在安静状态下也能听到明显的喘息声。\n\n08:59.731 --> 09:01.656\n部分患儿可能会出现呼吸困难，\n\n09:01.656 --> 09:04.182\n表现为呼吸急促、鼻翼煽动等。\n\n09:09.958 --> 09:11.283\n发热发热呢，\n\n09:11.283 --> 09:13.908\n在急性细支气管炎中较为常见，\n\n09:14.208 --> 09:15.958\n体温可高达38°C，\n\n09:15.958 --> 09:16.658\n甚至更高。\n\n09:16.859 --> 09:21.908\n发热和持续的时间因个体差异和病原体的不同而有所不同。\n\n09:22.008 --> 09:22.484\n例如，\n\n09:22.484 --> 09:24.383\n由呼吸道合胞病毒感染引起的发热，\n\n09:24.383 --> 09:25.708\n一般可持续3.5天，\n\n09:25.859 --> 09:27.083\n合并有细菌感染，\n\n09:27.083 --> 09:28.559\n发热可能会更为严重，\n\n09:28.658 --> 09:31.258\n持续时间可能更为延长达5.7天。\n\n09:36.708 --> 09:38.732\n不同年龄段的呢，\n\n09:38.732 --> 09:40.357\n症状也有不同的差异。\n\n09:40.357 --> 09:41.557\n如婴幼儿时期，\n\n09:41.658 --> 09:43.908\n婴儿免疫力发育不完善，\n\n09:44.007 --> 09:45.132\n症状往往较重，\n\n09:45.132 --> 09:47.757\n除了咳嗽、喘息、发热外，\n\n09:48.057 --> 09:50.057\n还有可能会出现拒奶、吐奶。\n\n09:50.916 --> 09:51.741\n精神萎靡等症状。\n\n09:51.741 --> 09:53.440\n例如6个月以下的婴幼儿，\n\n09:53.440 --> 09:54.966\n由于无法准确的表达不适，\n\n09:55.065 --> 09:58.616\n常常会表现为烦躁不安、哭闹不止、进食明显减少，\n\n09:58.616 --> 10:01.716\n甚至出现短暂的呼吸暂停等危及生命的情况。\n\n10:03.278 --> 10:03.752\n儿童期呢，\n\n10:03.752 --> 10:07.927\n由于儿由于由由于一个机体的发育和抵抗力的一个提升，\n\n10:07.927 --> 10:10.078\n儿童的症状期呢，\n\n10:10.078 --> 10:11.177\n较婴幼儿相对较轻。\n\n10:11.478 --> 10:13.052\n人以咳嗽喘息为主，\n\n10:13.052 --> 10:16.028\n部分患儿可能伴有头痛、肌肉酸痛等全身症状。\n\n10:18.190 --> 10:19.315\n与婴儿不同的是，\n\n10:19.315 --> 10:21.965\n儿童能够描述身自身的不适，\n\n10:21.965 --> 10:22.940\n比如说喉咙痛，\n\n10:22.940 --> 10:23.690\n胸口闷等。\n\n10:24.382 --> 10:25.606\n且儿童的活动能力较强，\n\n10:25.606 --> 10:27.831\n在活动后喘息、咳嗽可能会加剧。\n\n10:31.471 --> 10:32.322\n青少年时期呢？\n\n10:32.322 --> 10:33.521\n青少年时期的机体，\n\n10:33.521 --> 10:34.822\n机体症状可能更好。\n\n10:36.572 --> 10:37.872\n症状较轻，\n\n10:37.872 --> 10:39.247\n咳嗽可能是主要的表现，\n\n10:39.247 --> 10:41.171\n喘息就比较少见了。\n\n10:42.515 --> 10:45.065\n部分青少年可能仅出现轻微的发热，\n\n10:45.065 --> 10:46.265\n或者无症状的发热，\n\n10:46.664 --> 10:48.414\n或者无发热症状，\n\n10:48.414 --> 10:49.815\n全身症状也不明显，\n\n10:49.815 --> 10:50.390\n例如呢，\n\n10:50.390 --> 10:52.465\n一些青少年患儿可能只是偶尔咳嗽，\n\n10:52.664 --> 10:54.914\n对日常生活和学习影响较小，\n\n10:54.965 --> 10:55.715\n但仍需。\n\n10:56.568 --> 10:57.119\n及时治疗，\n\n10:57.468 --> 10:59.068\n以免病情迁延不愈。\n\n11:03.900 --> 11:04.400\n体征呢，\n\n11:04.400 --> 11:06.275\n也是十分重要的，\n\n11:06.575 --> 11:07.575\n肺部听诊呢，\n\n11:07.575 --> 11:11.275\n可可以闻及广泛的效能音和粗的湿啰音。\n\n11:11.325 --> 11:12.200\n哮能音呢，\n\n11:12.200 --> 11:13.325\n是由于气道狭窄，\n\n11:13.325 --> 11:16.825\n气道气流通过时产生的一个高调的声音，\n\n11:16.825 --> 11:18.525\n提示气道痉挛或狭窄。\n\n11:18.525 --> 11:19.549\n出湿罗音呢，\n\n11:19.549 --> 11:21.325\n是由于呼吸道内有分泌物，\n\n11:21.525 --> 11:25.424\n气流进出时引起分泌物震动产生的声音说明。\n\n11:26.200 --> 11:28.049\n气道存在炎症和分泌物增多。\n\n11:28.099 --> 11:31.150\n例如在听诊时可以听到两肺满布的哮铃音，\n\n11:31.349 --> 11:33.549\n在吸气和呼气时均可以听到，\n\n11:33.599 --> 11:35.150\n以呼气末更为明显。\n\n11:35.650 --> 11:38.700\n同时可伴有散在的明显的湿罗出湿罗音。\n\n11:39.770 --> 11:40.945\n呼吸频率的改变，\n\n11:41.096 --> 11:42.921\n急性细支气管炎患儿呢，\n\n11:42.921 --> 11:44.395\n呼吸频率通常会增快。\n\n11:44.546 --> 11:46.245\n正常婴幼儿的呼吸频率呢，\n\n11:46.245 --> 11:48.120\n约为30.40次每分，\n\n11:48.120 --> 11:50.346\n儿童约为20.30次每分。\n\n11:50.745 --> 11:51.745\n患病时呢，\n\n11:51.745 --> 11:54.471\n婴儿呼吸频率可增至50.60次每分，\n\n11:54.471 --> 11:55.145\n甚至更高。\n\n11:55.445 --> 11:56.171\n儿童呢，\n\n11:56.171 --> 11:57.945\n也可以达到40次每分左右。\n\n11:58.745 --> 12:00.346\n呼吸频率增快是为了机体，\n\n12:00.395 --> 12:03.145\n为了满足缺满足氧气的需要。\n\n12:04.142 --> 12:06.091\n代偿呼吸功能受损的一个表现，\n\n12:06.242 --> 12:07.291\n呼吸频率越快，\n\n12:07.442 --> 12:09.341\n提示病情可能更为严重。\n\n12:16.250 --> 12:18.000\n体征的特点和及其临床意义。\n\n12:18.846 --> 12:20.695\n发绀发绀的体征，\n\n12:20.695 --> 12:24.770\n发绀是指皮肤和粘膜呈现青紫色，\n\n12:24.770 --> 12:27.995\n主要由于血液中的还原血红蛋白增多所致。\n\n12:27.995 --> 12:29.596\n在急性心支气管炎患儿中。\n\n12:31.249 --> 12:32.198\n当病情严重时。\n\n12:33.229 --> 12:35.528\n出现明显的气体交换障碍导致机体缺氧时，\n\n12:35.528 --> 12:37.028\n可出现明显的发绀症状，\n\n12:37.278 --> 12:39.229\n常见于口唇、指甲等部位。\n\n12:39.379 --> 12:40.028\n例如。\n\n12:42.994 --> 12:43.320\n患儿，\n\n12:43.320 --> 12:44.869\n患儿口唇指甲逐渐变紫，\n\n12:44.869 --> 12:46.395\n说明缺氧情况较为严重，\n\n12:46.445 --> 12:49.419\n需要采取措施改善患者的呼吸功能，\n\n12:49.419 --> 12:50.695\n纠正缺氧缺氧状态。\n\n13:18.083 --> 13:19.632\n急性支气管炎的诊断呢，\n\n13:19.632 --> 13:21.132\n需要结合患者的一个。\n\n13:22.254 --> 13:26.004\n临床诊临床病史和体格检查，\n\n13:26.203 --> 13:29.754\n并对并对疾病程度进行一个严重进行一个分级。\n\n13:30.960 --> 13:33.010\n如果有患儿有感冒的前期症状，\n\n13:33.010 --> 13:35.210\n持续一到3天诊断为毛细。\n\n13:35.210 --> 13:37.060\n诊断为毛细气管炎呢，\n\n13:37.060 --> 13:38.710\n需要同时满足以下几个症状，\n\n13:38.861 --> 13:42.810\n一个是持续的咳嗽气促或者胸部有凹陷。\n\n13:42.810 --> 13:43.835\n胸部听诊呢，\n\n13:43.835 --> 13:47.060\n可闻及哮鸣音和或或失铃湿罗音。\n\n13:49.111 --> 13:51.361\n评估有严重的毛细血管炎的高危因素，\n\n13:51.361 --> 13:54.236\n如年龄小于12周、早产合并心肺。\n\n13:55.318 --> 13:57.244\n疾病或存在明显的明显的免疫缺陷，\n\n13:57.244 --> 13:58.818\n功能状功能状态。\n\n14:00.697 --> 14:01.122\n同时呢，\n\n14:01.122 --> 14:02.771\n该病也会如果严重的话，\n\n14:02.771 --> 14:04.822\n可能会出现一些比较重要的一个并发症，\n\n14:04.872 --> 14:09.447\n包括肺炎、气胸、纵膈气肿等呼吸系统并发症。\n\n14:09.447 --> 14:11.271\n心血心心血管系统呢，\n\n14:11.271 --> 14:14.872\n可以出现心律失常、心肌炎、心包积液。\n\n14:17.802 --> 14:18.151\n等等，\n\n14:18.302 --> 14:19.851\n中枢性神经系统呢，\n\n14:19.851 --> 14:20.401\n可以出现。\n\n14:21.982 --> 14:22.632\n癫痫发作，\n\n14:22.632 --> 14:24.732\n脑炎内斜视啊，\n\n14:24.732 --> 14:30.682\n病毒感染脑神经引起的及影响神经通路所致的一个内斜视等等，\n\n14:30.732 --> 14:31.408\n并且呢，\n\n14:31.408 --> 14:34.482\n还可以合并有其他性的其他其他其他症状，\n\n14:34.482 --> 14:35.033\n比如说。\n\n14:35.896 --> 14:36.721\n急性的中耳炎，\n\n14:36.721 --> 14:37.697\n血清转氨酶升高，\n\n14:37.697 --> 14:38.747\n低钠血症等等。\n\n14:42.315 --> 14:45.215\n急性性这这急性细支管炎呢，\n\n14:45.215 --> 14:46.440\n在临床上遇到的患儿呢，\n\n14:46.440 --> 14:48.739\n大多数都是轻度的那病程呢，\n\n14:48.739 --> 14:50.465\n自大多是自限性的。\n\n14:50.465 --> 14:51.239\n有条件呢，\n\n14:51.239 --> 14:52.039\n可以在家护理，\n\n14:52.039 --> 14:53.815\n关注饮食及液体的摄入，\n\n14:53.864 --> 14:55.565\n呼吸情况及体温情况。\n\n14:55.965 --> 14:57.565\n对于中重度的一个患儿呢，\n\n14:57.565 --> 14:58.690\n需要有一个住院治疗，\n\n14:58.690 --> 15:00.515\n密切监测患者生命生命变化。\n\n15:03.189 --> 15:05.039\n基于病情的严重程度，\n\n15:05.039 --> 15:06.414\n采取不同的处理措施。\n\n15:09.651 --> 15:11.000\n最主要的一个治疗呢，\n\n15:11.000 --> 15:12.301\n一个是包括支持治疗。\n\n15:12.351 --> 15:15.250\n支持治疗主要是包括监测患者的病情变化，\n\n15:15.401 --> 15:17.500\n供氧以及补充水电解质，\n\n15:17.551 --> 15:19.051\n维持内环境稳定等等。\n\n15:21.768 --> 15:22.492\n对症治疗呢，\n\n15:22.492 --> 15:25.843\n主要是包括一个支气管舒张剂的雾化使用。\n\n15:30.486 --> 15:32.210\n对于有过敏史或者。\n\n15:33.143 --> 15:33.744\n或者过敏，\n\n15:33.843 --> 15:35.919\n过敏过敏过敏疾病家族史的，\n\n15:35.919 --> 15:37.494\n或者有明显喘息的毛细。\n\n15:37.744 --> 15:39.443\n这个细支气管炎患者呢，\n\n15:39.443 --> 15:41.643\n建议使用雾化吸入或支气管舒张剂，\n\n15:41.643 --> 15:43.794\n并且动态评估患者的治疗效果。\n\n15:46.021 --> 15:46.921\n常用的一些药物呢，\n\n15:46.921 --> 15:50.322\n主要是包括沙丁胺醇、特布他林、异丙托溴铵，\n\n15:50.771 --> 15:51.296\n同时呢，\n\n15:51.296 --> 15:52.171\n糖皮质激素呢，\n\n15:52.572 --> 15:54.646\n在于在某些特定的患儿中呢，\n\n15:54.646 --> 15:57.921\n也有也也可以使用一些短疗程小剂量的一个治疗。\n\n16:01.085 --> 16:02.659\n对于重度有过敏史，\n\n16:02.659 --> 16:06.260\n或有过敏过过敏性疾病家族史的毛细支气管炎的患儿呢，\n\n16:06.260 --> 16:09.684\n可以酌情使用小剂量短疗程的一个全身的糖皮质激素治疗。\n\n16:14.030 --> 16:14.804\n主要的药物呢，\n\n16:14.804 --> 16:15.929\n包括布地奈德。\n\n16:17.434 --> 16:17.783\n等等，\n\n16:17.984 --> 16:18.783\n同时呢，\n\n16:18.833 --> 16:21.059\n对于一些个比较咳痰比较困难的，\n\n16:21.059 --> 16:24.234\n可以使用一些高渗的盐水进行雾化吸入。\n\n16:26.299 --> 16:29.098\n可以使用3%的高渗盐水进行雾化吸入治疗，\n\n16:29.148 --> 16:30.424\n注意保持气道通畅。\n\n16:30.424 --> 16:32.448\n如果过程中患儿咳喘加重的，\n\n16:32.448 --> 16:33.073\n需要立即停，\n\n16:33.073 --> 16:33.848\n立即停用。\n\n16:35.580 --> 16:36.130\n主要机制呢，\n\n16:36.130 --> 16:38.681\n毛细血管炎的患儿的病理特征生病生理特征呢，\n\n16:38.681 --> 16:41.906\n主要是一个气道水肿和粘膜阻塞固化。\n\n16:41.906 --> 16:42.880\n使用高渗盐水呢，\n\n16:42.880 --> 16:44.481\n可以减轻粘膜下的一个肿胀，\n\n16:44.580 --> 16:46.481\n减少减少痰液的粘度，\n\n16:46.481 --> 16:47.781\n加快痰液的一个排出。\n\n16:49.918 --> 16:50.143\n同时呢，\n\n16:50.143 --> 16:52.192\n胸部物理治疗也是十分重要的啊，\n\n16:52.192 --> 16:53.668\n比如说经常的翻身拍背。\n\n16:55.072 --> 16:57.223\n帮助患儿清除清理清清理呢，\n\n16:57.223 --> 16:59.497\n这个呼吸道的一个分泌物。\n\n17:01.200 --> 17:01.674\n也能够，\n\n17:01.674 --> 17:02.174\n也能够，\n\n17:02.174 --> 17:03.400\n也能够也能够。\n\n17:06.333 --> 17:07.057\n对患儿的病情呢，\n\n17:07.057 --> 17:07.682\n有所帮助。\n\n17:09.261 --> 17:10.286\n该疾病的预后呢，\n\n17:10.286 --> 17:10.911\n一般较好，\n\n17:11.411 --> 17:13.261\n大多数是一个自限性疾病，\n\n17:13.261 --> 17:13.962\n预后良好，\n\n17:13.962 --> 17:14.812\n不留后遗症。\n\n17:14.911 --> 17:15.487\n但是呢，\n\n17:15.487 --> 17:18.536\n部分的患儿呼吸道粘膜上皮破坏严重呢，\n\n17:18.536 --> 17:19.011\n可以。\n\n17:20.038 --> 17:23.239\n会会会削弱对于病原体的一个应变防御能力，\n\n17:23.489 --> 17:26.188\n增加呼吸道致敏概率和气道高反应性。\n\n17:26.239 --> 17:26.788\n同时呢，\n\n17:26.788 --> 17:27.989\n机体的免疫状态发生改变，\n\n17:27.989 --> 17:28.688\n也可激发。\n\n17:29.642 --> 17:30.442\n高反应性疾病。\n\n17:37.078 --> 17:38.328\n预主要的预防措施呢，\n\n17:38.328 --> 17:40.629\n主要是包括一个阻断传播途径，\n\n17:40.729 --> 17:41.779\n比如例如呢，\n\n17:41.779 --> 17:44.404\n和有一些呼吸道感染的疾病的患儿呢，\n\n17:44.404 --> 17:45.729\n要要分开居住。\n\n17:46.758 --> 17:47.907\n戴口罩，\n\n17:47.907 --> 17:48.883\n勤通风等等。\n\n17:50.510 --> 17:50.860\n第二个呢，\n\n17:50.860 --> 17:52.961\n是保护易感人群。\n\n17:54.240 --> 17:54.965\n在婴幼儿中，\n\n17:54.965 --> 17:55.629\n在婴幼儿中，\n\n17:55.629 --> 17:57.390\n特别是一些有基础疾病的婴幼儿呢，\n\n17:57.390 --> 17:57.740\n避免，\n\n17:57.740 --> 17:59.441\n避免去一些比较拥挤的人群，\n\n17:59.441 --> 18:00.941\n或者被动吸烟的环境中。\n\n18:05.451 --> 18:05.875\n同时呢，\n\n18:05.875 --> 18:06.500\n疫苗预防呢，\n\n18:06.500 --> 18:09.100\n也是也是一个比较推荐的一个方式，\n\n18:09.100 --> 18:12.076\n对于一些流感疫苗或者说其他的一些，\n\n18:12.076 --> 18:13.926\n对于有一些呼吸道病毒的疫苗呢，\n\n18:13.926 --> 18:16.276\n可以考虑进行一个疫苗的一个接种，\n\n18:16.276 --> 18:17.951\n以提高患者的免疫力，\n\n18:17.951 --> 18:19.776\n对病原体的抵抗抵抗力。\n\n18:22.104 --> 18:22.154\n好，\n\n18:22.154 --> 18:22.553\n谢谢大家，\n\n18:22.553 --> 18:23.803\n我今天的分享到此结束。\n\n","v0247cg10004d60s7valjht083edtl1g",1106,1486,0,"2026-01-24 22:13:33"," 急性支气管炎疾病概述 - 症状、病因及治疗方法  "," 急性支气管炎, 支气管炎症状, 支气管炎病因, 支气管炎治疗, 呼吸道感染  "," 本文详细介绍了急性支气管炎的疾病概述，包括常见症状如咳嗽、咳痰和胸闷，主要病因如病毒感染和细菌感染，以及有效的治疗方法，帮助您快速了解并应对这一呼吸道疾病。","2026-03-08 15:00:00",[37],{"menuId":38,"menuName":39,"parentId":30,"orderNum":40,"path":41,"component":42,"isFrame":43,"isCache":44,"menuType":45,"visible":21,"status":30,"createDept":6,"remark":24,"createTime":46,"children":47,"columnImage":48,"columnLogo":49,"uncheckedLogo":6,"checkedLogo":6,"isHot":30,"isHome":30,"forceLogin":30,"color":6,"seoTitle":50,"seoKeywords":51,"seoDescription":52,"contentNum":6,"promotionalPoster":53,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":54,"routerPath":41,"componentInfo":42},"1986622624134549505","科普视频",3,"video","/video.html","1","0","T","2025-11-07 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