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--> 00:02.049\n大家好，\n\n00:02.049 --> 00:04.750\n我今天跟大家分享的题目呢，\n\n00:04.800 --> 00:08.100\n是上气道梗阻的一些基本的认识。\n\n00:10.581 --> 00:10.982\n首先，\n\n00:10.982 --> 00:13.331\n我们来了解一下什么叫上气道。\n\n00:13.432 --> 00:15.031\n上气道的生理结构，\n\n00:15.182 --> 00:16.031\n也就是鼻腔，\n\n00:16.031 --> 00:17.832\n是上气道的起始部分，\n\n00:17.832 --> 00:20.131\n由鼻中隔分为左右两腔。\n\n00:20.381 --> 00:23.232\n鼻腔内有鼻毛粘膜等结构。\n\n00:23.381 --> 00:24.131\n鼻毛呢，\n\n00:24.131 --> 00:27.207\n可以过滤空气中的灰尘和异物粘膜，\n\n00:27.207 --> 00:29.031\n能温暖湿润空气。\n\n00:29.281 --> 00:34.782\n鼻窦则包括上颌窦、筛窦、额窦和蝶窦，\n\n00:34.782 --> 00:37.231\n它们通过小孔与鼻腔相通，\n\n00:37.332 --> 00:40.681\n对共鸣减轻头颅重量有重要的作用。\n\n00:41.048 --> 00:43.897\n例如上颌窦是鼻窦中最大的一对，\n\n00:43.948 --> 00:45.147\n在面部两侧，\n\n00:45.198 --> 00:46.897\n当发生鼻窦炎的时候，\n\n00:46.897 --> 00:48.798\n上颌窦是易受到影响，\n\n00:48.798 --> 00:49.698\n引发鼻试。\n\n00:50.347 --> 00:54.048\n咽分为鼻咽、口咽和喉咽三个部分，\n\n00:54.248 --> 00:56.048\n鼻咽位于鼻腔的后方，\n\n00:56.198 --> 00:57.048\n有咽鼓管，\n\n00:57.048 --> 00:58.698\n咽口与中耳相通，\n\n00:58.948 --> 01:01.048\n口咽在口腔的后方，\n\n01:01.248 --> 01:03.897\n是食物和空气的共同通道。\n\n01:04.447 --> 01:06.498\n扁桃体就位于口咽的两侧，\n\n01:06.847 --> 01:09.447\n喉咽则连接着口咽和食管。\n\n01:09.447 --> 01:14.297\n喉会咽在吞咽时可以防止食物进入气管。\n\n01:14.597 --> 01:15.597\n如感冒时，\n\n01:15.697 --> 01:18.898\n口咽部位常常因炎症而疼痛。\n\n01:19.648 --> 01:20.947\n喉喉呢，\n\n01:20.947 --> 01:24.736\n是由软骨、肌肉、韧带和黏膜等构成的，\n\n01:24.736 --> 01:26.148\n是呼吸的通道，\n\n01:26.248 --> 01:27.597\n也是发音器官。\n\n01:27.898 --> 01:28.547\n其中，\n\n01:28.597 --> 01:31.797\n甲状软骨是喉软骨中最大的一块儿，\n\n01:31.797 --> 01:34.648\n形成喉结声带位于喉腔。\n\n01:34.732 --> 01:37.132\n腔内通过振动产生声音，\n\n01:37.332 --> 01:39.732\n当声带出现病变的时候，\n\n01:39.882 --> 01:43.031\n如声带小结就会影响我们的发音。\n\n01:44.449 --> 01:46.000\n上气道梗阻的定义，\n\n01:46.150 --> 01:53.250\n上气道梗阻是指由于各种原因引起的上呼吸道部分或者是完全阻塞，\n\n01:53.400 --> 01:55.500\n导致气体进出受限，\n\n01:55.699 --> 01:58.099\n这会影响正常的气体交换，\n\n01:58.250 --> 02:02.000\n进而影响身体的氧气供应和二氧化碳排出。\n\n02:02.250 --> 02:02.949\n例如，\n\n02:03.000 --> 02:05.449\n当气道被异物完全阻塞时，\n\n02:05.650 --> 02:09.149\n患者会迅速的出现呼吸困难等症状。\n\n02:09.600 --> 02:11.800\n上气道梗阻按照程度，\n\n02:11.899 --> 02:13.375\n它分为轻度，\n\n02:13.375 --> 02:14.850\n中度和重度。\n\n02:15.145 --> 02:16.546\n轻度梗阻时，\n\n02:16.595 --> 02:20.895\n患者可能仅仅是在活动期出现呼吸稍急促，\n\n02:21.345 --> 02:26.246\n中度梗阻会导致安静时也有呼吸费力的梗阻情况，\n\n02:26.645 --> 02:28.195\n当重度梗阻时，\n\n02:28.195 --> 02:30.246\n则会严重的影响呼吸，\n\n02:30.345 --> 02:32.595\n甚至会危及患者的生命。\n\n02:32.945 --> 02:37.145\n比如小儿因腺样体肥大导致的气道狭窄，\n\n02:37.296 --> 02:40.345\n轻度时睡眠可能有轻微的鼾声，\n\n02:40.595 --> 02:43.945\n中度时鼾声加重且有呼吸暂停。\n\n02:44.619 --> 02:48.119\n重度时可以出现憋醒等低氧的情况，\n\n02:48.820 --> 02:52.220\n那么上气道梗阻有哪些常见的部位呢？\n\n02:53.121 --> 02:59.871\n鼻腔及鼻窦鼻腔的鼻中隔偏曲、鼻息肉等情况容易导致鼻腔狭窄，\n\n02:59.871 --> 03:00.921\n引起梗阻。\n\n03:01.272 --> 03:05.371\n鼻中隔偏曲可能是由于外伤等原因造成的，\n\n03:05.572 --> 03:11.472\n严重的鼻中隔偏曲可以使一侧鼻腔几乎完全呈现堵塞的状态。\n\n03:12.145 --> 03:16.445\n鼻息肉则是鼻腔和鼻窦黏膜的慢性炎症性疾病，\n\n03:16.945 --> 03:19.296\n多个鼻息肉可以充满鼻腔，\n\n03:19.496 --> 03:20.996\n阻碍气流的通过。\n\n03:21.246 --> 03:24.746\n例如有患者因长期鼻息肉没有治疗，\n\n03:24.796 --> 03:27.496\n导致嗅觉减退、呼吸困难等。\n\n03:29.156 --> 03:34.055\n咽喉部的会咽炎、扁桃体肿大等是常见的梗阻原因。\n\n03:34.356 --> 03:37.856\n会厌炎多由细菌或者是病毒感染引起，\n\n03:38.055 --> 03:41.205\n会厌迅速的肿胀可以堵塞气道。\n\n03:41.555 --> 03:44.205\n扁桃体在儿童时期较为发达，\n\n03:44.406 --> 03:48.406\n反复的扁桃体发炎可以导致扁桃体过度肿大，\n\n03:48.555 --> 03:50.555\n阻塞咽喉的通道。\n\n03:50.856 --> 03:53.656\n如有些儿童因扁桃体三度肿大，\n\n03:53.656 --> 03:57.555\n睡觉时会出现严重的打鼾和呼吸暂停的现象。\n\n03:59.662 --> 04:05.061\n气道入口部位气道入口处的异物卡顿、肿瘤等会造成梗阻。\n\n04:05.361 --> 04:07.311\n异物卡顿常见于儿童，\n\n04:07.511 --> 04:11.311\n如花生米、玩具零件等误入气管入口，\n\n04:11.662 --> 04:14.011\n气管肿瘤则相对的少见，\n\n04:14.261 --> 04:17.812\n但肿瘤生长会逐渐的占据气管的空间，\n\n04:17.911 --> 04:19.411\n导致气管梗阻。\n\n04:20.032 --> 04:23.481\n曾有儿童玩耍时将小珠子放入口中，\n\n04:23.532 --> 04:25.282\n不慎滑入气管入口，\n\n04:25.282 --> 04:28.282\n引发了一个剧烈的咳嗽和呼吸困难。\n\n04:29.082 --> 04:31.432\n那上气道梗阻的病因有哪些？\n\n04:31.932 --> 04:34.131\n先天性因素以及后天因素。\n\n04:34.432 --> 04:35.832\n先天性因素中，\n\n04:35.981 --> 04:41.082\n腺样体肥大在儿童时期会随着年龄的增长而逐渐增大，\n\n04:41.381 --> 04:43.832\n约在6.7岁时达到了巅峰。\n\n04:44.131 --> 04:47.782\n部分儿童由于遗传或者是自身发育等原因，\n\n04:47.832 --> 04:50.231\n腺样体过度肥大阻塞。\n\n04:50.339 --> 04:52.190\n后鼻孔及咽鼓管咽口，\n\n04:52.190 --> 04:54.390\n进而引发上气道的梗阻。\n\n04:54.839 --> 04:55.440\n例如，\n\n04:55.489 --> 04:59.040\n有些孩子在睡觉时会出现明显的鼾声，\n\n04:59.239 --> 05:00.589\n且呼吸不规律，\n\n05:00.690 --> 05:06.640\n这可能就是腺样体肥大堵住后鼻孔引起的先天性喉软骨软化。\n\n05:06.790 --> 05:09.690\n它是一种常见的先天性喉部疾病，\n\n05:09.989 --> 05:14.339\n主要是由于儿童在母体内喉软骨发育不良引起。\n\n05:14.690 --> 05:18.040\n喉软骨软化会使喉部结构不稳定，\n\n05:18.290 --> 05:19.989\n吸气时容易塌陷。\n\n05:20.324 --> 05:24.574\n导致气道狭窄一般出生后不久即可出现症状，\n\n05:24.924 --> 05:27.324\n如吸气性喉鸣症状，\n\n05:27.324 --> 05:29.174\n在哭闹、进食时加重。\n\n05:29.574 --> 05:34.674\n像有些婴新生儿在吃奶时会发出呼噜呼噜的声音，\n\n05:34.773 --> 05:37.723\n可能就是先天性喉软骨软化导致。\n\n05:39.201 --> 05:45.402\n先天性气管狭窄是由于气管发育异常导致气管内径变窄，\n\n05:45.601 --> 05:48.076\n这种狭窄可能是阶段性的，\n\n05:48.076 --> 05:49.752\n也可能是弥漫性的。\n\n05:49.851 --> 05:51.302\n狭窄程度不同，\n\n05:51.351 --> 05:53.402\n症状表现也有所差异，\n\n05:53.601 --> 05:57.701\n轻者可能仅仅是在剧烈运动后出现呼吸急促，\n\n05:57.951 --> 06:02.502\n重者则安在安静状态下也会有明显的呼吸困难。\n\n06:02.902 --> 06:09.302\n曾有患儿因先天性气管狭窄反复出现了呼吸道的感染以及喘息的症状。\n\n06:09.997 --> 06:11.947\n后天疾病引发的梗阻，\n\n06:12.097 --> 06:13.447\n如过敏性鼻炎，\n\n06:13.648 --> 06:16.648\n它是一种常见的鼻腔过敏性疾病。\n\n06:16.898 --> 06:18.548\n当接触过敏源后，\n\n06:18.648 --> 06:21.747\n鼻腔粘膜会出现充血、水肿，\n\n06:21.898 --> 06:23.597\n产生大量的分泌物，\n\n06:23.798 --> 06:26.197\n这些变化会导致鼻腔狭窄，\n\n06:26.197 --> 06:27.247\n影响通气。\n\n06:27.747 --> 06:28.548\n据统计，\n\n06:28.597 --> 06:32.648\n约有20%.30%的过敏性鼻炎患者，\n\n06:32.747 --> 06:37.947\n会因病情的发作而出现不同程度上的上气道梗阻症状。\n\n06:38.395 --> 06:43.145\n表现为鼻痒、打喷嚏、流鼻涕、鼻塞等。\n\n06:43.496 --> 06:45.346\n例如在花粉季节，\n\n06:45.395 --> 06:49.696\n很多过敏性鼻炎患者的症状会明显的加重鼻塞，\n\n06:49.795 --> 06:51.545\n进而影响呼吸。\n\n06:52.395 --> 06:56.446\n扁桃体炎多由细菌或者是病毒感染引起，\n\n06:56.696 --> 06:59.545\n炎症刺激会导致扁桃体肥大，\n\n06:59.795 --> 07:03.895\n反复发炎的扁桃体会使扁桃体组织增生肥大，\n\n07:04.045 --> 07:06.295\n严重时可以堵塞咽喉部，\n\n07:06.346 --> 07:07.996\n造成上气道的梗阻。\n\n07:08.791 --> 07:12.141\n临床上不少患者因扁桃体炎反复发作，\n\n07:12.191 --> 07:14.941\n出现吞咽困难、呼吸不畅等，\n\n07:15.141 --> 07:17.891\n尤其是在睡眠时鼾声较大，\n\n07:17.891 --> 07:20.441\n甚至会出现呼吸暂停的现象。\n\n07:21.141 --> 07:22.666\n后天疾病中呢，\n\n07:22.666 --> 07:27.891\n咽喉部肿瘤也是常见的导致呼吸梗阻的一个原因。\n\n07:28.242 --> 07:31.941\n咽喉部肿瘤包括良性肿瘤和恶性肿瘤，\n\n07:32.191 --> 07:35.191\n如乳头状瘤、纤维瘤、喉癌等，\n\n07:35.492 --> 07:38.742\n肿瘤的生长会逐渐的占据咽。\n\n07:38.799 --> 07:41.200\n咽喉部的空间导致气道狭窄，\n\n07:41.450 --> 07:42.649\n以喉癌为例，\n\n07:42.750 --> 07:45.899\n早期可能仅仅是表现为声音嘶哑，\n\n07:46.100 --> 07:47.524\n随着疾病的进展，\n\n07:47.524 --> 07:48.450\n肿瘤增大，\n\n07:48.549 --> 07:50.149\n会出现呼吸困难，\n\n07:50.149 --> 07:53.000\n吞咽困难等上气道梗阻的症状。\n\n07:53.350 --> 07:55.950\n有患者因声音嘶哑没有重视，\n\n07:56.149 --> 07:58.799\n输液后会出现明显的呼吸不畅。\n\n07:59.049 --> 08:03.049\n检查才发现原来是因为喉癌导致了气道梗阻。\n\n08:03.649 --> 08:08.000\n外部异物造成的梗梗阻儿童异物吸入，\n\n08:08.100 --> 08:08.750\n由于儿。\n\n08:08.816 --> 08:10.415\n儿童是好奇心强，\n\n08:10.615 --> 08:13.415\n且吞咽功能尚未完全的发育成熟，\n\n08:13.716 --> 08:15.966\n容易将小物件放入口中，\n\n08:16.265 --> 08:17.566\n不慎吸入气道。\n\n08:17.765 --> 08:19.740\n常见的异物有花生米，\n\n08:19.740 --> 08:20.415\n瓜子，\n\n08:20.566 --> 08:21.865\n玩具零件等。\n\n08:22.115 --> 08:24.216\n根据相关数据显示，\n\n08:24.415 --> 08:26.341\n在儿童上气道梗阻中，\n\n08:26.341 --> 08:28.915\n异物吸入占据比例较高。\n\n08:29.216 --> 08:32.666\n例如有患儿童在吃花生米时嬉笑打闹，\n\n08:32.815 --> 08:36.216\n花生米误入气道就会引发剧烈的咳嗽，\n\n08:36.216 --> 08:37.166\n呼吸困难，\n\n08:37.366 --> 08:38.765\n严重时会危及。\n\n08:38.828 --> 08:39.177\n生命。\n\n08:40.547 --> 08:42.197\n成人在进食过程中，\n\n08:42.197 --> 08:43.572\n如果注意力不集中，\n\n08:43.572 --> 08:47.747\n也可能导致因误食异物引起的上气道梗阻。\n\n08:47.947 --> 08:49.973\n常见的异物有鱼刺，\n\n08:49.973 --> 08:50.523\n鸡骨，\n\n08:50.523 --> 08:51.247\n鸭骨等，\n\n08:51.497 --> 08:54.848\n这些异物可能卡在咽喉部或食管入口处，\n\n08:54.997 --> 08:56.422\n引起局部的疼痛，\n\n08:56.422 --> 08:57.447\n吞咽困难。\n\n08:57.648 --> 08:58.648\n若处理不当，\n\n08:58.648 --> 09:00.747\n还可能会导致气道的受压，\n\n09:00.898 --> 09:01.947\n影响呼吸。\n\n09:02.197 --> 09:04.148\n曾有成年人在吃鱼时，\n\n09:04.348 --> 09:06.898\n因说话导致鱼刺卡在喉咙，\n\n09:07.098 --> 09:08.947\n出现了吞咽疼痛，\n\n09:08.947 --> 09:10.497\n进一步引发气道梗阻。\n\n09:10.547 --> 09:11.098\n的症状。\n\n09:12.513 --> 09:14.989\n那上气道梗阻的症状有哪些呢？\n\n09:14.989 --> 09:19.138\n它其中包括典型的呼吸异常的症状，\n\n09:19.138 --> 09:24.364\n其实是分为吸气性呼吸困难以及呼气性呼吸困难的。\n\n09:24.713 --> 09:30.114\n吸气性呼吸困难是上气道梗阻时气体进入肺部受阻，\n\n09:30.314 --> 09:33.164\n患者会出现吸气费力的现象，\n\n09:33.463 --> 09:35.763\n表现为吸气时间延长，\n\n09:36.164 --> 09:38.914\n吸气时胸廓周围软组织凹陷，\n\n09:39.263 --> 09:42.864\n如胸骨上窝、锁骨上窝、肋间隙等。\n\n09:42.963 --> 09:43.314\n部位，\n\n09:43.414 --> 09:45.213\n它出现明显的凹陷，\n\n09:45.364 --> 09:47.814\n即我们所常说的三凹征。\n\n09:48.314 --> 09:51.713\n当小儿急性喉炎导致急性梗阻时，\n\n09:51.864 --> 09:54.713\n吸气性呼吸困难症状较为突出，\n\n09:55.114 --> 09:59.564\n家长可以明显的观察到孩子吸气时的异常表现。\n\n10:00.289 --> 10:01.614\n以此提示一下，\n\n10:01.614 --> 10:05.090\n当小孩出现一些犬吠样咳嗽，\n\n10:05.239 --> 10:06.890\n例如空空声的时候，\n\n10:06.890 --> 10:09.840\n一定要注意是否有急性喉炎的发生。\n\n10:10.440 --> 10:14.190\n当梗阻部位在较下气道或存在气道痉挛时，\n\n10:14.489 --> 10:16.440\n呼气过程会受到影响，\n\n10:16.640 --> 10:18.215\n出现呼气费力，\n\n10:18.215 --> 10:19.539\n呼气时间延长，\n\n10:19.840 --> 10:22.340\n呼气时发出哮鸣音等症状。\n\n10:22.739 --> 10:25.090\n如患有支气管哮喘的患者，\n\n10:25.190 --> 10:30.590\n在病情发作导致上气道部分梗阻时呼气性的呼吸。\n\n10:30.739 --> 10:33.140\n困难症状是明显的，\n\n10:33.289 --> 10:36.640\n患者呼气时就会像吹口哨一样，\n\n10:36.690 --> 10:40.340\n且呼气的时间是显著长于吸气时间的。\n\n10:44.257 --> 10:46.257\n典型的呼吸异常的症状，\n\n10:46.307 --> 10:53.057\n喘息喘息是上气道梗阻常见的呼吸异常症状之一。\n\n10:53.208 --> 10:59.557\n表现为呼吸时伴有高调的类似于吹哨或者是拉风箱样的声音，\n\n10:59.857 --> 11:04.257\n这是由于气流通过狭窄的气道所产生震动导致。\n\n11:04.607 --> 11:06.158\n喘息的声音大小，\n\n11:06.307 --> 11:11.908\n频率和性质会因梗阻的部位以及程度不同而有所差异。\n\n11:12.158 --> 11:12.807\n例如，\n\n11:12.807 --> 11:14.607\n当异物卡在气管内。\n\n11:14.736 --> 11:15.036\n时，\n\n11:15.036 --> 11:17.835\n患者会出现一个阵发性的喘息，\n\n11:18.085 --> 11:20.135\n且喘息声较为尖锐。\n\n11:21.090 --> 11:24.090\n那它也会伴有一些全身性的症状，\n\n11:24.590 --> 11:27.239\n如缺氧表现上气道梗阻，\n\n11:27.289 --> 11:29.289\n导致气体交换不足。\n\n11:29.539 --> 11:30.340\n身体呢，\n\n11:30.340 --> 11:32.489\n它会出现缺氧症状。\n\n11:32.840 --> 11:38.690\n患者可能会出现口唇发干、指甲发干及颜色变深，\n\n11:38.690 --> 11:40.140\n或者是青紫色。\n\n11:40.440 --> 11:41.739\n严重缺氧时，\n\n11:41.840 --> 11:43.690\n还会影响神经系统，\n\n11:43.840 --> 11:48.440\n导致患者出现头晕、乏力、嗜睡等，\n\n11:48.489 --> 11:50.789\n甚至是昏迷等症状。\n\n11:51.552 --> 11:51.827\n比如，\n\n11:51.827 --> 11:56.401\n长时间处于上气道严重梗阻患者的状态，\n\n11:56.452 --> 12:01.351\n会因大脑缺氧而导致意识的一个逐渐的模糊。\n\n12:01.952 --> 12:03.651\n心血管系统的症状，\n\n12:03.802 --> 12:06.151\n为了保证身体的氧气供应，\n\n12:06.252 --> 12:09.651\n心脏会加快跳动来增加心输出量，\n\n12:09.952 --> 12:15.901\n因此患者可能会出现心率加快、血压升高等症状。\n\n12:16.528 --> 12:18.328\n若梗阻持续时间较长，\n\n12:18.478 --> 12:19.627\n得不到缓解，\n\n12:19.778 --> 12:21.828\n心脏的负担将会加重，\n\n12:22.028 --> 12:26.528\n可能会引发心律失常等严重的心血管系动。\n\n12:27.228 --> 12:30.927\n曾有患者因上气道梗阻未及时的处理，\n\n12:30.978 --> 12:33.478\n出现了心慌、心跳加快，\n\n12:33.578 --> 12:36.177\n检查时发现心律失常。\n\n12:37.526 --> 12:38.926\n精神状态的改变，\n\n12:38.976 --> 12:41.125\n由于身体缺氧和不适，\n\n12:41.325 --> 12:44.176\n患者的精神状态也会发生改变。\n\n12:44.526 --> 12:49.676\n初期可能会表现为患者的烦躁不安、焦虑，\n\n12:49.825 --> 12:51.575\n伴随着病情的加重，\n\n12:51.625 --> 12:53.625\n会逐渐变得萎靡不振，\n\n12:53.726 --> 12:54.825\n反应迟钝。\n\n12:55.125 --> 12:55.750\n例如，\n\n12:55.750 --> 12:58.875\n一些老年患者在上气道梗阻时，\n\n12:58.976 --> 13:02.176\n原本清醒的状态会逐渐变得嗜睡，\n\n13:02.426 --> 13:05.476\n对周围事物反应变差。\n\n13:07.469 --> 13:07.794\n那么，\n\n13:07.794 --> 13:09.320\n由于不同年龄段，\n\n13:09.469 --> 13:12.669\n它的生理结构以及机体反应不同，\n\n13:12.869 --> 13:13.669\n所以呢，\n\n13:13.669 --> 13:15.594\n当发生上气道梗阻时，\n\n13:15.594 --> 13:18.320\n它的症状也是存在些许差异的。\n\n13:18.932 --> 13:21.331\n婴幼儿由于气道相对狭窄，\n\n13:21.632 --> 13:24.432\n且他自身的表达能力是有限的，\n\n13:24.581 --> 13:27.781\n上气道梗阻时症状较为隐秘，\n\n13:27.882 --> 13:29.481\n且进展是迅速，\n\n13:29.882 --> 13:32.382\n常表现为喂养的困难。\n\n13:33.168 --> 13:35.418\n吃奶时容易呛咳、停顿，\n\n13:35.567 --> 13:37.518\n呼吸急促且不规则，\n\n13:37.918 --> 13:42.567\n睡眠时可以出现异常的呼噜声或者是呼吸暂停。\n\n13:42.918 --> 13:44.968\n比如患者先天性。\n\n13:46.166 --> 13:51.265\n喉软骨软化的婴幼儿在吃奶和睡眠时症状就很明显，\n\n13:51.466 --> 13:55.216\n家长需要额外留意是否有憋气的情况。\n\n13:55.916 --> 13:57.815\n儿童上气道梗阻时，\n\n13:57.866 --> 14:00.565\n除了有明显的呼吸异常症状外，\n\n14:00.616 --> 14:02.716\n还可能出现睡眠障碍，\n\n14:02.866 --> 14:05.116\n如夜间睡眠不安稳，\n\n14:05.265 --> 14:06.515\n频繁的发声，\n\n14:06.515 --> 14:07.765\n磨牙等。\n\n14:07.765 --> 14:13.065\n长期的上气道梗阻还可能影响儿童的面部发育，\n\n14:13.166 --> 14:14.916\n导致腺样体面容，\n\n14:15.116 --> 14:16.565\n表现为上颌骨。\n\n14:16.632 --> 14:17.182\n的变长，\n\n14:17.531 --> 14:18.781\n颚骨的高拱，\n\n14:19.132 --> 14:20.481\n牙列不齐等。\n\n14:20.882 --> 14:21.281\n嗯，\n\n14:21.382 --> 14:24.581\n因腺样体肥大导致气道梗阻的儿童，\n\n14:24.731 --> 14:27.231\n由于长口长期的张口呼吸，\n\n14:27.331 --> 14:29.481\n面部形态会逐渐改变，\n\n14:29.581 --> 14:31.731\n形成一个腺样体面容。\n\n14:32.331 --> 14:37.731\n那成人期的症状特点又与儿童跟婴幼儿是不同的。\n\n14:37.882 --> 14:42.682\n成人对上气道梗阻的耐受性其实是相对较强的，\n\n14:42.932 --> 14:44.081\n与此同时呢，\n\n14:44.081 --> 14:46.581\n也就印证了它的症状也是多样。\n\n14:46.632 --> 14:47.132\n化的。\n\n14:47.432 --> 14:49.882\n除了呼吸异常的症状之外，\n\n14:49.981 --> 14:51.831\n成人期的症状还。\n\n14:52.700 --> 14:58.700\n可以表现为咽喉部的疼痛、异物感、梗阻感等局部症状。\n\n14:59.200 --> 15:03.200\n如果是由于疾病如咽喉部肿瘤引发的梗阻，\n\n15:03.400 --> 15:06.750\n还可能出现声音嘶哑、吞咽困难等。\n\n15:07.049 --> 15:10.900\n例如成人患喉癌时导致的气道梗阻，\n\n15:11.299 --> 15:14.400\n声音嘶哑往往是早期症状之一，\n\n15:14.500 --> 15:15.349\n随后呢，\n\n15:15.450 --> 15:17.299\n由于病变范围的增大，\n\n15:17.299 --> 15:20.549\n可能逐渐出现了呼吸、吞咽方面的问题。\n\n15:21.049 --> 15:22.950\n那么在上气道梗阻中。\n\n15:23.044 --> 15:26.443\n其实最重要的是一个急性会咽炎，\n\n15:26.994 --> 15:28.218\n急性会咽炎呢，\n\n15:28.218 --> 15:31.843\n它就是会厌舌面或者是喉面的粘膜肿胀，\n\n15:32.093 --> 15:35.193\n然后进一步堵塞了声门，\n\n15:35.193 --> 15:37.393\n导致了一个上呼吸道梗阻。\n\n15:37.794 --> 15:39.443\n所以对于一些。\n\n15:40.406 --> 15:42.806\n突发的咽喉肿痛明显，\n\n15:43.156 --> 15:45.156\n然后梗阻感明显，\n\n15:45.406 --> 15:47.755\n甚至是影响呼吸的病人，\n\n15:47.806 --> 15:52.255\n一定要到医院去排除一下是否是有急性性会咽炎。\n\n15:53.005 --> 15:54.281\n到医院之后呢，\n\n15:54.281 --> 15:58.056\n医生会根据症状进行一个病史的询问，\n\n15:58.156 --> 15:59.556\n以及体格检查，\n\n15:59.755 --> 16:03.656\n包括一些血血液检查或者是喉镜，\n\n16:03.856 --> 16:06.156\n然后咽喉部CT的检查，\n\n16:06.406 --> 16:10.056\n共同的去判断是否存在有急性会咽炎，\n\n16:10.306 --> 16:10.806\n因为。\n\n16:10.872 --> 16:11.872\n急性会咽炎，\n\n16:12.072 --> 16:14.971\n其实它除了疼痛之外，\n\n16:15.072 --> 16:18.721\n最可怕的是影响到气道的梗阻。\n\n16:18.921 --> 16:20.771\n当气道梗阻明显时，\n\n16:20.971 --> 16:21.372\n嗯，\n\n16:21.622 --> 16:25.221\n由于低氧会导致一个大脑血供的不足，\n\n16:25.421 --> 16:28.372\n或者是短时间的一个憋气。\n\n16:28.471 --> 16:29.271\n这时呢，\n\n16:29.322 --> 16:32.171\n患者就无法进行气道的通气，\n\n16:32.271 --> 16:33.521\n导致一个窒息。\n\n16:33.822 --> 16:34.846\n最严重时，\n\n16:34.846 --> 16:37.622\n可能要进行一个床旁的气管切开，\n\n16:37.671 --> 16:40.271\n维护上气道的一个通气性。\n\n16:40.859 --> 16:41.093\n所以，\n\n16:41.093 --> 16:41.710\n当我们，\n\n16:41.859 --> 16:45.609\n尤其是之前发作过会咽炎的咽痛的病人，\n\n16:45.659 --> 16:49.210\n一定要排除是否是存在呼吸会咽炎。\n\n16:49.359 --> 16:50.609\n以免呢，\n\n16:50.609 --> 16:53.684\n因为自己的不重视，\n\n16:53.684 --> 16:55.609\n没有到医院及时的就诊，\n\n16:55.710 --> 16:58.960\n然后发生严重的医疗安全。\n\n17:00.817 --> 17:01.367\n问题。\n\n","v0347cg10004d60se1iljht3fq6j5hp0",1028,847,0,"2026-01-24 22:24:03","上气道梗阻的基础认知 - 症状、原因与治疗方法  ","上气道梗阻, 气道阻塞症状, 呼吸困难原因, 上气道梗阻治疗, 急性气道梗阻, 儿童气道梗阻  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