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--> 00:01.936\n好，\n\n00:01.936 --> 00:02.736\n各位读等。\n\n00:03.381 --> 00:06.931\n今天我们来分享一下肺源性心脏病的概述。\n\n00:10.418 --> 00:12.868\n从以下六个部分进行解读。\n\n00:13.680 --> 00:15.479\n肺癌性心脏病的基本概念。\n\n00:16.402 --> 00:18.302\n病理、生理及危险因素。\n\n00:19.104 --> 00:20.854\n临床表现与诊断技术。\n\n00:21.535 --> 00:23.635\n治疗方案及患者管理，\n\n00:24.285 --> 00:26.586\n病发的预防与处理策略。\n\n00:27.426 --> 00:29.275\n康复锻炼与营养支持。\n\n00:32.416 --> 00:35.466\n我们来先看一下病原性心脏病的基本概念。\n\n00:36.478 --> 00:37.327\n他是怎么定义。\n\n00:39.176 --> 00:40.227\n他是如何发病的？\n\n00:41.653 --> 00:42.804\n肺源性心脏病啊，\n\n00:42.804 --> 00:45.453\n是指由支气管肺组织。\n\n00:46.301 --> 00:47.801\n胸廓或者是。\n\n00:48.672 --> 00:49.821\n肺血管病变。\n\n00:51.042 --> 00:52.693\n使肺血管阻力增加，\n\n00:53.092 --> 00:54.943\n引起肺动脉高压。\n\n00:55.640 --> 00:56.441\n最终导致。\n\n00:57.209 --> 00:58.459\n右心室肥厚。\n\n01:00.217 --> 01:00.568\n或者。\n\n01:02.492 --> 01:03.742\n衰竭的一个心脏病。\n\n01:05.038 --> 01:05.938\n发病机制呢，\n\n01:05.938 --> 01:11.737\n是缺氧、高碳酸血症和呼吸道酸中毒等因素啊，\n\n01:11.737 --> 01:14.237\n导致肺血管收缩痉挛。\n\n01:15.161 --> 01:17.111\n其中缺氧是最重要的因素。\n\n01:20.989 --> 01:22.540\n肺心病类型及其特点。\n\n01:24.337 --> 01:27.087\n分为急性肺心病和慢性肺心病。\n\n01:27.758 --> 01:30.057\n急性肺心病是起病较急、急促，\n\n01:30.458 --> 01:31.807\n病情发展迅速，\n\n01:32.108 --> 01:36.258\n主要表现为急性呼吸困难、胸痛、窒息感。\n\n01:36.928 --> 01:38.428\n严重的可到死亡。\n\n01:40.209 --> 01:41.184\n慢性肺心病呢，\n\n01:41.184 --> 01:42.459\n是起病缓慢，\n\n01:42.660 --> 01:43.510\n病程较长，\n\n01:43.959 --> 01:50.260\n主要表现为咳嗽、咳痰、喘息、呼吸困难等慢性症状。\n\n01:51.365 --> 01:51.941\n同时呢，\n\n01:51.941 --> 01:54.865\n伴有不同程度的右心衰竭体征。\n\n01:58.025 --> 02:00.025\n临床表现与诊断依据，\n\n02:00.675 --> 02:02.074\n肺心病患者呢，\n\n02:02.074 --> 02:05.425\n可出现咳嗽、咳痰、气促。\n\n02:06.269 --> 02:07.169\n呼吸困难。\n\n02:07.872 --> 02:13.272\n心悸、胸痛、乏力、食欲减退、腹胀等症状，\n\n02:13.472 --> 02:19.322\n严重者可出现昏迷、抽搐等肺性脑病表现。\n\n02:21.360 --> 02:22.360\n那么如何诊断呢？\n\n02:22.360 --> 02:27.761\n可以根据患者的病史、临床表现、体征及辅助检查。\n\n02:28.061 --> 02:29.610\n辅助检查包括啥呢？\n\n02:29.811 --> 02:34.460\nX线胸片、心电图、超声心动图等。\n\n02:34.992 --> 02:36.391\n进行综合判断，\n\n02:36.641 --> 02:38.492\n以确诊肺心病。\n\n02:42.807 --> 02:44.307\n预防措施的重要性。\n\n02:45.274 --> 02:46.248\n得了肺心病啊，\n\n02:46.248 --> 02:48.423\n一定要先预防呼吸道感染，\n\n02:48.723 --> 02:53.623\n因为肺呼吸道感染是肺心病急性加重的重要诱因，\n\n02:53.873 --> 02:55.623\n因此应加强预防。\n\n02:56.425 --> 02:58.425\n避免感冒等呼吸道疾病。\n\n03:00.320 --> 03:00.695\n第二呢，\n\n03:00.695 --> 03:02.020\n要戒烟酒。\n\n03:03.563 --> 03:06.912\n吸烟和饮酒是肺心病的重要危险因素。\n\n03:08.300 --> 03:13.001\n戒烟限酒有助于减少肺心病的发生与反展。\n\n03:14.048 --> 03:14.423\n同时呢，\n\n03:14.423 --> 03:15.348\n要加强锻炼。\n\n03:15.649 --> 03:18.699\n适当的身体锻炼可以提高心肺功能，\n\n03:18.748 --> 03:20.548\n增强免疫力，\n\n03:20.649 --> 03:23.248\n有助于预防心肺心病。\n\n03:24.121 --> 03:24.647\n最后呢，\n\n03:24.647 --> 03:25.972\n要做定期的检查。\n\n03:26.322 --> 03:28.972\n对于有肺心病高危因素的人群，\n\n03:29.371 --> 03:31.222\n应定期进行相关检查，\n\n03:31.671 --> 03:33.772\n以便及早发现。\n\n03:34.503 --> 03:35.104\n急诊治疗。\n\n03:38.692 --> 03:39.042\n第二呢，\n\n03:39.042 --> 03:41.492\n我们看看病理生理期危险因素。\n\n03:42.910 --> 03:45.811\n肺部病变对心脏的影响主要是体现在？\n\n03:46.703 --> 03:47.654\n肺动脉高压。\n\n03:48.854 --> 03:52.380\n慢性阻塞性肺疾病等肺部病变啊，\n\n03:52.380 --> 03:53.755\n导致肺动脉高压，\n\n03:53.804 --> 03:55.455\n可以增加心脏的负担。\n\n03:56.451 --> 03:56.776\n第二呢，\n\n03:56.776 --> 03:58.350\n肺循环阻力增加。\n\n03:59.195 --> 04:04.395\n肺部血管阻力增加导致右心室后负荷增加引起。\n\n04:05.259 --> 04:07.160\n右心室肥厚或扩大。\n\n04:08.585 --> 04:10.485\n还有就是说低氧血症，\n\n04:10.785 --> 04:11.960\n低氧血症啊，\n\n04:11.960 --> 04:14.285\n肺部疾病可能导致氧不足，\n\n04:14.335 --> 04:15.934\n引起低氧血症。\n\n04:16.903 --> 04:20.753\n低氧血症的出现可以进一步影响心脏功能。\n\n04:22.796 --> 04:24.497\n心脏的病变及其机制。\n\n04:26.377 --> 04:27.277\n有那么几个部分，\n\n04:27.777 --> 04:30.027\n包括右心室肥厚，\n\n04:30.377 --> 04:34.326\n长期肺动脉高压导致右心室代偿性肥厚，\n\n04:34.576 --> 04:36.976\n进而发展为右心衰竭。\n\n04:38.589 --> 04:38.989\n游戏。\n\n04:39.779 --> 04:41.380\n因右心功能不全，\n\n04:41.929 --> 04:44.329\n右心室扩大、肥厚，\n\n04:44.329 --> 04:45.279\n功能受损，\n\n04:45.480 --> 04:47.880\n导致右心排血量下降，\n\n04:48.029 --> 04:49.579\n静脉回流受阻。\n\n04:50.276 --> 04:50.700\n最后呢，\n\n04:50.700 --> 04:52.325\n是导致全心的衰竭。\n\n04:52.575 --> 04:53.825\n随着病情的进展，\n\n04:53.876 --> 04:56.126\n左心也有可能会受到影响，\n\n04:56.126 --> 04:56.825\n最终呢，\n\n04:56.825 --> 04:58.825\n导致全心衰竭。\n\n05:00.989 --> 05:02.989\n危险因素的识别与评估。\n\n05:04.243 --> 05:06.292\n一个从年龄来看，\n\n05:06.342 --> 05:08.667\n肺源性心脏病的发病率啊，\n\n05:08.667 --> 05:10.542\n随年龄增长而增加。\n\n05:11.423 --> 05:12.773\n第二个因素的是吸烟。\n\n05:13.656 --> 05:19.455\n吸烟是慢性阻塞性肺疾病和肺源性心脏病的重要危险因素。\n\n05:20.917 --> 05:22.667\n第三方面的职业和环境因素。\n\n05:23.018 --> 05:29.317\n长期吸入粉尘、化学物质等可增加肺癌性心脏病的风险。\n\n05:30.880 --> 05:32.429\n我们也不能忽视遗传因素，\n\n05:32.579 --> 05:35.980\n家族中如果有肺源性心脏病的病史者，\n\n05:36.130 --> 05:37.880\n其发病率可能较高。\n\n05:40.434 --> 05:41.459\n那么如何干预呢？\n\n05:41.459 --> 05:43.135\n生活方式上面如何干预呢？\n\n05:43.135 --> 05:45.285\n我们采取这些几个建议，\n\n05:45.285 --> 05:45.660\n第一，\n\n05:45.660 --> 05:46.234\n戒烟，\n\n05:46.734 --> 05:47.434\n戒烟。\n\n05:48.466 --> 05:51.966\n一直是预防肺源性心脏病的重要措施。\n\n05:52.753 --> 05:54.604\n第二个是要一定要改善环境，\n\n05:54.803 --> 05:56.303\n避免长期吸烟，\n\n05:56.803 --> 05:59.403\n长期吸入有害气体和粉尘，\n\n05:59.653 --> 06:02.253\n包括避免吸入二手烟。\n\n06:03.014 --> 06:05.864\n可以保持室内的空气清新。\n\n06:06.869 --> 06:07.394\n第二个呢，\n\n06:07.394 --> 06:08.519\n适当的规律运动，\n\n06:08.519 --> 06:11.570\n适当运动和增强心肺功能，\n\n06:11.869 --> 06:14.369\n有助于预防肺源性心脏病。\n\n06:15.760 --> 06:16.209\n此外呢，\n\n06:16.209 --> 06:17.609\n可以通过合理的饮食，\n\n06:17.760 --> 06:19.660\n保持健康饮食习惯，\n\n06:19.910 --> 06:21.709\n多吃蔬菜水果，\n\n06:22.010 --> 06:25.709\n减少高脂高盐高糖食品摄入。\n\n06:29.066 --> 06:31.415\n接下来我们看一下临床表现及诊断技术。\n\n06:31.665 --> 06:35.066\n我们看一下典型临床表现有哪些。\n\n06:35.920 --> 06:36.494\n包括什么呢？\n\n06:36.494 --> 06:37.519\n包括呼吸困难。\n\n06:37.720 --> 06:39.369\n患者常常感到气短，\n\n06:39.470 --> 06:41.970\n尤其在活动或平躺时更加明显。\n\n06:44.260 --> 06:44.686\n第二个呢，\n\n06:44.686 --> 06:45.510\n同时有咳嗽，\n\n06:45.510 --> 06:49.960\n咳痰分为白色粘液痰或者是黄色脓性痰，\n\n06:50.061 --> 06:51.760\n有时可能是带有血丝。\n\n06:53.294 --> 06:55.294\n有的病人还可能出现胸痛或者胸闷。\n\n06:56.736 --> 07:00.687\n由于心脏供血不足和肺部炎症所导致。\n\n07:01.858 --> 07:02.358\n最后呢，\n\n07:02.358 --> 07:03.507\n随着病情的发展，\n\n07:03.507 --> 07:04.808\n可能导致下肢水肿。\n\n07:05.540 --> 07:08.339\n当进入下肢和腹部严重的时候呢，\n\n07:08.540 --> 07:10.739\n可能导致全身的水肿。\n\n07:13.248 --> 07:15.098\n我们可以用哪些辅助检查？\n\n07:15.955 --> 07:16.156\n那么，\n\n07:16.156 --> 07:19.006\n这些辐射检查的意义是在哪里？\n\n07:19.910 --> 07:22.609\n第一个可以用心电图可发现呢，\n\n07:22.609 --> 07:24.059\n心电图可发现心律失常。\n\n07:24.992 --> 07:26.842\n经期缺血等异常表现。\n\n07:27.873 --> 07:28.324\n第二个呢，\n\n07:28.324 --> 07:29.723\n我们可以用超声心动图。\n\n07:30.273 --> 07:31.398\n超声心动图呢，\n\n07:31.398 --> 07:34.723\n能够评估心脏大小结构和功能，\n\n07:34.873 --> 07:37.824\n判断是否存在肺动脉高压等病变。\n\n07:38.494 --> 07:41.795\n我们还可以拍一个胸部的X线片，\n\n07:42.295 --> 07:45.695\n有助于观察肺部和心脏的形态变化，\n\n07:45.845 --> 07:48.894\n如肺动脉的扩张、心脏的增大等。\n\n07:49.609 --> 07:49.984\n最后，\n\n07:49.984 --> 07:55.509\n我们可以用实验室的血气分析和检测血液中的氧和二氧化碳的含量，\n\n07:55.609 --> 07:57.609\n来评估肺功能。\n\n08:00.261 --> 08:01.812\n鉴别诊断的策略分享。\n\n08:02.520 --> 08:04.770\n第一个可以与支气管哮喘鉴别。\n\n08:06.528 --> 08:07.428\n支气管哮喘呢，\n\n08:07.428 --> 08:08.878\n多见于年轻人。\n\n08:09.532 --> 08:11.381\n以发作性喘息为特点。\n\n08:12.113 --> 08:13.787\n而肺源性心脏病患者呢，\n\n08:13.787 --> 08:16.812\n多有长期慢性咳嗽、咳痰病史。\n\n08:18.201 --> 08:18.451\n第二个呢，\n\n08:18.451 --> 08:20.601\n我们可以与慢性阻塞性肺疾病鉴别。\n\n08:21.268 --> 08:25.368\n慢性阻塞性肺疾病主要的表现是持续性的气流受限。\n\n08:26.092 --> 08:27.691\n而我们的肺源性心脏病呢，\n\n08:27.691 --> 08:29.092\n就是以心脏病变。\n\n08:30.445 --> 08:31.445\n为主要表现。\n\n08:32.981 --> 08:33.307\n第四呢，\n\n08:33.307 --> 08:35.081\n最后我们可以冠心病来鉴别。\n\n08:35.331 --> 08:37.331\n冠心病患者的心电图表现呢，\n\n08:37.331 --> 08:38.281\n是心肌缺血。\n\n08:39.075 --> 08:40.976\n且胸痛多为与合同有关。\n\n08:41.226 --> 08:43.026\n而肺源性心脏病的胸痛。\n\n08:43.791 --> 08:45.791\n一般多数与呼吸。\n\n08:48.177 --> 08:50.127\n我们要重视早期发现的重要性。\n\n08:50.940 --> 08:52.940\n早期发现可以早期治疗，\n\n08:53.090 --> 08:54.739\n延缓病情的进展，\n\n08:54.890 --> 08:56.239\n提高生活质量。\n\n08:56.640 --> 08:57.640\n早期发现呢，\n\n08:57.640 --> 09:00.090\n还有助于减少并发症的发生，\n\n09:00.140 --> 09:02.840\n如心力衰竭、心律失常等。\n\n09:04.010 --> 09:04.635\n发现呢，\n\n09:04.635 --> 09:07.260\n还能够降低医疗成本，\n\n09:07.409 --> 09:09.309\n减轻患者的一个经济负担。\n\n09:11.921 --> 09:13.620\n我们接下来看一下治疗方案，\n\n09:14.020 --> 09:17.221\n以及如何对患者进行管理治疗。\n\n09:17.221 --> 09:20.020\n药物治疗的原则和选择，\n\n09:20.421 --> 09:22.820\n可以通过这些几大类的药，\n\n09:23.020 --> 09:24.171\n一、利尿剂。\n\n09:24.797 --> 09:26.047\n通过增加尿量，\n\n09:26.047 --> 09:27.398\n减少体液潴留，\n\n09:27.547 --> 09:29.898\n减轻肺和心脏的负担。\n\n09:30.247 --> 09:32.848\n需监测电解质的平衡。\n\n09:33.728 --> 09:34.078\n第二呢，\n\n09:34.078 --> 09:37.453\n可以用一点血管扩张剂扩张肺动脉，\n\n09:37.453 --> 09:38.877\n降低肺动脉压，\n\n09:38.877 --> 09:40.627\n减轻右心负荷。\n\n09:40.728 --> 09:43.328\n需注意血压变化和药物副作用。\n\n09:44.000 --> 09:44.474\n第三方面，\n\n09:44.474 --> 09:46.349\n我们可以用一些正性的激励药物。\n\n09:47.059 --> 09:49.309\n定性的肌力药物可以增强心肌的收缩率，\n\n09:49.309 --> 09:50.859\n提高心输出量。\n\n09:51.309 --> 09:55.710\n适用于心衰急性期或者是心脏负荷过重的时候。\n\n09:55.960 --> 09:56.434\n最后，\n\n09:56.434 --> 09:59.609\n我们可以靠一些使用一些抗炎的药物，\n\n09:59.760 --> 10:02.159\n防止血栓形成和肺动脉栓塞。\n\n10:02.159 --> 10:04.760\n根据患者病情和医生指导用药。\n\n10:08.049 --> 10:10.198\n养疗的策略有哪些？\n\n10:11.750 --> 10:14.849\n氧疗可提高氧血氧饱和度，\n\n10:15.099 --> 10:16.450\n改善心肺功能，\n\n10:16.799 --> 10:21.150\n可根据患者病情调整氧流量和吸氧时间。\n\n10:23.179 --> 10:24.778\n尤其关注一下夜间氧疗，\n\n10:24.979 --> 10:28.479\n夜间氧疗适用于夜间血氧饱和度下降的患者，\n\n10:28.528 --> 10:31.328\n可以改善睡眠质量和提高生活质量。\n\n10:32.023 --> 10:36.573\n那么氧疗设备的选择就包括氧气瓶啊、制氧机等，\n\n10:36.823 --> 10:39.874\n可以根据患者需求和经济条件的选择。\n\n10:41.443 --> 10:42.693\n同时也要注意一些事项。\n\n10:44.669 --> 10:45.218\n要避免呢，\n\n10:45.218 --> 10:46.119\n避免明火，\n\n10:46.218 --> 10:47.169\n防止爆炸。\n\n10:47.619 --> 10:49.119\n定期清洁设备，\n\n10:49.169 --> 10:50.919\n保证氧气纯净，\n\n10:51.518 --> 10:53.068\n监测血氧饱和度啊，\n\n10:53.119 --> 10:54.968\n调整氧流量。\n\n10:57.401 --> 10:57.552\n那么，\n\n10:57.552 --> 10:59.552\n如患者如何进行自我管理。\n\n11:00.276 --> 11:02.677\n第一个是我们要学会症状识别与处理，\n\n11:02.976 --> 11:04.177\n对于患者的识别，\n\n11:04.177 --> 11:06.927\n心衰加重的症状和呼吸困难、水肿。\n\n11:07.640 --> 11:09.840\n如果出现呼吸困难、水肿这些症状，\n\n11:09.840 --> 11:11.590\n应要及时采取措施。\n\n11:13.568 --> 11:14.994\n可以加强药物的一个管理，\n\n11:14.994 --> 11:16.693\n指导患者正确服用药物，\n\n11:16.693 --> 11:20.468\n了解药物名称、剂量、副作用及处理的一些方法。\n\n11:21.851 --> 11:23.351\n还可以通过饮食的一些调整，\n\n11:23.651 --> 11:25.651\n限制盐水的摄入，\n\n11:26.101 --> 11:27.250\n控制液体量，\n\n11:27.351 --> 11:29.551\n避免加重心脏负担负担，\n\n11:29.851 --> 11:32.000\n增加膳食纤维摄入，\n\n11:32.000 --> 11:33.551\n防止预防便秘。\n\n11:34.320 --> 11:36.419\n那么还有是生活方式的一些改变，\n\n11:36.669 --> 11:37.520\n戒烟啊，\n\n11:37.520 --> 11:38.369\n限酒啊，\n\n11:38.419 --> 11:39.619\n减轻体重啊，\n\n11:39.619 --> 11:42.719\n适当锻炼的可以改善心肺的功能，\n\n11:42.969 --> 11:45.719\n从而提高我们的生活质量。\n\n11:46.453 --> 11:46.953\n那么。\n\n11:47.760 --> 11:48.409\n此外呢，\n\n11:48.409 --> 11:52.309\n还可以有一些心理支持与心肺康复的一些计划。\n\n11:52.760 --> 11:54.534\n一个可以通过心理干预，\n\n11:54.534 --> 11:55.659\n提供心理咨询，\n\n11:55.809 --> 11:56.960\n支持性治疗，\n\n11:56.960 --> 11:59.409\n帮助患者的间接战胜疾病的信心。\n\n12:00.442 --> 12:02.742\n第二个可以通过心理评估。\n\n12:03.737 --> 12:05.338\n评估患者心理状态，\n\n12:05.538 --> 12:07.437\n及时处理并交。\n\n12:08.625 --> 12:10.676\n处理焦虑、抑郁等心理问题。\n\n12:12.650 --> 12:14.575\n根据患者病情和身体状况，\n\n12:14.575 --> 12:16.325\n制定个性化的康复计划，\n\n12:16.325 --> 12:18.174\n包括什么运动训练啊，\n\n12:18.174 --> 12:20.325\n生活自理能力的训练，\n\n12:20.325 --> 12:21.750\n促进患者全面康复。\n\n12:22.395 --> 12:26.895\n鼓励患者参加心肺病康复俱乐部患者互助会诊，\n\n12:26.995 --> 12:28.596\n增加与他人的交流，\n\n12:28.745 --> 12:30.096\n获得社会支持。\n\n12:33.396 --> 12:36.346\n并发症的处理预期一些处理的一些策略。\n\n12:37.031 --> 12:38.632\n那么常见的并发症呢？\n\n12:38.632 --> 12:42.981\n有呼吸衰竭、心力衰竭、肺部感染、肺性脑病。\n\n12:44.255 --> 12:46.181\n呼吸衰竭是因为肺功能的受损，\n\n12:46.181 --> 12:47.856\n导致氧气交换不足，\n\n12:48.156 --> 12:50.205\n引起身体各器官的缺氧。\n\n12:50.935 --> 12:51.835\n心力衰竭的，\n\n12:51.835 --> 12:54.085\n随着心脏负荷的持续加重，\n\n12:54.185 --> 12:55.185\n心肌受损，\n\n12:55.236 --> 12:57.236\n导致心脏功能的衰竭。\n\n12:58.030 --> 12:59.505\n肺源性心脏病的患者呢，\n\n12:59.505 --> 13:01.429\n免疫力是普遍降低的，\n\n13:01.429 --> 13:03.330\n容易引起肺部感染。\n\n13:04.213 --> 13:07.513\n由于呼吸衰竭导致二氧化碳潴留和缺氧。\n\n13:08.237 --> 13:11.588\n引起头痛、昏迷等神经性精神的症状。\n\n13:11.987 --> 13:12.888\n这个时候。\n\n13:13.564 --> 13:15.414\n又到了肺性脑病的阶段。\n\n13:17.776 --> 13:20.327\n那么我们也可以用一些预防性的用药，\n\n13:20.677 --> 13:21.726\n那么第一部分呢，\n\n13:21.726 --> 13:24.776\n我们会用一些支气管舒张剂用于什么扩张。\n\n13:25.690 --> 13:26.190\n支气管，\n\n13:26.239 --> 13:27.590\n改善呼吸功能。\n\n13:28.372 --> 13:29.771\n可以选择一些利尿剂，\n\n13:30.072 --> 13:31.721\n用于减轻心脏负担，\n\n13:32.221 --> 13:33.171\n消除水肿。\n\n13:33.820 --> 13:35.719\n还可以加一些抗凝的药物，\n\n13:35.719 --> 13:38.419\n用于预防肺栓塞等并发症的发生。\n\n13:39.507 --> 13:39.908\n最后呢，\n\n13:39.908 --> 13:41.908\n如果是有感染征象的时候，\n\n13:42.007 --> 13:45.408\n并通过化验室确认是有感染的情况的时候，\n\n13:45.408 --> 13:46.107\n我们要。\n\n13:46.703 --> 13:47.254\n利己。\n\n13:48.067 --> 13:49.867\n使用抗生素以控制感染。\n\n13:51.984 --> 13:53.934\n对于急性期的处理，\n\n13:54.335 --> 13:56.184\n一个是一定要及时的氧疗，\n\n13:56.184 --> 13:57.934\n给予患者充足的氧气，\n\n13:57.934 --> 13:59.234\n缓解缺氧症状。\n\n13:59.484 --> 14:00.159\n第二个呢，\n\n14:00.159 --> 14:00.585\n可以。\n\n14:01.364 --> 14:02.838\n用支气管镜去吸痰，\n\n14:02.838 --> 14:03.614\n帮助吸痰。\n\n14:03.763 --> 14:07.064\n对于痰道阻痰液阻塞的患者呀，\n\n14:07.114 --> 14:09.064\n可通过支气管镜吸痰，\n\n14:09.263 --> 14:10.664\n保持呼吸道畅通。\n\n14:11.348 --> 14:11.848\n第二个，\n\n14:11.848 --> 14:14.773\n根据药物药药物敏试验的结果，\n\n14:14.773 --> 14:16.747\n选择合适的抗生素进行治疗。\n\n14:17.297 --> 14:18.322\n最后呢，\n\n14:18.322 --> 14:20.598\n对于严重呼吸衰竭的患者，\n\n14:20.797 --> 14:22.098\n我们可以借助。\n\n14:22.835 --> 14:27.486\nEmo等这种机械设备来保持呼吸道的一些操作。\n\n14:32.797 --> 14:33.822\n在康复期的时候呢，\n\n14:33.822 --> 14:38.447\n我们可以做制定一下长期随访的一个管理计划。\n\n14:38.648 --> 14:39.922\n一定期检查，\n\n14:39.922 --> 14:42.922\n包括肺功能啊、心电图啊、心脏彩超等，\n\n14:42.922 --> 14:44.447\n以评估病情的进展。\n\n14:45.366 --> 14:46.791\n第二个药物的治疗呢，\n\n14:46.791 --> 14:48.440\n我们可以坚持长期用药，\n\n14:48.440 --> 14:50.015\n以控制病情进展。\n\n14:50.166 --> 14:52.015\n生活方式是要需要调整，\n\n14:52.265 --> 14:53.265\n戒烟限酒，\n\n14:53.515 --> 14:54.515\n适当锻炼。\n\n14:55.861 --> 14:57.586\n甚至于包括一些心理调适，\n\n14:57.586 --> 14:59.111\n以改善我们的生活质量。\n\n14:59.411 --> 15:01.661\n最后我们要坚持康复锻炼，\n\n15:01.661 --> 15:03.036\n进行肺康复锻炼，\n\n15:03.036 --> 15:04.211\n提高心肺功能，\n\n15:04.312 --> 15:05.262\n减轻症状。\n\n15:06.236 --> 15:06.786\n最后呢，\n\n15:06.786 --> 15:09.137\n康复锻炼的营养支持是怎么做的呢？\n\n15:09.137 --> 15:10.812\n有一个原则很重要，\n\n15:10.812 --> 15:13.086\n康复锻炼是可以增强心肺功能，\n\n15:13.187 --> 15:15.036\n提高身体代谢的水平，\n\n15:15.137 --> 15:16.887\n减轻呼吸困难和乏力症状，\n\n15:16.887 --> 15:17.786\n提高生活质量。\n\n15:17.986 --> 15:19.937\n原则就是要个性化。\n\n15:20.533 --> 15:22.833\n循序渐进和持之以恒。\n\n15:23.625 --> 15:26.599\n那么最后讲个体化康复锻炼的设计，\n\n15:26.599 --> 15:28.424\n一个是要评估患者心肺功能。\n\n15:29.195 --> 15:32.096\n第二个是选择适适当的锻炼方式。\n\n15:33.974 --> 15:35.974\n逐步的增加锻炼的强度。\n\n15:36.781 --> 15:39.632\n那么营养方面在康复中也占有重要的作用，\n\n15:39.632 --> 15:43.231\n包括营养的需求、营养的补充以及营养的调整。\n\n15:44.690 --> 15:44.989\n最后。\n\n15:47.041 --> 15:47.291\n要。\n\n15:48.028 --> 15:50.153\n让家属来共同参与，\n\n15:50.153 --> 15:51.778\n共同的促进康复。\n\n15:51.778 --> 15:53.127\n家属的角色呢，\n\n15:53.127 --> 15:55.228\n因为家属是患者康复的重要支持人力，\n\n15:55.228 --> 15:58.028\n参与的应给予患者心理和生活上的支持。\n\n15:58.789 --> 16:01.140\n这个时候对家属的也需要一些培训，\n\n16:01.140 --> 16:04.289\n对康复的一些知识跟用药管理的一些培训。\n\n16:05.888 --> 16:07.288\n包括家属的监督，\n\n16:07.588 --> 16:09.913\n确保患者按照康复计划的进行，\n\n16:09.913 --> 16:13.588\n并及时向医生反馈患者的康复情况。\n\n16:15.301 --> 16:15.450\n好，\n\n16:15.450 --> 16:16.450\n谢谢大家理解。\n\n","v0247cg10004d74uafaljht0a6et6o0g",981,580,"2026-03-03 00:09:56","2026-06-11 18:42:40",[32],{"menuId":33,"menuName":34,"parentId":17,"orderNum":35,"path":36,"component":37,"isFrame":38,"isCache":39,"menuType":40,"visible":24,"status":17,"createDept":6,"remark":15,"createTime":41,"children":42,"columnImage":43,"columnLogo":44,"uncheckedLogo":6,"checkedLogo":6,"isHot":17,"isHome":17,"forceLogin":17,"color":6,"seoTitle":45,"seoKeywords":46,"seoDescription":47,"contentNum":6,"promotionalPoster":48,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":49,"routerPath":36,"componentInfo":37},"1986622624134549505","科普视频",3,"video","/video.html","1","0","T","2025-11-07 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