WEBVTT00:00:03.760 --> 00:00:05.240大家好今天呢00:00:05.240 --> 00:00:06.960跟大家分享的题目是00:00:06.960 --> 00:00:09.980上气道梗阻的一个基础认知00:00:10.600 --> 00:00:11.080首先呢00:00:11.080 --> 00:00:14.340我们来了解一下上气道的生理结构00:00:14.600 --> 00:00:16.300呃鼻腔与鼻窦00:00:16.640 --> 00:00:19.280鼻腔是上气道的起始部分00:00:19.280 --> 00:00:21.740由鼻中隔分为左右两腔00:00:21.800 --> 00:00:24.820鼻腔内有鼻毛黏膜等结构00:00:25.200 --> 00:00:28.340鼻毛可以过滤空气中的灰尘和异物00:00:28.480 --> 00:00:32.020黏膜呢它有温暖湿润空气的功能00:00:32.320 --> 00:00:36.740鼻窦则包括上颌窦筛窦额窦跟蝶窦00:00:36.800 --> 00:00:39.460它们通过小孔与鼻腔相通00:00:39.680 --> 00:00:40.840对共鸣00:00:40.840 --> 00:00:43.820减轻头颅重量等有重要的作用00:00:44.040 --> 00:00:47.080例如上颌窦是鼻窦中最大的一对00:00:47.080 --> 00:00:48.440在面部的两侧00:00:48.440 --> 00:00:50.260当发生鼻窦炎时00:00:50.280 --> 00:00:51.760上颌窦易受影响00:00:51.760 --> 00:00:52.900引发不适00:00:53.280 --> 00:00:56.860咽分为鼻咽口咽喉咽三部分00:00:57.080 --> 00:00:58.980鼻咽位于鼻腔的后方00:00:59.000 --> 00:00:59.800有咽鼓管00:00:59.800 --> 00:01:02.340咽口与中耳相通00:01:02.440 --> 00:01:04.560口咽分为呃口00:01:04.560 --> 00:01:06.080咽在口腔的后方00:01:06.080 --> 00:01:08.700是食物和空气的共同通道00:01:08.840 --> 00:01:11.140扁桃体就位于口咽的两侧00:01:11.560 --> 00:01:13.860喉咽则连接口咽和食管00:01:13.920 --> 00:01:15.120喉会咽00:01:15.120 --> 00:01:18.980在吞咽时可以防止食物的进入气管00:01:19.000 --> 00:01:19.920如感冒时00:01:19.920 --> 00:01:22.620口咽部位常因炎症而头痛00:01:23.080 --> 00:01:25.840上气道的呃中的喉呢00:01:25.840 --> 00:01:30.500它是由软骨肌肉韧带和黏膜等构成00:01:30.560 --> 00:01:31.880是呼吸的通道00:01:31.880 --> 00:01:33.380也是发音器官00:01:33.600 --> 00:01:34.420其中00:01:34.440 --> 00:01:37.440甲状软骨是喉软骨中最大的一块00:01:37.440 --> 00:01:38.660形成喉结00:01:38.840 --> 00:01:40.560声带位于喉腔内00:01:40.560 --> 00:01:42.580通过震动发出声音00:01:42.880 --> 00:01:45.280当声带发生病变时00:01:45.280 --> 00:01:46.440如声带小结00:01:46.440 --> 00:01:48.100就会影响发音00:01:49.520 --> 00:01:51.880那么什么叫上气道梗阻呢00:01:51.880 --> 00:01:52.960上气道梗阻00:01:52.960 --> 00:01:55.720是指由于各种原因引起的00:01:55.720 --> 00:01:58.780上气道部分或者是完全阻塞00:01:58.840 --> 00:02:00.900导致气体进出受限00:02:01.120 --> 00:02:04.280这会影响正常的气体交换00:02:04.280 --> 00:02:06.440进而影响身体的氧气供应00:02:06.440 --> 00:02:08.260和二氧化碳的排出00:02:08.400 --> 00:02:11.620例如当气道被异物完全阻塞时00:02:11.840 --> 00:02:13.680患者会迅速出现呼吸困00:02:13.680 --> 00:02:14.700难等症状00:02:15.120 --> 00:02:18.320上气道梗阻按照程度可以分为轻中00:02:18.320 --> 00:02:19.540重度三类00:02:19.760 --> 00:02:21.840轻度上呼吸道梗阻时00:02:21.840 --> 00:02:24.360患者可能仅在活动后出现00:02:24.360 --> 00:02:25.740呼吸稍急促00:02:25.880 --> 00:02:26.800中度梗阻00:02:26.800 --> 00:02:30.180会导致安静时也有呼吸费力的表现00:02:30.360 --> 00:02:33.920重度梗阻得会严重的影响呼吸00:02:33.920 --> 00:02:35.420甚至危及生命00:02:35.520 --> 00:02:37.640比如小儿因腺样体肥大00:02:37.640 --> 00:02:39.100导致气道狭窄00:02:39.240 --> 00:02:43.620轻度嗯睡眠可以有轻微的鼾声00:02:43.920 --> 00:02:46.960中度时鼾声加重且有呼吸暂停00:02:46.960 --> 00:02:50.380重度则可出现憋型等严重的状况00:02:51.320 --> 00:02:52.920鼻腔跟鼻窦部位00:02:52.920 --> 00:02:54.880上气道梗阻的常见部位00:02:54.880 --> 00:02:56.720包括鼻腔与鼻窦00:02:56.720 --> 00:02:58.020喉咽部位等00:02:58.720 --> 00:03:01.960鼻腔的鼻中隔偏曲鼻息肉等情况00:03:01.960 --> 00:03:04.280容易导致鼻腔的狭窄00:03:04.280 --> 00:03:05.380引起梗阻00:03:05.520 --> 00:03:06.560鼻中隔偏曲00:03:06.560 --> 00:03:09.480可能是由于外伤等原因造成的00:03:09.480 --> 00:03:12.340也有可能是先天性的鼻中隔偏曲00:03:12.680 --> 00:03:14.040严重的鼻中隔偏曲00:03:14.040 --> 00:03:17.020可以使一侧鼻腔几乎完全堵塞00:03:17.280 --> 00:03:17.840鼻息肉00:03:17.840 --> 00:03:20.160则是鼻腔和鼻窦黏膜的慢性00:03:20.160 --> 00:03:21.460炎症性疾病00:03:21.640 --> 00:03:24.060多个鼻息肉可以充满鼻腔00:03:24.080 --> 00:03:25.820阻碍气流的通过00:03:25.880 --> 00:03:28.960例如有患者因长期鼻息肉未治疗00:03:28.960 --> 00:03:31.860导致嗅觉减退呼吸困难等症状00:03:32.320 --> 00:03:34.480咽喉部的会咽炎00:03:34.480 --> 00:03:38.180扁桃体肿大等是常见的梗阻原因00:03:38.240 --> 00:03:38.880会咽炎00:03:38.880 --> 00:03:41.820多由细菌或者是病毒感染引起00:03:41.880 --> 00:03:44.080使得会咽黏膜迅速肿胀00:03:44.080 --> 00:03:45.500可以阻塞气道00:03:45.880 --> 00:03:48.540扁桃体在儿童时期较为发达00:03:48.560 --> 00:03:49.480反复发炎00:03:49.480 --> 00:03:51.980可以导致扁桃体的过度肿大00:03:52.040 --> 00:03:53.820阻塞咽喉药道00:03:53.840 --> 00:03:57.140如有一些儿童因扁桃体三度肿大00:03:57.160 --> 00:03:59.680睡觉时可以出现严重的打呼00:03:59.680 --> 00:04:01.580以及呼吸暂停的现象00:04:03.400 --> 00:04:06.060另一个常见的部位是气管入口00:04:06.160 --> 00:04:08.200气管入口处的异物卡顿00:04:08.200 --> 00:04:11.260肿瘤等会造成上气道的阻塞00:04:11.560 --> 00:04:13.600异物卡顿常见于儿童00:04:13.600 --> 00:04:16.480如花生米玩具零件等误00:04:16.480 --> 00:04:17.780入气管入口00:04:18.119 --> 00:04:20.459气管肿瘤则相对的少见00:04:20.559 --> 00:04:21.679但肿瘤生长00:04:21.679 --> 00:04:24.200会逐渐的占据气管的空间00:04:24.200 --> 00:04:26.500导致上气道的梗阻00:04:26.680 --> 00:04:30.560曾有儿童玩耍时将小珠子放入口中00:04:30.560 --> 00:04:33.440不慎滑入气管隆凸的地方00:04:33.440 --> 00:04:36.300引发了剧烈的咳嗽以及呼吸困难00:04:36.760 --> 00:04:39.740那么上气道梗阻的原因有哪些呢00:04:39.840 --> 00:04:42.500分为先天性因素导致的梗阻00:04:42.640 --> 00:04:43.900如腺样体00:04:43.960 --> 00:04:46.080腺样体肥大在儿童时期00:04:46.080 --> 00:04:48.780会随着年龄增长而逐渐的增大00:04:48.880 --> 00:04:51.340约在六到七岁时达到高峰00:04:51.720 --> 00:04:53.640部分患者由于遗传00:04:53.640 --> 00:04:55.620或者是自身的原因00:04:55.720 --> 00:04:58.380导致腺样体过度的肥大00:04:58.440 --> 00:05:01.320堵塞后鼻孔及咽鼓管咽口00:05:01.320 --> 00:05:03.420进而引起上气道梗阻00:05:03.640 --> 00:05:06.240例如有些孩子在睡觉时00:05:06.240 --> 00:05:08.140会出现明显的鼾声00:05:08.200 --> 00:05:09.660且呼吸不规律00:05:09.720 --> 00:05:12.460这可能是腺样体肥大导致的00:05:12.960 --> 00:05:15.140先天性喉软骨软化00:05:15.280 --> 00:05:18.420这是一种常见的先天性喉部疾病00:05:18.560 --> 00:05:20.640主要是由于胎儿在母体内00:05:20.640 --> 00:05:22.740喉软骨发育不良引起00:05:22.960 --> 00:05:26.220喉软骨软化会使喉部结构不稳定00:05:26.360 --> 00:05:28.000吸气时容易塌陷00:05:28.000 --> 00:05:29.540导致气道狭窄00:05:29.640 --> 00:05:32.460一般出生后不久即可出现症状00:05:32.800 --> 00:05:34.500如吸气性的喉鸣00:05:34.640 --> 00:05:37.660症状在哭闹进食时加重00:05:37.800 --> 00:05:40.280像有些新生儿在吃奶的时候00:05:40.280 --> 00:05:43.080会发出呼噜呼噜的声音00:05:43.080 --> 00:05:46.340可能就是先天性喉软骨软化造成的00:05:47.600 --> 00:05:49.460先天性气管狭窄00:05:50.080 --> 00:05:51.520先天性气管狭窄00:05:51.520 --> 00:05:53.440是由于气管发育异常00:05:53.440 --> 00:05:55.580导致的气管内径变窄00:05:55.840 --> 00:05:58.360这种狭窄可能是截断性的00:05:58.360 --> 00:06:00.060也可能是弥漫性的00:06:00.440 --> 00:06:01.640狭窄程度不同00:06:01.640 --> 00:06:04.020症状表现也有所差异00:06:04.200 --> 00:06:06.880轻者可能仅在剧烈活动后00:06:06.880 --> 00:06:08.880出现呼吸急促00:06:08.880 --> 00:06:10.520重者在安静状态下00:06:10.520 --> 00:06:12.580也会有明显的呼吸困难00:06:12.800 --> 00:06:15.720曾有患儿因先天性气管狭窄00:06:15.720 --> 00:06:17.640反复出现呼吸道感染00:06:17.640 --> 00:06:19.220以及喘息的症状00:06:19.680 --> 00:06:21.820后天因素引起的梗阻00:06:21.960 --> 00:06:23.220过敏性鼻炎00:06:23.280 --> 00:06:26.060是一种常见的鼻腔过敏性疾病00:06:26.200 --> 00:06:28.240当接触过敏源后00:06:28.240 --> 00:06:30.960鼻腔粘膜会出现充血水肿00:06:30.960 --> 00:06:33.220并产生大量的分泌物00:06:33.360 --> 00:06:35.660这些变化会导致鼻腔狭窄00:06:35.680 --> 00:06:36.860影响通气00:06:36.880 --> 00:06:39.000据统计约有百分之二十00:06:39.000 --> 00:06:41.000到百分之三十的过敏性鼻炎00:06:41.000 --> 00:06:43.580患者会因病情发病00:06:44.160 --> 00:06:46.940而出现不同程度上的气道梗阻00:06:47.160 --> 00:06:51.100表现为鼻痒喷嚏流涕鼻塞等00:06:51.280 --> 00:06:53.000例如在花粉季节00:06:53.000 --> 00:06:55.040很多过敏性鼻炎患者的症状00:06:55.040 --> 00:06:56.460会明显的加重00:06:56.480 --> 00:06:58.340鼻塞影响呼吸00:06:58.760 --> 00:06:59.740扁桃体炎00:06:59.920 --> 00:07:00.560扁桃体炎00:07:00.560 --> 00:07:03.100多由细菌或病毒性感染引起00:07:03.160 --> 00:07:05.700炎症刺激会导致扁桃体肿大00:07:05.760 --> 00:07:07.760反复发生的扁桃体炎00:07:07.760 --> 00:07:10.380会使扁桃体组织增生肥大00:07:10.720 --> 00:07:13.020严重时可以阻塞咽喉部00:07:13.120 --> 00:07:14.940造成上气道的梗阻00:07:15.040 --> 00:07:15.680临床上00:07:15.680 --> 00:07:18.820不少患者因扁桃体炎反复的发作00:07:18.840 --> 00:07:21.740进而出现吞咽困难呼吸不畅等00:07:22.000 --> 00:07:24.760尤其是在睡眠时鼾声较大00:07:24.760 --> 00:07:27.860甚至会出现严重的呼吸暂停现象00:07:28.160 --> 00:07:29.380咽喉部肿瘤00:07:29.560 --> 00:07:33.500咽喉中肿瘤包括良性肿瘤恶性肿瘤00:07:33.600 --> 00:07:36.900如乳头状瘤显微瘤喉癌等00:07:37.120 --> 00:07:38.160肿瘤的生长00:07:38.160 --> 00:07:41.060会逐渐的占据咽喉部的空间00:07:41.080 --> 00:07:42.700导致气道狭窄00:07:43.840 --> 00:07:45.120以喉癌为例00:07:45.120 --> 00:07:47.740早期可能即表现为声音嘶哑00:07:47.840 --> 00:07:49.560随着病情的发展00:07:49.560 --> 00:07:50.640肿瘤增大00:07:50.640 --> 00:07:53.220会出现进行性的呼吸困难00:07:53.280 --> 00:07:56.500吞咽困难等上气道梗阻的症状00:07:56.640 --> 00:07:58.360有患者因声音嘶哑00:07:58.360 --> 00:08:00.000未重视输液后00:08:00.000 --> 00:08:02.180出现了明显的呼吸不畅00:08:02.320 --> 00:08:05.300检查发现喉癌导致的气道梗阻00:08:05.640 --> 00:08:09.460儿童异物吸入儿童由于好奇心强00:08:09.520 --> 00:08:13.260且吞咽功能尚未完全发育成熟00:08:13.280 --> 00:08:15.480容易将小物件放入口中00:08:15.480 --> 00:08:16.980不慎吸入气道00:08:17.080 --> 00:08:20.420常见的异物有花生米瓜子00:08:20.720 --> 00:08:21.940玩具零件等00:08:22.120 --> 00:08:24.020据相关数据显示00:08:24.040 --> 00:08:26.520在儿童上气道梗阻的原因中00:08:26.520 --> 00:08:28.620异物吸入占比较高00:08:28.720 --> 00:08:32.460例如有儿童在吃花生米时嬉戏打闹00:08:32.520 --> 00:08:34.160花生米误入气道00:08:34.160 --> 00:08:36.860引发剧烈的咳嗽呼吸困难等00:08:36.960 --> 00:08:40.140严重时甚至会影响呃生命00:08:40.640 --> 00:08:44.480成人异物问勿吞成人在进食过程中00:08:44.480 --> 00:08:46.280如果注意力不集中00:08:46.280 --> 00:08:48.440也可能会导致异物00:08:48.440 --> 00:08:50.900引起一个上气道的梗阻00:08:51.080 --> 00:08:54.160常见的异物有鱼刺鸡骨头等00:08:54.160 --> 00:08:54.920这些异物00:08:54.920 --> 00:08:57.860可能卡在咽喉部或食管入口处00:08:58.040 --> 00:09:00.580引起局部疼痛吞咽困难00:09:00.720 --> 00:09:01.760若处理不当00:09:01.760 --> 00:09:03.680还可能导致气道的受压00:09:03.680 --> 00:09:04.780影响呼吸00:09:05.040 --> 00:09:07.360曾经就有成年人在吃鱼时00:09:07.360 --> 00:09:09.860因说话导致鱼刺卡在喉咙00:09:09.880 --> 00:09:11.340出现吞咽疼痛00:09:11.480 --> 00:09:13.900进而引发气道梗阻的症状00:09:15.320 --> 00:09:18.660外伤异物的残留外伤异物残留00:09:18.840 --> 00:09:21.000呃头颈部受到外伤时00:09:21.000 --> 00:09:23.020如车祸高处坠落00:09:23.160 --> 00:09:26.260可能会有异物残留到气道周围组织00:09:26.280 --> 00:09:28.440这些异物可能会压迫气道00:09:28.440 --> 00:09:29.720导致气道狭窄00:09:29.720 --> 00:09:30.860引发梗阻00:09:31.080 --> 00:09:33.780例如在一些严重的交通事故中00:09:33.840 --> 00:09:35.380伤者头部受伤00:09:35.520 --> 00:09:38.420碎玻璃金属碎片等异物残留00:09:39.480 --> 00:09:41.880后期可能因异物周围组织肿胀00:09:41.880 --> 00:09:44.280或者是异物的移位压迫气道00:09:44.280 --> 00:09:45.520出现呼吸困难等00:09:45.520 --> 00:09:47.220上气道梗阻的症状00:09:47.640 --> 00:09:47.800那么00:09:47.800 --> 00:09:50.460上气道梗阻的症状表现有哪些呢00:09:50.600 --> 00:09:52.580典型的呼吸异常症状00:09:53.080 --> 00:09:56.480吸气性呼吸困难上气道梗阻时00:09:56.480 --> 00:09:58.860气体进入肺部受阻00:09:58.920 --> 00:10:01.460患者会出现吸气费力的情况00:10:01.480 --> 00:10:03.780表现为吸气时间延长00:10:03.880 --> 00:10:07.800吸气是胸廓周围组织凹陷00:10:07.800 --> 00:10:11.160如胸骨上窝锁骨上窝肋间隙等部位00:10:11.160 --> 00:10:13.620出现明显的凹陷及三凹征00:10:13.960 --> 00:10:16.160在例如小儿急性喉炎00:10:16.160 --> 00:10:17.900导致气道梗阻时00:10:17.920 --> 00:10:20.400吸气性呼吸困难症状较为突出00:10:20.400 --> 00:10:22.440家长可以明显观察到00:10:22.440 --> 00:10:24.780孩子吸气时的异常表现00:10:25.120 --> 00:10:26.800当梗堵部位在较00:10:26.800 --> 00:10:27.480下气道00:10:27.480 --> 00:10:30.180或者是存在气道痉挛等情况时00:10:30.320 --> 00:10:32.380呼气的过程会受到影响00:10:32.480 --> 00:10:34.140出现呼气费力00:10:34.200 --> 00:10:35.740呼气时间延长00:10:35.840 --> 00:10:38.260呼气时发出哮鸣音等症状00:10:38.440 --> 00:10:41.100如患有支气管哮喘的患者00:10:41.120 --> 00:10:44.660在病情发作导致上气道部分梗堵时00:10:44.680 --> 00:10:47.060吸气性呼吸困难症状明显00:10:47.280 --> 00:10:50.220患者会感觉呼气像吹口哨一样00:10:50.240 --> 00:10:53.540且呼吸时间明显是长于吸气时间的00:10:54.880 --> 00:10:56.640喘息喘息00:10:56.640 --> 00:10:57.920是上气道梗阻00:10:57.920 --> 00:11:01.100最常见的呼吸异常症状之一00:11:01.120 --> 00:11:03.800表现为呼吸时伴有高调的00:11:03.800 --> 00:11:06.300类似吹哨或拉风相样的声音00:11:06.560 --> 00:11:09.560这是由于气流通过狭窄的气道时00:11:09.560 --> 00:11:11.420所产生震动引起00:11:11.920 --> 00:11:14.480喘息的声音大小频率和性质00:11:14.480 --> 00:11:16.600会因梗阻的部位和程度不同00:11:16.600 --> 00:11:17.820而有所差异00:11:17.880 --> 00:11:21.560例如当异物卡在气道内时气管内时00:11:21.560 --> 00:11:24.120患者会出现阵发性的喘息气00:11:24.120 --> 00:11:27.700喘息音是较为尖锐的伴随症状00:11:27.880 --> 00:11:28.200嗯00:11:28.200 --> 00:11:30.900缺氧的表现以及心血管系统的症状00:11:31.120 --> 00:11:33.980上气道梗阻导致气体交换不足00:11:34.000 --> 00:11:36.140身体会出现缺氧症状00:11:36.400 --> 00:11:39.900患者可能会出现口唇指甲翻干00:11:39.920 --> 00:11:41.200及颜色变深00:11:41.200 --> 00:11:42.700呈青紫色00:11:42.800 --> 00:11:45.660严重缺氧时还会影响神经系统00:11:45.680 --> 00:11:49.320导致患者出现头晕乏力嗜睡00:11:49.320 --> 00:11:51.100甚至是昏迷等症状00:11:51.360 --> 00:11:52.200比如长时间00:11:52.200 --> 00:11:54.640处于上气道严重梗阻状态下的00:11:54.640 --> 00:11:55.440患者00:11:55.440 --> 00:11:58.720会因大脑缺氧而逐渐的意识模糊00:11:58.720 --> 00:12:00.860甚至是出现生命危险00:12:01.200 --> 00:12:03.320为了保证机体的氧气供应00:12:03.320 --> 00:12:05.200心脏会加快跳动00:12:05.200 --> 00:12:07.740因此来增加心输出量00:12:07.880 --> 00:12:10.580所以患者会出现心率加快00:12:10.600 --> 00:12:12.260血压升高等症状00:12:12.440 --> 00:12:14.520若梗阻情况持续不缓解00:12:14.520 --> 00:12:16.460心脏的负担将会加重00:12:16.480 --> 00:12:18.600可能会引发心律失常等00:12:18.600 --> 00:12:20.740更严重的心血管问题00:12:20.880 --> 00:12:24.280曾有患者因上气道梗阻未及时处理00:12:24.280 --> 00:12:26.560会出现心慌心跳加快00:12:26.560 --> 00:12:27.420的症状00:12:27.480 --> 00:12:29.980检查发现有心律失常的表现00:12:30.400 --> 00:12:32.400那么由于缺氧和不适00:12:32.400 --> 00:12:35.020患者的精神状态也会发生改变00:12:35.080 --> 00:12:38.380初期可能表现为烦躁不安焦虑00:12:38.400 --> 00:12:39.680随着病情的加重00:12:39.680 --> 00:12:41.400会逐渐变得萎靡不振00:12:41.400 --> 00:12:42.540反应迟钝00:12:42.720 --> 00:12:45.820例如一些老年患者在上气道梗阻时00:12:45.840 --> 00:12:48.480原本清醒的状态会逐渐变得嗜睡00:12:48.480 --> 00:12:50.660对周围事物反应不灵敏00:12:51.640 --> 00:12:54.660不同年龄段症状也是有所差异的00:12:54.680 --> 00:12:57.080由于婴幼儿气道相对狭窄00:12:57.080 --> 00:12:58.980且自身表达能力有限00:12:59.040 --> 00:13:01.400上气道梗阻时症状较为隐匿00:13:01.400 --> 00:13:02.700且进展迅速00:13:02.920 --> 00:13:05.160常表现为喂养困难00:13:05.160 --> 00:13:07.580吃奶时容易呛咳停顿00:13:07.800 --> 00:13:09.500呼吸急促且不规则00:13:09.680 --> 00:13:12.000睡眠时可以出现异常的呼噜声00:13:12.000 --> 00:13:13.500或者是呼吸暂停00:13:13.880 --> 00:13:14.200比如00:13:14.200 --> 00:13:16.800患有先天性喉软骨软化的婴幼儿00:13:16.800 --> 00:13:19.760在吃奶和睡眠时症状比较明显00:13:19.760 --> 00:13:21.620家长需要格外的注意00:13:22.080 --> 00:13:23.320儿童上气道梗阻00:13:23.320 --> 00:13:25.700除了有明显的呼吸异常之外00:13:25.760 --> 00:13:28.100还可以表现为睡眠障碍00:13:28.160 --> 00:13:30.120如夜间睡眠不安稳00:13:30.120 --> 00:13:32.800频繁发生磨牙等00:13:32.800 --> 00:13:34.200长期的上气道梗阻00:13:34.200 --> 00:13:36.640还可能影响儿童的面部发育00:13:36.640 --> 00:13:38.500导致腺样体面容00:13:38.600 --> 00:13:40.540表现为上颌骨的变长00:13:40.640 --> 00:13:42.860颚骨高拱牙列不齐等00:13:43.120 --> 00:13:43.760例如00:13:43.760 --> 00:13:46.520因腺样体肥大导致气道梗阻的儿童00:13:46.520 --> 00:13:47.920长期张口呼吸00:13:47.920 --> 00:13:50.420面部形态会逐渐的发生改变00:13:52.120 --> 00:13:53.840成人对上气道梗阻的耐受性00:13:53.840 --> 00:13:55.020相对较强00:13:55.040 --> 00:13:57.060但症状也较为多样化00:13:57.080 --> 00:13:58.920除了呼吸异常症状外00:13:58.920 --> 00:14:01.400还可能伴有咽喉部的疼痛00:14:01.400 --> 00:14:03.340异物感等局部症状00:14:03.520 --> 00:14:05.400如果是由于疾病00:14:05.400 --> 00:14:08.400如咽喉部的肿瘤引起的梗阻00:14:08.400 --> 00:14:11.980还可能出现声音的嘶哑吞咽困难等00:14:12.280 --> 00:14:14.640例如当成人患有喉癌时00:14:14.640 --> 00:14:16.460可以导致气道梗阻00:14:16.640 --> 00:14:17.800声音嘶哑呢00:14:17.800 --> 00:14:18.040又00:14:18.040 --> 00:14:21.280往往是成人声门型喉癌的早期症状00:14:21.280 --> 00:14:23.000之一随后呢00:14:23.000 --> 00:14:25.560也随着肿瘤的增长啊00:14:25.560 --> 00:14:27.480以及周围组织的侵犯00:14:27.480 --> 00:14:29.240他会逐渐出现呼吸00:14:29.240 --> 00:14:31.140以及吞咽方面的问题