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--> 00:06.118\n隐源性激发性肺炎的诊治的相关问题。\n\n00:11.098 --> 00:11.449\n病例，\n\n00:11.849 --> 00:12.248\n女，\n\n00:12.548 --> 00:13.498\n45岁，\n\n00:13.899 --> 00:14.248\n嗯，\n\n00:14.248 --> 00:14.748\n咳嗽，\n\n00:14.748 --> 00:15.348\n少痰，\n\n00:15.399 --> 00:16.999\n低热3个月，\n\n00:17.249 --> 00:18.298\n体重下降。\n\n00:19.434 --> 00:21.634\n有SLE病史女，\n\n00:21.634 --> 00:23.784\n肺部感染治疗不佳，\n\n00:24.233 --> 00:29.083\n薄层CT提示两肺片状渗出实变阴影。\n\n00:29.767 --> 00:31.618\n见支气管充气针。\n\n00:37.034 --> 00:39.034\n这就是充支气管充气症。\n\n00:42.124 --> 00:42.762\n病例二，\n\n00:42.762 --> 00:43.199\n女，\n\n00:43.199 --> 00:44.074\n72岁，\n\n00:44.074 --> 00:44.749\n咳嗽，\n\n00:44.749 --> 00:45.348\n白痰，\n\n00:45.348 --> 00:46.023\n低热，\n\n00:46.173 --> 00:48.523\n并轻度切除半半月，\n\n00:48.923 --> 00:50.574\n白细胞轻度升高，\n\n00:50.574 --> 00:51.423\n嗜酸性。\n\n00:52.289 --> 00:54.214\n细胞正常，\n\n00:54.214 --> 00:55.039\nEES2升高，\n\n00:55.289 --> 00:57.138\n既往无特殊病例，\n\n00:57.289 --> 00:59.313\n拟诊肺部感染，\n\n00:59.313 --> 01:02.789\n反复抗炎治疗1个月后症状加重。\n\n01:03.646 --> 01:04.546\n出现黄疸。\n\n01:05.624 --> 01:06.924\n一般状态尚好，\n\n01:06.924 --> 01:07.573\n复杂。\n\n01:08.664 --> 01:10.763\nX片胸部阴影增大。\n\n01:11.263 --> 01:14.213\n支气管镜显示支气管黏膜。\n\n01:15.167 --> 01:16.167\n炎症改变，\n\n01:16.517 --> 01:17.792\n少量分泌物，\n\n01:17.792 --> 01:19.867\n肺泡冲洗液见炎性，\n\n01:20.568 --> 01:22.667\n见炎性细胞增多，\n\n01:23.017 --> 01:25.617\n结核菌和真菌阴性的。\n\n01:26.265 --> 01:29.416\n胸部CT见两肺片状阴影，\n\n01:29.765 --> 01:31.416\n少量胸腔积液，\n\n01:31.515 --> 01:34.966\n对比影像见游走现象。\n\n01:35.740 --> 01:36.691\n这是什么病呢？\n\n01:37.735 --> 01:37.985\n对。\n\n01:39.067 --> 01:39.467\n第一个。\n\n01:40.388 --> 01:45.987\n大叶性肺炎是军团菌肺炎、病毒性肺炎。\n\n01:46.842 --> 01:47.291\n那个。\n\n01:48.627 --> 01:49.477\n肺结核。\n\n01:50.530 --> 01:51.180\n新鲜感。\n\n01:52.741 --> 01:54.641\n下一步应该怎么治疗呢？\n\n01:54.692 --> 01:55.291\n继续。\n\n01:56.297 --> 01:57.597\nA是继续抗感染。\n\n01:58.472 --> 02:00.321\n还是诊断性抗老，\n\n02:00.421 --> 02:02.872\n还是经皮肺活检，\n\n02:02.972 --> 02:05.321\n是开胸肺活检。\n\n02:07.513 --> 02:09.164\n临床诊断和治疗过程，\n\n02:09.914 --> 02:11.863\n一个就是穿刺病理。\n\n02:12.414 --> 02:15.514\n肺泡腔机化性炎症。\n\n02:15.514 --> 02:16.313\n肺炎的。\n\n02:17.136 --> 02:21.785\n改变临床影像和病理综合分析诊断。\n\n02:22.335 --> 02:23.910\n病例一，\n\n02:23.910 --> 02:26.686\nSLE并发机化性肺炎。\n\n02:26.936 --> 02:27.785\n病例二，\n\n02:27.785 --> 02:30.136\n隐源性继发性肺炎。\n\n02:31.414 --> 02:33.914\n经过激素治疗效果良好，\n\n02:34.315 --> 02:36.414\n病灶明显吸收。\n\n02:37.115 --> 02:40.365\n病例二在半年后停药复发，\n\n02:40.464 --> 02:42.764\n再次治疗效果良好。\n\n02:44.087 --> 02:47.787\n隐源性继发性肺炎治疗诊治的相关问题。\n\n02:48.850 --> 02:49.899\n基本概念，\n\n02:49.949 --> 02:51.600\n流行病学特点。\n\n02:52.574 --> 02:55.248\nCOP的诊断及相关治疗。\n\n02:56.733 --> 03:00.309\nCOP的治疗及相关问题。\n\n03:00.309 --> 03:01.384\nCOP的预后。\n\n03:03.876 --> 03:05.860\n机化性肺炎基本概念，\n\n03:05.860 --> 03:07.576\n机化性肺炎啊，\n\n03:07.576 --> 03:10.376\n是肺部炎症的一种病理学表现。\n\n03:11.865 --> 03:12.214\n嗯。\n\n03:13.246 --> 03:14.320\n激发性肺炎，\n\n03:14.320 --> 03:17.345\n激化性肺炎主要特点是远端气腔，\n\n03:17.695 --> 03:22.746\n包括细支气管炎、细支气管肺泡管、肺泡壁。\n\n03:23.522 --> 03:25.421\n内内激化性炎症，\n\n03:25.822 --> 03:31.822\n小气道和肺泡腔、肺泡管内过多的肉芽组织增殖。\n\n03:33.190 --> 03:35.889\n第三个就是原发性气化肺炎。\n\n03:36.533 --> 03:41.182\n和继发性继发性肺炎在病理学并无明显差异。\n\n03:41.483 --> 03:44.483\n病理不能区分患者。\n\n03:46.660 --> 03:48.860\n隐源性新冠性肺炎概念。\n\n03:50.104 --> 03:53.005\n应COP的历史和认识的变迁，\n\n03:53.554 --> 03:54.630\n1983年，\n\n03:54.630 --> 03:58.755\n戴维森提出计划性肺炎的病理学概念。\n\n04:01.279 --> 04:07.929\nB、第二个就闭塞性细支气管炎并机化性肺炎COPP。\n\n04:08.815 --> 04:11.541\nIBOOP 2002年。\n\n04:12.300 --> 04:15.800\n美国胸科协会、欧洲呼吸病学会建议，\n\n04:15.800 --> 04:22.350\n将特发性的继发性肺炎命名为肺原体其他疾病相关的继发性肺炎。\n\n04:22.906 --> 04:27.605\n这称为这称为继发性继发性激发性。\n\n04:29.113 --> 04:29.463\n肺炎，\n\n04:30.013 --> 04:30.338\n嗯，\n\n04:30.338 --> 04:34.363\n隐源性机化性肺炎呈病理学概念。\n\n04:35.023 --> 04:39.923\n到CRP上传COP是指不明原因的OP。\n\n04:40.273 --> 04:44.548\n2002年国际共性提示，\n\n04:44.548 --> 04:48.472\nCOP属于特发性间质性肺炎2P的一个亚型。\n\n04:49.041 --> 04:52.742\n取相应的临床影像病理学定义。\n\n04:54.057 --> 04:55.756\n没有明确的致病源。\n\n04:56.457 --> 04:59.807\n感染或其他临床伴随疾病，\n\n04:59.856 --> 05:03.856\n结缔组织病情出现的激发性肺炎。\n\n05:05.265 --> 05:12.839\nCOP的那个病理学名称成为一个CRP综合的临床诊断名称。\n\n05:14.539 --> 05:19.938\n20202年ATS e r s的二批分类国际共识，\n\n05:19.989 --> 05:27.438\n一个就是弥漫性肺实质疾病和药物CTD感染相关的DPLD。\n\n05:28.394 --> 05:31.144\n一个特发性间质性肺炎，\n\n05:31.445 --> 05:34.195\n诺亚整形DPL结节病，\n\n05:34.494 --> 05:37.445\n其他LAHHX。\n\n05:38.575 --> 05:40.125\n一个突发性件事情。\n\n05:41.915 --> 05:43.115\n新五化IPF。\n\n05:43.960 --> 05:44.210\n然后，\n\n05:44.210 --> 05:55.510\n除IPF以外的其他类型的LPS是TCLPAIPDRBLDDIPALIP等等。\n\n05:57.334 --> 06:01.834\n2013年ATS e r s的二批分类修订版，\n\n06:01.984 --> 06:05.783\n特发性间质性肺病2批分为主要的。\n\n06:06.690 --> 06:06.964\nOP,\n\n06:07.065 --> 06:08.339\n罕见的op p，\n\n06:08.339 --> 06:11.415\n还不能分类的OP啊，\n\n06:11.515 --> 06:12.515\n2%。\n\n06:13.385 --> 06:15.186\n到20%有家族性，\n\n06:15.385 --> 06:17.585\n80%没有家族性。\n\n06:18.515 --> 06:22.665\n病人也分成一个慢性导致纤维化的IP，\n\n06:23.415 --> 06:24.815\n吸烟相关IP，\n\n06:24.815 --> 06:26.265\n突血性IP，\n\n06:26.315 --> 06:28.065\n呼吸性细支气管。\n\n06:28.970 --> 06:30.269\n眼合并IP，\n\n06:31.369 --> 06:39.869\n常见的IP变分为特发性淋巴细胞IP和特发性胸膜肺弹力纤维增生。\n\n06:40.220 --> 06:40.545\n嗯，\n\n06:40.545 --> 06:49.070\n不能分类的AP就是气道中心型IP而变成急性纤维素性op p。\n\n06:52.074 --> 06:52.348\n嗯，\n\n06:52.348 --> 06:52.799\n急性，\n\n06:52.799 --> 06:55.398\n亚急性，\n\n06:55.398 --> 06:56.074\nIPCOPAIP等等。\n\n06:57.542 --> 06:59.743\n隐源性机化性肺炎，\n\n06:59.942 --> 07:00.292\n嗯，\n\n07:00.292 --> 07:02.042\n流行病学特点，\n\n07:02.192 --> 07:03.192\n发病率。\n\n07:04.565 --> 07:06.765\nCOP确切的发病率不清楚，\n\n07:06.964 --> 07:10.114\n有报道OP的发病率估计。\n\n07:11.691 --> 07:12.342\n6.7个，\n\n07:12.342 --> 07:14.541\n使每十万个人有6.7个，\n\n07:14.842 --> 07:18.242\n其中超过、超过、超过半数为COP。\n\n07:18.541 --> 07:19.566\n近30年，\n\n07:19.566 --> 07:22.592\n国内外COP的报道病例逐渐增多。\n\n07:23.239 --> 07:24.088\n性别特点，\n\n07:24.338 --> 07:28.539\n文献报道COP男女发病率情况相近。\n\n07:29.139 --> 07:30.139\n年龄特点。\n\n07:31.292 --> 07:34.243\n50.60岁发病率较高。\n\n07:35.153 --> 07:36.303\n与吸烟关系，\n\n07:36.602 --> 07:36.953\n嗯，\n\n07:36.953 --> 07:38.453\n不太密切。\n\n07:40.395 --> 07:44.821\n隐源性机化性肺炎病理学特点，\n\n07:44.821 --> 07:46.696\nCOP的镜像特点，\n\n07:47.196 --> 07:50.746\n呈小叶中心分布的斑片状病灶，\n\n07:50.795 --> 07:53.795\n其间可夹杂正常的肺泡组织。\n\n07:54.808 --> 07:58.558\n以MASO mass小体形成为特征，\n\n07:58.558 --> 08:06.658\n中末细支气管以下小气道和肺泡腔内输送的胶原样肉芽组织小结填塞，\n\n08:07.158 --> 08:11.709\n伴或不伴小气道或肺肺泡腔狭窄或闭塞。\n\n08:12.664 --> 08:15.864\n肉芽组织病变呈均匀移植，\n\n08:16.114 --> 08:20.463\n可通过肺泡孔扩散到邻近的肺泡。\n\n08:21.496 --> 08:23.121\n肺部结构不受损，\n\n08:23.121 --> 08:28.746\n细支气管、肺泡管和肺泡结构相对完整。\n\n08:29.145 --> 08:31.545\n肺间质轻度炎症的。\n\n08:32.507 --> 08:32.906\n进入。\n\n08:35.116 --> 08:37.265\n这是它的镜下的一个特点，\n\n08:38.065 --> 08:43.565\n镜下肺泡内胶原样疏松结缔组织肉芽，\n\n08:43.966 --> 08:45.015\n肉芽小结。\n\n08:45.801 --> 08:47.450\n免肺泡孔扩散。\n\n08:48.382 --> 08:48.781\n线头。\n\n08:50.174 --> 08:50.773\n建设性。\n\n08:52.232 --> 08:55.882\n禁止炎性细胞浸润肺泡结构。\n\n08:56.685 --> 08:57.585\n是完整的。\n\n09:00.257 --> 09:04.083\n隐约计划性肺炎的发病机制和病因，\n\n09:04.083 --> 09:07.807\nCOP的发病机制和病因目前尚不十分清楚。\n\n09:08.307 --> 09:12.357\n由于起病时多数病人有类似流感样的表现，\n\n09:12.458 --> 09:14.958\n推测可能与感染有关。\n\n09:15.760 --> 09:22.359\n艾丽A用呼吸道肠病毒复制出BOP的肺部病理模型。\n\n09:23.059 --> 09:23.184\n嗯，\n\n09:23.184 --> 09:23.659\n提示。\n\n09:24.556 --> 09:26.455\n那个呼吸道病毒感染，\n\n09:26.455 --> 09:28.106\n参与COP的形成。\n\n09:29.445 --> 09:35.395\nCOP的病理机制致病因素导致周末呼吸道肺泡上皮。\n\n09:36.080 --> 09:36.630\n损伤，\n\n09:36.931 --> 09:38.580\n毛细血管渗出，\n\n09:39.431 --> 09:43.981\n然后肺泡内渗出炎性肉芽疹。\n\n09:45.140 --> 09:48.340\n疏松结缔组织肉芽可逆性。\n\n09:49.226 --> 09:49.776\n真是。\n\n09:50.945 --> 09:51.945\n临床表现，\n\n09:52.346 --> 09:55.145\n起病情况一般是亚急性疾病，\n\n09:55.296 --> 09:56.546\n病情较轻，\n\n09:56.895 --> 10:00.895\n偶急性疾病临床表现同ARDS。\n\n10:02.320 --> 10:03.820\n主要临床表现两大类，\n\n10:03.820 --> 10:06.270\n第一个是呼吸系统症状体征。\n\n10:07.059 --> 10:09.710\n咳嗽、气促、咯血、胸痛，\n\n10:10.010 --> 10:11.309\n肺部湿柔音，\n\n10:11.359 --> 10:12.309\n无哮鸣。\n\n10:13.159 --> 10:15.059\n全身症状和体征，\n\n10:15.210 --> 10:17.510\n低热、乏力、盗汗等，\n\n10:17.859 --> 10:19.710\n多无杵状体。\n\n10:21.401 --> 10:22.952\n影像学特点，\n\n10:23.101 --> 10:27.601\n典型表现一个就是CT提示两肺多发性。\n\n10:28.429 --> 10:38.078\n小片状肺泡渗出实变影70%、磨玻璃影50%和条索影多为两种以上影像混合存在，\n\n10:38.328 --> 10:42.778\n多在胸膜下区分布或沿支气管束分布。\n\n10:44.521 --> 10:47.346\n35%病灶边缘模糊，\n\n10:47.346 --> 10:52.372\n有35%.60%病灶内见气支气管充气症。\n\n10:52.372 --> 10:57.622\n百分之三十百分之50病理的病灶显示游走性的特点。\n\n10:59.364 --> 11:02.440\n10%.25%见少量胸水。\n\n11:04.716 --> 11:06.341\nCOP典型性影像，\n\n11:06.341 --> 11:09.416\n两肺多发小片渗出幅度。\n\n11:11.219 --> 11:13.969\nGGO胸膜下分布特点。\n\n11:16.276 --> 11:18.177\n这就是他骗子的一个特点。\n\n11:19.153 --> 11:20.304\n典型表现。\n\n11:21.293 --> 11:22.442\n胸部下的一个。\n\n11:23.455 --> 11:23.854\n分布。\n\n11:28.681 --> 11:34.330\n这个就是两肺多发的GGO与胸膜下和支气管术。\n\n11:35.210 --> 11:37.460\n分布最纹理增粗。\n\n11:38.244 --> 11:38.744\n模糊。\n\n11:41.788 --> 11:46.138\n典型表现就是两肺多发的渗出事变。\n\n11:46.288 --> 11:48.638\n急酒条条状影。\n\n11:49.546 --> 11:51.046\n然后眼眼胸膜，\n\n11:51.046 --> 11:53.546\n胸膜下支气管束分布。\n\n11:56.041 --> 11:58.291\n影像的特点不典型的表现，\n\n11:58.640 --> 12:04.890\n当一个单发的结节或团块病灶HRCT可见小空洞。\n\n12:06.408 --> 12:08.408\n我那个多发小结节炎。\n\n12:09.510 --> 12:14.309\n而不规则条索和线状弥漫起大片的。\n\n12:15.742 --> 12:16.643\n房源证。\n\n12:19.270 --> 12:21.570\n这烧机单反的快。\n\n12:22.544 --> 12:25.143\n边缘模糊的形态，\n\n12:25.143 --> 12:26.044\n不规则。\n\n12:27.306 --> 12:27.455\n嗯，\n\n12:27.455 --> 12:28.106\n多型，\n\n12:28.455 --> 12:29.606\n多型结节，\n\n12:29.806 --> 12:30.705\n空洞影。\n\n12:31.661 --> 12:33.711\n这个多形结节还有一个空洞。\n\n12:36.276 --> 12:37.575\n不规则的线状。\n\n12:39.135 --> 12:40.236\n不规则的网状。\n\n12:41.424 --> 12:43.825\n多边形线样阴影。\n\n12:45.106 --> 12:46.557\n条带状腺样影。\n\n12:47.409 --> 12:49.609\n这个图片条带状的，\n\n12:49.760 --> 12:51.109\n不规则网状的。\n\n12:52.164 --> 12:56.213\n然后多发的弥漫性的大片状的机气。\n\n12:57.260 --> 12:59.609\n那些诈骗的骗子。\n\n13:00.924 --> 13:01.200\n第五，\n\n13:01.200 --> 13:04.000\n五COP营销的特点，\n\n13:04.000 --> 13:05.474\n无多一少的特征。\n\n13:06.166 --> 13:06.767\n有一个。\n\n13:07.659 --> 13:08.510\n多态性，\n\n13:08.710 --> 13:11.159\n多种影像形态如实变影，\n\n13:11.159 --> 13:16.409\n磨玻璃影、条索影、团块影、结节影、网格影。\n\n13:16.760 --> 13:17.609\n多发性，\n\n13:17.609 --> 13:19.859\n每侧肺可见多个病灶。\n\n13:20.833 --> 13:22.382\n多两肺受累，\n\n13:22.432 --> 13:24.333\n多数为两肺累积，\n\n13:24.382 --> 13:28.932\n多变性、游走迁徙性病灶此起彼伏。\n\n13:30.489 --> 13:31.046\n多复发，\n\n13:31.046 --> 13:32.213\n性激素治疗，\n\n13:32.213 --> 13:34.739\n病灶吸收后容易复发。\n\n13:35.138 --> 13:37.414\n少蜂窝肺少见，\n\n13:37.414 --> 13:38.838\n胸膜下纤维化，\n\n13:38.888 --> 13:40.388\n蜂窝增加。\n\n13:41.205 --> 13:42.255\n实验室检查。\n\n13:42.931 --> 13:46.181\n外周白细胞中数正常或轻度升高，\n\n13:46.431 --> 13:48.580\n中性粒细胞可轻度升高。\n\n13:49.780 --> 13:52.580\n血沉和C反应蛋白明显增高，\n\n13:52.729 --> 13:57.630\n糖藻细菌、真菌、抗碱抗酸杆菌均为阴性。\n\n13:57.679 --> 14:06.080\n抗核抗体、中性粒细胞胞浆抗体、风湿系列的免疫学检查体质不存在系统性疾病。\n\n14:06.705 --> 14:08.981\n肺泡灌洗液的细胞分类中，\n\n14:08.981 --> 14:10.606\n淋巴细胞中心里。\n\n14:11.327 --> 14:11.726\n增高。\n\n14:13.215 --> 14:14.590\n41%.59%，\n\n14:14.640 --> 14:18.065\n嗜酸性可也可增高，\n\n14:18.065 --> 14:20.840\nCD 4 CD 8比值明显降低，\n\n14:20.890 --> 14:23.090\n巨噬细胞大于20%，\n\n14:23.789 --> 14:26.190\n肺功能轻至中度，\n\n14:26.190 --> 14:28.090\n限制性通气功能障碍。\n\n14:30.156 --> 14:32.057\n一氧化碳弥散率降低，\n\n14:32.057 --> 14:32.757\n血气，\n\n14:32.856 --> 14:36.007\n重症可出现严重低氧血症。\n\n14:37.385 --> 14:41.010\nCOP诊断临床影像学病理啊。\n\n14:41.010 --> 14:44.236\n根据结合临床影像学和病理检测，\n\n14:45.435 --> 14:49.085\n下列临床特点是高度提示COP。\n\n14:49.909 --> 14:52.609\n以流感样症状亚急性起病，\n\n14:52.609 --> 14:56.109\n有低热、咳嗽、少痰、体重减轻。\n\n14:57.713 --> 14:58.213\n肺部有。\n\n14:59.497 --> 14:59.997\n爆裂性，\n\n14:59.997 --> 15:04.822\n爆裂性肺部多段多叶的胸膜下斑片状阴影，\n\n15:04.822 --> 15:06.346\n可有游走性。\n\n15:06.646 --> 15:08.846\n多种抗生素治疗时可。\n\n15:12.195 --> 15:12.270\n嗯，\n\n15:12.270 --> 15:16.195\n鉴于病情可进行从从那个进行性加重，\n\n15:16.494 --> 15:20.145\n除肺结核支支原体真菌的肺部感染，\n\n15:20.145 --> 15:25.294\n以及胶原病患者无大量服用激素免疫抑制剂的病史。\n\n15:26.385 --> 15:27.684\n或免疫功能受损，\n\n15:27.684 --> 15:30.635\n并且病程迁延2.3个月，\n\n15:30.734 --> 15:33.234\n病灶不吸收的原因不好解释。\n\n15:34.151 --> 15:35.351\n患者一般情况好，\n\n15:35.351 --> 15:37.377\n肺部影像表现相对重，\n\n15:37.377 --> 15:40.351\n临床表现影像表现不相称。\n\n15:41.781 --> 15:43.806\nCOP诊断的相关问题，\n\n15:43.806 --> 15:48.156\n诊断过程及COP诊断的现实影像学特点，\n\n15:48.156 --> 15:50.031\n抗感染治疗效果不佳，\n\n15:50.130 --> 15:53.481\n结合病理改变排除其他结果。\n\n15:54.101 --> 15:58.851\n诊断COP最基本的问题就是排除其他继发性OP，\n\n15:58.952 --> 16:03.427\n临床表现与影像学和COP非常相似的疾病，\n\n16:03.427 --> 16:05.302\n包括肺淋巴瘤，\n\n16:05.552 --> 16:06.651\n细支气管。\n\n16:08.333 --> 16:15.833\n肺泡癌、慢性嗜酸性细胞性肺炎、肺栓塞可通过TBLB或B、L帮助鉴别。\n\n16:16.383 --> 16:23.133\n重症和进行性进展的COP需要机械通气治疗与a RDAP。\n\n16:23.760 --> 16:24.710\n一起相处。\n\n16:26.461 --> 16:27.562\n周为诊断，\n\n16:27.562 --> 16:30.111\n诊断分级、拟诊和确诊，\n\n16:30.211 --> 16:32.711\n周为诊断保动态随访。\n\n16:34.096 --> 16:38.945\n病理取材最好经胸腔镜活检和小切口肺活检。\n\n16:39.762 --> 16:43.312\n常见性继发性O、P的影响感染疾病，\n\n16:43.562 --> 16:45.961\n感染性疾病包括细菌T病。\n\n16:46.934 --> 16:49.585\n真菌、病毒、支原体、原体、原虫，\n\n16:49.835 --> 16:52.085\n与药物、呼吸道治疗相关的op，\n\n16:52.335 --> 16:57.484\n常有氨、碘的博来霉素、金制剂的放射性损伤，\n\n16:57.484 --> 16:59.534\n各种原因所致的吸入性损伤，\n\n16:59.984 --> 17:03.534\n胃内容物吸入毒气、毒性气体。\n\n17:04.336 --> 17:06.336\n其他胶原血管系统疾病，\n\n17:06.385 --> 17:07.485\n多发疾病，\n\n17:07.735 --> 17:10.586\n皮肌炎、类风光SLE，\n\n17:10.836 --> 17:12.135\n肿瘤性疾病，\n\n17:12.235 --> 17:13.086\n白血病，\n\n17:13.086 --> 17:13.586\n肺癌。\n\n17:13.586 --> 17:14.186\n其他，\n\n17:14.586 --> 17:14.911\n嗯，\n\n17:14.911 --> 17:16.536\nA、RD过敏性肺炎，\n\n17:16.635 --> 17:17.360\n结节病，\n\n17:17.360 --> 17:20.135\n慢性嗜酸性细胞性肺炎，\n\n17:20.436 --> 17:21.561\n维格诺亚症，\n\n17:21.561 --> 17:24.836\n慢性心肾功能衰竭的治疗方法，\n\n17:25.536 --> 17:27.536\n糖皮质激素是治疗。\n\n17:28.222 --> 17:33.822\nCOP主要药物目前尚无国际国内统一的规范激素用法主要两种，\n\n17:33.822 --> 17:35.947\n起始低剂量、短疗种。\n\n17:35.947 --> 17:41.097\n起始剂量强生0.575mg/kg/d住院前量总量是6个月。\n\n17:41.396 --> 17:47.546\n其实高剂疗长疗程强强基从1.1.5mg千克总量是12个月。\n\n17:50.542 --> 17:51.017\n肌肉，\n\n17:51.017 --> 17:52.692\n这使用整体原则，\n\n17:52.692 --> 17:53.743\n降解体长，\n\n17:53.743 --> 17:55.892\n调个体动态。\n\n17:58.415 --> 18:02.714\n减量有关问题就是减接受治疗有关问题，\n\n18:02.714 --> 18:04.614\n减量过程和停药步骤。\n\n18:05.286 --> 18:12.235\n可以百分之三十十三到百分之五五十五的复发激受起始剂量方法，\n\n18:12.235 --> 18:15.186\n疗程的选择需个体化困难，\n\n18:15.485 --> 18:19.586\n治疗过程最困难的问题就是治疗过程病情加重，\n\n18:19.985 --> 18:21.786\n对技术反应最差的情况，\n\n18:21.786 --> 18:28.286\n晚其重症只应积极寻找其他治疗方法或参考up的方案治疗。\n\n18:29.161 --> 18:29.487\n嗯，\n\n18:29.487 --> 18:32.112\n他们就治疗前后的一个病灶变化，\n\n18:32.212 --> 18:34.862\n这个前后应该明显改善。\n\n18:36.401 --> 18:38.301\n这两个人民生愈后，\n\n18:38.651 --> 18:38.975\nC,\n\n18:38.975 --> 18:40.676\nB愈后是良好的报道，\n\n18:40.676 --> 18:40.826\nC,\n\n18:40.826 --> 18:43.114\nB的五年生存率达3%，\n\n18:43.114 --> 18:43.625\n73，\n\n18:43.625 --> 18:45.975\n98到九十八复发，\n\n18:45.975 --> 18:47.826\n并不增加死亡部分，\n\n18:47.826 --> 18:50.651\n死亡率部分病例有自行粒子的。\n\n18:51.911 --> 18:57.312\n趋势小结就是小结一下就COP是特发性间质性肺炎，\n\n18:57.312 --> 18:58.812\n有独特的临床影像，\n\n18:58.812 --> 19:00.661\n病理表现愈后较好，\n\n19:01.112 --> 19:02.286\n亚急性疾病，\n\n19:02.286 --> 19:02.937\n呼吸困难，\n\n19:02.937 --> 19:03.337\n咳嗽，\n\n19:03.337 --> 19:04.087\n咳问题，\n\n19:04.087 --> 19:04.862\n免发音。\n\n19:05.673 --> 19:07.499\n胸部CT表现呈多样性，\n\n19:07.499 --> 19:08.473\n一多一少，\n\n19:08.524 --> 19:10.024\n诊断是排他性。\n\n19:12.060 --> 19:16.160\n病理活检发现O、P改变为基本诊断条件，\n\n19:16.160 --> 19:19.160\nCOP诊断CRP诊断最为精准。\n\n19:19.709 --> 19:24.260\n激素是COB治疗主要药物大部分的两部分。\n\n19:26.165 --> 19:28.489\n患者激素减疗或停内激素出现复发，\n\n19:28.489 --> 19:30.364\n再次激素治疗能有效，\n\n19:30.614 --> 19:34.265\n少数处于晚期病例疗效差效较差，\n\n19:34.714 --> 19:35.864\n这个病愈后良好，\n\n19:35.864 --> 19:36.640\n容易复发，\n\n19:36.640 --> 19:38.515\n需保持长期的随访。\n\n19:40.378 --> 19:40.578\n嗯。\n\n","v0347cg10004d71kur2ljhtfpmhsrqhg",1188,914,"2026-01-26 12:00:18"," COP诊治相关问题解析 - 症状、诊断与治疗全指南  "," COP诊治, 慢性阻塞性肺病, 呼吸系统疾病, 肺病诊断, 肺病治疗, 呼吸道健康  "," 本视频详细讲解慢性阻塞性肺病（COP）的常见症状、精准诊断方法和最新治疗方案，帮助患者和家属全面了解疾病管理要点，提升呼吸健康生活质量。","2026-04-24 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