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--> 00:04.711\n今天我们来介绍一下急性呼吸窘迫综合征。\n\n00:06.385 --> 00:13.034\n我们将从疾病概述、病因与发病机制、临床表现、诊断方法四个方面进行介绍。\n\n00:15.772 --> 00:18.523\n以及治疗手段、预防措施和预后情况。\n\n00:19.738 --> 00:20.788\n首先是疾病概述。\n\n00:22.302 --> 00:24.877\n急性呼吸窘迫综合征定义是，\n\n00:24.877 --> 00:30.451\n急性呼吸窘迫综合征是由肺内外严重疾病引发的急性呼吸衰竭。\n\n00:31.377 --> 00:37.527\n它的病理特征是以肺泡毛细血管损伤、肺微血管通透性增加为主要的病理特征。\n\n00:38.605 --> 00:39.456\n在临床特点上，\n\n00:39.456 --> 00:44.905\n临床主要呈现为呼吸频数窘迫、顽固性的低氧血症等特点。\n\n00:47.536 --> 00:49.637\n流行病学特征首先是发病率，\n\n00:49.786 --> 00:54.036\n急性呼吸窘迫综合征发病率在不同地区有明显的差异，\n\n00:54.337 --> 00:56.687\n如欧美部分地区则较高。\n\n00:57.430 --> 00:58.205\n死亡率的话，\n\n00:58.205 --> 00:59.830\n该疾病死亡率非常高，\n\n01:00.029 --> 01:02.305\n像一些重症监护室中的患者，\n\n01:02.305 --> 01:04.830\n死亡率可达30%.40%。\n\n01:05.893 --> 01:08.319\n好发人群主要在严重感染，\n\n01:08.319 --> 01:10.744\n创伤患者是好发人群，\n\n01:10.793 --> 01:13.444\n如车祸重伤者容易患发此病。\n\n01:14.825 --> 01:15.875\n病因与发病机制。\n\n01:16.981 --> 01:19.930\n直接的肺损伤的因素就包括我们的肺炎，\n\n01:20.180 --> 01:22.130\n肺炎也是最常见的病因，\n\n01:22.130 --> 01:26.231\n如新型冠状病毒肺炎就可直接损伤肺部，\n\n01:26.231 --> 01:28.630\n引发急性呼吸窘迫综合征。\n\n01:28.981 --> 01:33.231\n肺挫伤如车祸等外伤导致肺挫伤破坏了肺组织，\n\n01:33.331 --> 01:35.831\n易诱发呼急性呼吸窘迫综合征。\n\n01:36.746 --> 01:37.996\n包括吸入有害物质，\n\n01:38.195 --> 01:41.996\n吸入烟雾、毒气等有害物质损害了被套，\n\n01:41.996 --> 01:43.246\n增加了患病风险。\n\n01:44.330 --> 01:49.279\n间接的肺损伤因素包括严重感染、创伤与休克、药物与毒药。\n\n01:49.680 --> 01:52.504\n严重感染如肺部感染和肺炎，\n\n01:52.504 --> 01:54.355\n可引发全身的炎症反应，\n\n01:54.355 --> 01:55.430\n损伤肺组织。\n\n01:56.257 --> 01:57.007\n创伤与休克，\n\n01:57.007 --> 01:59.507\n严重车祸创伤导致休克，\n\n01:59.656 --> 02:01.507\n会使肺部微循环障碍，\n\n02:01.507 --> 02:02.357\n引发损伤。\n\n02:03.188 --> 02:03.987\n药物与毒物。\n\n02:03.987 --> 02:09.087\n过量使用某些药物或者接触毒物会破坏肺部细胞结构。\n\n02:10.134 --> 02:11.285\n发病的分子机制。\n\n02:12.272 --> 02:13.522\n炎症介质释放，\n\n02:13.522 --> 02:15.072\n感染等触发炎症，\n\n02:15.272 --> 02:17.722\n如T、NF、阿尔法等介质的释放，\n\n02:17.722 --> 02:20.496\n会损伤肺组织氧化应激反应，\n\n02:20.496 --> 02:22.197\n体内的氧自由基增多，\n\n02:22.197 --> 02:23.746\n像吸烟可引发，\n\n02:23.746 --> 02:25.272\n破坏肺细胞的结构。\n\n02:25.820 --> 02:27.169\n细胞凋亡异常，\n\n02:27.570 --> 02:29.220\n肺内细胞凋亡失衡，\n\n02:29.220 --> 02:30.244\n如肺炎时，\n\n02:30.244 --> 02:32.270\n会影响肺脏的正常功能。\n\n02:34.011 --> 02:34.712\n临床表现。\n\n02:35.589 --> 02:37.214\n临床的主要症状表现是在，\n\n02:37.214 --> 02:38.440\n首先是呼吸困难，\n\n02:38.740 --> 02:40.914\n患者常会感到呼吸费力，\n\n02:40.914 --> 02:42.990\n像长跑后喘不上气，\n\n02:43.289 --> 02:45.389\n严重的时候会端坐呼吸。\n\n02:46.636 --> 02:46.986\n发干，\n\n02:47.236 --> 02:50.662\n口唇、指甲等部位会呈现青紫色，\n\n02:50.662 --> 02:53.486\n如肺炎重症患者可见此等症状。\n\n02:54.304 --> 02:56.955\n咳嗽咳痰多为刺激性的干咳，\n\n02:57.154 --> 02:59.755\n部分有少量白色粘液痰，\n\n02:59.804 --> 03:01.654\n类似感冒初期的表现。\n\n03:02.757 --> 03:03.408\n体征方面。\n\n03:04.292 --> 03:06.576\n体征的特点首先是呼吸频率加快，\n\n03:06.576 --> 03:12.292\nAR、DS患者常见的呼吸急促频率可达到30次每分以上，\n\n03:12.442 --> 03:14.143\n如ICU常见的病例。\n\n03:15.552 --> 03:19.602\n发干患者口唇指甲端会呈现青紫色，\n\n03:19.802 --> 03:23.003\n像严重病例征可见明显发干表现。\n\n03:23.503 --> 03:26.203\n肺部的罗音听诊可闻及湿罗音，\n\n03:26.302 --> 03:29.302\n类似肺炎患者肺部的异常声音体征。\n\n03:31.343 --> 03:32.093\n诊断的方法，\n\n03:32.143 --> 03:34.442\n诊断标准主要靠临床症状，\n\n03:34.442 --> 03:36.992\n影像学检查和氧合分数三个方面。\n\n03:37.442 --> 03:38.692\n临床症状方面，\n\n03:38.843 --> 03:41.617\n患者会出现进行性的呼吸困难，\n\n03:41.617 --> 03:42.893\n发干等症状，\n\n03:43.192 --> 03:45.942\n如AIDS患者的常见的呼吸急促，\n\n03:46.192 --> 03:47.343\n影像学检查，\n\n03:47.643 --> 03:53.643\n胸部X线或CT会显示双肺的浸润度像磨玻璃一样的改变很常见。\n\n03:53.843 --> 03:59.117\n氧合指数就是动脉血氧分压与吸入氧浓度比值低于一定值，\n\n03:59.117 --> 04:00.692\n又小于300mmHg。\n\n04:03.921 --> 04:08.121\n辅助的检查有肺部的X线检查、CT检查和动脉血系分析。\n\n04:08.906 --> 04:11.957\n肺部X线检查可发现肺部的浸润阴影。\n\n04:12.057 --> 04:17.307\n如SARS时候患者早期胸片可见肺部的斑片状阴影。\n\n04:18.333 --> 04:21.608\nCT检查能更清晰的显示肺部病变，\n\n04:21.958 --> 04:26.458\n像新型冠状肺炎患者就会有CT上有磨玻璃影等表现。\n\n04:27.136 --> 04:30.437\n动脉血气分析检测氧分压等指标，\n\n04:30.587 --> 04:33.587\n如AR、DS患者会出现低氧血症。\n\n04:36.145 --> 04:37.045\n治疗手段方面。\n\n04:38.441 --> 04:40.041\n包括呼吸支持治疗。\n\n04:41.674 --> 04:43.373\n无创的正压通气，\n\n04:43.574 --> 04:47.148\n部分轻症患者用此通气方式，\n\n04:47.148 --> 04:50.424\n如家庭氧疗中常用的辅助来改善呼吸。\n\n04:51.303 --> 04:52.653\n有创的机械通气。\n\n04:53.053 --> 04:55.803\n重症的患者常常需要有创的通气，\n\n04:56.053 --> 04:59.303\n像严重肺炎患者来借此维持呼吸。\n\n05:00.419 --> 05:01.618\n还有俯卧位通气，\n\n05:02.069 --> 05:03.269\n特定患者适用，\n\n05:03.269 --> 05:07.069\n如AR、DS患者常用该方法来改善咬合情况。\n\n05:09.092 --> 05:14.742\n药物治疗方面主要包括糖皮质激素、血管活性药物和抗氧化剂。\n\n05:16.339 --> 05:17.339\n糖皮质激素方面，\n\n05:17.339 --> 05:19.390\n我们经常会使用甲泼尼龙等，\n\n05:19.790 --> 05:22.489\n如某患者用后炎症会减轻，\n\n05:22.489 --> 05:23.940\n呼吸动道能改善。\n\n05:24.863 --> 05:26.613\n血管活性药物如多巴胺，\n\n05:26.662 --> 05:30.912\n能维持急性呼吸窘迫综合征患者的稳定循环稳定。\n\n05:31.635 --> 05:38.434\n抗氧化剂用N乙酰半胱氨酸可减轻肺组织氧化应激损伤。\n\n05:39.977 --> 05:41.428\n其他治疗措施方面。\n\n05:43.011 --> 05:46.511\n通常还会利用营养支持、心理干预及康复训练。\n\n05:47.348 --> 05:48.248\n营养支持方面，\n\n05:48.248 --> 05:50.799\n会给予高热量、易消化的食物，\n\n05:51.098 --> 05:55.248\n如牛奶、鸡蛋等来帮助患者恢复体力。\n\n05:55.598 --> 05:56.598\n心理干预，\n\n05:56.598 --> 05:59.398\n通过心理疏导缓解患者焦虑，\n\n05:59.598 --> 06:03.148\n如专业的心理咨询师沟通康复训练，\n\n06:03.148 --> 06:06.148\n病情稳定后会进行呼吸操训练，\n\n06:06.498 --> 06:09.598\n像缩唇呼吸等来促进康复。\n\n06:11.236 --> 06:11.837\n预防措施，\n\n06:12.087 --> 06:13.337\n高危人群预防。\n\n06:14.197 --> 06:16.697\n高危人群预防主要是一个是定期体检，\n\n06:16.898 --> 06:20.097\n长期吸烟的人群应该定期的体检，\n\n06:20.347 --> 06:24.398\n像每年做肺部CT来早期发现这个肺部的异常。\n\n06:25.226 --> 06:25.976\n避免诱因。\n\n06:26.177 --> 06:28.201\n接触有害气体的高危者，\n\n06:28.201 --> 06:30.576\n如化工工人要做好防护，\n\n06:30.576 --> 06:31.476\n避免诱因。\n\n06:32.477 --> 06:33.328\n增强免疫力，\n\n06:33.528 --> 06:39.727\n年老体弱者可接种疫苗如流感疫苗和肺炎疫苗来增强免疫力，\n\n06:39.727 --> 06:40.852\n防防住，\n\n06:40.852 --> 06:41.678\n防止感染。\n\n06:42.490 --> 06:43.691\n基础疾病管理，\n\n06:44.191 --> 06:51.040\n控制慢性肺部疾病、哮喘、慢性阻塞性肺病的患者应该要规律用药，\n\n06:51.490 --> 06:54.240\n如钟南山团队推广的规范治疗。\n\n06:55.089 --> 06:55.390\n稳定，\n\n06:55.390 --> 06:59.790\n心血管疾病、冠心病、高血压的患者要遵医嘱服药，\n\n06:59.989 --> 07:02.989\n像胡大一教授倡导的管理模式。\n\n07:04.033 --> 07:10.834\n管好糖尿病、高血压糖友要控制血糖和瑞金医院的综合管理方案来稳定病情。\n\n07:12.106 --> 07:12.756\n预后情况，\n\n07:12.907 --> 07:17.407\n影响预后的因素包括基础疾病的状况，\n\n07:17.506 --> 07:19.707\n年龄因素以及治疗时机。\n\n07:20.994 --> 07:23.644\n或患有糖尿病、心脏病等基础病，\n\n07:23.744 --> 07:27.445\n会增加急性呼吸窘迫综合征的综合死亡风险。\n\n07:28.407 --> 07:31.282\n高龄患者身体的机能比较差，\n\n07:31.282 --> 07:33.433\n患急性呼吸窘迫综合症后，\n\n07:33.433 --> 07:35.157\n预后往往不如年轻人。\n\n07:35.912 --> 07:36.562\n治疗的时机，\n\n07:36.562 --> 07:38.162\n发病后应尽早治疗，\n\n07:38.363 --> 07:42.263\n急性呼吸窘迫综合征患者的预后情况就会相对更好。\n\n07:44.497 --> 07:51.097\n预后评估指标包括我们的氧合指数、炎症因子水平和器官功能障碍评分。\n\n07:52.045 --> 07:53.770\n氧合指数低，\n\n07:53.770 --> 07:55.545\n那提示预后差。\n\n07:55.846 --> 07:58.895\n如ARDS患者氧合指数小于两百的时候，\n\n07:58.895 --> 08:00.145\n死亡率就比较高。\n\n08:01.167 --> 08:02.268\n炎症因子水平，\n\n08:02.717 --> 08:04.917\n炎症因子高预示预后不佳，\n\n08:04.917 --> 08:09.768\n像I、L六持续高水平的患者恢复会比较慢。\n\n08:10.829 --> 08:12.604\n器官功能障碍评分，\n\n08:12.604 --> 08:14.479\n评分高往往预后不良，\n\n08:14.829 --> 08:19.278\n多器官功能障碍评分高的患者死亡的风险会较大。\n\n08:22.950 --> 08:23.700\n除此之外，\n\n08:23.700 --> 08:32.051\n急性呼吸窘迫综合征在中医的范畴里面不属于哮喘、肺栓喘脱等急危病症。\n\n08:32.882 --> 08:34.033\n它的核心病机呢，\n\n08:34.033 --> 08:35.333\n是肺失宣肃，\n\n08:35.333 --> 08:36.382\n气机逆乱，\n\n08:36.732 --> 08:38.182\n常肩胛痰热，\n\n08:38.182 --> 08:40.083\n寒湿气虚等症型，\n\n08:40.333 --> 08:41.908\n多因外感邪毒，\n\n08:41.908 --> 08:43.033\n内伤正气，\n\n08:43.232 --> 08:46.232\n致肺脏功能急剧受损。\n\n08:46.924 --> 08:51.674\n中医认为A、R、DS的发病与肺、脾、肾三脏密切相关，\n\n08:52.174 --> 08:56.323\n外感湿热邪毒或者痰湿之邪侵袭肺胃，\n\n08:56.573 --> 08:58.723\n导致肺气壅塞，\n\n08:58.973 --> 09:00.523\n宣发肃降失常，\n\n09:00.973 --> 09:03.374\n出现呼吸困难、喘息不止，\n\n09:03.723 --> 09:06.273\n久病或年老体弱者。\n\n09:07.083 --> 09:07.932\n肺肾气虚，\n\n09:07.932 --> 09:08.833\n卫外不固，\n\n09:08.932 --> 09:10.583\n易受外邪侵袭，\n\n09:11.033 --> 09:13.283\n且病情更易进展为危象。\n\n09:15.377 --> 09:17.302\n临床常见的症型中，\n\n09:17.302 --> 09:19.778\n痰热壅肺症最为多见。\n\n09:19.927 --> 09:22.677\n表现为高热、喘息、气促、痰。\n\n09:24.164 --> 09:24.914\n说痰黄稠。\n\n09:26.077 --> 09:30.627\n痰湿阻肺症则以低热、喘息、痰多粘稠为特征，\n\n09:30.976 --> 09:33.726\n疾病后期多出现肺肾气虚，\n\n09:33.927 --> 09:35.351\n伴乏力、气促，\n\n09:35.351 --> 09:36.476\n活动后加重。\n\n09:36.827 --> 09:38.627\n危重阶段可提出。\n\n09:39.426 --> 09:41.125\n可出现阳气欲脱，\n\n09:41.325 --> 09:43.026\n需要紧急就医。\n\n09:43.986 --> 09:46.286\n中医治疗遵循急则治其标，\n\n09:46.286 --> 09:47.836\n缓则治其本的原则。\n\n09:48.236 --> 09:50.036\n急性期以祛邪为主，\n\n09:50.036 --> 09:51.736\n恢复期以扶正为要。\n\n09:51.986 --> 09:57.336\n寒热壅肺者用麻杏石甘汤和千金苇茎汤清热化痰。\n\n09:58.260 --> 09:58.909\n宣肺平喘，\n\n09:59.260 --> 10:00.260\n痰湿阻肺者，\n\n10:00.260 --> 10:04.059\n与二陈汤、合三子养心汤燥湿化痰，\n\n10:04.059 --> 10:05.159\n降逆平喘。\n\n10:05.559 --> 10:07.010\n肺肾气虚者，\n\n10:07.359 --> 10:10.197\n以金水六君煎补肺益肾，\n\n10:10.197 --> 10:11.559\n阳气欲脱者，\n\n10:11.760 --> 10:14.359\n需要用参附汤合生脉散，\n\n10:14.359 --> 10:15.309\n回阳救逆，\n\n10:15.309 --> 10:16.260\n益气固脱。\n\n10:18.443 --> 10:19.494\n需要重点提醒的是，\n\n10:19.494 --> 10:21.794\nA、R、DS属急危重症，\n\n10:22.093 --> 10:24.943\n中医治疗必须在西医规范抢救，\n\n10:25.143 --> 10:29.643\n比如说机械通气、抗感染、纠正缺氧等的基础上再进行，\n\n10:29.893 --> 10:31.294\n不可单独应用。\n\n10:32.008 --> 10:32.359\n同时，\n\n10:32.559 --> 10:34.359\n中医特色外治法，\n\n10:34.359 --> 10:36.008\n比如说穴位按摩，\n\n10:36.309 --> 10:39.609\n取背俞、膻中、足三里等穴。\n\n10:40.450 --> 10:44.599\n中药雾化吸入等可作为辅助手段改善症状。\n\n10:45.049 --> 10:48.599\n日常预防需要需要注意增强体质。\n\n10:49.385 --> 10:50.736\n避免外感邪气，\n\n10:50.885 --> 10:54.135\n有慢性肺病患者应要积极调理，\n\n10:54.536 --> 10:56.486\n减少急性发作危险。\n\n10:56.935 --> 10:59.036\n若出现突发呼吸困难，\n\n10:59.135 --> 11:00.536\n需要持续喘啊，\n\n11:00.536 --> 11:01.861\n持续喘息等症状，\n\n11:01.861 --> 11:02.986\n需要立即就医。\n\n11:03.655 --> 11:04.905\n切勿延误病情。\n\n11:08.302 --> 11:08.552\n嗯，\n\n11:08.702 --> 11:10.151\n常见的症状。\n\n11:11.856 --> 11:14.882\n如痰热壅肺者的治法是清热化痰，\n\n11:14.882 --> 11:15.706\n宣肺平喘。\n\n11:15.856 --> 11:19.057\n我们常用的方剂是麻杏石甘汤和千金苇茎汤。\n\n11:19.836 --> 11:25.711\n常用的药材也包括麻黄、杏仁、生石膏、甘草、芦根、苇茎、冬瓜仁等，\n\n11:25.711 --> 11:29.687\n可根据病症加用黄芩、鱼腥草等清热化痰之力。\n\n11:30.591 --> 11:35.591\n而对于痰湿阻肺的常用的方剂是二陈汤和三子养心汤。\n\n11:36.447 --> 11:44.098\n这当中常用的药材有半夏、陈皮、茯苓、甘草、苏子、来福子、白芥子等，\n\n11:44.497 --> 11:45.848\n若痰湿较重呢，\n\n11:45.848 --> 11:47.697\n则可加用苍术厚朴。\n\n11:48.695 --> 11:50.346\n对于肺肾气虚者，\n\n11:50.596 --> 11:53.395\n这个多见于疾病后期或者是恢复期。\n\n11:54.526 --> 11:58.875\n它的常用方剂是金水六君煎和生葛散加减。\n\n11:59.632 --> 12:06.981\n常用的药材包括茯苓、熟地、当归、半夏、陈皮、人参、蛤蚧等。\n\n12:07.901 --> 12:11.101\n也可以根据气虚程度调整人参的用量，\n\n12:11.101 --> 12:13.101\n或换用党参、黄芪等。\n\n12:14.656 --> 12:15.007\n危重，\n\n12:15.706 --> 12:19.531\n病情危重的阶段会出现这种阳气欲脱症，\n\n12:19.531 --> 12:22.507\n也就是西医常见的休克症状。\n\n12:22.856 --> 12:24.406\n这个治法是回阳救逆，\n\n12:24.406 --> 12:25.156\n益气不脱。\n\n12:25.206 --> 12:29.557\n常用的方剂是珊瑚汤和生脉散加减。\n\n12:30.385 --> 12:34.184\n常用的药材有人参、附子、麦冬、五味子等。\n\n12:34.937 --> 12:36.036\n需要紧急救治。\n\n12:37.245 --> 12:39.796\n多配合西医的抗休克治疗一块应用。\n\n12:41.195 --> 12:41.495\n嗯。\n\n12:42.294 --> 12:42.494\n嗯。\n\n12:48.137 --> 12:48.312\n嗯，\n\n12:48.312 --> 12:52.137\n急性呼吸窘迫综合症是临床上的急危重症。\n\n12:52.979 --> 12:53.179\n嗯，\n\n12:53.679 --> 12:56.030\n除了预防疾病的发生之外，\n\n12:56.030 --> 12:58.030\n还需要日常的调养。\n\n12:59.112 --> 12:59.312\n嗯。\n\n13:01.231 --> 13:04.080\n一个是预防我们基础疾病的发生。\n\n13:04.080 --> 13:07.731\n前面讲到的我们肺炎。\n\n13:08.646 --> 13:09.296\n呼吸感染。\n\n13:09.296 --> 13:09.846\n这些。\n\n13:16.799 --> 13:17.150\n减少。\n\n13:18.593 --> 13:21.544\n高危的因素控制的全身感染，\n\n13:21.693 --> 13:23.893\n皮肤泌尿系统等部分感染。\n\n13:24.294 --> 13:24.693\n嗯，\n\n13:24.744 --> 13:26.994\n按照医嘱使用抗生素，\n\n13:26.994 --> 13:28.393\n避免感染的扩散，\n\n13:28.643 --> 13:30.943\n同时减少医源性的创伤，\n\n13:31.294 --> 13:33.044\n避免误吸。\n\n13:33.143 --> 13:34.369\n出现意识障碍，\n\n13:34.369 --> 13:37.744\n吞咽功能差的患者需要采取侧卧，\n\n13:37.794 --> 13:39.044\n抬高床头。\n\n13:40.474 --> 13:42.075\n30.40°等体位，\n\n13:42.075 --> 13:47.450\n必要时要通过鼻饲鼻饲管进食来减少胃酸食物误吸入肺。\n\n13:48.447 --> 13:52.622\n规范的医疗操作可以避免不必要的侵入性操作啊。\n\n13:52.622 --> 13:54.047\n需要机械通气的时候，\n\n13:54.047 --> 13:57.547\n医生会采用肺保护性通气策略，\n\n13:57.547 --> 13:59.747\n减少呼吸机对肺组织的损伤。\n\n14:00.536 --> 14:02.286\n创伤后要及时进行处理，\n\n14:02.286 --> 14:06.461\n严重的创伤如车祸、高处坠落后尽快就医，\n\n14:06.461 --> 14:08.687\n控制出血来修复损伤，\n\n14:08.736 --> 14:12.187\n避免休克或局部炎症的扩散累积到肺部。\n\n14:13.505 --> 14:13.630\n嗯，\n\n14:13.630 --> 14:16.281\n日常状态还要管理基础的疾病。\n\n14:16.281 --> 14:16.830\n比如说，\n\n14:16.830 --> 14:21.455\n我们控制我们的慢性病、高血压、糖尿病、慢性肺病、心功能不全等，\n\n14:21.906 --> 14:26.156\n需要长期的规范化治疗来增强机体的抵抗力，\n\n14:26.356 --> 14:29.856\n来降低感染或者病情急性期加重的风险。\n\n14:30.609 --> 14:31.809\n避免高危的行为，\n\n14:31.958 --> 14:34.458\n我们可以要求患者不吸烟，\n\n14:34.658 --> 14:38.958\n然后避免接触有毒气体、粉尘等肺损伤的因素，\n\n14:39.258 --> 14:40.208\n合理的用药，\n\n14:40.208 --> 14:42.658\n滥用可能引发肺损伤的药物，\n\n14:42.658 --> 14:45.008\n比如说化疗药、抗炎药，\n\n14:45.109 --> 14:46.809\n需要遵医嘱使用。\n\n14:47.567 --> 14:50.466\n还有高危人群要进行早期的监测。\n\n14:50.617 --> 14:53.466\n对于已存在A、R、DS高危因素的人群，\n\n14:53.767 --> 14:56.867\n如重症感染了休克、大手术患者，\n\n14:57.117 --> 15:01.817\n需要在医护人员指导下密切监测呼吸血氧饱和度。\n\n15:02.770 --> 15:05.195\n若出现呼吸加快、血氧下降，\n\n15:05.296 --> 15:06.796\n要及时告知医生，\n\n15:06.945 --> 15:08.096\n尽早干预，\n\n15:08.145 --> 15:09.520\n以阻止病情进展。\n\n15:09.520 --> 15:10.495\n为A r DS。\n\n15:11.838 --> 15:12.138\n谢谢。\n\n","v0347cg10004d70b2biljht6tflg4qj0",914,1,893,"2026-01-26 11:01:47","急性呼吸窘迫综合征（ARDS）症状、诊断与治疗 | 权威指南  ","急性呼吸窘迫综合征, ARDS症状, ARDS病因, ARDS治疗, 呼吸衰竭, 低氧血症, 重症监护  ","急性呼吸窘迫综合征（ARDS）是一种危及生命的呼吸衰竭疾病，表现为严重低氧血症和肺部炎症。本文详解ARDS的病因、临床表现、诊断标准及最新治疗方案，帮助患者及家属了解关键救治信息。","2026-04-22 21:30:00",[38],{"menuId":39,"menuName":40,"parentId":17,"orderNum":41,"path":42,"component":43,"isFrame":44,"isCache":45,"menuType":46,"visible":30,"status":17,"createDept":6,"remark":25,"createTime":47,"children":48,"columnImage":49,"columnLogo":50,"uncheckedLogo":6,"checkedLogo":6,"isHot":17,"isHome":17,"forceLogin":17,"color":6,"seoTitle":51,"seoKeywords":52,"seoDescription":53,"contentNum":6,"promotionalPoster":54,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":55,"routerPath":42,"componentInfo":43},"1986622624134549505","科普视频",3,"video","/video.html","1","0","T","2025-11-07 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