[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$ffNSafoxMLIzIY0sRHh3qJMybko5J-1ZJCo9ggOUtYxE":8,"$fmKaJ3Tn4o9J8lAv0yYc0NjG1l7QVxBhmO6p0_Y15Vys":60,"$falOvyBCdmmj5HfbpzkZMYeWUeu3CeH1RklFOJnU_Vdc":61,"$firZ9RFZ4O3CINNvKfByY9pjgEn5QqQeHFPPlThdGYE4":65},{"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":59},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"roleType":17,"adept":18,"hospital":19,"department":20,"postsTitle":21,"materialTotal":17,"videoTotal":22,"isConcern":7,"title":23,"coverVertical":24,"coverAcross":25,"directionMarker":26,"description":27,"vid":28,"time":29,"mediaType":26,"views":30,"likes":17,"isThumbsUp":7,"isCollection":7,"collections":17,"createTime":31,"seoTitle":32,"seoKeywords":33,"seoDescription":34,"shelvesTime":35,"menus":36,"menuId":38,"type":55,"quality":56,"commentCount":17,"isComment":26,"deviceType":57,"url":58},10373,871790,[],"https://cdn.yishi-tong.com/console/store-unknown/uF7OMd0P_hB1LaAPsAH23kXFsYY6stA4.png","张晓燕",0,"急诊常见症的诊疗，如呼吸系统疾病、神经系统疾病、消化系统疾病等\n重症常见症的诊疗，如脓毒症、多发伤等","上海市第一人民医院","急诊科","主治医师",5,"急性上呼吸道感染疾病概述","","https://cdn.yishi-tong.com/console/3/DnJVHEaxzUzOpzjKzH_MeBbpImfXPgl5.png",1,"WEBVTT\n\n00:01.413 --> 00:01.613\n嗯，\n\n00:01.663 --> 00:02.513\n大家中午好，\n\n00:02.513 --> 00:06.862\n今天跟大家分享一下急性上呼吸道感染疾病的概述。\n\n00:12.319 --> 00:14.819\n那什么是急性上呼吸道感染呢？\n\n00:15.220 --> 00:19.770\n急性上呼吸道感染是鼻腔、咽或喉部急性炎症的总称。\n\n00:19.920 --> 00:20.969\n狭义的上。\n\n00:22.219 --> 00:23.620\n上感又称普通感冒，\n\n00:23.620 --> 00:26.219\n是最常见的急性呼吸道感染疾病，\n\n00:26.319 --> 00:27.469\n多呈自械性，\n\n00:27.469 --> 00:28.620\n但发生率高。\n\n00:30.766 --> 00:31.340\n简单来说，\n\n00:31.340 --> 00:34.015\n就是我们呼吸道最上面的部分，\n\n00:34.015 --> 00:37.316\n包括鼻子、咽喉这些地方突然发炎了，\n\n00:37.316 --> 00:40.566\n比如着凉后出现鼻塞、流涕、咽痛等症状，\n\n00:40.715 --> 00:42.916\n很可能就是急性上呼吸道感染。\n\n00:45.930 --> 00:46.305\n嗯，\n\n00:46.305 --> 00:49.330\n急性上呼吸道感染在人群中发病率极高，\n\n00:49.330 --> 00:50.630\n全年即可发病，\n\n00:50.630 --> 00:53.229\n平均每人每年可发病2.3次。\n\n00:53.580 --> 00:56.880\n儿童、老年人及免疫力低下者发病率更高。\n\n00:58.416 --> 01:00.266\n冬春季节发病率相对较高，\n\n01:00.367 --> 01:02.867\n这是因为冬春季节气温变化大，\n\n01:02.966 --> 01:04.217\n室内通风较差，\n\n01:04.266 --> 01:07.616\n有利于病毒、细菌等病原体的一个传播。\n\n01:07.916 --> 01:09.692\n例如在北方、北方，\n\n01:09.692 --> 01:11.217\n冬季供暖期间，\n\n01:11.317 --> 01:14.041\n室内人群密集且空气不流通，\n\n01:14.041 --> 01:16.467\n上感发生几率明显增加。\n\n01:17.216 --> 01:19.615\n儿童由于免疫系统发育尚未完善，\n\n01:19.816 --> 01:22.265\n是急性上呼吸道感染的高发人群，\n\n01:22.566 --> 01:24.765\n发病次数可能多于成年人，\n\n01:24.865 --> 01:27.166\n老年人则因身体机能衰退，\n\n01:27.216 --> 01:28.265\n免疫力下降。\n\n01:29.321 --> 01:30.772\n患病时间相对较长。\n\n01:31.889 --> 01:34.790\n常见的感染部位包括鼻腔。\n\n01:35.089 --> 01:37.540\n鼻腔是上呼吸道的起始部位，\n\n01:37.540 --> 01:39.639\n很容易受到病原体侵袭。\n\n01:39.790 --> 01:42.790\n感染时鼻粘膜会出现充血肿胀，\n\n01:42.889 --> 01:43.839\n导致鼻塞，\n\n01:43.940 --> 01:45.389\n同时分泌物增加，\n\n01:45.739 --> 01:47.540\n出现流鼻涕等症状。\n\n01:47.589 --> 01:49.315\n初期多为清水样鼻涕，\n\n01:49.315 --> 01:51.589\n后期则可能变为脓性鼻涕。\n\n01:53.319 --> 01:55.469\n咽部分为鼻咽、口咽和喉咽，\n\n01:55.619 --> 01:58.918\n感染后可出现咽干、咽痒、咽痛等症状。\n\n01:58.969 --> 02:00.619\n比如在急性咽炎时，\n\n02:00.819 --> 02:03.819\n患者常感觉咽部有异物感，\n\n02:03.819 --> 02:05.668\n吞咽时疼痛可能会增加。\n\n02:06.486 --> 02:07.210\n喉部感染时，\n\n02:07.210 --> 02:09.835\n患者可出现声嘶、咳嗽等症状，\n\n02:10.085 --> 02:11.985\n严重时可能会影响呼吸。\n\n02:13.054 --> 02:14.054\n如急性喉炎，\n\n02:14.154 --> 02:15.804\n尤其是小儿急性喉炎，\n\n02:15.804 --> 02:17.604\n由于小儿喉部解剖特点，\n\n02:17.654 --> 02:19.253\n更容易出现喉梗阻，\n\n02:19.253 --> 02:20.404\n导致呼吸困难。\n\n02:21.822 --> 02:25.223\n那急性上呼吸道感染的病因与发病机制，\n\n02:25.373 --> 02:27.173\n它主要的病原体，\n\n02:27.473 --> 02:29.548\n常见的病毒类型，\n\n02:29.548 --> 02:32.923\n引起急性上呼吸道感染的病毒种类繁多。\n\n02:33.977 --> 02:34.227\n其中，\n\n02:34.227 --> 02:35.578\nB病毒最为常见，\n\n02:35.677 --> 02:38.777\n约占所有病因的30%.50%。\n\n02:39.227 --> 02:39.828\n此外，\n\n02:39.878 --> 02:44.177\n冠状病毒、流感病毒、副流感病毒等也较为常见。\n\n02:44.328 --> 02:45.878\n例如在流感季节，\n\n02:45.977 --> 02:49.578\n流感病毒引发的上呼吸道感染病例明显增多。\n\n02:50.662 --> 02:54.263\n细菌类型感染相对于病毒感染较少见，\n\n02:54.613 --> 02:57.662\n但在某些情况下也可引发疾病。\n\n02:57.763 --> 03:03.063\n常见的细菌有溶血性链球菌、肺炎链球菌、葡萄球菌等。\n\n03:03.263 --> 03:08.563\n其中溶血性链球菌是导致扁桃体炎等上呼吸道感染的重要致病菌。\n\n03:11.414 --> 03:15.563\n病毒感染的特点还具有传播速度快、变异性强的特点。\n\n03:15.664 --> 03:18.264\n病毒感染具有极强的传播能力，\n\n03:18.313 --> 03:19.863\n以飞沫传播为主。\n\n03:19.964 --> 03:21.664\n在人员密集的场所，\n\n03:21.764 --> 03:23.313\n如学校、商场等，\n\n03:23.563 --> 03:31.238\n一个感染病毒的患者咳嗽、打喷嚏产生的分末中携带的病毒可迅速传播给周围的人，\n\n03:31.238 --> 03:34.214\n可可能在短时间内造成多人感染发病。\n\n03:35.332 --> 03:37.233\n病毒的基因容易发生变异。\n\n03:37.283 --> 03:37.757\n例如，\n\n03:37.757 --> 03:41.533\n流感病毒每年都可能会出现新的变异毒株，\n\n03:41.582 --> 03:46.283\n这使得人体免疫系统难以对其产生持久有效的免疫反应，\n\n03:46.432 --> 03:51.082\n导致人们可能反复感染同类型病毒引发的上呼吸道感染。\n\n03:53.759 --> 03:56.860\n病毒感染的特点具有自限性的特点，\n\n03:56.860 --> 04:01.009\n多数病毒引引起的急性上呼吸道感染具有自限性。\n\n04:01.768 --> 04:03.768\n一般在一到两周内可自行恢复。\n\n04:04.067 --> 04:05.117\n比如普通感冒，\n\n04:05.167 --> 04:07.117\n即使不使用抗病毒药物，\n\n04:07.167 --> 04:08.768\n只要患者注意休息，\n\n04:08.768 --> 04:09.468\n多饮水，\n\n04:09.617 --> 04:12.143\n身体的免疫系统通常能逐渐清除，\n\n04:12.143 --> 04:14.167\n病毒症状也会随之缓解。\n\n04:16.190 --> 04:17.190\n细菌感染的诱因，\n\n04:17.339 --> 04:20.890\n病毒感染后继发当人体受到病毒感染后，\n\n04:21.040 --> 04:23.589\n呼吸道黏膜的防御功能会受到破坏，\n\n04:23.790 --> 04:25.890\n这为细菌的入侵创造了条件。\n\n04:26.140 --> 04:26.640\n例如，\n\n04:26.640 --> 04:29.040\n在患者普通感冒后，\n\n04:29.040 --> 04:31.489\n如果没有得到很好的休息和治疗，\n\n04:31.540 --> 04:32.839\n病情迁延不愈，\n\n04:32.839 --> 04:34.489\n就容易继发细菌感染，\n\n04:34.489 --> 04:36.790\n引发扁桃体炎、中耳炎等症状。\n\n04:38.661 --> 04:39.462\n免疫功能低下。\n\n04:39.562 --> 04:44.511\n长期熬夜、过度劳累、营养不良等因素会导致人体免疫力下降，\n\n04:44.661 --> 04:47.111\n使身体对细菌的抵抗力减弱。\n\n04:48.199 --> 04:50.324\n比如一些上班族长期加班熬夜，\n\n04:50.324 --> 04:51.848\n身体处于疲惫状态，\n\n04:51.998 --> 04:54.199\n此时更容易受到细菌的侵袭，\n\n04:54.199 --> 04:55.998\n引发急性上呼吸道感染。\n\n04:58.877 --> 05:00.078\n细菌感染的诱因，\n\n05:00.278 --> 05:01.227\n环境因素。\n\n05:02.212 --> 05:06.536\n生活环境不卫生、通风不良等也会增加细菌感染的几率，\n\n05:06.536 --> 05:09.411\n像在一些卫生条件较差的集体宿舍。\n\n05:10.697 --> 05:13.048\n人员居住密集且空气流通不畅，\n\n05:13.298 --> 05:15.148\n细菌容易滋生和传播，\n\n05:15.197 --> 05:17.247\n从而引发上呼吸道感染。\n\n05:21.701 --> 05:23.502\n麻痹的内在机制主要有，\n\n05:23.552 --> 05:24.027\n第一，\n\n05:24.027 --> 05:24.951\n病原体入侵。\n\n05:25.351 --> 05:27.652\n当人体抵抗力下降时，\n\n05:27.802 --> 05:32.552\n外界的病原体如病毒、细菌等通过呼吸道进入人体，\n\n05:32.652 --> 05:35.851\n首先会粘附在呼吸道粘膜上皮细胞表面，\n\n05:36.101 --> 05:39.101\n然后突破粘膜屏障侵入细胞内部，\n\n05:39.152 --> 05:41.201\n开始在体内大量繁殖。\n\n05:41.552 --> 05:42.752\n免疫反应激活，\n\n05:43.002 --> 05:46.201\n病原体的入侵会激活人体的免疫系统。\n\n05:46.733 --> 05:49.782\n免疫系统会识别并清除病原体，\n\n05:49.983 --> 05:54.757\n此时体内的免疫细胞如淋巴细胞、巨噬细胞等会被动员起来，\n\n05:54.757 --> 05:56.433\n释放多种细胞因子，\n\n05:56.483 --> 05:57.833\n引发炎症反应。\n\n05:59.890 --> 06:01.290\n鼻塞炎症反应表现，\n\n06:01.690 --> 06:07.040\n炎症反应会导致呼吸道黏膜出现充血、水肿、分泌物增多等现象，\n\n06:07.339 --> 06:13.140\n进而引起鼻塞、流涕、咽痛、咳嗽等一系列急性上呼吸道感染的症状。\n\n06:13.440 --> 06:17.114\n例如鼻粘膜充血肿胀会导致鼻腔通气不畅，\n\n06:17.114 --> 06:18.589\n出现鼻塞的表现。\n\n06:20.053 --> 06:24.604\n急性上呼吸道感染的临床表现症状的总体特征，\n\n06:24.753 --> 06:25.753\n起病急骤，\n\n06:25.903 --> 06:28.753\n急性上呼吸道感染通常起病较急，\n\n06:28.954 --> 06:31.253\n患者可能在短时间内，\n\n06:31.253 --> 06:35.454\n比如几个小时到一天内就突然出现各种不适症状，\n\n06:35.604 --> 06:41.104\n如原本健康的人在受凉后可能当晚就开始出现打喷嚏、流鼻涕等表现。\n\n06:42.960 --> 06:43.860\n症状多样性，\n\n06:43.960 --> 06:47.210\n其症状涵盖了局部和全身多个方面，\n\n06:47.311 --> 06:50.510\n就会有鼻部、咽部等呼吸道局部的症状，\n\n06:50.610 --> 06:52.260\n像鼻塞、咽痛等，\n\n06:52.360 --> 06:55.960\n也会出现发热、发热、乏力等全身症状，\n\n06:56.210 --> 06:59.210\n不同患者症状组合可能有所不同。\n\n07:01.829 --> 07:03.829\n病情发展具有阶段性，\n\n07:04.079 --> 07:06.628\n病程初期可能以鼻部症状为主，\n\n07:06.678 --> 07:09.079\n如打喷嚏、流清鼻涕，\n\n07:09.178 --> 07:11.579\n随后可能逐渐出现咽部症状，\n\n07:11.628 --> 07:12.428\n如咽痛。\n\n07:12.628 --> 07:14.329\n若病情进一步发展，\n\n07:14.428 --> 07:16.329\n还可能出现全身症状，\n\n07:16.329 --> 07:18.378\n如发烧、肌肉酸痛等。\n\n07:18.428 --> 07:21.028\n整个病程一般在一到两周左右。\n\n07:22.717 --> 07:23.117\n吕布。\n\n07:25.515 --> 07:26.464\n鼻部症状表现。\n\n07:27.592 --> 07:27.893\n鼻塞。\n\n07:28.042 --> 07:28.993\n鼻塞是。\n\n07:30.384 --> 07:30.584\n草。\n\n07:31.414 --> 07:32.364\n是常见症状，\n\n07:32.414 --> 07:34.588\n多由于鼻粘膜充血肿胀，\n\n07:34.588 --> 07:37.114\n导致鼻腔空间变窄，\n\n07:37.164 --> 07:39.213\n患者会感觉呼吸不畅，\n\n07:39.313 --> 07:41.063\n尤其在夜间睡眠时，\n\n07:41.213 --> 07:42.813\n可能需要张口呼吸，\n\n07:42.914 --> 07:44.614\n严重影响睡眠质量，\n\n07:44.764 --> 07:47.313\n部分鼻塞症状可持续3.5天。\n\n07:47.614 --> 07:50.864\n流鼻涕发病初期多为清水样鼻涕，\n\n07:50.963 --> 07:55.164\n这是鼻粘膜为了稀释排出病原体而产生的。\n\n07:55.213 --> 07:56.414\n随着病情发展，\n\n07:56.514 --> 07:57.914\n鼻涕可能变得粘稠，\n\n07:58.164 --> 08:00.914\n颜色也可能变为淡黄色或脓性。\n\n08:02.934 --> 08:05.535\n往往提示可能合并了细菌感染。\n\n08:05.684 --> 08:08.684\n打喷嚏是身体的一种自我保护机制，\n\n08:08.834 --> 08:13.385\n通过快速有力的气流将鼻腔内的病原体和异物排出。\n\n08:13.734 --> 08:16.135\n患者可能会连续打多个喷嚏，\n\n08:16.334 --> 08:21.834\n在接触过敏源或冷空气等刺激时打喷打喷嚏症状可能会加重。\n\n08:23.096 --> 08:25.045\n咽部的临床表现第一，\n\n08:25.045 --> 08:28.145\n咽干患者常感觉咽部干燥不适，\n\n08:28.145 --> 08:30.196\n就像有一层膜覆盖在上面，\n\n08:30.395 --> 08:33.609\n这是因为咽部黏膜在炎症刺激下，\n\n08:33.609 --> 08:35.145\n水分蒸发加快，\n\n08:35.195 --> 08:36.495\n分泌的粘液。\n\n08:38.901 --> 08:39.276\n减少，\n\n08:39.276 --> 08:40.651\n导致咽干症状，\n\n08:40.702 --> 08:42.752\n尤其是在晨起较为明显。\n\n08:43.101 --> 08:46.552\n咽痒咽痒会使患者不自觉的想要清嗓子，\n\n08:46.651 --> 08:48.901\n这种痒感通常是持续性的，\n\n08:48.952 --> 08:51.851\n在吞咽或说话时可能会有所加重。\n\n08:52.101 --> 08:54.901\n部分患者可能因咽痒而频繁咳嗽。\n\n08:55.252 --> 08:57.526\n咽痛程度因人而异，\n\n08:57.526 --> 08:59.802\n轻者仅有吞咽时稍有疼痛，\n\n09:00.052 --> 09:01.851\n重者则疼痛剧烈，\n\n09:01.901 --> 09:04.351\n甚至会影响进食和说话。\n\n09:04.601 --> 09:07.452\n疼痛部位多在双侧扁桃体及咽后皮。\n\n09:07.802 --> 09:08.327\n严重，\n\n09:08.327 --> 09:08.802\n严重。\n\n09:09.168 --> 09:10.268\n炎症严重时，\n\n09:10.268 --> 09:12.218\n咽部可见明显的红肿。\n\n09:14.466 --> 09:15.515\n全身症状表现。\n\n09:17.127 --> 09:17.476\n第一，\n\n09:17.526 --> 09:18.177\n发热。\n\n09:18.476 --> 09:21.226\n发热是较为常见的全身症状，\n\n09:21.476 --> 09:23.726\n体温可高达38°C，\n\n09:23.726 --> 09:24.526\n甚至更高，\n\n09:24.677 --> 09:27.077\n一般在感染后的1.3天内出现。\n\n09:27.276 --> 09:30.526\n八时患者会感觉全身发烫、乏力，\n\n09:30.776 --> 09:32.401\n儿童发热时还可表，\n\n09:32.401 --> 09:34.427\n还可能出现惊厥等症状。\n\n09:35.156 --> 09:37.731\n乏力患者会感到全身疲惫，\n\n09:37.731 --> 09:38.507\n没有力气，\n\n09:38.606 --> 09:42.257\n日常活动如走路、上下楼梯等都会觉得费力，\n\n09:42.557 --> 09:47.406\n这是因为身体在与病原体做斗争的过程中消耗了大量能量。\n\n09:47.406 --> 09:49.406\n一般在疾病恢复后症，\n\n09:49.706 --> 09:51.856\n乏力症状才会逐渐消失。\n\n09:52.106 --> 09:53.007\n具有酸痛，\n\n09:53.356 --> 09:55.206\n可累及全身多个部位，\n\n09:55.206 --> 09:56.757\n如四肢、腰背等，\n\n09:56.906 --> 09:59.906\n患者会感觉肌肉有酸痛沉重感。\n\n10:00.570 --> 10:02.119\n活动时疼痛可能加剧，\n\n10:02.320 --> 10:07.570\n这是由于炎症介质释放刺激了肌肉组织和神经末梢导致的。\n\n10:10.757 --> 10:15.208\n急性上呼吸道感染诊断与鉴别诊断常见的诊断方法，\n\n10:15.357 --> 10:15.882\n第一，\n\n10:15.882 --> 10:17.307\n临床症状诊断。\n\n10:17.507 --> 10:20.557\n医生通过详细询问患者的临床表现，\n\n10:20.708 --> 10:24.807\n如是否有鼻塞、流涕、咽痛、发热、咳嗽等，\n\n10:24.807 --> 10:29.307\n以及症状出现的先后顺序、持续时间等进行初步判断。\n\n10:29.507 --> 10:29.958\n例如，\n\n10:29.958 --> 10:31.458\n若患者以鼻部症状，\n\n10:31.458 --> 10:33.557\n如打喷嚏、流清涕、擤鼻，\n\n10:33.607 --> 10:34.757\n随后出现咽痛，\n\n10:34.757 --> 10:37.208\n很可能提示急性上呼吸道感染。\n\n10:39.504 --> 10:40.153\n体格检查，\n\n10:40.754 --> 10:43.504\n医生会对患者进行全面的体格检查。\n\n10:44.677 --> 10:47.026\n重点包括鼻腔、咽喉部等部位。\n\n10:47.026 --> 10:49.177\n查看鼻粘膜是否充血、水肿，\n\n10:49.226 --> 10:50.976\n扁桃体有无肿大、化脓，\n\n10:51.127 --> 10:53.077\n咽喉部是否有红肿等。\n\n10:53.177 --> 10:56.226\n如扁桃体肿大且表面有脓性分泌物，\n\n10:56.226 --> 11:00.177\n可能提示存在细菌感染引发的上呼吸道症状。\n\n11:02.828 --> 11:04.177\n实验室检查项目，\n\n11:04.228 --> 11:11.427\n血常规检查通常检测血液中白细胞、红细胞、血小板等各类细胞的数量和比例来辅助诊断。\n\n11:11.627 --> 11:12.978\n一般病毒感染时，\n\n11:13.078 --> 11:15.478\n白细胞计计数正常或偏低，\n\n11:15.478 --> 11:17.427\n淋巴细胞比例可能升高，\n\n11:17.478 --> 11:18.578\n细菌感染时，\n\n11:18.677 --> 11:20.578\n白细胞计数通常升高，\n\n11:20.627 --> 11:23.328\n中性粒细胞比例也会增加。\n\n11:23.377 --> 11:26.127\n例如白细胞计数为15000，\n\n11:26.328 --> 11:28.127\n中性粒比例为80%。\n\n11:29.182 --> 11:30.466\n提示可能为细菌感染。\n\n11:30.466 --> 11:32.083\nC、反应蛋白检测。\n\n11:33.150 --> 11:36.674\nC反应蛋白是一种急性时像反应蛋白，\n\n11:36.674 --> 11:39.599\n在感染、炎症等情况下会迅速升高。\n\n11:39.799 --> 11:41.750\n在急性上呼吸道感染中，\n\n11:41.799 --> 11:45.000\n细菌感染时C反应蛋白升高较为明显，\n\n11:45.000 --> 11:48.000\n而病毒感染时一般轻度升高或正常。\n\n11:48.150 --> 11:50.799\n若C反应蛋白值为50mg/L，\n\n11:50.900 --> 11:52.950\n提示细菌感染的可能性大。\n\n11:55.723 --> 11:57.273\n实验室检测项目，\n\n11:57.424 --> 12:04.073\n病原体检测可通过采集患者的鼻咽试纸、痰液等标本进行检测。\n\n12:07.322 --> 12:08.572\n确定具体的宾语。\n\n12:09.323 --> 12:10.473\n具体的致病病原体，\n\n12:10.473 --> 12:13.973\n例如采用核酸检测方法检测流感病毒，\n\n12:14.374 --> 12:15.598\n若结果呈阳性，\n\n12:15.598 --> 12:18.723\n即可明确为流感病毒引起的上呼吸道感染，\n\n12:18.773 --> 12:21.374\n有助于针对性的选择治疗药物。\n\n12:27.981 --> 12:29.431\n影像学检查要点。\n\n12:32.210 --> 12:33.460\n胸部X光检查，\n\n12:33.710 --> 12:38.210\n对于症状不典型或怀疑有下呼吸道并发症的患者，\n\n12:38.409 --> 12:41.059\n可能需要进行胸部X光检查，\n\n12:41.409 --> 12:44.059\n主要目的在于排除肺炎等疾病。\n\n12:44.309 --> 12:46.960\n如果X光片显示肺部纹理清晰，\n\n12:47.210 --> 12:49.260\n无片状阴影等异常表现，\n\n12:49.359 --> 12:51.909\n可初步排除肺部实质性病变，\n\n12:51.960 --> 12:55.059\n支持急性上呼吸道感染的鉴诊断。\n\n12:56.335 --> 12:57.434\n胸部CT检查，\n\n12:57.434 --> 13:04.135\n当胸部X光检查结果不明确或高度怀疑有肺部其他疾病时，\n\n13:04.135 --> 13:06.784\n会进一步进行胸部CT检查。\n\n13:07.638 --> 13:10.638\nCT能更清晰的显示肺部的细微结构，\n\n13:10.739 --> 13:15.039\n对于早期发现肺炎、肺部占位性病变等有重要意义。\n\n13:15.239 --> 13:17.789\n若CT扫描未发现肺部异常，\n\n13:17.939 --> 13:20.838\n可进一步佐证急性上呼吸道感染的诊断。\n\n13:28.015 --> 13:29.965\n需要鉴别的相似疾病，\n\n13:30.015 --> 13:31.215\n过敏性鼻炎。\n\n13:34.526 --> 13:39.026\n过敏性鼻炎也会出现鼻塞、流涕、打喷嚏等症状，\n\n13:39.127 --> 13:41.627\n但都有明显的过敏原接触史，\n\n13:41.827 --> 13:44.427\n如接触花粉、尘螨等后发作，\n\n13:44.577 --> 13:48.276\n且一般无发热、全身乏力等全身症状，\n\n13:48.476 --> 13:50.927\n鼻腔分泌物多为清水样，\n\n13:51.077 --> 13:53.776\n脱离过敏源后症状可迅速缓解。\n\n13:53.976 --> 14:03.026\n例如患者在春季花粉季接触花粉后出现立即出现的鼻痒、连续打喷嚏、流大量清水样鼻涕，\n\n14:03.226 --> 14:04.627\n无发烧等表现。\n\n14:04.830 --> 14:06.679\n更倾向于过敏性鼻炎。\n\n14:08.461 --> 14:08.637\n第二，\n\n14:08.637 --> 14:09.111\n流感。\n\n14:12.276 --> 14:15.625\n流感与急性上呼吸道感染疾病相似，\n\n14:15.625 --> 14:18.776\n但流感通常全身症状更重，\n\n14:18.926 --> 14:23.325\n如高热、乏力、肌肉酸痛等症状较为突出，\n\n14:23.375 --> 14:24.676\n且传播速度快，\n\n14:24.726 --> 14:26.426\n可呈爆发性发作。\n\n14:26.575 --> 14:29.125\n例如在流感流行季节。\n\n14:30.081 --> 14:37.932\n多人短期内相继出现高热、体温高达39.40°C、头痛、全身肌肉酸痛、乏力等症状，\n\n14:37.981 --> 14:39.432\n应高度怀疑流感，\n\n14:39.432 --> 14:41.981\n需通过病原学检测进行鉴别。\n\n14:44.239 --> 14:45.239\n急性扁桃体炎。\n\n14:46.468 --> 14:48.143\n主要表现为咽痛明显，\n\n14:48.143 --> 14:48.869\n尤其是。\n\n14:57.653 --> 15:00.153\n急性扁桃体炎主要表现为咽痛明显，\n\n15:00.254 --> 15:02.403\n尤其是吞咽时疼痛加剧，\n\n15:02.604 --> 15:03.703\n可伴有发热。\n\n15:03.854 --> 15:08.653\n但急性扁桃体炎患者扁桃体肿大、充血更为显著。\n\n15:09.651 --> 15:12.401\n严重时表面可出现脓性分泌物。\n\n15:12.502 --> 15:15.651\n而急性上呼吸道感染的咽痛相对较轻，\n\n15:15.802 --> 15:18.351\n且不一定有扁桃体的明显病变。\n\n15:18.552 --> 15:20.101\n如患者咽痛剧烈，\n\n15:20.101 --> 15:21.452\n扁桃体二度肿大，\n\n15:21.452 --> 15:24.702\n表面有黄白色脓性分泌物，\n\n15:24.702 --> 15:27.202\n更符合急性扁桃体炎的表现。\n\n15:43.073 --> 15:45.374\n非常感谢各位大家的收听。\n\n15:46.484 --> 15:47.635\n今天讲解结束。\n\n","v0347cg10004d61g7miljht8bjta14e0",950,838,"2026-01-25 01:09:34","急性上呼吸道感染疾病概述 - 症状、病因与治疗指南  ","急性上呼吸道感染,感冒症状,病毒性呼吸道感染,上呼吸道感染治疗,鼻塞喉咙痛,流感预防  ","本文详细解析急性上呼吸道感染的常见症状（如咳嗽、发热）、病因（病毒/细菌感染）、诊断方法及科学治疗建议，帮助您快速识别疾病并采取正确防护措施。","2026-04-03 20:00:00",[37],{"menuId":38,"menuName":39,"parentId":17,"orderNum":40,"path":41,"component":42,"isFrame":43,"isCache":44,"menuType":45,"visible":26,"status":17,"createDept":6,"remark":24,"createTime":46,"children":47,"columnImage":48,"columnLogo":49,"uncheckedLogo":6,"checkedLogo":6,"isHot":17,"isHome":17,"forceLogin":17,"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 10:31:58",[],"https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:09:40/0d7fcb56-3dc4-4dcb-99ca-a5d5c438378e.png","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:09:43/958efac7-dd02-4681-b8fd-0dd84b1bbf42.png","健康科普视频大全,了解你的健康生活","健康科普视频, 戒烟视频, 饮食健康视频, 胸痛科普, 用药知识, 职业健康视频, 贫血科普, 眼健康视频","精选健康科普视频,涵盖戒烟、胸痛、饮食、用药与职业健康等多个主题,让你轻松获取科学健康知识,提升生活质量。","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:09:45/fa8fe113-deaa-4454-8105-d629769963dd.png","Video",2,"高发轻症",4,"https://vod.haohuanjiao.com/huanjiao/specialistVideo/871790/4b6f3781-b268-41bb-b9eb-5c6c2d2d874a.tmp?a=0&auth_key=1789013867-380bcdab35c34e309f715341711cd6b8-0-56e4f2e40db8d51cbbbf81997dee4083&br=606&bt=606&cd=0%7C0%7C0&ch=0&cr=0&cs=0&dr=0&ds=4&eid=v0347cg10004d61g7miljht8bjta14e0&er=0&l=2026081102015440B834E9BE47A52D8AEA&lr=&mime_type=video_mp4&net=0&pl=0&qs=13&rc=MzdkbTtrb3BqOTczNGY3M0ApaDR3ZXdtbDo0ZzMzajo2eWdiLnFfcWdmNC5hLS1kNDBzcy0xXmc1ZWlqZDMxLS5gMS06Yw%3D%3D&vl=&vr=",true,{"code":9,"msg":58,"message":6,"data":6,"success":59},{"code":9,"msg":10,"message":6,"data":62,"success":59},{"pageNo":26,"pageSize":63,"result":64,"totalSize":17},10,[],{"code":9,"msg":10,"message":6,"data":66,"success":59},{"authors":67,"appraiseDimensionScoresVos":68},[],[]]