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--> 00:01.049\n嗯，\n\n00:01.650 --> 00:02.799\n大家好，\n\n00:02.799 --> 00:03.500\n今天呢，\n\n00:03.700 --> 00:07.449\n我们一起来学习一下关于急性上呼吸道感染。\n\n00:08.541 --> 00:09.892\n些知识。\n\n00:15.064 --> 00:18.065\n先讲一讲急性上呼吸道感染的概述。\n\n00:18.815 --> 00:22.864\n其实我们平时几乎每个人每年。\n\n00:23.847 --> 00:24.322\n都会有，\n\n00:24.322 --> 00:26.497\n会有得一次两次感冒，\n\n00:26.497 --> 00:27.773\n甚至更多的啊，\n\n00:27.773 --> 00:28.947\n有轻有重。\n\n00:29.398 --> 00:31.798\n细菌感染是引起有病毒感染，\n\n00:31.798 --> 00:33.897\n但多数都是病毒感染，\n\n00:33.897 --> 00:35.448\n比较严重的就是流感。\n\n00:37.280 --> 00:37.480\n嗯。\n\n00:39.096 --> 00:41.695\n我们先看一下它的定义和常见的类型。\n\n00:42.145 --> 00:43.745\n第一个是普通的感冒，\n\n00:44.096 --> 00:47.296\n普通感冒由多种病原体引起，\n\n00:47.445 --> 00:50.145\n以鼻病毒、冠状病毒为主，\n\n00:50.195 --> 00:52.546\n多表现为鼻塞、流涕。\n\n00:53.540 --> 00:54.639\n咽部干痒，\n\n00:54.840 --> 00:56.340\n一般不会发热，\n\n00:56.740 --> 00:57.889\n全身症状呢，\n\n00:57.889 --> 00:58.590\n比较轻。\n\n00:59.631 --> 00:59.780\n嗯，\n\n00:59.780 --> 01:00.706\n普通感冒呢，\n\n01:00.706 --> 01:02.480\n一般全年都可以发病。\n\n01:02.730 --> 01:03.780\n冬春季呢，\n\n01:03.780 --> 01:04.630\n较为多见，\n\n01:04.880 --> 01:06.880\n病程一般为3.7天。\n\n01:07.331 --> 01:08.731\n它具有自限性，\n\n01:08.981 --> 01:10.831\n多数患者的可以自愈。\n\n01:11.081 --> 01:12.405\n什么叫自限性呢？\n\n01:12.405 --> 01:12.930\n也就是说，\n\n01:12.930 --> 01:13.831\n你要是不吃药，\n\n01:13.831 --> 01:15.081\n它过几天也会好，\n\n01:15.081 --> 01:16.280\n也就是自限性。\n\n01:18.555 --> 01:22.055\n所以得了普通感冒不用太紧张啊。\n\n01:23.904 --> 01:25.654\n那第二种类型就是流感。\n\n01:26.442 --> 01:26.866\n流感呢，\n\n01:26.866 --> 01:30.942\n是由甲型或者乙型流感病毒引起的急性呼吸道传染。\n\n01:31.915 --> 01:32.339\n传染病，\n\n01:32.339 --> 01:33.114\n他疾病呢，\n\n01:33.114 --> 01:33.714\n比较急，\n\n01:34.165 --> 01:36.114\n常表现为突发的高热，\n\n01:36.214 --> 01:38.089\n肌肉肌肉的酸痛，\n\n01:38.089 --> 01:38.764\n乏力，\n\n01:38.815 --> 01:39.964\n头痛剧烈，\n\n01:40.565 --> 01:41.489\n伴有干咳，\n\n01:41.489 --> 01:42.264\n胸闷等。\n\n01:43.045 --> 01:44.945\n流感具有明显的季节性，\n\n01:45.346 --> 01:47.096\n多在冬春季流行，\n\n01:47.146 --> 01:48.195\n传染性强，\n\n01:48.646 --> 01:50.295\n可引起爆发流行，\n\n01:50.496 --> 01:54.045\n严重者可并发肺炎和心肌炎。\n\n01:56.386 --> 01:58.585\n那还有一个就是链球菌的咽炎，\n\n01:58.786 --> 02:00.011\n链球菌咽炎呢，\n\n02:00.011 --> 02:02.386\n由A组链链球菌感染引起，\n\n02:02.786 --> 02:04.935\n它可以有剧烈的咽痛，\n\n02:05.036 --> 02:07.786\n扁桃体可以发炎肿大，\n\n02:07.786 --> 02:10.436\n可见扁桃体有脓性的渗出，\n\n02:10.835 --> 02:12.686\n颌下的淋巴结的肿痛，\n\n02:12.936 --> 02:14.386\n但一般没有咳嗽。\n\n02:15.246 --> 02:15.647\n一般呢，\n\n02:15.647 --> 02:16.897\n血常规检查呢，\n\n02:16.897 --> 02:18.371\n可以发现CRP呢，\n\n02:18.371 --> 02:19.996\n会大于50mg/L。\n\n02:20.296 --> 02:21.121\n本病呢，\n\n02:21.121 --> 02:22.996\n多见于儿童和青少年。\n\n02:23.589 --> 02:24.988\n若不及时治疗呢，\n\n02:24.988 --> 02:28.839\n可引发风湿热、肾小球肾炎等并发症。\n\n02:30.356 --> 02:30.606\n好，\n\n02:30.707 --> 02:32.682\n我们看看这个上呼吸道感染，\n\n02:32.682 --> 02:34.757\n它的危害和社会的影响呢。\n\n02:34.807 --> 02:35.457\n第一。\n\n02:36.304 --> 02:41.429\n急性上呼吸道感染可导致患者出现发热、咳嗽、咽痛等不适症状，\n\n02:41.429 --> 02:43.904\n影响日常生活和工作。\n\n02:44.404 --> 02:44.804\n嗯，\n\n02:45.154 --> 02:46.703\n降低了生活质量。\n\n02:46.953 --> 02:47.854\n部分患者，\n\n02:47.854 --> 02:52.979\n尤其是老年人、儿童、孕妇及患有慢性基础疾病者，\n\n02:52.979 --> 02:54.453\n病情可能加重。\n\n02:55.246 --> 02:56.296\n出现并发症，\n\n02:56.296 --> 03:00.895\n如病毒性的肺炎、病毒性的心肌炎、病毒性的脑膜炎。\n\n03:00.945 --> 03:03.095\n这些都可以威胁到。\n\n03:03.889 --> 03:04.438\nThe need.\n\n03:05.268 --> 03:06.268\n可以威胁到生命，\n\n03:06.268 --> 03:09.768\n所以这就如果一旦出现并发症，\n\n03:09.817 --> 03:11.817\n那就是比较严重。\n\n03:12.798 --> 03:14.598\n然后看一下对社会的影响，\n\n03:14.848 --> 03:15.822\n这类疾病呢，\n\n03:15.822 --> 03:17.322\n具有较强的传染性，\n\n03:17.322 --> 03:18.947\n易在人群中传播，\n\n03:19.048 --> 03:23.447\n导致学校、幼儿园、养老院等场所出现聚集性的发病，\n\n03:23.697 --> 03:26.397\n增加了医疗资源的负担。\n\n03:26.397 --> 03:29.848\n流感等急性上呼吸道感染的大规模流行，\n\n03:29.848 --> 03:30.548\n可影响。\n\n03:31.481 --> 03:34.332\n社会经济活动的正常进行，\n\n03:34.531 --> 03:37.231\n造成一定的经济损失，\n\n03:37.432 --> 03:41.106\n就是我们这个新冠病毒引起的那个上呼吸道感染，\n\n03:41.106 --> 03:44.082\n引起大家都经历过风控啊，\n\n03:44.082 --> 03:44.682\n然后。\n\n03:46.380 --> 03:47.880\n社会的影响比较大，\n\n03:47.880 --> 03:49.404\n经济也停滞了，\n\n03:49.404 --> 03:51.429\n现在在慢慢的恢复，\n\n03:51.429 --> 03:53.755\n但是那段封控的记忆，\n\n03:53.755 --> 03:57.880\n大家肯定一定还深深的印在脑海里面。\n\n03:58.667 --> 04:02.192\n那么我们先讲一下它的预防和控制的重要性。\n\n04:02.957 --> 04:05.807\n加强对急性上呼吸道感染的预防和控制，\n\n04:05.957 --> 04:08.906\n有助于减少疾病的发生和传播，\n\n04:09.057 --> 04:10.406\n保护易感人群，\n\n04:10.406 --> 04:11.682\n降低医疗成本，\n\n04:11.682 --> 04:14.106\n维护社会的稳定和正常秩序。\n\n04:15.044 --> 04:17.868\n提高公共对疾病的认知和水平，\n\n04:17.868 --> 04:19.694\n增强自我防护意识，\n\n04:20.394 --> 04:24.593\n是有效预防和控制急性上呼吸道感染的关键。\n\n04:25.243 --> 04:27.468\n第一个就是要你要有知识啊，\n\n04:27.468 --> 04:28.894\n要对疾病有认知。\n\n04:29.964 --> 04:30.364\n然后呢，\n\n04:30.364 --> 04:31.940\n要有自我的保护意识，\n\n04:31.940 --> 04:33.315\n但后面会慢慢讲，\n\n04:33.364 --> 04:35.565\n怎么个来自自我保护，\n\n04:35.565 --> 04:37.815\n怎么来有效的控制。\n\n04:39.756 --> 04:41.807\n他的那个急性上呼道感染。\n\n04:44.838 --> 04:48.638\n我们讲一讲临床的表现和分类的识别啊，\n\n04:49.088 --> 04:51.187\n同的病原体的典型症状，\n\n04:51.537 --> 04:53.138\n刚才其实也说过，\n\n04:53.138 --> 04:54.588\n大体说过一下，\n\n04:54.588 --> 04:56.713\n一个普通的感冒就鼻塞流涕，\n\n04:56.713 --> 04:59.988\n就最常见的那种患者出现鼻腔堵塞，\n\n04:59.988 --> 05:01.138\n分泌物增多，\n\n05:01.588 --> 05:03.388\n初期为清水样鼻涕，\n\n05:03.388 --> 05:06.037\n后可转为粘液性或者脓性涕。\n\n05:06.950 --> 05:07.649\n喉咙干痒，\n\n05:08.000 --> 05:09.399\n咽喉部又干燥。\n\n05:10.399 --> 05:10.899\n瘙痒感，\n\n05:10.899 --> 05:13.100\n部分患者可伴有轻微咽痛。\n\n05:13.399 --> 05:14.500\n全身症状呢，\n\n05:14.500 --> 05:15.549\n一般比较轻，\n\n05:15.600 --> 05:17.750\n因为他没有高热。\n\n05:18.485 --> 05:20.186\n也没有很明显的乏力，\n\n05:20.485 --> 05:20.885\n嗯，\n\n05:21.485 --> 05:22.411\n所以病程呢，\n\n05:22.411 --> 05:23.686\n多在一周左右啊，\n\n05:23.686 --> 05:24.536\n会治愈，\n\n05:25.085 --> 05:25.485\n嗯。\n\n05:26.470 --> 05:27.144\n流感呢，\n\n05:27.144 --> 05:28.420\n它会有一个高热，\n\n05:28.519 --> 05:31.570\n体温可以升高39.40°，\n\n05:31.670 --> 05:34.420\n发病持续时间可以3.5周。\n\n05:34.619 --> 05:37.269\n然后有一个明显的肌肉酸痛，\n\n05:37.369 --> 05:40.670\n那就有些病人得了疼痛会说我浑身酸痛，\n\n05:40.869 --> 05:45.369\n其实就是一个病毒引起的全身肌肉的酸痛，\n\n05:45.369 --> 05:48.195\n尤其是背部四肢肌肉疼痛明显，\n\n05:48.195 --> 05:50.119\n同时伴有明显的乏力感。\n\n05:50.682 --> 05:51.731\n呼吸道症状呢，\n\n05:51.731 --> 05:52.881\n有干咳、胸闷，\n\n05:52.881 --> 05:55.282\n部分患者可出现鼻塞、流涕。\n\n05:56.214 --> 05:57.989\n但是鼻塞流涕的症状呢，\n\n05:57.989 --> 06:00.265\n要比普通感冒药症状比较轻。\n\n06:02.138 --> 06:02.562\n然后，\n\n06:02.562 --> 06:04.988\n链球菌的咽炎，\n\n06:05.238 --> 06:06.388\n咽喉剧痛，\n\n06:06.738 --> 06:08.187\n咽部疼痛明显，\n\n06:08.287 --> 06:09.988\n吞咽时疼痛加剧，\n\n06:10.388 --> 06:11.937\n可放射至耳部。\n\n06:12.187 --> 06:13.488\n扁桃体脓栓，\n\n06:13.687 --> 06:14.937\n扁桃体红肿，\n\n06:15.037 --> 06:18.638\n表面可见黄白色脓点或者脓性分泌物。\n\n06:18.738 --> 06:20.488\n颌下淋巴结肿痛，\n\n06:20.787 --> 06:22.388\n颌下淋巴结肿大，\n\n06:22.488 --> 06:23.812\n后肢可以疼痛，\n\n06:23.812 --> 06:25.437\n可伴有发热啊，\n\n06:25.437 --> 06:30.537\n这就是三个三种类型感冒的一个典型的临床表现。\n\n06:32.023 --> 06:32.398\n然后，\n\n06:32.398 --> 06:35.247\n我们有一个看看流感的预警症状，\n\n06:35.247 --> 06:38.747\n就是要及时就诊的那些症状啊。\n\n06:38.747 --> 06:40.173\n那有哪些看一下，\n\n06:40.173 --> 06:42.222\n一个是呼吸系统的预警症状，\n\n06:42.372 --> 06:46.572\n如果他气促呼吸频率增快超过了每分钟30次啊，\n\n06:46.673 --> 06:51.622\n我们正常人一般在十十十二到十十五次左右，\n\n06:52.023 --> 06:53.023\n那些，\n\n06:53.023 --> 06:56.822\n所以如果超过每分钟30次的时候，\n\n06:56.822 --> 06:59.622\n他体质可能存在呼吸衰竭的风险。\n\n06:59.822 --> 07:02.423\n还有一个就是血氧饱和度的下降。\n\n07:02.700 --> 07:09.325\n就是我们在新冠那那那时候发就流行的时候也是这样，\n\n07:09.325 --> 07:12.049\n就是家用有一个止痒监测仪，\n\n07:12.100 --> 07:17.375\n现在也是每个家庭都会有很都会有备有一个止氧监测仪。\n\n07:17.375 --> 07:21.350\n那如果他的血氧饱和度低于93%了，\n\n07:21.350 --> 07:23.325\n表明了机体有缺氧啊，\n\n07:23.325 --> 07:24.600\n需要及时就诊。\n\n07:25.208 --> 07:25.483\n嗯，\n\n07:25.483 --> 07:28.808\n还有一个预警症状就是神经系统的预警症状。\n\n07:29.108 --> 07:35.407\n它会有瞻望患者出现意识模糊、言语混乱、行为异常等瞻妄表现，\n\n07:35.657 --> 07:37.308\n因此可能并发脑炎。\n\n07:38.346 --> 07:39.246\n还有一个抽搐，\n\n07:39.795 --> 07:42.496\n突发全身或者局部肌肉的抽搐，\n\n07:42.545 --> 07:45.746\n可能是由于病毒侵犯神经系统所致。\n\n07:47.286 --> 07:48.536\n另外一个颈部僵硬，\n\n07:48.885 --> 07:50.536\n颈部活动受限，\n\n07:50.536 --> 07:51.286\n强直，\n\n07:51.485 --> 07:53.436\n它是脑膜刺激症的表现，\n\n07:53.485 --> 07:55.860\n那么就要去去警惕，\n\n07:55.860 --> 07:59.885\n是不是有并发病毒性脑炎的风险，\n\n08:00.686 --> 08:02.360\n那个一旦发现，\n\n08:02.360 --> 08:04.485\n也是要立即就诊。\n\n08:05.639 --> 08:05.963\n然后，\n\n08:05.963 --> 08:08.289\n一个是循环系统的预警症状，\n\n08:08.489 --> 08:10.389\n如果皮肤出现花斑，\n\n08:10.539 --> 08:12.389\n皮肤出现花斑样改变，\n\n08:12.389 --> 08:12.914\n其实呢，\n\n08:12.914 --> 08:16.639\n微循环障碍可能有一个感染性休克的存在。\n\n08:17.088 --> 08:17.713\n另外呢，\n\n08:17.713 --> 08:20.588\n就是一个毛细血管充盈时间延长。\n\n08:21.675 --> 08:22.825\n时间超过3秒，\n\n08:22.825 --> 08:24.776\n就是循环灌注不足，\n\n08:24.925 --> 08:27.001\n立立即进行评估和处理。\n\n08:27.001 --> 08:30.226\n这是一个休克的一个前期的一个症状表示。\n\n08:30.226 --> 08:33.700\n如果你说如果不及时纠正的话，\n\n08:33.700 --> 08:35.700\n那他就是要进入休克，\n\n08:35.700 --> 08:37.526\n那也是要危及生命的。\n\n08:39.697 --> 08:42.596\n看一下它的发病机制与病程的演变，\n\n08:43.346 --> 08:46.197\n第一个就是病毒入侵的四个阶段，\n\n08:46.447 --> 08:47.997\n第一它就是粘附，\n\n08:48.197 --> 08:54.447\n流感病毒的血凝素蛋白与呼吸道上皮细胞表面的唾液酸受体结合，\n\n08:54.447 --> 08:56.796\n是病毒入侵宿主细胞的第一步。\n\n08:56.896 --> 08:58.721\n这一过程具有特异性，\n\n08:58.721 --> 09:01.346\n决定了病毒对宿主细胞的感染能力。\n\n09:01.396 --> 09:03.646\n第二个就是复制病毒。\n\n09:04.466 --> 09:06.166\nRNA进入宿主细胞后，\n\n09:06.166 --> 09:08.390\n在细胞内大量增殖，\n\n09:08.440 --> 09:12.091\n一般在感染后24.72小时达到峰值，\n\n09:12.291 --> 09:13.765\n病毒复制过程中呢，\n\n09:13.765 --> 09:16.440\n会消耗宿主的细胞的营养物质，\n\n09:16.440 --> 09:17.940\n导致细胞的损伤。\n\n09:18.091 --> 09:24.140\n所以这个病毒的复制是导致你后面出现一系列症状的一个关键的步骤。\n\n09:24.440 --> 09:24.991\n所以说，\n\n09:24.991 --> 09:31.091\n我们治疗流感的就是关键就是要在它的复制期抑制它的复制，\n\n09:31.241 --> 09:33.216\n所以现在有很多抗病毒的药物。\n\n09:33.216 --> 09:34.591\n像大家也。\n\n09:34.676 --> 09:35.026\n知道的，\n\n09:35.026 --> 09:36.325\n网吧那个。\n\n09:37.703 --> 09:37.903\n嗯。\n\n09:38.591 --> 09:39.065\n就两粒，\n\n09:39.065 --> 09:39.591\n他就，\n\n09:39.591 --> 09:43.666\n但是用这种抗病毒药最好是在48小时以内用，\n\n09:43.666 --> 09:44.841\n因为不要让它。\n\n09:46.033 --> 09:46.934\n继续的复值，\n\n09:46.934 --> 09:52.633\n因为它到二十四七十二小时达到负值的负值的峰值超过72小时，\n\n09:52.633 --> 09:56.033\n再用抗病毒药已经没有这个意义啊。\n\n09:56.234 --> 09:57.434\n还有一个就是，\n\n09:57.434 --> 09:59.383\n还有一个是四个阶段，\n\n09:59.383 --> 09:59.958\n一个粘附，\n\n09:59.958 --> 10:00.434\n一个复制，\n\n10:00.434 --> 10:02.283\n还有一个炎炎性风暴，\n\n10:02.383 --> 10:05.033\n在病毒感染引起机体免疫反应，\n\n10:05.033 --> 10:06.833\n释放大量的细胞因子。\n\n10:07.940 --> 10:09.190\n形成炎症风暴，\n\n10:09.190 --> 10:12.241\n炎症风暴可以导致全身的炎症反应，\n\n10:12.241 --> 10:15.565\n引起发热、乏力等全身症状，\n\n10:15.565 --> 10:17.541\n严重可损伤多个器官。\n\n10:17.690 --> 10:18.841\n就是简单的讲，\n\n10:18.841 --> 10:21.716\n就是它的病毒感染以后，\n\n10:21.716 --> 10:23.966\n全身的免疫系统被调动起来，\n\n10:23.966 --> 10:28.216\n然后全身免疫系统会有时候过度反应，\n\n10:28.216 --> 10:32.390\n也引起就是对自身器官的损伤。\n\n10:32.440 --> 10:33.041\n所以说，\n\n10:33.041 --> 10:35.241\n它严重的时候可以损伤多个器官。\n\n10:35.241 --> 10:38.140\n所以这也是一个一个一个。\n\n10:38.392 --> 10:38.517\n嗯，\n\n10:38.517 --> 10:39.242\n病毒性。\n\n10:40.130 --> 10:40.380\n嗯，\n\n10:40.431 --> 10:43.531\n上呼吸道感染病毒感染的一个特征，\n\n10:44.330 --> 10:45.830\n最后就是一个修复期。\n\n10:45.931 --> 10:46.981\n感染后期呢，\n\n10:46.981 --> 10:49.531\n呼吸道上皮细胞的纤毛开始再生，\n\n10:49.630 --> 10:51.330\n一般需要7.14天。\n\n10:51.580 --> 10:52.156\n首先呢，\n\n10:52.156 --> 10:55.231\n患者可能出现暂时性的气道高反应。\n\n10:55.231 --> 10:58.681\n纤毛再生有助于恢复呼吸道的正常功能，\n\n10:58.731 --> 11:00.981\n清除残留的病原体和分泌物，\n\n11:00.981 --> 11:02.406\n也就是会有咳嗽嘛，\n\n11:02.406 --> 11:06.830\n咳嗽就是要把痰清除残留的病原体和分泌物再咳出来，\n\n11:07.130 --> 11:09.531\n它裹着痰液一起咳出来。\n\n11:09.531 --> 11:10.330\n那就慢慢。\n\n11:10.372 --> 11:12.721\n就会把病毒赶出体内。\n\n11:14.607 --> 11:14.857\n好，\n\n11:15.007 --> 11:18.057\n现在讲一讲高危人群重症化机制，\n\n11:18.158 --> 11:22.408\n一就是哪些人有容易就是得了感，\n\n11:22.408 --> 11:26.783\n那个流感以后必须特别注意的一个就是免疫低下者，\n\n11:26.783 --> 11:28.807\n免疫低下的患者。\n\n11:29.690 --> 11:33.940\n它的CDC+T细胞数量减少。\n\n11:34.890 --> 11:35.090\n嗯。\n\n11:35.994 --> 11:41.143\n小于200微针机体免疫监测。\n\n11:41.997 --> 11:44.598\n和清除病毒的能力就下降，\n\n11:44.598 --> 11:46.047\n导致病毒清除延迟。\n\n11:46.047 --> 11:49.122\n病毒在体内持续性存在和复制，\n\n11:49.122 --> 11:50.622\n以引发重症感染，\n\n11:50.622 --> 11:52.997\n并发增加并发症的危险。\n\n11:53.047 --> 11:55.648\n还有一个就是慢性肺病患者，\n\n11:55.747 --> 11:57.447\n特别是自由基里的患者。\n\n11:58.130 --> 11:58.630\n是的。\n\n11:59.731 --> 12:03.182\n肺组织人A、C、e二受体表达上调，\n\n12:03.382 --> 12:06.432\n流感病毒更易入侵并引起感染，\n\n12:06.481 --> 12:08.331\n患者常合并细菌感染，\n\n12:08.331 --> 12:09.581\n进一步加重病情，\n\n12:09.581 --> 12:12.331\n导致呼吸衰竭等严重后果。\n\n12:12.432 --> 12:14.981\n还有一个我们必须重视的就是个孕妇，\n\n12:15.281 --> 12:18.456\n因为孕晚期孕妇膈肌上抬，\n\n12:18.456 --> 12:19.682\n肺部扩张受限，\n\n12:19.682 --> 12:21.106\n有效咳嗽减弱，\n\n12:21.106 --> 12:22.581\n呼吸道分泌物不易排出，\n\n12:22.581 --> 12:23.981\n滞留风险增加，\n\n12:24.182 --> 12:25.882\n分泌物滞留引发。\n\n12:26.594 --> 12:27.195\n感染。\n\n12:28.791 --> 12:30.716\n孕妇感染后病情进展迅速，\n\n12:30.716 --> 12:32.640\n对母婴健康造成威胁，\n\n12:32.890 --> 12:36.591\n最讨厌的是孕妇感染后你用药还要注意。\n\n12:36.591 --> 12:37.041\n如果。\n\n12:38.729 --> 12:41.854\n要避免运用那个对胎儿影响的药物。\n\n12:41.854 --> 12:42.979\n所以说孕妇。\n\n12:45.304 --> 12:45.830\n当然的话，\n\n12:45.830 --> 12:48.104\n就也是一件很棘手的事情，\n\n12:48.155 --> 12:49.804\n也必须及时的就医。\n\n12:52.216 --> 12:55.367\n然后我们说一下规规范化分级治疗特点，\n\n12:55.416 --> 12:57.067\n一个是抗病原治疗，\n\n12:57.367 --> 12:59.067\n抗流感病毒治疗，\n\n12:59.267 --> 13:01.767\n奥司他韦是流感治疗一线药物，\n\n13:01.767 --> 13:04.541\n成人口服剂量激素完成每日两次疗程，\n\n13:04.541 --> 13:05.017\n5天。\n\n13:05.166 --> 13:06.642\n那刚才我也说过了，\n\n13:06.642 --> 13:07.916\n对抗病毒的治疗，\n\n13:07.916 --> 13:12.517\n也就是在发病48小时内的患者是可以缩短病程，\n\n13:12.517 --> 13:13.517\n减轻症状，\n\n13:13.517 --> 13:16.416\n而超过72小时其实意义就不大了，\n\n13:16.416 --> 13:17.367\n刚才已经说过，\n\n13:17.416 --> 13:21.692\n它的复制的峰值在四十二十四到七十二小时，\n\n13:21.692 --> 13:22.416\n而我们。\n\n13:22.452 --> 13:23.802\n一定要在他复制。\n\n13:25.443 --> 13:27.393\n达到峰值前发的抑制啊，\n\n13:27.443 --> 13:29.343\n还有一个抗细菌治疗。\n\n13:29.343 --> 13:31.869\n当患者抑制值培养结果阳性，\n\n13:31.869 --> 13:34.068\n体质有合并细菌感染的时候，\n\n13:34.068 --> 13:36.943\n可以使用阿莫西林克拉维甲酸进行治疗。\n\n13:37.044 --> 13:38.943\n一般剂量为625mg，\n\n13:38.943 --> 13:39.643\n每日三次，\n\n13:39.643 --> 13:40.544\n疗程10天，\n\n13:40.593 --> 13:42.093\n可以有效清除细菌，\n\n13:42.143 --> 13:43.193\n缓解症状。\n\n13:43.343 --> 13:47.994\n如果重症的患者像特别是像这种刚才说的就是，\n\n13:48.193 --> 13:49.218\n比较，\n\n13:49.218 --> 13:51.093\n特殊的患者就是肺部，\n\n13:51.093 --> 13:52.544\n慢性肺部疾病呢。\n\n13:53.080 --> 13:53.255\n还有，\n\n13:53.255 --> 13:53.955\n免疫力低下，\n\n13:53.955 --> 13:59.431\n一般我们都会有抗病毒和那个抗细菌的药物抗菌素合并一起使用。\n\n13:59.681 --> 14:01.781\n还有一个就是免疫条件的治疗，\n\n14:02.031 --> 14:02.431\n嗯。\n\n14:03.109 --> 14:08.784\n脾泰碳冻干粉可用于慢性基础病患者急性期的辅助治疗啊，\n\n14:08.784 --> 14:09.734\n剂量为两毫克，\n\n14:09.734 --> 14:10.284\n每日一次，\n\n14:10.284 --> 14:11.109\n疗程7天，\n\n14:11.210 --> 14:12.659\n既可以调节免疫功能，\n\n14:12.659 --> 14:13.484\n增强免疫力，\n\n14:13.484 --> 14:15.609\n有助患者更好的抵抗病毒。\n\n14:15.909 --> 14:18.109\n那肾脏控制我们都知道的，\n\n14:18.159 --> 14:18.510\n哎，\n\n14:18.510 --> 14:20.460\n退热就是说这种，\n\n14:20.460 --> 14:23.109\n那对基氨基酚是常用的退热药物，\n\n14:23.109 --> 14:25.234\n但需注重用药时间，\n\n14:25.234 --> 14:26.359\n一般不超过3天，\n\n14:26.359 --> 14:27.909\n以免掩盖病情。\n\n14:28.109 --> 14:31.284\n儿童使用时剂量为每公斤10.15mg，\n\n14:31.284 --> 14:32.984\n间隔时间不少于4小时，\n\n14:32.984 --> 14:33.510\n以保。\n\n14:33.572 --> 14:34.947\n用药安全啊，\n\n14:34.947 --> 14:35.872\n缓解鼻塞。\n\n14:35.872 --> 14:36.872\n我们也有的，\n\n14:37.271 --> 14:37.671\n嗯。\n\n14:38.932 --> 14:41.981\n赛洛唑林喷鼻剂可用于缓解鼻塞症状。\n\n14:42.997 --> 14:44.747\n还有一个就是缓解咽痛。\n\n14:45.979 --> 14:50.130\n低温的生理盐色含漱是一种简单有效的缓解咽痛的方式。\n\n14:50.130 --> 14:51.630\n水温控制在4°左右，\n\n14:51.630 --> 14:53.429\n每日含漱6次。\n\n14:53.679 --> 14:54.929\n要含漱的时候呢，\n\n14:54.929 --> 14:57.255\n要让盐盐分充分接触咽部，\n\n14:57.255 --> 14:58.679\n可以减少咽部水肿，\n\n14:58.830 --> 14:59.830\n缓解疼痛。\n\n15:00.538 --> 15:00.687\n然后，\n\n15:00.687 --> 15:02.388\n就这个中医的辨证治疗，\n\n15:02.388 --> 15:02.763\n嗯，\n\n15:02.763 --> 15:10.038\n它有风热犯肺风寒素素表恢复气虚症等各种各种的症，\n\n15:10.038 --> 15:10.763\n就辨证，\n\n15:10.763 --> 15:12.487\n你要辨证它在哪个阶段，\n\n15:12.487 --> 15:14.788\n然后我们用不同的药物啊。\n\n15:14.888 --> 15:15.338\n然后，\n\n15:15.338 --> 15:15.913\n恢复期呢，\n\n15:15.913 --> 15:17.088\n可以用点生脉饮，\n\n15:17.187 --> 15:17.588\n嗯，\n\n15:18.088 --> 15:21.237\n也可以用点益气养阴的药物啊。\n\n15:24.094 --> 15:25.544\n在刚开始的时候，\n\n15:25.544 --> 15:26.895\n可以用莲花清瘟胶囊，\n\n15:26.994 --> 15:27.395\n嗯，\n\n15:27.895 --> 15:29.895\n也是风热犯肺的一个，\n\n15:30.145 --> 15:31.645\n用用于风热犯肺。\n\n15:31.645 --> 15:33.219\n主要主要，\n\n15:33.219 --> 15:34.744\n药物有清热解毒，\n\n15:34.744 --> 15:35.244\n宣肺。\n\n15:36.039 --> 15:37.190\n泄热的功效。\n\n15:38.286 --> 15:41.310\n那还有说一个立体化的预防措施啊，\n\n15:41.310 --> 15:42.710\n免疫屏障的建立，\n\n15:42.710 --> 15:45.435\n一个最主要的一个是对疫疫苗的接种。\n\n15:45.585 --> 15:48.510\n三介流感疫苗是预防流感的重要手段，\n\n15:48.510 --> 15:52.236\n每年10月接种可使保护率达到60%.70%。\n\n15:52.486 --> 15:56.986\n对高危人群65上以的老年人建议先用佐剂疫苗，\n\n15:57.135 --> 15:59.385\n抗体效价可提高30%，\n\n15:59.536 --> 16:01.036\n增强保护效应。\n\n16:01.036 --> 16:02.986\n还有一个特殊人群的疫苗接种，\n\n16:02.986 --> 16:05.786\n孕妇在认娠期接种流感疫苗，\n\n16:05.786 --> 16:07.135\n可有效保护自身。\n\n16:07.731 --> 16:08.132\n系啊。\n\n16:09.901 --> 16:11.427\n降低感感染风险，\n\n16:11.427 --> 16:12.077\n医务人员，\n\n16:12.077 --> 16:14.276\n当然因为他接触的患者比较多，\n\n16:14.276 --> 16:15.851\n也必须要接种疫苗，\n\n16:16.101 --> 16:19.552\n那我们还要一个接种疫苗的注意事项，\n\n16:19.552 --> 16:21.802\n就接种后要观察三十分钟，\n\n16:22.101 --> 16:24.502\n然后没有异常方可离开。\n\n16:25.885 --> 16:27.734\n还有一个就是环境和行为的防控，\n\n16:27.984 --> 16:31.909\n那我们家里可以我们自己来来来来来调节，\n\n16:31.909 --> 16:34.085\n但是在社会就需要有政府。\n\n16:34.596 --> 16:34.796\n嗯，\n\n16:34.796 --> 16:35.145\n来。\n\n16:37.309 --> 16:41.059\n我们的居住的环境及那个行为的防控，\n\n16:41.109 --> 16:42.184\n一个空气消毒，\n\n16:42.184 --> 16:43.133\n一个接触隔离，\n\n16:43.133 --> 16:44.758\n还有一个呼吸道的卫生，\n\n16:44.758 --> 16:50.133\n所以说就是戴口罩还是一个很有效的预防感冒的一一个手段。\n\n16:50.133 --> 16:53.684\n然后就是我们从从外面回来，\n\n16:53.684 --> 16:54.958\n那就要洗手，\n\n16:55.008 --> 16:56.859\n因为手上的细菌病毒。\n\n16:57.612 --> 16:57.812\n嗯。\n\n16:58.900 --> 17:02.049\n可以洗手以后可以减少百分之九十九十。\n\n17:02.299 --> 17:02.700\n哎，\n\n17:02.849 --> 17:06.050\n还有一个说到一个重点人群的强化防护，\n\n17:06.050 --> 17:08.250\n就是一个医务人员的防护啊。\n\n17:08.250 --> 17:12.300\n我们医务人员还是在就诊时要佩戴口罩，\n\n17:12.650 --> 17:15.349\n如果是发热门诊还需佩戴护目镜。\n\n17:16.046 --> 17:17.020\n有必要的时候，\n\n17:17.020 --> 17:18.046\n以及防护衣，\n\n17:18.095 --> 17:20.046\n还有养老机构的防护，\n\n17:20.046 --> 17:21.495\n那么因为它密，\n\n17:21.546 --> 17:22.946\n它密闭的环境，\n\n17:23.245 --> 17:25.645\n那多给老人补充维生素D，\n\n17:26.196 --> 17:27.196\n这样也可以。\n\n17:28.003 --> 17:29.152\n减少感染风险，\n\n17:29.453 --> 17:32.853\n同时要加强环境消毒和通风，\n\n17:32.853 --> 17:33.902\n减少人员聚集，\n\n17:33.902 --> 17:35.402\n保障老人健康。\n\n17:35.402 --> 17:36.927\n还有个学校也是一样的，\n\n17:36.927 --> 17:39.253\n要把通风换气进行消毒。\n\n17:40.052 --> 17:43.802\n那病程监测康复馆一个是居家观察的指标，\n\n17:43.953 --> 17:50.927\n我们可以看看他如果体温、心率、血管保氧饱和度都已经恢复正常了，\n\n17:50.927 --> 17:55.302\n那么他病情也慢慢的就会去缓解好转，\n\n17:55.552 --> 17:57.003\n甚至痊痊愈。\n\n17:57.003 --> 17:58.203\n刚才已经说过了。\n\n17:58.276 --> 17:59.701\n预预警的预警，\n\n17:59.701 --> 18:01.401\n一个就是纹一个呼吸，\n\n18:01.401 --> 18:02.901\n一个是血氧饱和度，\n\n18:02.901 --> 18:05.801\n还有一个就是他的神志，\n\n18:05.801 --> 18:09.250\n他的皮肤的那个有没有花斑什么，\n\n18:09.250 --> 18:11.875\n这个也是的一个一个一个预警的预制。\n\n18:11.875 --> 18:14.701\n我们要都要注意在康复期的调理，\n\n18:14.701 --> 18:18.151\n一个就是特别是对那些慢性病患者，\n\n18:18.151 --> 18:21.475\n就是重点人群的那要有一个呼吸的训练，\n\n18:21.475 --> 18:23.776\n营养的支持吗？\n\n18:25.442 --> 18:26.916\n有一个良好的心态，\n\n18:26.916 --> 18:29.391\n然后逐步逐步恢复，\n\n18:29.741 --> 18:31.041\n如正常啊。\n\n18:31.041 --> 18:35.416\n我们现在最后说一说认知的误区和纠正常见的误区。\n\n18:35.416 --> 18:37.442\n输液比口服液见效快。\n\n18:37.491 --> 18:39.991\n许多人认为输液比口服药见效快，\n\n18:40.141 --> 18:43.141\n但实际上对轻症患者口服给药即可。\n\n18:43.241 --> 18:45.141\n静脉输液并不能缩短病程，\n\n18:45.141 --> 18:48.291\n过度输液还能增加感染风险和药物不良反应。\n\n18:48.954 --> 18:49.405\n还有一个就是，\n\n18:49.405 --> 18:50.655\n退烧后立即停药，\n\n18:50.704 --> 18:51.755\n那也是不对的，\n\n18:51.755 --> 18:53.854\n因为他刚才已经说了，\n\n18:53.854 --> 18:56.204\n病毒感染它的病程是3到五天，\n\n18:56.204 --> 18:57.430\n甚至到七天。\n\n18:57.430 --> 18:57.905\n所以说，\n\n18:57.905 --> 19:00.354\n我们还是要有需要完成5天的疗程，\n\n19:00.354 --> 19:03.255\n特别是那些抗病毒的药物，\n\n19:03.255 --> 19:05.030\n它需要5个叫奥司他韦，\n\n19:05.030 --> 19:06.155\n就是它就是五天，\n\n19:06.405 --> 19:09.704\n你就不能自已自行缩短它的疗程。\n\n19:10.586 --> 19:13.786\n还有新促氢和杀灭病毒，\n\n19:13.885 --> 19:15.686\n它是一种促促氢，\n\n19:15.686 --> 19:17.135\n是一种传统的消毒方法，\n\n19:17.135 --> 19:18.936\n但醋酸浓度达不到有效。\n\n19:19.853 --> 19:20.703\n杀菌的水平，\n\n19:20.953 --> 19:22.902\n所以无法消除灭度。\n\n19:23.784 --> 19:24.034\n嗯，\n\n19:24.183 --> 19:24.784\n而且呢，\n\n19:24.784 --> 19:26.859\n醋酸浓度过高还会刺激呼吸道，\n\n19:26.859 --> 19:28.034\n加重患者的病情。\n\n19:28.583 --> 19:29.333\n所以我们呢，\n\n19:29.333 --> 19:30.984\n要有正确的观念啊，\n\n19:30.984 --> 19:32.509\n合理选择治疗方式。\n\n19:32.509 --> 19:33.958\n那还是生病，\n\n19:33.958 --> 19:35.208\n如果是普通的感冒，\n\n19:35.208 --> 19:37.433\n你可以自己在家备一点药，\n\n19:37.933 --> 19:38.333\n嗯，\n\n19:38.833 --> 19:40.034\n他也有个自限性，\n\n19:40.034 --> 19:40.859\n到时就好了。\n\n19:40.859 --> 19:43.509\n然后如果说出现是流感什么，\n\n19:43.509 --> 19:45.183\n还是建议。\n\n19:46.015 --> 19:46.965\n第院教育。\n\n19:48.482 --> 19:50.131\n还有一个就是一个防护。\n\n19:52.181 --> 19:52.980\n就刚才也说了，\n\n19:52.980 --> 19:55.306\n要什么打疫苗，\n\n19:55.306 --> 19:56.656\n每年10月份打疫苗，\n\n19:56.656 --> 19:59.781\n这也是自我保护的一个最好的方法啊。\n\n20:00.479 --> 20:00.680\n嗯，\n\n20:01.229 --> 20:02.755\n刚才大体说了一说，\n\n20:02.755 --> 20:07.479\n也是简单的说说对流感的治疗方法。\n\n20:08.670 --> 20:10.944\n现在我今天就讲到这里，\n\n20:10.944 --> 20:11.719\n谢谢大家。\n\n","v0d47cg10004d76ucd2ljht12l7uaugg",1216,1,668,"2026-01-25 05:48:33","急性上呼吸道感染症状与治疗 | 专业健康指南  ","急性上呼吸道感染,感冒症状,喉咙痛治疗,病毒感染,呼吸道疾病预防  ","了解急性上呼吸道感染（如感冒、咽炎）的常见症状、病因及有效治疗方法，掌握家庭护理和预防措施，帮助快速缓解鼻塞、咳嗽等不适。","2026-04-15 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