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--> 00:13.333\n各位老师，\n\n00:13.333 --> 00:13.958\n大家下午好，\n\n00:13.958 --> 00:15.258\n我今天分享的题目是。\n\n00:16.451 --> 00:18.350\n预预防肺结核的科普知识。\n\n00:20.808 --> 00:22.433\n我将从四个方面进行介绍，\n\n00:22.583 --> 00:24.183\n一个是肺结核的基本知识，\n\n00:24.333 --> 00:25.783\n肺结核的传染性，\n\n00:25.933 --> 00:27.533\n肺结核的疾病症状，\n\n00:27.583 --> 00:29.183\n以及肺结核的预防措施。\n\n00:31.999 --> 00:34.098\n我来讲一下肺结核的基本知识。\n\n00:34.898 --> 00:35.749\n肺结核呢，\n\n00:35.749 --> 00:36.098\n我们。\n\n00:37.261 --> 00:37.736\n可以分发，\n\n00:37.736 --> 00:39.936\n可以可以分为呢，\n\n00:39.936 --> 00:40.960\n原发性的肺结核，\n\n00:40.960 --> 00:42.611\n包括原发综合征及。\n\n00:44.196 --> 00:46.146\n胸腔内的淋巴结核还有呢，\n\n00:46.146 --> 00:47.722\n血栓血型播散性的肺结核，\n\n00:47.722 --> 00:49.222\n包括急性粟粒性肺结核，\n\n00:49.222 --> 00:51.997\n亚急性以及慢性血型播散型的肺结核。\n\n00:52.916 --> 00:54.116\n继发性肺结核呢？\n\n00:55.883 --> 00:57.933\n是肺结核中的一个重要重要类型，\n\n00:57.984 --> 00:58.609\n病变呢，\n\n00:58.609 --> 00:59.933\n可以包含有增殖啊，\n\n00:59.933 --> 01:04.033\n浸润干酪以及空洞样等不同的病理改变。\n\n01:04.749 --> 01:10.524\n结核性胸膜炎包括结核性干性胸膜炎、渗出性胸膜炎和结核性脓胸等等。\n\n01:12.257 --> 01:13.882\n其他的肺其他的结核，\n\n01:13.882 --> 01:15.332\n包括比如说肺癌结核。\n\n01:15.382 --> 01:16.482\n按照各脏器。\n\n01:17.425 --> 01:17.925\n进行命名，\n\n01:17.925 --> 01:21.875\n比如说骨结核、结核性脑膜炎和肾结核等等。\n\n01:25.292 --> 01:29.818\n肺结核还可以还可以还可以分为一个活动性肺结核。\n\n01:29.818 --> 01:30.742\n活动性肺结核呢，\n\n01:30.742 --> 01:33.517\n是指病灶处于活动期，\n\n01:33.517 --> 01:34.093\n提示呢，\n\n01:34.093 --> 01:36.718\n结核分枝杆菌繁殖活跃，\n\n01:36.968 --> 01:42.318\n这类病人需要注意的是有较强的传染性且并且发展迅速。\n\n01:42.318 --> 01:43.443\n非活动性肺结核呢，\n\n01:43.443 --> 01:43.867\n是指。\n\n01:44.785 --> 01:48.785\n具有相对稳定的肺肺结核相关病变的胸部影像。\n\n01:48.885 --> 01:49.785\n既往呢？\n\n01:50.857 --> 01:52.357\n有或无肺结核病史。\n\n01:53.185 --> 01:54.786\n无肺结核相关的临床表现，\n\n01:54.886 --> 01:56.736\n结核分枝杆菌感染证据，\n\n01:56.886 --> 01:58.685\n有结核风湿杆菌感染的证据。\n\n01:59.629 --> 02:00.154\n结合。\n\n02:01.741 --> 02:04.717\n结合病原病原学检测为阴性，\n\n02:04.717 --> 02:07.442\n排除其他原因所致的肺部疾病。\n\n02:11.757 --> 02:13.031\n结核病的发病机制呢，\n\n02:13.031 --> 02:16.582\n主要是结核菌入侵人体所引起的组织反应。\n\n02:16.582 --> 02:18.382\n基本上与一般细菌啊，\n\n02:18.382 --> 02:18.957\n化学。\n\n02:19.736 --> 02:22.011\n和物理刺激引起的炎症反应一样，\n\n02:22.011 --> 02:24.587\n主要有真渗出性和增生性病变，\n\n02:24.736 --> 02:29.886\n如机体抵抗力弱或感染大量毒性强的细菌时。\n\n02:30.742 --> 02:31.567\n病缘肉芽，\n\n02:31.567 --> 02:32.591\n肉芽组织很少，\n\n02:32.841 --> 02:33.641\n已产生。\n\n02:35.475 --> 02:37.675\n原发性坏死、变质、变质、变化。\n\n02:39.686 --> 02:42.412\n主要包括一个渗透性病变和增殖性病变。\n\n02:43.813 --> 02:46.063\n渗出性病变主要是肺组织最初有充血。\n\n02:47.188 --> 02:47.537\n水肿，\n\n02:47.537 --> 02:49.837\n接着有中性粒细胞、淋巴细胞的浸润，\n\n02:49.888 --> 02:51.638\n继而出现大量的单核细胞。\n\n02:52.417 --> 02:53.417\n其中常有结核菌。\n\n02:54.565 --> 02:56.865\n渗出性病变如发生在浆膜腔，\n\n02:57.365 --> 02:59.115\n则渗出物以浆液为主。\n\n03:00.251 --> 03:02.126\n纤维蛋白原和细胞成分较少，\n\n03:02.276 --> 03:03.477\n增殖性病变呢？\n\n03:05.097 --> 03:05.296\n是。\n\n03:05.947 --> 03:07.697\n特点是结核结节的形成，\n\n03:07.746 --> 03:10.697\n结核结节是具有特征性的瑞瓦组组织。\n\n03:11.988 --> 03:14.188\n以多层的放射性排列。\n\n03:15.078 --> 03:16.529\n类上皮细胞为主要成分，\n\n03:16.578 --> 03:19.929\n其中多多核的结合巨细胞是其。\n\n03:22.173 --> 03:24.473\n其其中外围是淋巴细胞浸润。\n\n03:27.863 --> 03:29.138\n肺结核的发病机制呢，\n\n03:29.138 --> 03:31.238\n肺结核病人主要是空洞性肺结核，\n\n03:31.388 --> 03:33.837\n从呼吸道排出大量的带菌微粒，\n\n03:33.888 --> 03:36.613\n吸入这些带菌微粒即可造成感染。\n\n03:36.613 --> 03:39.037\n直径小于五五微米的微粒呢，\n\n03:39.037 --> 03:39.837\n能够达到肺泡，\n\n03:40.087 --> 03:42.287\n其因其致病性。\n\n03:43.591 --> 03:46.891\n最强达到肺泡的肺结核区化和性巨噬细胞，\n\n03:46.891 --> 03:48.391\n并为巨噬细胞所吞噬。\n\n03:50.662 --> 03:52.662\n在有效的细胞免疫清理之前，\n\n03:52.813 --> 03:53.613\n就是细胞。\n\n03:54.460 --> 03:56.259\n将其杀灭的能力有限。\n\n03:57.503 --> 03:59.453\n结核细菌在细胞内繁殖，\n\n03:59.552 --> 04:01.253\n一方面可以引起局部的炎症，\n\n04:01.253 --> 04:04.203\n另一方面可发生全身性的血源性播散。\n\n04:04.917 --> 04:07.567\n成为以后肺外结核病变的发生根源。\n\n04:11.074 --> 04:12.274\n结核病的传染性。\n\n04:17.273 --> 04:17.972\n相对而言啊，\n\n04:17.972 --> 04:21.423\n肺结核病人中的类型是具有传染性的，\n\n04:21.523 --> 04:26.173\n而肺外结核的病人如骨结核、脑膜结核等则不具有传染性。\n\n04:27.134 --> 04:28.509\n由于肺腔与外界相通，\n\n04:28.509 --> 04:31.783\n在肺结核的发发展恶化或形成空洞时，\n\n04:31.933 --> 04:34.033\n病变中的结核菌大量繁殖，\n\n04:34.084 --> 04:35.634\n通过支气管排出体外，\n\n04:35.734 --> 04:37.134\n造成肺结核的传播。\n\n04:38.290 --> 04:40.365\n这样的肺结核病人才具有传染性，\n\n04:40.365 --> 04:41.540\n但病人治愈了，\n\n04:41.540 --> 04:42.941\n便不再成为传染源。\n\n04:46.246 --> 04:47.395\n衡量和判断。\n\n04:48.683 --> 04:49.632\n肺结核的传染性的。\n\n04:51.611 --> 04:54.437\n有有有有有有有，\n\n04:54.437 --> 04:56.786\n对病人的痰液进行涂片染色，\n\n04:56.786 --> 04:57.962\n进行显微镜观察。\n\n04:58.733 --> 05:00.983\n如果图片中发生了抗酸杆菌阳性，\n\n05:00.983 --> 05:02.032\n则认为具有传染性，\n\n05:02.032 --> 05:02.882\n成为传染源。\n\n05:03.845 --> 05:07.170\n肺结核传染性最强的时间是发生在治疗之前。\n\n05:07.369 --> 05:08.220\n所以应当。\n\n05:09.179 --> 05:10.755\n重视早期发现，\n\n05:10.755 --> 05:12.679\n正确和及时治疗传染源。\n\n05:15.984 --> 05:16.933\n肺结核的病理变化呢，\n\n05:16.933 --> 05:19.084\n主要是以渗出性病变为主，\n\n05:19.084 --> 05:20.959\n增殖性病变为增生。\n\n05:20.959 --> 05:24.984\n增生为主的病变和坏死病和坏死为主的病变分为这三类。\n\n05:27.286 --> 05:29.661\n渗出为渗出为主的病变，\n\n05:29.661 --> 05:33.111\n出现于肺结核炎症早期或机体抵抗力较弱的情况下。\n\n05:37.264 --> 05:38.864\n细菌量多，\n\n05:39.313 --> 05:41.213\n无力强或变态反应强时，\n\n05:41.213 --> 05:44.864\n主要表现为浆液性或浆液纤维性纤纤维素性炎症，\n\n05:45.063 --> 05:46.889\n病变早期中性粒细胞浸润，\n\n05:46.889 --> 05:48.313\n后被巨噬细胞取代。\n\n05:49.114 --> 05:49.214\n嗯，\n\n05:49.214 --> 05:50.214\n以增殖性病变，\n\n05:50.714 --> 05:52.815\n以增生为主的病变很少，\n\n05:52.964 --> 05:53.364\n嗯。\n\n05:55.464 --> 05:57.440\n毒低和免疫力免疫反应强，\n\n05:57.440 --> 05:59.515\n以增生为主形成的结核结节。\n\n05:59.714 --> 06:02.315\n结核结节主要是由上皮样细胞狼干死细胞。\n\n06:05.381 --> 06:09.807\n加上外周的聚集的少量聚集的淋巴细胞和少量反应增生的纤维。\n\n06:09.807 --> 06:11.731\n纤维细胞构成典型。\n\n06:13.559 --> 06:16.109\n典型者一些中央有干酪性干酪样坏死。\n\n06:16.309 --> 06:18.709\n坏死为主的病变主要是顶多毒强。\n\n06:18.809 --> 06:21.760\n以渗出或增生性病变为主的病变可分为。\n\n06:23.373 --> 06:24.424\n继发肝脏炎坏死。\n\n06:26.205 --> 06:27.131\n结合坏死道，\n\n06:27.131 --> 06:30.868\n由于由由于由含脂质的多，\n\n06:30.868 --> 06:32.406\n多呈黄色细。\n\n06:34.088 --> 06:34.562\n均匀细腻，\n\n06:34.562 --> 06:35.287\n质地较实，\n\n06:35.388 --> 06:36.338\n状如奶酪。\n\n06:38.795 --> 06:41.071\n结核病患者的症状结核病患者的症状呢？\n\n06:42.959 --> 06:44.459\n比较多样，\n\n06:44.709 --> 06:45.884\n有有时呢，\n\n06:45.884 --> 06:50.009\n婴儿肺结核以头喘为首发的症状，\n\n06:50.009 --> 06:50.783\n全身不适，\n\n06:50.783 --> 06:51.908\n倦怠乏力，\n\n06:52.058 --> 06:53.408\n不能坚持日常工作，\n\n06:53.408 --> 06:54.134\n容易烦躁，\n\n06:54.134 --> 06:54.709\n心悸，\n\n06:54.859 --> 06:55.683\n食欲减退，\n\n06:55.683 --> 06:57.259\n体重减轻的盗汗。\n\n07:08.789 --> 07:10.688\n都发生在重症患者。\n\n07:12.485 --> 07:15.385\n在入睡时或睡醒时发生时全身出汗，\n\n07:15.585 --> 07:16.385\n严重者。\n\n07:17.200 --> 07:19.450\n衣服浸湿伴随衰竭感。\n\n07:23.095 --> 07:24.994\n发热是肺结核的早期症状之一，\n\n07:25.095 --> 07:27.045\n体温的变化主要有以下几种，\n\n07:27.244 --> 07:28.420\n一个是体温不稳定，\n\n07:28.420 --> 07:29.345\n轻微的劳动，\n\n07:29.795 --> 07:31.295\n体力劳动即可引起发热，\n\n07:31.295 --> 07:34.945\n经过休息30分钟后也能往也往往不能恢复正常。\n\n07:35.897 --> 07:38.296\n长期的微热多见于下午或傍晚，\n\n07:38.446 --> 07:39.696\n色沉降到正常，\n\n07:39.946 --> 07:42.247\n伴随倦怠不适感。\n\n07:43.170 --> 07:44.709\n病灶急剧进展和扩散时，\n\n07:44.709 --> 07:45.596\n发热更显著，\n\n07:45.596 --> 07:46.520\n可出现恶寒，\n\n07:46.770 --> 07:49.770\n发热达到39°.40°。\n\n07:51.674 --> 07:54.898\n局部的症状主要包括咳嗽、咯血和胸痛。\n\n07:54.949 --> 07:57.199\n咳嗽早期轻微的咳嗽，\n\n07:57.199 --> 07:58.574\n无痰或有少量黏痰。\n\n07:58.574 --> 07:59.773\n病变扩大时有空洞，\n\n07:59.773 --> 08:01.699\n形成时痰液可形成脓性，\n\n08:02.049 --> 08:02.799\n量较多。\n\n08:03.957 --> 08:05.457\n若并发支气管肺结核，\n\n08:05.457 --> 08:06.407\n咳嗽加剧。\n\n08:07.682 --> 08:08.557\n如果支气管狭窄，\n\n08:08.557 --> 08:13.207\n只有局限于效淋支气管淋巴结和压迫支气管时，\n\n08:13.207 --> 08:14.582\n可可引起咳。\n\n08:16.341 --> 08:17.290\n呛咳和喘灵。\n\n08:19.571 --> 08:20.145\n大约呢，\n\n08:20.145 --> 08:22.621\n有1/3.1/2的病人呢，\n\n08:22.621 --> 08:23.246\n有咯血。\n\n08:23.346 --> 08:27.520\n咯血量不等病灶炎炎症使毛细血管通透性增高，\n\n08:27.520 --> 08:30.096\n可引起痰中带血或夹血。\n\n08:30.145 --> 08:32.596\n小血管损伤时可有中等量咯血。\n\n08:32.745 --> 08:36.346\n空洞壁上较大动脉瘤破裂时可以引起较大量的咯血。\n\n08:37.888 --> 08:37.963\n嗯，\n\n08:37.963 --> 08:38.364\n胸痛，\n\n08:38.364 --> 08:39.164\n部位不稳，\n\n08:39.164 --> 08:41.189\n部位不定的隐痛是。\n\n08:42.456 --> 08:43.057\n尝试神，\n\n08:43.106 --> 08:45.507\n尝试神经发作的发射。\n\n08:45.557 --> 08:48.706\n尝试神经发射作用引起的，\n\n08:48.807 --> 08:50.057\n不受呼吸的影响。\n\n08:51.091 --> 08:54.366\n固定部位的针刺样疼痛伴随呼吸或咳嗽时加重，\n\n08:54.366 --> 08:58.440\n是因为炎症波及壁层胸膜所引起的。\n\n08:58.491 --> 08:59.091\n如果。\n\n09:00.685 --> 09:01.736\n膈胸膜受到刺激。\n\n09:02.611 --> 09:04.861\n疼痛可放射到肩部或上腹部。\n\n09:07.525 --> 09:09.750\n呼吸功能障碍引起的症状。\n\n09:09.750 --> 09:11.025\n由于肺脏的功能。\n\n09:12.482 --> 09:13.182\n储备强储，\n\n09:13.182 --> 09:14.132\n储备能力强大，\n\n09:14.132 --> 09:14.807\n代偿性高，\n\n09:14.807 --> 09:16.833\n轻度的组织损害不会引起气机。\n\n09:17.232 --> 09:20.232\n当肺组织破坏严重、范围广泛时，\n\n09:20.432 --> 09:22.232\n可引起肺和并发。\n\n09:23.713 --> 09:24.263\n肺萎缩，\n\n09:24.263 --> 09:24.864\n肺气肿，\n\n09:25.064 --> 09:25.414\n嗯，\n\n09:25.414 --> 09:26.664\n胸膜增厚时。\n\n09:27.791 --> 09:30.142\n代偿功能已经不能满足生理需要，\n\n09:30.142 --> 09:32.192\n患者首先在体力活动时感到气喘。\n\n09:34.851 --> 09:36.226\n结核病的预防措施呢，\n\n09:36.426 --> 09:40.125\n那主要是包括卡介苗接种呢。\n\n09:41.369 --> 09:41.895\n卡介苗，\n\n09:41.895 --> 09:45.145\n卡介苗接种肺结核感染主要通过呼吸道传播。\n\n09:45.145 --> 09:45.594\n因此。\n\n09:47.809 --> 09:52.609\n空气因此因此因此控制空气污染是防止肺结核病人的关键。\n\n09:52.758 --> 09:55.109\n常通过以下措施进行进行预防，\n\n09:55.109 --> 09:56.809\n一个是培养良好的生活习惯，\n\n09:57.008 --> 09:57.658\n第三个，\n\n09:57.658 --> 10:00.408\n第二个是定期检查肺部的肺部的健康，\n\n10:00.559 --> 10:01.133\n第三呢，\n\n10:01.133 --> 10:01.809\n卡介苗接种，\n\n10:01.809 --> 10:03.309\n第四是做好自我保护。\n\n10:07.442 --> 10:08.242\n彻底消毒，\n\n10:08.242 --> 10:09.117\n做一次彻底消毒。\n\n10:09.117 --> 10:13.442\n根据结核杆菌耐寒、耐耐干热但不耐湿的特点，\n\n10:13.492 --> 10:19.966\n将用过的毛巾、餐具、衣物、手帕、口罩等放入物品中煮沸10.15分钟。\n\n10:19.966 --> 10:22.466\n对书籍、棉花、纤维衣物呢，\n\n10:22.466 --> 10:23.567\n不能用水煮的衣物，\n\n10:23.567 --> 10:25.666\n可可在阳光下暴晒4.6小时，\n\n10:25.666 --> 10:27.392\n或用紫外线灯消毒两小时。\n\n10:27.492 --> 10:27.992\n此外，\n\n10:27.992 --> 10:29.541\n也可用苏打水。\n\n10:31.831 --> 10:34.382\n来苏水等消毒液进行消毒，\n\n10:34.382 --> 10:34.981\n多通风，\n\n10:34.981 --> 10:35.882\n定时开窗通风，\n\n10:35.882 --> 10:37.932\n保持室内的空气新鲜。\n\n10:38.132 --> 10:38.856\n据统计，\n\n10:38.856 --> 10:39.831\n每十分钟换。\n\n10:41.093 --> 10:41.593\n通风换气，\n\n10:41.593 --> 10:42.692\n一次4.5分钟后，\n\n10:42.692 --> 10:44.793\n可以吹掉空气中90%的结核杆菌。\n\n10:46.963 --> 10:48.039\n勤洗手，\n\n10:48.039 --> 10:49.539\n培养良好的卫生习惯，\n\n10:49.539 --> 10:51.439\n如实行分餐制，\n\n10:51.539 --> 10:53.239\n洗漱用具专人专用，\n\n10:53.289 --> 10:54.489\n勤洗手、勤换衣，\n\n10:54.489 --> 10:55.789\n衣服定期消毒等等。\n\n10:58.469 --> 10:59.070\n定期检查，\n\n10:59.070 --> 11:00.219\n定期检查肺部健康，\n\n11:00.219 --> 11:01.270\n可以发现早期病例，\n\n11:01.270 --> 11:02.294\n以便及时的治。\n\n11:03.232 --> 11:03.882\n及时的治疗，\n\n11:04.083 --> 11:05.783\n防止播散传播。\n\n11:05.882 --> 11:06.783\n健康体检呢，\n\n11:06.783 --> 11:08.083\n应当结合当地的，\n\n11:08.083 --> 11:10.583\n当地的结合播散疫情进行一到两年一次。\n\n11:11.562 --> 11:12.137\n尽早治疗。\n\n11:12.137 --> 11:17.211\n在农村根据个人病史、痰液检查情况的自觉体征的配合进行肺部检查，\n\n11:17.211 --> 11:18.161\n以便及时发现，\n\n11:18.161 --> 11:18.961\n尽早治疗。\n\n11:27.614 --> 11:28.590\n卡介苗呢，\n\n11:28.590 --> 11:38.965\n是流行肺结核杆菌的特种含胆、含流胆之中培养的经多代转、经多代移种后对人体无害而能产生免疫力的活菌疫苗。\n\n11:39.833 --> 11:41.658\n为正确查明是否需要接种，\n\n11:41.658 --> 11:44.857\n一般在接种前需做结核结核菌素试验，\n\n11:45.007 --> 11:46.357\n阴性者才需接种。\n\n11:49.129 --> 11:51.929\n但过敏反应对身体并无多大影响，\n\n11:51.929 --> 11:54.278\n在结核病感染率很低的地区，\n\n11:54.278 --> 11:55.953\n可以免做结核菌素实验啊，\n\n11:55.953 --> 11:57.004\n直接接种卡介疫苗。\n\n11:57.723 --> 11:58.822\n接种6.8周后，\n\n11:58.822 --> 12:03.072\n结核感结合菌素实验抗体转移阳性，\n\n12:03.072 --> 12:05.072\n表示人体因肠为免疫力，\n\n12:05.422 --> 12:06.297\n如试验阴性，\n\n12:06.297 --> 12:07.398\n则表示接种没有成功，\n\n12:07.398 --> 12:08.223\n需要再次接种。\n\n12:11.401 --> 12:11.476\n嗯，\n\n12:11.476 --> 12:12.351\n做好自我保护，\n\n12:12.351 --> 12:13.452\n卧卧床休息。\n\n12:14.385 --> 12:15.159\n活动性肺结核中，\n\n12:15.159 --> 12:16.885\n家庭患者要做好隔离消毒，\n\n12:16.885 --> 12:17.734\n切断传染途径，\n\n12:17.734 --> 12:19.059\n如病人的碗筷要分开，\n\n12:19.059 --> 12:20.484\n必须每日煮沸消毒，\n\n12:20.635 --> 12:21.684\n保持正常睡眠。\n\n12:21.684 --> 12:22.684\n急性期病人呢，\n\n12:22.684 --> 12:22.984\n要。\n\n12:25.309 --> 12:25.960\n绝对卧床休息，\n\n12:25.960 --> 12:27.585\n病情稳定后可进行轻度的活动，\n\n12:27.585 --> 12:28.284\n咯血冰凉的，\n\n12:28.284 --> 12:29.460\n要消除紧张情绪。\n\n12:30.258 --> 12:30.783\n卧床休息，\n\n12:30.783 --> 12:32.033\n并及时去专科院。\n\n12:37.101 --> 12:38.500\n并并及时去专科医院。\n\n12:40.242 --> 12:41.692\n进行进行进行进行就诊。\n\n12:43.218 --> 12:44.619\n经常擦拭桌椅及地面，\n\n12:44.619 --> 12:46.068\n经常晒被褥，\n\n12:46.169 --> 12:47.218\n更换清洁栏杆，\n\n12:47.218 --> 12:48.318\n每日开窗通风，\n\n12:48.318 --> 12:50.244\n保持室内空气新鲜。\n\n12:50.244 --> 12:51.343\n肺结核的治疗呢，\n\n12:51.343 --> 12:52.169\n主要是包括。\n\n12:52.986 --> 12:53.536\n的原则呢，\n\n12:53.536 --> 12:57.786\n主要是遵循早期联合、适量规律全程的原则。\n\n13:02.060 --> 13:03.060\n抗结核治疗呢，\n\n13:03.060 --> 13:05.060\n利福平敏感或耐药的患者呢，\n\n13:05.060 --> 13:09.986\n胰腺胰腺抗结核药物包括异烟肼、利福平、吡嗪酰胺等，\n\n13:09.986 --> 13:11.661\n推荐采用固定的复合剂量。\n\n13:13.677 --> 13:14.877\n利福平耐药的患者呢，\n\n13:14.877 --> 13:16.653\n我们去采用个体化的。\n\n13:18.005 --> 13:18.681\n制定方案，\n\n13:18.681 --> 13:20.656\n并结合药敏的结果，\n\n13:20.656 --> 13:21.406\n手术治疗呢，\n\n13:21.406 --> 13:24.005\n主要适应症主要是包括一些严重并发症，\n\n13:24.005 --> 13:25.106\n化学治疗失败。\n\n13:26.013 --> 13:30.763\n导致持续痰菌阳性或病灶复发风险较大的患者，\n\n13:30.812 --> 13:31.638\n禁忌症呢，\n\n13:31.638 --> 13:36.562\n主要是包括一些糖尿病未控制营养不良、肺功能受损等。\n\n13:36.562 --> 13:39.513\n术式包括肺叶切除术、肺畸形切除术。\n\n13:42.275 --> 13:44.049\n支气管袖状切除。\n\n13:45.200 --> 13:47.851\n具体具体依据病灶的范围决定。\n\n13:48.200 --> 13:50.250\n营养支持治疗重在改善患者的。\n\n13:51.302 --> 13:53.952\n全身状况增强免疫力介入治疗呢，\n\n13:54.302 --> 13:55.877\n对于部分特殊病情，\n\n13:55.877 --> 13:56.877\n特对于特殊病，\n\n13:56.877 --> 13:58.052\n特殊特殊的病例，\n\n13:58.052 --> 13:58.877\n比如说咯血啊，\n\n13:58.877 --> 14:00.651\n支气管扩气管狭窄等，\n\n14:00.952 --> 14:02.927\n可以进入一些介入治疗啊。\n\n14:02.927 --> 14:03.601\n免疫治疗呢，\n\n14:03.601 --> 14:04.952\n主要是针对宿主的。\n\n14:05.752 --> 14:07.077\n靶蛋白控制，\n\n14:07.077 --> 14:08.552\n调节免疫通路，\n\n14:08.552 --> 14:10.052\n限制结核分枝杆菌的感染。\n\n14:11.013 --> 14:11.763\n常用制剂呢，\n\n14:11.763 --> 14:13.513\n包括母牛风湿杆菌。\n\n14:14.580 --> 14:16.929\n菌苗、草、分枝杆菌、菌苗等。\n\n14:16.929 --> 14:19.679\n适用于重度耐药、无反应性的肺结核治疗。\n\n14:33.900 --> 14:35.349\n抗结核菌的治疗呢，\n\n14:35.349 --> 14:38.075\n要遵循早期、联合、适量、规律、全程的原则，\n\n14:38.224 --> 14:39.875\n尽可能通过多种途径。\n\n14:41.241 --> 14:42.991\n采取患者呼吸道系统的标本，\n\n14:43.041 --> 14:46.015\n进行结核繁殖杆菌的敏感敏感性试验，\n\n14:46.015 --> 14:50.640\n和分子学耐分和分子和分子生物生物耐药检测，\n\n14:51.140 --> 14:53.591\n根据检测结果制定科学的治疗方案。\n\n14:53.591 --> 14:54.466\n治疗期间呢，\n\n14:54.466 --> 14:55.541\n应及时评估疗效，\n\n14:55.541 --> 14:56.640\n密切观察患者。\n\n14:58.179 --> 14:58.804\n密切观察患者，\n\n14:58.804 --> 14:59.280\n并且呢，\n\n14:59.280 --> 15:00.780\n及时处理药物的不良反应。\n\n15:05.679 --> 15:06.203\n目前呢，\n\n15:06.203 --> 15:06.604\n我们。\n\n15:08.401 --> 15:08.875\n抗结核，\n\n15:08.875 --> 15:09.726\n抗结核药物呢，\n\n15:09.726 --> 15:10.551\n主要是包括。\n\n15:11.573 --> 15:16.999\n异烟肼、利福平、利福喷丁、吡嗪酰胺、乙胺丁醇、链霉素。\n\n15:37.411 --> 15:37.711\n同时呢，\n\n15:37.711 --> 15:38.661\n结核分枝杆菌呢，\n\n15:38.661 --> 15:41.586\n也患者也应当进行一个长期监测。\n\n15:41.586 --> 15:43.486\n每月的监查患者的血常规啊，\n\n15:43.486 --> 15:44.762\n肝肾功能、电解质啊，\n\n15:44.812 --> 15:48.812\n尿常规的体重的每两个月进行一次抗栓图片，\n\n15:48.812 --> 15:51.411\n结核分枝杆菌培养和胸部CT等等。\n\n16:08.830 --> 16:08.905\n嗯，\n\n16:08.905 --> 16:09.080\n好，\n\n16:09.080 --> 16:09.554\n谢谢大家，\n\n16:09.554 --> 16:11.679\n今天的分享到此结束。\n\n","v0247cg10004d60s8bqljhtfmgd979d0",978,1499,0,"2026-01-24 22:14:33","预防肺结核的科普知识 - 全面了解肺结核的传播与预防措施  ","肺结核预防,肺结核传播途径,肺结核症状,结核病防治,肺结核疫苗,健康科普  ","本文详细介绍了肺结核的传播途径、常见症状及有效预防措施，包括接种卡介苗、保持良好卫生习惯等，帮助公众科学预防结核病，提升健康防护意识。","2026-03-10 22:30:00",[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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