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--> 00:04.230\n各位患者大家好，\n\n00:04.630 --> 00:10.779\n今天我和大家分享一下急性气管支气管炎临床诊疗规范。\n\n00:11.616 --> 00:11.866\n嗯。\n\n00:16.600 --> 00:19.750\n我将从以下五个方面进行分享，\n\n00:20.100 --> 00:20.701\n第一，\n\n00:20.750 --> 00:22.801\n急性气管支气管炎的概述。\n\n00:23.777 --> 00:24.128\n第二，\n\n00:24.577 --> 00:26.577\n诊断依据与鉴别诊断，\n\n00:26.927 --> 00:29.577\n三、治疗原则与方法，\n\n00:30.378 --> 00:32.827\n四、预防与预后评估，\n\n00:33.428 --> 00:35.978\n五、文献综述与展望。\n\n00:38.757 --> 00:39.056\n嗯。\n\n00:40.325 --> 00:41.875\n首先我们来看第一部分。\n\n00:42.877 --> 00:45.327\n急性气管支气管炎的概述方面。\n\n00:52.969 --> 00:53.368\n嗯。\n\n00:54.608 --> 00:57.908\n对急性气管支气管炎的定义与分类，\n\n00:58.257 --> 01:03.007\n我们常见分型有单纯性支气管炎、喘息性支气管炎。\n\n01:04.332 --> 01:07.931\n是儿童的患者总的人数，\n\n01:07.931 --> 01:12.281\n成人患者总的人数以及合并肺炎患者的人数。\n\n01:12.732 --> 01:13.707\n有分这五，\n\n01:13.707 --> 01:14.931\n可以大致分五大类。\n\n01:15.692 --> 01:18.541\n首先我们看第一个单纯性支气管炎呢，\n\n01:18.592 --> 01:19.741\n它的发病率呢，\n\n01:19.991 --> 01:22.991\n每年每千人大约88.5%。\n\n01:24.166 --> 01:26.390\n它这个季节变化中呢，\n\n01:26.390 --> 01:27.566\n在寒冷季节呢，\n\n01:27.666 --> 01:29.416\n占比可以达到75%，\n\n01:30.316 --> 01:33.390\n然后继发以上呼吸道感染的病例有多少呢？\n\n01:33.390 --> 01:34.216\n大约60%，\n\n01:34.566 --> 01:37.015\n他的病它的病程平均是7.10天。\n\n01:38.001 --> 01:39.302\n因为它是一个单纯性支气管炎，\n\n01:39.302 --> 01:40.652\n所以它没有喘息症状。\n\n01:41.976 --> 01:43.476\n第二个喘息性支气管炎。\n\n01:44.839 --> 01:47.290\n它的发病率是每年每千人4.2，\n\n01:47.739 --> 01:50.514\n然后在寒冷季节发病率多少呢？\n\n01:50.514 --> 01:50.790\n82%。\n\n01:52.781 --> 01:53.207\n然后，\n\n01:53.207 --> 01:55.232\n他的继发上游的感染比例呢，\n\n01:55.232 --> 01:56.382\n大约55%。\n\n01:56.931 --> 01:58.607\n他病情比较严重一点，\n\n01:58.607 --> 02:02.031\n所以他那个平均病程大约在9.14天。\n\n02:03.916 --> 02:06.816\n他出现喘息症状的比例就比较高了，\n\n02:07.066 --> 02:08.815\n因为它是喘息性支气管炎嘛，\n\n02:08.865 --> 02:10.766\n所以大约占比85%。\n\n02:12.354 --> 02:13.453\n儿童患者呢，\n\n02:13.654 --> 02:16.804\n大约占每年每千人大约十二点七，\n\n02:17.953 --> 02:19.503\n它在寒冷季节的发病率，\n\n02:20.054 --> 02:22.203\n它的比例大约在80%左右，\n\n02:22.453 --> 02:24.104\n而继发上的感染比例呢，\n\n02:24.104 --> 02:24.953\n大约70%。\n\n02:27.026 --> 02:27.826\n他的病程呢，\n\n02:27.826 --> 02:28.438\n也比较长，\n\n02:28.438 --> 02:30.475\n大约需要8.12天啊。\n\n02:30.526 --> 02:31.826\n合并喘息症状呢，\n\n02:31.826 --> 02:33.175\n大约40%会出现。\n\n02:34.639 --> 02:35.839\n成年患者呢，\n\n02:35.839 --> 02:37.389\n他的发病率每人每千人，\n\n02:37.389 --> 02:38.664\n因为成年人抵抗力会好，\n\n02:38.664 --> 02:39.490\n稍微好一些，\n\n02:39.539 --> 02:43.389\n所以他每每年每每千人的发病大约33.4%。\n\n02:44.744 --> 02:45.770\n它在寒冷季节的，\n\n02:45.770 --> 02:46.994\n也是一个寒冷季节高发，\n\n02:46.994 --> 02:48.244\n大约比例65%，\n\n02:48.645 --> 02:51.044\n继发上呼吸的感染比例有多少呢？\n\n02:51.044 --> 02:52.395\n大约40%左右，\n\n02:52.445 --> 02:53.369\n它病程呢，\n\n02:53.369 --> 02:55.195\n就是需要6.9天，\n\n02:55.494 --> 02:57.095\n他出现喘息症状的。\n\n02:57.932 --> 02:58.533\n概率多少呢？\n\n02:58.533 --> 02:59.483\n有10%左右，\n\n02:59.983 --> 03:00.382\n嗯，\n\n03:00.832 --> 03:03.557\n对于这些急性气管支气管炎呢，\n\n03:03.557 --> 03:05.082\n难道合并肺炎的患者呢？\n\n03:05.332 --> 03:07.483\n他有一个一个统计一个指标，\n\n03:07.983 --> 03:11.382\n它每年每千人的发病率在于1.8%，\n\n03:11.783 --> 03:12.983\n在寒冷季节呢，\n\n03:12.983 --> 03:14.658\n它的比例合并更高，\n\n03:14.658 --> 03:15.682\n大约90%。\n\n03:16.479 --> 03:17.979\n继发上呼吸道感染比例呢，\n\n03:18.378 --> 03:19.429\n有85%，\n\n03:19.479 --> 03:21.179\n它因为它合并了肺炎嘛，\n\n03:21.179 --> 03:23.179\n它所以它平均病程会更长，\n\n03:23.679 --> 03:25.029\n大约10.15天。\n\n03:26.046 --> 03:27.945\n合并喘息症状出现率呢，\n\n03:27.945 --> 03:29.046\n大概70%。\n\n03:30.246 --> 03:30.570\n嗯，\n\n03:30.570 --> 03:31.970\n通过我们简单一个分类，\n\n03:31.970 --> 03:36.145\n我们知道急性气管支气管炎的一些基本的分类，\n\n03:36.145 --> 03:39.496\n以及它这个这这各个分类的一些基本的特征。\n\n03:45.005 --> 03:47.904\n从上面从从上面的统计表格我们可以看出来呢。\n\n03:48.882 --> 03:54.382\n它的发病年龄可以说是各个年龄段都是都是发病率高发期，\n\n03:54.731 --> 03:56.531\n特别是小孩和老人，\n\n03:56.531 --> 03:58.082\n老人发病率会更高。\n\n03:59.839 --> 04:00.789\n对他相对来说，\n\n04:01.688 --> 04:03.813\n小孩和老人的抵抗力会比较差一些。\n\n04:03.813 --> 04:05.438\n他一般发病季节呢，\n\n04:06.039 --> 04:07.514\n一般是天气寒冷的时候，\n\n04:07.514 --> 04:09.238\n像秋冬季啊，\n\n04:09.238 --> 04:12.063\n和冬春季这种天气变化的时候，\n\n04:12.063 --> 04:13.738\n气温骤降的时候容易。\n\n04:14.395 --> 04:17.195\n容易出现它症状有哪些呢？\n\n04:17.244 --> 04:21.220\n那么这里有为咳嗽咳痰这最常见的症状，\n\n04:21.220 --> 04:25.845\n当然还会有一些发热、胸闷、气喘等等症状。\n\n04:27.720 --> 04:28.994\n它病因有哪些呢？\n\n04:28.994 --> 04:30.570\n其实就是各种病原体的感染。\n\n04:30.570 --> 04:40.119\n我们知道有细菌、病毒、非典、非典型菌以及特特殊的病原体都可能导致感染。\n\n04:44.377 --> 04:45.177\n第二部分，\n\n04:45.777 --> 04:49.826\n急性气管支气管炎的一个诊断的依据以及它鉴别诊断有哪些？\n\n04:58.662 --> 04:59.062\n嗯，\n\n04:59.162 --> 05:00.613\n对他诊断我们可以。\n\n05:03.022 --> 05:04.421\n也可以大致分成四大类，\n\n05:04.471 --> 05:08.272\n第一个就是单纯的急急性气管支气管炎，\n\n05:08.272 --> 05:11.946\n第二类就是流感病毒相关性的第三呼吸道合胞病毒相关性，\n\n05:11.946 --> 05:14.171\n第四就是副流感病毒性的。\n\n05:14.721 --> 05:15.921\n对于急性气管。\n\n05:17.132 --> 05:17.833\n支气管炎呢，\n\n05:18.183 --> 05:22.183\n它这里面的病毒感染导致占比大于75%，\n\n05:22.433 --> 05:24.532\n它很容易激发细菌感染嘛，\n\n05:24.532 --> 05:25.683\n大约30%左右，\n\n05:26.183 --> 05:27.558\n常见诱因触发率呢，\n\n05:27.558 --> 05:28.608\n大约65%，\n\n05:28.608 --> 05:29.933\n常见的一些辅助检查，\n\n05:29.933 --> 05:31.208\n大部分都可以检测出来，\n\n05:31.208 --> 05:33.233\n就是它呈阳性率80%左右。\n\n05:33.962 --> 05:35.462\n那典型症状的覆盖率呢，\n\n05:35.611 --> 05:37.712\n可以达到覆盖到90%以上。\n\n05:40.261 --> 05:42.411\n第二个就是流感病毒相关性的。\n\n05:43.518 --> 05:43.868\n这种呢，\n\n05:43.868 --> 05:46.768\n它那个病毒感染比例占85%，\n\n05:47.467 --> 05:49.042\n细菌感染呢，\n\n05:49.042 --> 05:49.730\n35%，\n\n05:49.730 --> 05:51.868\n常见诱因触发率呢，\n\n05:51.868 --> 05:53.317\n有大于70%。\n\n05:54.226 --> 05:56.376\n对于它的辅助检查的一些阳性，\n\n05:56.376 --> 05:57.575\n阳性检出率呢。\n\n05:58.936 --> 06:00.135\n可以达到85%。\n\n06:01.011 --> 06:02.861\n它的典型症状覆盖率呢，\n\n06:03.011 --> 06:04.312\n可以达到95%。\n\n06:09.100 --> 06:11.049\n对于呼吸道合胞病毒型呢，\n\n06:11.200 --> 06:13.850\n它的病毒感染占比70%，\n\n06:14.700 --> 06:17.450\n它继发细菌感染的比例呢，\n\n06:17.700 --> 06:18.799\n有25%，\n\n06:19.100 --> 06:20.774\n常见诱因的触发率呢，\n\n06:20.774 --> 06:21.750\n在60%。\n\n06:22.986 --> 06:24.212\n它复检阳性率呢，\n\n06:24.212 --> 06:25.636\n也可以达到75%左右。\n\n06:26.584 --> 06:28.135\n对于典型症状覆盖率呢，\n\n06:28.285 --> 06:29.785\n它可以达到85%。\n\n06:31.244 --> 06:32.795\n对于副流感病毒型的，\n\n06:32.994 --> 06:35.494\n它病毒感染占比占65%。\n\n06:36.449 --> 06:38.598\n也继发一些细菌感染的可以占20%，\n\n06:39.748 --> 06:40.148\n嗯，\n\n06:40.449 --> 06:43.799\n它一些常见的诱因触发率就可以达到55%。\n\n06:43.799 --> 06:47.398\n然后辅助辅助检查阳性率可以达到70%。\n\n06:47.848 --> 06:49.398\n这些典型症状覆盖率呢，\n\n06:49.398 --> 06:51.648\n也可以达到80%的程度。\n\n06:55.403 --> 06:56.203\n抽完诊断，\n\n06:56.203 --> 06:59.852\n接下来我们来看一下它的气管支气管的鉴别诊断。\n\n07:01.492 --> 07:03.191\n我们知道对一个疾病的诊断，\n\n07:03.791 --> 07:04.941\n疾病的治疗来说，\n\n07:04.941 --> 07:06.342\n诊断是大于治疗的，\n\n07:06.342 --> 07:08.791\n而诊断里面的关键一步是鉴别诊断。\n\n07:09.502 --> 07:11.476\n因为可以做好更好的鉴别诊断，\n\n07:11.476 --> 07:15.601\n对于我们接下来诊断以及治疗等提供非常重要的帮助意义。\n\n07:17.617 --> 07:19.617\n例如我们急性气管支气管炎呢，\n\n07:19.617 --> 07:20.916\n它的鉴别诊断呢，\n\n07:21.367 --> 07:23.391\n它需要与其他的呼吸系统疾病，\n\n07:23.391 --> 07:25.467\n还有一些全身性的疾病来相鉴别，\n\n07:25.717 --> 07:26.816\n从而来保证呢，\n\n07:26.967 --> 07:29.666\n这确治疗的诊断的准确，\n\n07:29.666 --> 07:31.416\n以及制定更合理的治疗方案。\n\n07:32.126 --> 07:34.026\n可以通过哪些来进行鉴别呢？\n\n07:34.026 --> 07:36.876\n我们当然包括他患者临床症状呀，\n\n07:36.876 --> 07:37.825\n辅助检查呀，\n\n07:37.825 --> 07:39.626\n以及患者既往病史等等。\n\n07:40.825 --> 07:43.376\n通过我们可以问患者的病史，\n\n07:43.575 --> 07:45.976\n完善完善体格检查，\n\n07:45.976 --> 07:47.526\n还有一些实验室检查，\n\n07:47.776 --> 07:52.376\n可以通过排除其他疾病来诊断急性气管支气管炎。\n\n07:53.760 --> 07:55.510\n比如需要哪些疾病相鉴别呢？\n\n07:55.661 --> 07:58.760\n我们知道像肺炎、支气管哮喘这些疾病，\n\n07:59.311 --> 08:05.710\n它的当然这些疾病可以通过痰培养呀、胸片呀、CT来进行明确诊断。\n\n08:07.726 --> 08:08.925\n还有一些注意的事项，\n\n08:09.075 --> 08:10.976\n因为有些类似嘛，\n\n08:11.026 --> 08:13.675\n除了我们刚才讲的肺炎、支气管炎之外，\n\n08:13.675 --> 08:15.726\n还有流感和急性上呼吸道感染，\n\n08:15.976 --> 08:17.925\n这也是要一个重要鉴别点。\n\n08:19.036 --> 08:20.610\n哪些需要做哪些辅助检查呢？\n\n08:20.610 --> 08:21.686\n我们刚才提了一下，\n\n08:22.186 --> 08:24.210\n包括血血常规啊，\n\n08:24.210 --> 08:25.335\nCRP啊，\n\n08:25.335 --> 08:25.885\nPCDSA等，\n\n08:25.936 --> 08:27.085\n还有呼吸。\n\n08:28.282 --> 08:29.856\n肺功能对肺功能的检查，\n\n08:30.407 --> 08:31.907\nX线、CT啊，\n\n08:31.907 --> 08:33.257\n还有痰培养等等，\n\n08:33.757 --> 08:35.356\n可以提供一些关联信息。\n\n08:35.906 --> 08:39.307\n我们可以通过看血常规里面的白细胞计数，\n\n08:39.456 --> 08:40.206\n正常啊，\n\n08:40.206 --> 08:40.956\n升高啦。\n\n08:41.841 --> 08:42.742\n来进行判断。\n\n08:43.192 --> 08:43.591\n对。\n\n08:44.723 --> 08:45.572\n对于肺功能检查，\n\n08:45.572 --> 08:48.898\n有没有看有出塞肺功能的肺通气功能的障碍呀，\n\n08:48.898 --> 08:51.773\n然后胸片的肺部内增粗呀，\n\n08:51.822 --> 08:52.622\n或者CT，\n\n08:52.773 --> 08:54.473\n然后排除有没有肺炎等等。\n\n08:54.523 --> 08:56.723\n这些关这些辅助检查至关重要。\n\n09:00.456 --> 09:02.656\n第三部分治疗原则与方法。\n\n09:05.591 --> 09:07.341\n我们包括基础治疗。\n\n09:08.380 --> 09:08.580\n和。\n\n09:10.888 --> 09:12.487\n药物治疗两两两部分，\n\n09:13.538 --> 09:15.038\n对于基础治疗我们需要。\n\n09:16.338 --> 09:18.338\n就是充分休息和补充水分。\n\n09:18.338 --> 09:19.039\n为什么呢？\n\n09:19.338 --> 09:20.039\n因为。\n\n09:22.041 --> 09:25.492\n支气管支气管炎发病期间身体比较疲劳，\n\n09:25.791 --> 09:29.591\n我们通过充分的吸收休息之后呢。\n\n09:33.127 --> 09:34.228\n可以避免过度劳累，\n\n09:34.228 --> 09:35.627\n保持良好的作息，\n\n09:36.328 --> 09:37.028\n另外呢，\n\n09:37.627 --> 09:40.778\n还可以要充分饮水来稀释痰液，\n\n09:41.078 --> 09:44.478\n当然戒烟限酒这个不可不必说啊，\n\n09:44.478 --> 09:45.078\n一定要。\n\n09:48.442 --> 09:50.942\n从而来可以达到一个更好的康复治疗。\n\n09:53.520 --> 09:54.619\n对于药物治疗呢，\n\n09:54.619 --> 09:59.469\n我们包括根据它这辅助检查确定它是病毒感染呢，\n\n09:59.570 --> 10:01.244\n还是继发的细菌感染呢，\n\n10:01.244 --> 10:02.619\n来采用不同的治疗方法。\n\n10:02.969 --> 10:04.119\n对于病毒感染嘛，\n\n10:04.119 --> 10:05.570\n除了这些对症治疗之外，\n\n10:05.619 --> 10:11.669\n像止咳化痰解痉平喘等等药物相关的药物要使用。\n\n10:12.369 --> 10:14.219\n对于如果合并的细菌感染呢。\n\n10:15.205 --> 10:16.630\n要使用抗生素，\n\n10:16.630 --> 10:18.056\n具体用什么抗生素呢？\n\n10:18.205 --> 10:19.080\n也因人而异，\n\n10:19.080 --> 10:19.981\n以病情而定。\n\n10:19.981 --> 10:22.306\n那我们可以根据痰培养来进行决定。\n\n10:28.466 --> 10:31.466\n一些呼吸道疾病治疗数据我们可以了解一下，\n\n10:32.617 --> 10:34.067\n对症治疗一个措施呢，\n\n10:34.067 --> 10:35.416\n就我刚才讲讲到三项，\n\n10:35.567 --> 10:37.367\n止咳祛痰、解痉平喘。\n\n10:38.466 --> 10:39.591\n这药物的作用呢，\n\n10:39.591 --> 10:41.166\n它主要是改善症状，\n\n10:41.317 --> 10:43.267\n就是缓解咳嗽啊，\n\n10:43.267 --> 10:48.617\n咳痰就支气支气管痉挛等这些主要症状可以改善减轻患者临床症状，\n\n10:48.916 --> 10:50.216\n提高患者生活质量。\n\n10:51.823 --> 10:52.749\n对于抗生素嘛，\n\n10:52.749 --> 10:54.023\n我们刚才也讲过的，\n\n10:54.023 --> 10:56.148\n有两大类抗生素，\n\n10:56.148 --> 10:59.073\n主要用于就是细菌继发细菌感染的情况，\n\n10:59.223 --> 11:01.174\n根据痰培养结果来进行选择，\n\n11:01.773 --> 11:03.323\n我们有青霉素啊，\n\n11:03.323 --> 11:04.148\n头孢类的，\n\n11:04.148 --> 11:08.148\n还有喹诺酮类、大环内酯类等等都可以使用，\n\n11:08.148 --> 11:09.299\n从而消除病原体，\n\n11:09.299 --> 11:10.523\n并且促进黏膜的修复。\n\n11:13.854 --> 11:15.630\n还有一个不常用的一个治疗方法，\n\n11:15.630 --> 11:16.705\n但是也非常有效，\n\n11:16.705 --> 11:18.455\n就是气管切开与插管，\n\n11:19.155 --> 11:20.804\n因为通过这个这个方法呢，\n\n11:20.804 --> 11:22.880\n可以减少室腔，\n\n11:22.880 --> 11:24.429\n可以使死腔呼吸，\n\n11:24.429 --> 11:26.255\n呼吸道死腔减少15%以上。\n\n11:27.185 --> 11:27.435\n嗯。\n\n11:28.638 --> 11:28.987\n从而呢，\n\n11:28.987 --> 11:31.138\n可以有效的恢复减少，\n\n11:31.138 --> 11:34.888\n可以有效的帮助肺功肺功能的恢复，\n\n11:35.138 --> 11:36.937\n对于保持呼吸道通畅呢。\n\n11:38.927 --> 11:39.552\n非常关键，\n\n11:39.552 --> 11:43.478\n并且有也方便对呼吸、呼吸道管理和气道内给药。\n\n11:47.392 --> 11:50.341\n预防预防和预后评估这一块我们看一下。\n\n11:51.297 --> 11:52.297\n怎么预防呢？\n\n11:52.348 --> 11:53.497\n其实就两个方面，\n\n11:53.547 --> 11:54.047\n第一个，\n\n11:54.047 --> 11:54.672\n增强体质，\n\n11:54.672 --> 11:55.023\n第二，\n\n11:55.023 --> 11:55.648\n注意保暖。\n\n11:56.247 --> 11:59.797\n我们预防急性气管支气管炎的主要关键在于增强体质。\n\n12:01.286 --> 12:02.911\n避免劳累过度劳累，\n\n12:02.911 --> 12:04.885\n并且要积极预防感冒，\n\n12:05.185 --> 12:07.635\n同时改善我们的生活生活环境，\n\n12:07.885 --> 12:10.085\n确保空气清新的无污染，\n\n12:10.536 --> 12:12.786\n从而减少呼吸道感染的风险。\n\n12:13.635 --> 12:14.185\n另外呢，\n\n12:14.185 --> 12:15.185\n还是要注意保暖，\n\n12:15.435 --> 12:17.835\n因为急性气管支气管炎常常发生于。\n\n12:18.859 --> 12:22.958\n寒冷的季节变化或者是气温突然变冷的时候，\n\n12:22.958 --> 12:24.859\n因此要注意保暖，\n\n12:25.258 --> 12:28.109\n避免呼吸道受凉来防止疾病的发生。\n\n12:33.491 --> 12:34.216\n预后呢，\n\n12:34.216 --> 12:34.791\n我们知道。\n\n12:36.289 --> 12:37.213\n这是个良性病变，\n\n12:37.213 --> 12:39.739\n所以大多数的急性气管支气管炎的患者呢，\n\n12:39.739 --> 12:40.739\n预后都是良好。\n\n12:42.278 --> 12:43.828\n但是也要注意一些并发症的出现，\n\n12:43.828 --> 12:46.778\n例如肺炎、哮喘等等严重的并发症，\n\n12:47.078 --> 12:49.377\n因为这些并发症会导致病情病程延长。\n\n12:49.377 --> 12:50.028\n从而。\n\n12:51.005 --> 12:55.156\n从而影响这个急性气管气管支气管炎的一个康复的一个进程。\n\n12:56.205 --> 12:57.656\n对于并发症的处理呢，\n\n12:57.856 --> 13:01.955\n我们要也要及时的识别识并且积极治疗。\n\n13:03.515 --> 13:04.765\n从而保证患者的健康。\n\n13:09.072 --> 13:09.721\n第五部分，\n\n13:09.721 --> 13:14.122\n我们看一下有关急性气管支气管炎的一些文献综述和展望，\n\n13:14.122 --> 13:15.872\n也了我们可以了解一下。\n\n13:18.903 --> 13:21.153\n对一些重症的急性气管支气管炎呢，\n\n13:21.153 --> 13:24.203\n我们可以要可能要去到去需要到ICU来治疗了。\n\n13:24.554 --> 13:27.554\n我们首先了解一下什么是ICUICU呢？\n\n13:27.554 --> 13:28.304\n它是医院的，\n\n13:28.653 --> 13:29.703\n就危重病房，\n\n13:29.754 --> 13:32.354\n它是危重病人集中监护治疗的一个场所，\n\n13:32.453 --> 13:37.604\n它是有专业的医护人员利用先进的高科技医疗设备，\n\n13:37.703 --> 13:39.854\n应用先进的诊疗护理技术，\n\n13:40.004 --> 13:43.578\n将急性危重病人集中进行严密的动态监测，\n\n13:43.578 --> 13:44.328\n强化治疗，\n\n13:44.328 --> 13:45.453\n精心护理场所。\n\n13:46.153 --> 13:47.604\n它可以有效的改善。\n\n13:49.953 --> 13:52.603\n患者在低二氧化碳浓度。\n\n13:53.661 --> 13:54.111\n的情况，\n\n13:54.510 --> 13:55.760\n还有可能可以对。\n\n13:57.518 --> 13:57.718\n患者，\n\n13:57.718 --> 14:00.968\n一些气管切开之后的一些吸痰的处理？\n\n14:01.854 --> 14:02.155\n等等，\n\n14:02.155 --> 14:04.729\n这些在门常规门诊上不进行操作的，\n\n14:04.729 --> 14:06.354\n可以在ICU进行。\n\n14:09.443 --> 14:09.794\n嗯。\n\n14:11.554 --> 14:12.304\n气管插管呢，\n\n14:12.304 --> 14:16.953\n我们知道最严重的呼吸困难可以有采用气管插管，\n\n14:17.254 --> 14:18.903\n那包括让患者仰卧位呀，\n\n14:18.953 --> 14:19.778\n头后仰，\n\n14:19.778 --> 14:20.554\n颈上抬，\n\n14:20.854 --> 14:23.403\n让口咽和气管成一条直线，\n\n14:23.854 --> 14:25.804\n然后在直视下进行插管。\n\n14:26.203 --> 14:26.729\n当然，\n\n14:26.729 --> 14:28.479\n最最好在一个麻醉状态下进行，\n\n14:28.479 --> 14:30.153\n不然人患者会比较痛苦嘛。\n\n14:30.203 --> 14:31.328\n然后建立人工气道，\n\n14:31.328 --> 14:33.403\n保持呼吸道通通通畅，\n\n14:33.854 --> 14:36.203\n还有一些气管预防性的切开。\n\n14:37.489 --> 14:38.588\n因为对于一些。\n\n14:41.004 --> 14:43.778\n口腔、鼻咽、颌面、咽喉部大手术患者，\n\n14:43.778 --> 14:48.203\n为了防止这种血液流入下呼吸道及保持术后呼吸道通畅，\n\n14:48.203 --> 14:49.703\n可以行气管切开。\n\n14:51.828 --> 14:53.927\n因为目前那个气管插管应用的比较多，\n\n14:53.927 --> 14:56.927\n所以气气管气切就比较少见，\n\n14:57.028 --> 14:59.528\n但是它我们要知道这也是一种方法。\n\n15:01.560 --> 15:01.960\n其实，\n\n15:01.960 --> 15:02.710\n未来的展望啊，\n\n15:02.710 --> 15:05.385\n我们可以知道随着技术发展呀，\n\n15:05.385 --> 15:07.861\nICU的监测设备以及治疗手段更更加先进。\n\n15:07.960 --> 15:12.010\n但为急性气管支气管炎这种极少数的危重病人，\n\n15:12.010 --> 15:14.286\n提供一个更精准有效的监活治疗，\n\n15:14.286 --> 15:16.060\n提高救治成功率。\n\n15:17.734 --> 15:18.309\n另外呢，\n\n15:18.309 --> 15:19.033\n患者的。\n\n15:19.950 --> 15:20.799\n有个体差异，\n\n15:21.000 --> 15:22.349\n未来的精准治疗，\n\n15:22.599 --> 15:24.125\n例如基因检测呀，\n\n15:24.125 --> 15:26.099\n蛋白组蛋白质组学分析啊，\n\n15:26.099 --> 15:28.799\n可以为患者提供更有针对性的治疗，\n\n15:29.450 --> 15:30.500\n从而让患者。\n\n15:31.898 --> 15:32.848\n的治疗更加满意。\n\n15:34.098 --> 15:36.098\n对于气切和插管术呢，\n\n15:36.098 --> 15:38.322\n我们可以进一步优化来减少了并发症，\n\n15:38.322 --> 15:39.547\n然后提高安全性。\n\n15:40.349 --> 15:40.700\n嗯。\n\n15:42.804 --> 15:44.354\n来评来进行啊，\n\n15:44.354 --> 15:46.955\n这个获益风险的一个评估，\n\n15:50.705 --> 15:51.054\n好，\n\n15:51.054 --> 15:52.380\n今天的分享就到这里，\n\n15:52.380 --> 15:53.604\n谢谢大家的收听，\n\n15:54.005 --> 15:54.604\n再见。\n\n","v0247cg10004d71odo2ljht2gobgc6d0",961,669,"2026-01-26 12:40:17"," 急性气管支气管炎临床诊疗规范 - 症状、诊断与治疗指南  \n"," 急性气管支气管炎, 支气管炎诊疗, 呼吸道感染治疗, 咳嗽症状, 临床指南, 支气管炎诊断, 抗生素使用, 呼吸系统疾病  \n"," 本视频详细讲解急性气管支气管炎的临床表现、诊断标准及规范治疗方案，涵盖病因分析、鉴别诊断、药物选择及预防措施，适合医疗从业者及患者参考学习。","2026-05-02 14:00:00",[36],{"menuId":37,"menuName":38,"parentId":17,"orderNum":39,"path":40,"component":41,"isFrame":42,"isCache":43,"menuType":44,"visible":25,"status":17,"createDept":6,"remark":18,"createTime":45,"children":46,"columnImage":47,"columnLogo":48,"uncheckedLogo":6,"checkedLogo":6,"isHot":17,"isHome":17,"forceLogin":17,"color":6,"seoTitle":49,"seoKeywords":50,"seoDescription":51,"contentNum":6,"promotionalPoster":52,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":53,"routerPath":40,"componentInfo":41},"1986622624134549505","科普视频",3,"video","/video.html","1","0","T","2025-11-07 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