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--> 00:04.164\n下面我们讲一个这个关于闭合性气胸的一个定义，\n\n00:04.264 --> 00:06.114\n与流行病学的一个特点。\n\n00:08.628 --> 00:10.928\n闭合性气胸的一个核心的一个定义。\n\n00:11.607 --> 00:12.456\n闭合性气胸。\n\n00:13.163 --> 00:13.762\n是指。\n\n00:15.286 --> 00:15.987\n肺裂伤。\n\n00:17.386 --> 00:18.586\n或胸壁穿透。\n\n00:18.586 --> 00:19.086\n伤后。\n\n00:20.964 --> 00:24.913\n少量空气从肺、从肺内或胸膜外进入胸膜腔。\n\n00:26.059 --> 00:28.384\n肺部及胸壁的闭合，\n\n00:28.384 --> 00:29.409\n伤口闭合，\n\n00:29.509 --> 00:32.558\n不再有气体漏入胸膜腔所造成的一个。\n\n00:33.652 --> 00:34.603\n胸膜腔的机器，\n\n00:34.952 --> 00:37.277\n其特点是气体进入胸膜腔，\n\n00:37.277 --> 00:40.127\n但无持续气体进入胸腔内，\n\n00:40.127 --> 00:41.702\n压力低于大气压。\n\n00:45.798 --> 00:48.298\n流行病学特点与高发人群。\n\n00:50.303 --> 00:54.103\n自发性气胸多见于瘦高体型的青壮年。\n\n00:54.353 --> 00:56.152\n肺尖部的肺大泡破裂。\n\n00:57.268 --> 00:58.717\n或合并肺部疾病者。\n\n00:58.717 --> 01:00.818\n如慢阻肺、肺结核。\n\n01:01.669 --> 01:06.419\n外伤性气胸可由肺、胸部的一个钝伤、外伤或医源性的操作引发，\n\n01:06.620 --> 01:08.019\n无特定人群倾向，\n\n01:08.720 --> 01:11.269\n常见发病部位与就诊科室。\n\n01:12.228 --> 01:15.079\n闭合性气胸常见的发病部位为胸部，\n\n01:15.228 --> 01:18.829\n患者通常就诊于呼吸科及外科。\n\n01:20.579 --> 01:26.628\n流行病学的特点之诱发因素闭合性气胸多为肋骨骨折的并发症。\n\n01:27.750 --> 01:31.699\n骨折断端刺破肺表面空气漏入胸膜腔所造成。\n\n01:31.900 --> 01:32.599\n也可。\n\n01:33.582 --> 01:38.832\n由自发性气胸、肺部肿瘤、肺囊性纤维化等因素引起。\n\n01:42.674 --> 01:44.823\n气胸的临床分类与鉴别要点，\n\n01:45.374 --> 01:48.274\n闭合性气胸气体局限性，\n\n01:48.473 --> 01:50.799\n胸膜腔与外界不相通，\n\n01:50.799 --> 01:53.424\n气体进入后伤口闭合，\n\n01:53.973 --> 01:56.274\n胸腔压力低于大气压，\n\n01:56.473 --> 02:01.424\n常见于肋骨骨折或自发性肺大泡破裂，\n\n02:02.024 --> 02:05.174\n肺压缩程度决定症状的轻重。\n\n02:06.778 --> 02:12.679\n开放性气胸气体自由进出型胸壁存在于开放性伤口，\n\n02:12.729 --> 02:15.229\n气体随呼吸自由进出胸腔，\n\n02:15.679 --> 02:20.753\n出现特征是吸水声、胸腔压力与大气压相等，\n\n02:20.753 --> 02:22.529\n需紧急封闭伤口。\n\n02:23.968 --> 02:27.817\n张力性气胸张力性气胸压力性进行性升高，\n\n02:28.417 --> 02:31.667\n气体单向进入胸膜腔无法排出，\n\n02:31.768 --> 02:37.617\n胸腔压力持续升高可导致严重的呼吸困难、低血压甚至休克，\n\n02:37.867 --> 02:38.968\n属于危重症。\n\n02:41.998 --> 02:42.748\n需一级。\n\n02:43.619 --> 02:44.320\n减压引流。\n\n02:47.458 --> 02:48.208\n核心鉴别。\n\n02:50.376 --> 02:51.826\n压力特征与临床表现，\n\n02:52.175 --> 02:53.326\n闭合性气胸，\n\n02:53.326 --> 02:54.326\n叩诊鼓音。\n\n02:55.270 --> 02:56.169\n呼吸音减弱，\n\n02:56.169 --> 02:57.220\n开放性气胸，\n\n02:57.220 --> 02:57.970\n有伤口，\n\n02:57.970 --> 03:01.419\n吮吸声张力性气胸伴气管移位。\n\n03:02.869 --> 03:06.619\n颈静脉怒张影像学检查可辅助明确的一个类型。\n\n03:10.255 --> 03:12.356\n闭合性气胸的一个病理生理机制。\n\n03:13.820 --> 03:15.470\n气体进入胸膜腔的途径，\n\n03:15.770 --> 03:20.919\n闭合性气胸多因肺裂伤或胸壁穿透伤后，\n\n03:21.119 --> 03:25.619\n少量空气从肺内或胸膜外进入胸膜腔。\n\n03:26.169 --> 03:26.869\n随后。\n\n03:28.014 --> 03:30.063\n肺部与胸壁的伤口闭合，\n\n03:30.414 --> 03:32.514\n不再有气体漏入，\n\n03:32.764 --> 03:36.514\n常见肋骨骨折断端刺破的一个肺表面等情况。\n\n03:37.264 --> 03:39.113\n胸膜腔压力变化特点。\n\n03:40.095 --> 03:41.296\n气胸形成后，\n\n03:41.595 --> 03:45.020\n胸膜腔内积气压迫肺裂口，\n\n03:45.020 --> 03:47.645\n使之封闭或破口自动闭合，\n\n03:48.246 --> 03:49.595\n不再继续漏气。\n\n03:49.945 --> 03:53.796\n此类气胸抵消胸膜腔负压，\n\n03:53.945 --> 03:56.195\n胸腔内压力低于大气压，\n\n03:56.395 --> 03:59.296\n使伤侧肺部分塌陷。\n\n04:00.759 --> 04:02.110\n对肺通气功能的影响，\n\n04:02.559 --> 04:03.660\n小量的气胸，\n\n04:03.660 --> 04:05.509\n肺压缩30%以下，\n\n04:05.559 --> 04:07.509\n对呼吸循环影响较小，\n\n04:08.259 --> 04:10.809\n肺压缩50以上为大量气胸，\n\n04:10.910 --> 04:14.059\n可出现局限性的限制性的通气障碍，\n\n04:14.210 --> 04:15.809\n导致肺容量减少，\n\n04:15.809 --> 04:17.559\n影响正常的通气功能。\n\n04:18.209 --> 04:20.160\n对循环系统的潜在影响。\n\n04:23.859 --> 04:24.260\n换色。\n\n04:25.105 --> 04:25.955\n被肺压缩，\n\n04:25.955 --> 04:28.855\n健侧肺可导致循环不畅。\n\n04:31.483 --> 04:33.308\n严重者导致循环不畅，\n\n04:33.308 --> 04:35.083\n增加心血管的一个风险，\n\n04:35.532 --> 04:36.958\n尤其是大量气胸，\n\n04:36.958 --> 04:38.782\n可能影响心脏功能。\n\n04:43.410 --> 04:44.359\n第二是病因。\n\n04:45.476 --> 04:46.425\n与危险因素。\n\n04:48.337 --> 04:52.536\n外伤致外伤性致病因因素分析。\n\n04:53.611 --> 04:55.212\n胸部的一个钝性的外伤，\n\n04:55.411 --> 04:58.761\n胸部受到撞击、挤压等钝性暴力时，\n\n04:58.861 --> 05:00.462\n可能导致肋骨骨折，\n\n05:00.761 --> 05:02.911\n骨折断端刺破肺表面，\n\n05:03.212 --> 05:05.136\n使空气漏入胸膜腔，\n\n05:05.136 --> 05:06.661\n引发闭合性气胸。\n\n05:07.312 --> 05:08.511\n医源性的操作，\n\n05:08.761 --> 05:13.361\n胸腔穿刺、机械通气等医疗操作过程中，\n\n05:13.562 --> 05:14.687\n若操作不当，\n\n05:14.687 --> 05:16.161\n可能损伤肺，\n\n05:16.411 --> 05:18.187\n导致气体进入胸膜腔，\n\n05:18.187 --> 05:21.312\n形成闭合性气胸锐器伤口，\n\n05:21.361 --> 05:22.361\n伤口闭合。\n\n05:22.963 --> 05:25.388\n胸壁遭受锐器穿透伤。\n\n05:25.388 --> 05:26.213\n若伤口。\n\n05:27.309 --> 05:30.084\n随后闭合不再有气体漏入腹膜腔，\n\n05:30.084 --> 05:31.760\n可能造成闭合性气胸，\n\n05:31.959 --> 05:34.059\n但这个情况一般比较少见。\n\n05:36.023 --> 05:38.174\n自发性气胸的高危人群特征，\n\n05:38.824 --> 05:41.623\n瘦高体型的青壮年群体，\n\n05:42.074 --> 05:44.074\n瘦高体型的青壮年人群。\n\n05:47.178 --> 05:51.627\n由于肺尖部容易形成肺大泡，\n\n05:52.227 --> 05:55.578\n在肺大泡破裂后容易引发自发性气胸，\n\n05:55.828 --> 05:58.278\n是临床常见的高危人群之一。\n\n06:00.580 --> 06:06.980\n肺部基础疾病患者患有慢性阻塞性肺疾病、肺结核、肺囊性纤维化等，\n\n06:06.980 --> 06:09.580\n患者的肺部、肺部结构受损，\n\n06:09.730 --> 06:10.881\n肺组织脆弱，\n\n06:10.980 --> 06:12.730\n更易发生自发性气胸。\n\n06:13.430 --> 06:15.605\n有肺部疾病的家家族史。\n\n06:15.605 --> 06:17.080\n患者部分。\n\n06:17.738 --> 06:20.037\n肺部疾病具有一定的遗传倾向，\n\n06:20.338 --> 06:22.488\n有肺部疾病家族史的人群，\n\n06:22.738 --> 06:27.238\n其肺部组织可能存在先天性的发育异常或易感性，\n\n06:27.588 --> 06:30.088\n增加自发性气胸的发病风险。\n\n06:31.230 --> 06:32.329\n长期吸烟的人群。\n\n06:34.315 --> 06:36.364\n长期吸烟会损伤肺组织，\n\n06:36.364 --> 06:37.815\n导致肺功能下降，\n\n06:38.065 --> 06:40.315\n使肺部更容易出现病变，\n\n06:40.464 --> 06:43.714\n从而提高自发性气胸的发生几率。\n\n06:46.653 --> 06:49.278\n医源性与继发性病因，\n\n06:49.278 --> 06:53.252\n探讨医源性气胸的常见的操作因素。\n\n06:54.165 --> 06:59.665\n医源性闭合性气胸多由胸腔穿刺、机械通气等诊疗操作引发。\n\n07:00.548 --> 07:03.197\n因操作过程中肺组织意外损伤，\n\n07:03.247 --> 07:05.048\n导致气体漏入胸膜腔。\n\n07:06.289 --> 07:12.289\n胸膜腔闭合引起的伤口闭合引起继发性气胸的肺部疾病基础。\n\n07:12.959 --> 07:19.359\n继发性闭合性气胸常继发于慢性阻塞性肺病、肺结核、肺肿瘤病变，\n\n07:19.959 --> 07:22.084\n肺组织脆弱，\n\n07:22.084 --> 07:22.609\n易破，\n\n07:23.010 --> 07:24.459\n如囊性纤维化，\n\n07:24.709 --> 07:27.760\n患者因肺结构异常而更容易发生。\n\n07:28.558 --> 07:30.459\n肋骨骨折的并发症机制。\n\n07:31.205 --> 07:34.855\n肋骨骨折断端刺破肺表面是常见病因，\n\n07:35.105 --> 07:37.955\n空气经破口漏入胸膜腔后，\n\n07:38.156 --> 07:40.656\n伤口闭合形成闭合性气胸。\n\n07:41.391 --> 07:44.041\n尤其是多发的肋骨骨折的，\n\n07:44.441 --> 07:47.441\n它自发性气胸的风险显著是增高的。\n\n07:50.305 --> 07:50.631\n第三，\n\n07:50.631 --> 07:51.605\n临床表现，\n\n07:52.605 --> 07:53.631\n典型的症状，\n\n07:53.631 --> 07:55.205\n胸痛、呼吸困难。\n\n07:58.398 --> 07:59.148\n突发的胸痛，\n\n07:59.798 --> 08:01.298\n定位明确的刺痛。\n\n08:02.960 --> 08:09.960\n患者常于肺组织破裂、外伤后突发患侧的锐痛或刺痛。\n\n08:10.773 --> 08:13.773\n深呼吸、咳嗽或体位改变时加剧，\n\n08:14.023 --> 08:17.523\n疼痛可能向肩部或背部放射。\n\n08:18.484 --> 08:20.234\n由胸膜腔压力差。\n\n08:21.200 --> 08:23.399\n导致神经受压或牵拉，\n\n08:23.399 --> 08:23.799\n引起。\n\n08:26.614 --> 08:30.415\n呼吸困难、肺压缩引发的通气障碍。\n\n08:31.403 --> 08:31.803\n气体。\n\n08:32.645 --> 08:36.346\n在胸膜腔积聚导致的肺组织受压，\n\n08:36.546 --> 08:38.054\n影响通气功能，\n\n08:38.054 --> 08:39.546\n表现为呼吸急促，\n\n08:39.596 --> 08:40.296\n气短，\n\n08:40.745 --> 08:43.695\n严重时可因肺压缩程度加重。\n\n08:43.945 --> 08:46.070\n肺压缩大于等于50%，\n\n08:46.070 --> 08:48.346\n可出现明显的一个缺氧症状，\n\n08:48.945 --> 08:53.596\n需要更频繁的增加呼吸频率来满足身体的一个氧合需求。\n\n08:55.526 --> 08:57.325\n症状程度与气胸量的关联。\n\n08:58.916 --> 09:02.117\n小量气胸是所谓小量气胸，\n\n09:02.117 --> 09:04.567\n指的是肺塌陷小于30%，\n\n09:05.017 --> 09:06.817\n多无明显的症状，\n\n09:07.166 --> 09:10.267\n中到大量肺压缩大于等于20。\n\n09:11.604 --> 09:13.604\n可出现限制性的通气功能障碍，\n\n09:14.104 --> 09:16.828\n同时伴有胸闷、气喘等症状，\n\n09:16.828 --> 09:20.004\n严重时缺氧导致口唇紫干，\n\n09:20.004 --> 09:20.953\n心率加快。\n\n09:25.041 --> 09:26.416\n气胸的一个体格检查，\n\n09:26.416 --> 09:27.242\n体征检查，\n\n09:27.442 --> 09:28.642\n叩诊鼓音，\n\n09:28.642 --> 09:30.091\n呼吸音变化。\n\n09:31.166 --> 09:33.315\n患侧叩诊呈鼓音，\n\n09:33.515 --> 09:34.666\n闭合性气胸。\n\n09:34.916 --> 09:36.565\n患侧肺组织受压，\n\n09:36.866 --> 09:37.616\n肺内。\n\n09:38.682 --> 09:40.932\n胸膜腔积气较多，\n\n09:40.932 --> 09:44.281\n积气叩诊患侧胸部可闻及鼓音。\n\n09:44.731 --> 09:46.031\n这是由于气体。\n\n09:48.289 --> 09:49.289\n阻隔音传导，\n\n09:49.440 --> 09:52.140\n使叩诊音变得更响亮高调。\n\n09:53.857 --> 09:55.607\n患者呼吸音的减弱与消失，\n\n09:55.908 --> 09:57.708\n听诊经过听诊器，\n\n09:57.708 --> 10:01.158\n患者胸部的一个呼吸音显著的降低甚至消失。\n\n10:01.458 --> 10:03.658\n因为气体占据了整个胸膜腔，\n\n10:03.708 --> 10:08.432\n肺组织塌陷导致呼吸器气流流动产生的声音减弱，\n\n10:08.432 --> 10:09.307\n无法传导。\n\n10:12.682 --> 10:13.783\n气管的移位，\n\n10:13.932 --> 10:14.882\n大量气胸，\n\n10:15.632 --> 10:17.283\n当发生大量气胸，\n\n10:17.783 --> 10:20.583\n大量气胸就是肺压缩50%以上，\n\n10:21.033 --> 10:23.232\n患侧的胸膜腔压力增高，\n\n10:23.382 --> 10:25.732\n可将气管推向健侧。\n\n10:28.395 --> 10:30.594\n复诊时发现气管位置偏移，\n\n10:30.844 --> 10:33.294\n这是严重气胸的重要体征之一。\n\n10:35.486 --> 10:36.185\n语颤减弱。\n\n10:38.200 --> 10:39.924\n触诊患者胸部的语颤减弱，\n\n10:39.924 --> 10:42.525\n由于气体在胸膜腔内聚集，\n\n10:42.525 --> 10:44.025\n使声波传导受阻，\n\n10:44.025 --> 10:46.150\n导致语颤减弱或消失，\n\n10:46.400 --> 10:49.799\n有助于判断气胸的存在和范围。\n\n10:51.267 --> 10:52.367\n严重的一个并发症。\n\n10:53.658 --> 10:55.458\n储存脂绀和循环障碍。\n\n10:57.150 --> 10:59.849\n口唇紫绀缺氧的典型症状，\n\n11:00.000 --> 11:01.950\n当闭合性气胸严重时，\n\n11:02.150 --> 11:05.849\n大量空气聚集在胸膜腔内压迫肺，\n\n11:06.099 --> 11:08.450\n显著减少氧合交换面积，\n\n11:08.599 --> 11:10.299\n导致血液中的。\n\n11:11.062 --> 11:12.461\n氧合量下降，\n\n11:12.512 --> 11:13.911\n出现缺氧症状，\n\n11:14.562 --> 11:16.262\n进而引发口唇紫绀，\n\n11:16.762 --> 11:17.911\n这是紧急情况，\n\n11:17.911 --> 11:19.512\n需要立即就医处理。\n\n11:19.812 --> 11:21.512\n循环障碍的病理基础，\n\n11:21.911 --> 11:23.236\n闭合性气胸时，\n\n11:23.236 --> 11:28.461\n患者被肺被压缩成为萎陷状态，\n\n11:29.312 --> 11:31.012\n健侧的肺过度膨胀，\n\n11:31.961 --> 11:35.661\n可能导致双肺大小不一的状态，\n\n11:35.661 --> 11:37.711\n这种情况造成循环不畅，\n\n11:37.961 --> 11:40.262\n增加心血管疾病的一个风险。\n\n11:41.026 --> 11:42.976\n心律失常与心功能影响，\n\n11:43.375 --> 11:46.125\n气胸导致胸膜腔压力变化与缺氧，\n\n11:46.226 --> 11:47.625\n影响心脏功能，\n\n11:47.976 --> 11:50.851\n患者可能出现心率加快等心律失常，\n\n11:50.851 --> 11:53.176\n严重时心脏供氧量不足，\n\n11:53.176 --> 11:55.176\n进一步加重了一个循环障碍。\n\n11:58.611 --> 12:01.010\n症状与肺压缩程度的关联性。\n\n12:04.283 --> 12:04.982\n小量气胸，\n\n12:05.132 --> 12:07.033\n肺压缩小于30%，\n\n12:07.033 --> 12:07.982\n症状轻微，\n\n12:08.182 --> 12:09.033\n无症状。\n\n12:09.864 --> 12:14.013\n小量气胸因肺陷陷塌程度较轻，\n\n12:14.013 --> 12:16.114\n对呼吸、循环功能影响小。\n\n12:16.919 --> 12:18.219\n多无明显症状，\n\n12:18.369 --> 12:21.320\n部分患者仅在影像学检查时发现。\n\n12:23.671 --> 12:27.346\n中等量气胸30.50出现胸闷，\n\n12:27.346 --> 12:28.421\n活动后气喘，\n\n12:29.020 --> 12:31.820\n肺压缩达30%.50%时，\n\n12:31.820 --> 12:33.221\n肺容量减少。\n\n12:33.921 --> 12:37.320\n肺容量减少导致了一个限制性的通气功能障碍，\n\n12:37.620 --> 12:41.921\n患者感胸部紧迫感或重量感，\n\n12:42.070 --> 12:45.120\n活动后胸闷气喘症状明显加重。\n\n12:45.471 --> 12:48.421\n大量气胸肺压缩大于50%。\n\n12:49.306 --> 12:51.656\n胸痛、呼吸困难与缺氧表现。\n\n12:53.218 --> 12:54.968\n肺压缩超过50%，\n\n12:54.968 --> 13:00.918\n可引发显著的一个胸痛、刺痛或牵拉痛、后背深呼吸式的放射痛，\n\n13:01.268 --> 13:04.168\n同时因肺活量降低出现窒息感，\n\n13:04.617 --> 13:07.293\n严重时因缺氧导致口唇紫绀，\n\n13:07.293 --> 13:08.468\n需紧急干预。\n\n13:09.588 --> 13:12.638\n体征随肺压缩程度递增，\n\n13:12.789 --> 13:14.739\n叩鼓音和呼吸音减弱，\n\n13:15.138 --> 13:16.614\n少量气胸不明显，\n\n13:16.614 --> 13:22.189\n大量气胸患侧叩鼓音听诊呼吸音显著减减弱与消失，\n\n13:22.638 --> 13:24.114\n触诊语颤减弱，\n\n13:24.114 --> 13:26.289\n气管可向健侧移位。\n\n13:29.135 --> 13:30.085\n诊断与评估。\n\n13:35.010 --> 13:37.810\n胸部X线检查的一个特征表现。\n\n13:40.210 --> 13:42.810\n弟胸线的一个典典型影像。\n\n13:47.018 --> 13:54.393\n胸部X线可见肺组织边缘与胸壁无纹理的一个透浪区被压缩，\n\n13:54.393 --> 13:56.919\n肺组织的边缘形成清晰的气胸线，\n\n13:57.318 --> 14:00.419\n是确诊闭合性气胸的一个重要依据。\n\n14:01.703 --> 14:05.854\n肺组织压缩正向患侧肺组织。\n\n14:07.479 --> 14:10.380\n因气体压缩纬线成团罐的一个致命。\n\n14:12.559 --> 14:14.809\n肺压缩程度可通过X线评估。\n\n14:15.010 --> 14:16.159\n小量气胸。\n\n14:18.132 --> 14:19.257\n为线在30以下，\n\n14:19.257 --> 14:21.132\n大量超过50%。\n\n14:21.971 --> 14:24.622\n患侧胸部的叩诊影像学，\n\n14:24.822 --> 14:27.221\n少量的一个X线的敏感性。\n\n14:28.760 --> 14:32.960\nCT扫描在微量气胸诊断中的价值高敏感性，\n\n14:33.309 --> 14:36.309\n捕捉常规的X线漏诊的一个微量气胸。\n\n14:37.353 --> 14:40.302\n一般的检测出小于20%的一个气胸，\n\n14:40.953 --> 14:42.002\n精准量化，\n\n14:42.002 --> 14:44.103\n明确肺组织的压缩的一个程度。\n\n14:45.512 --> 14:46.461\n提示这个病因。\n\n14:47.789 --> 14:50.239\n发现潜在肺部的一个基础病变，\n\n14:50.789 --> 14:53.140\n肺大泡、肺气肿、肺部肿瘤等。\n\n14:53.989 --> 14:55.739\n尤其是那种自发性气胸，\n\n14:55.739 --> 14:58.489\n有助于明确并指导后续的治疗及预防。\n\n14:59.703 --> 15:00.228\n鉴别诊断，\n\n15:00.228 --> 15:01.802\n排除其他胸腔疾病。\n\n15:03.697 --> 15:05.497\n临床严重程度的一个评估标准，\n\n15:05.596 --> 15:07.646\n基于肺压缩程度的一个分级，\n\n15:08.296 --> 15:10.346\n症状表现的一个评估要点，\n\n15:10.396 --> 15:12.697\n一个是影像学检测的一个评估依据，\n\n15:12.697 --> 15:14.796\n还有一个综合评估的一个临床意义。\n\n15:15.846 --> 15:19.645\n与开放性与张力性气胸的一个一个鉴别诊断。\n\n15:22.648 --> 15:26.273\n开放性气胸存在开放性伤口与吸水声，\n\n15:26.273 --> 15:30.448\n张力性气胸单活瓣与危及生命的一个压力升高。\n\n15:31.950 --> 15:32.700\n闭合性气胸，\n\n15:32.901 --> 15:35.851\n伤口闭合与压力稳定。\n\n15:37.241 --> 15:38.241\n治疗的一个策略，\n\n15:38.890 --> 15:41.341\n保守治疗指责与监测方案，\n\n15:41.841 --> 15:45.716\n一般都是肺小小小量气胸的肺压缩，\n\n15:45.716 --> 15:50.690\n少于20%的保守治疗适用人群还有一个核心治疗的一个措施，\n\n15:51.091 --> 15:52.515\n症状监测的一个要点，\n\n15:52.515 --> 15:53.515\n影像学复查，\n\n15:53.515 --> 15:56.491\n复查的一个计划生活管理的一个注意事项。\n\n15:57.987 --> 16:01.888\n胸腔穿刺抽气操作的一个规范适用情况，\n\n16:02.687 --> 16:04.862\n第二个就是一个操作之前的一个准备，\n\n16:04.862 --> 16:06.838\n还有操作时要注意的要点，\n\n16:07.288 --> 16:10.138\n操作以后的术后的一些常规的一些护理。\n\n16:11.369 --> 16:16.770\n胸腔闭式引流术的临床应用、适用情况还有操作方式，\n\n16:16.869 --> 16:18.570\n术后的一个护理要点，\n\n16:19.669 --> 16:22.320\n手术治疗适应症与术式选择，\n\n16:22.770 --> 16:25.119\n反复的一个发作性气胸，\n\n16:25.119 --> 16:28.919\n大量气胸伴严重症状合并肺大泡的一个病变，\n\n16:28.969 --> 16:30.070\n胸腔镜手术，\n\n16:30.070 --> 16:31.020\n开胸手术。\n\n16:32.244 --> 16:34.343\n氧疗与辅助治疗的一个措施。\n\n16:34.593 --> 16:36.143\n氧疗的作用与应用。\n\n16:37.072 --> 16:38.921\n还有氧疗的一个实施的一个方式，\n\n16:39.421 --> 16:42.322\n还有就是什么时候选择抗生素治疗的一个应用，\n\n16:42.671 --> 16:44.622\n镇静止痛方面的一个治疗。\n\n16:46.361 --> 16:47.861\n关于一个并发症的一个防治，\n\n16:48.260 --> 16:51.510\n感染预防与抗生素应用的一个原则，\n\n16:51.510 --> 16:53.611\n感染风险因素的一个识别，\n\n16:53.861 --> 16:56.060\n感染预防的一个核心的一个措施，\n\n16:56.161 --> 16:57.710\n抗生素使用的指针，\n\n16:58.260 --> 17:01.210\n抗生素使用时需要注意的注意事项。\n\n17:02.739 --> 17:04.640\n皮下气肿与纵膈气肿的处理，\n\n17:04.890 --> 17:06.790\n皮下气肿的一个保守治疗。\n\n17:08.793 --> 17:10.369\n切开引流的一个应用指针，\n\n17:10.369 --> 17:11.693\n纵膈气肿的一个氧疗，\n\n17:11.693 --> 17:14.093\n支持并发症的预防与监测。\n\n17:15.353 --> 17:16.953\n复发性气胸的预防策略，\n\n17:17.353 --> 17:18.953\n避免诱发因素，\n\n17:19.103 --> 17:20.753\n积极治疗基础疾病，\n\n17:20.902 --> 17:22.003\n手术干预，\n\n17:22.103 --> 17:23.152\n预防复发，\n\n17:23.402 --> 17:25.052\n定期影像学监测。\n\n17:25.761 --> 17:27.511\n康复与随访第七，\n\n17:27.962 --> 17:30.011\n术后康复锻炼的一个指导，\n\n17:30.011 --> 17:31.812\n早期呼吸功能的一个锻炼，\n\n17:32.312 --> 17:34.261\n有效咳嗽排痰的一个训练，\n\n17:34.612 --> 17:36.661\n肢体活动与体能的恢复。\n\n17:36.661 --> 17:37.862\n呼吸功能进。\n\n17:39.014 --> 17:39.864\n阶段的一个训练，\n\n17:41.514 --> 17:43.813\n生活方式的调整与禁忌事项，\n\n17:44.413 --> 17:45.764\n日常活动的管理，\n\n17:45.963 --> 17:47.713\n呼吸道卫生的一个维护，\n\n17:47.764 --> 17:49.313\n饮食营养的一个指导，\n\n17:49.563 --> 17:51.913\n还有定期复查与症状的一个监测，\n\n17:52.463 --> 17:54.963\n长期随访计划与影像学的监测。\n\n17:56.385 --> 17:57.885\n随访的一个周期和内容设定，\n\n17:58.086 --> 18:01.211\n胸部X线的一个监测价值，\n\n18:01.211 --> 18:02.536\nCT扫描的应用指针，\n\n18:02.586 --> 18:04.485\n随访中的一些注意事项。\n\n","v0347cg10004d71l9caljhte7mebib1g",1091,720,"2026-01-26 12:06:47"," 闭合性气胸的临床特征与规范化治疗 - 钱宝教授专业解读  \n"," 闭合性气胸,气胸症状,气胸治疗,胸腔闭式引流,钱宝教授,呼吸系统疾病,胸外科  \n"," 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