WEBVTT00:00:07.920-->00:00:08.200呃00:00:08.200-->00:00:12.000今天今天跟大家一起来分享一下00:00:12.000-->00:00:16.020就是关于上呼吸道感染的一些知识00:00:18.800-->00:00:21.720那我们以我们从以下5个方面00:00:21.720-->00:00:22.740来开始讲00:00:22.920-->00:00:26.580第一个呢就是上呼吸道感染的概述00:00:27.000-->00:00:30.020第二个就是上呼吸道感染的症状00:00:30.480-->00:00:32.580第三个是治疗方法00:00:32.600-->00:00:34.560还有就是预防00:00:34.560-->00:00:34.800上00:00:34.800-->00:00:37.740怎么样来预防那个上呼吸道感染00:00:38.800-->00:00:41.660还有就是环境与卫生习惯00:00:50.640-->00:00:54.620呃上呼吸道感染的定义是00:00:54.960-->00:00:57.180是指啊在影响鼻腔00:00:57.200-->00:01:01.020咽部或者是喉部的病毒或细菌感染00:01:02.480-->00:01:04.160常见呢包括有00:01:04.160-->00:01:05.320常见的症状呢00:01:05.320-->00:01:08.380有包括是咳嗽和嗓子痛00:01:09.240-->00:01:11.000病原体的话呃00:01:11.000-->00:01:13.800有就是包括种细菌性病原体00:01:13.800-->00:01:15.580还有病毒性病原体00:01:17.400-->00:01:18.120细菌的话00:01:18.120-->00:01:20.920如链球菌和葡萄球菌00:01:20.920-->00:01:24.380可以引起咽炎和扁桃体炎00:01:24.840-->00:01:27.640抗生抗生素治疗对于细菌00:01:27.640-->00:01:31.140细菌性上呼吸道感染是有效的00:01:32.040-->00:01:34.240呃病毒性病原体的话00:01:34.240-->00:01:37.880常见的是包括流感病毒00:01:37.880-->00:01:40.260呃冠状病毒和腺病毒00:01:40.720-->00:01:44.140它们是引起感冒和流感的主要病因00:01:53.560-->00:01:54.720啊这里有一张图00:01:54.720-->00:01:56.880上面分别是5个症状00:01:56.880-->00:01:58.240就是sorethroat00:01:58.240-->00:01:59.120咽嗓子痛00:01:59.120-->00:02:00.340cough咳嗽00:02:00.440-->00:02:01.760还有runnynose00:02:01.760-->00:02:03.040就是流鼻涕00:02:03.040-->00:02:04.720还有feverheadache00:02:04.720-->00:02:06.620呃发烧呕吐等00:02:07.560-->00:02:10.200它有一个自限性的一个特征00:02:10.200-->00:02:11.600就是上呼吸道感染00:02:11.600-->00:02:13.700通常是具有自限性的00:02:13.760-->00:02:15.320什么是自限性呢00:02:15.320-->00:02:18.920就是一般疾病发病到转归到康复00:02:18.920-->00:02:20.680它都有一个自然的过程00:02:20.680-->00:02:22.980不需要治疗也也会好00:02:23.480-->00:02:26.160呃多数患者在一周左右00:02:26.160-->00:02:27.360无需特殊治疗呢00:02:27.360-->00:02:30.420他是几就可以自行康复的00:02:31.200-->00:02:33.040呃常见的并发症啊00:02:33.040-->00:02:35.860它主要是包括中耳炎00:02:36.200-->00:02:37.100鼻窦炎00:02:37.240-->00:02:41.140严重时呢可发展为肺炎或心肌炎00:02:41.240-->00:02:41.920那这个呢00:02:41.920-->00:02:43.980是需要及时就诊的00:02:48.720-->00:02:50.080接下来我们来谈一谈00:02:50.080-->00:02:53.540那个上呼吸道感染的症状00:03:00.960-->00:03:01.440呃00:03:01.440-->00:03:02.400鼻部症状呢00:03:02.400-->00:03:05.680它主要表现为呃鼻塞啊00:03:05.680-->00:03:06.560上呼吸道感染00:03:06.560-->00:03:09.380会导致鼻腔粘膜的充血00:03:09.520-->00:03:10.740引起鼻塞00:03:10.800-->00:03:12.960呃有严重的呢00:03:12.960-->00:03:15.580它会影响就是正常的呼吸00:03:15.680-->00:03:17.160也会影响到休息00:03:17.160-->00:03:18.980这样晚上睡眠不好00:03:19.240-->00:03:20.360觉得鼻子堵住了00:03:20.360-->00:03:21.700没办法好好补鼻00:03:21.960-->00:03:23.680那张口呼吸睡觉呢00:03:23.680-->00:03:25.300又会觉得口干舌燥00:03:25.360-->00:03:28.260就会影响到一个人的正常的休息00:03:28.760-->00:03:30.420呃流鼻涕啊00:03:31.080-->00:03:32.820也是一个常见的症状00:03:33.240-->00:03:34.400感染病毒后呢00:03:34.400-->00:03:36.500鼻腔分泌物它会增多00:03:36.640-->00:03:36.880呃00:03:36.880-->00:03:40.260表现为清水样或者是呕性的鼻涕00:03:40.360-->00:03:42.320这确实是呃鼻子00:03:42.320-->00:03:44.000虽然不是特别难受00:03:44.000-->00:03:45.340确实是比较麻烦00:03:46.120-->00:03:47.340还有就是打喷嚏00:03:47.360-->00:03:49.440那鼻部受到刺激时呢00:03:49.440-->00:03:50.880人体通过打喷嚏00:03:50.880-->00:03:54.440来清除鼻腔内的病原体和异物啊00:03:54.440-->00:03:58.100这其实是一个防御的一个呃反射00:03:58.120-->00:03:58.480但是00:03:58.480-->00:04:01.580确实也会影响到平常的正常生活00:04:02.360-->00:04:04.380还有一个就是嗅觉的减退00:04:04.680-->00:04:05.960那上呼吸道感染呢00:04:05.960-->00:04:08.340可以引起鼻粘膜的肿胀00:04:08.560-->00:04:10.360导致嗅觉功能的00:04:10.360-->00:04:12.580暂时性的减退和丧失00:04:15.920-->00:04:19.380接下来就是呃咽部的症状00:04:19.800-->00:04:20.200咽部呢00:04:20.200-->00:04:22.340就是主要是咽部的疼痛00:04:22.720-->00:04:26.860患者常感到咽部啊咽咽喉有异物感00:04:27.120-->00:04:27.760吞咽时呢00:04:27.760-->00:04:29.400疼痛加剧啊00:04:29.400-->00:04:31.520这就是这是上呼吸道感染00:04:31.520-->00:04:33.580常见的咽部症状之一00:04:34.600-->00:04:35.980声音也会嘶哑00:04:36.280-->00:04:38.160由于咽部的炎症00:04:38.160-->00:04:40.180声带啊也会受到影响00:04:41.000-->00:04:43.400患者可能会出现声音嘶哑00:04:43.400-->00:04:45.340或者是失声的情况00:04:48.320-->00:04:49.560嗯这就让我想到了00:04:49.560-->00:04:53.440之前就是周深的英国的一个演唱会00:04:53.440-->00:04:55.600他因为就是上呼吸道感染00:04:55.600-->00:04:57.180导致的声带发炎00:04:57.760-->00:04:59.320所以不得不暂停了00:04:59.320-->00:05:02.180那次在英国的演唱会的演出00:05:02.400-->00:05:04.040确实这很可惜啊00:05:04.040-->00:05:05.280但是没办00:05:05.280-->00:05:09.280法这一个就是歌手的声带00:05:09.280-->00:05:11.640其实是非常宝贵的00:05:11.640-->00:05:13.680也要一定要好好保护他的声带00:05:13.680-->00:05:14.580所以他00:05:16.000-->00:05:20.460牺牲了那一次的呃表演演出00:05:20.520-->00:05:22.720所以对歌手来说00:05:22.720-->00:05:25.560对歌手来说是保护性的一个措施00:05:25.560-->00:05:28.220对观众来说确实有点可惜00:05:28.920-->00:05:29.800嗯再还有一个00:05:29.800-->00:05:32.600就是它的一个吞咽的困难啊00:05:32.600-->00:05:33.800咽部炎症呢00:05:33.800-->00:05:35.820会导致咽部的肿胀00:05:35.920-->00:05:36.160呃00:05:36.160-->00:05:39.980可能会引起吞咽时的不适和困难00:05:45.040-->00:05:48.140接下来就是全身症状和咳嗽00:05:48.520-->00:05:49.240全身症状呢00:05:49.240-->00:05:52.060比较多见的就是发热与寒战了00:05:52.240-->00:05:53.600上呼吸道感染呢00:05:53.600-->00:05:55.340常会引起发热00:05:55.480-->00:05:58.760患者可能会感到感觉到寒战啊00:05:58.760-->00:06:00.060体温呢升高00:06:00.120-->00:06:03.300是身体对抗病毒的一个自然反应00:06:04.320-->00:06:05.680全身乏力啊00:06:05.680-->00:06:06.800病毒感染后啊00:06:06.800-->00:06:09.580患者会感到明显的全身乏力00:06:09.760-->00:06:12.920这是因为免疫系统在与病毒作战时00:06:12.920-->00:06:14.700消耗了大量的能量00:06:16.360-->00:06:17.160咳嗽00:06:17.800-->00:06:20.040上呼吸道感染引起的咳嗽00:06:20.040-->00:06:24.160可能是干咳或者是伴有痰液的咳嗽00:06:24.160-->00:06:27.200有助于清除呼吸道中的病原体00:06:27.200-->00:06:28.220和分泌物00:06:32.920-->00:06:34.000嗯第3个呢00:06:34.000-->00:06:36.500我们来讲一下治疗的方法00:06:49.040-->00:06:49.760啊00:06:49.760-->00:06:52.420首先我们来讲一下就是物理治疗00:06:52.520-->00:06:54.400呃就是呃00:06:54.400-->00:06:57.160像这种蒸汽吸入啊00:06:57.160-->00:06:58.880通过吸入蒸汽啊00:06:58.880-->00:06:59.720可以缓解00:06:59.720-->00:07:03.400上呼吸道感染引起的鼻塞和喉咙痛00:07:03.400-->00:07:03.640啊00:07:03.640-->00:07:07.180有助于呢就是缓解局部的一个症状00:07:07.640-->00:07:09.840有很多病人就会觉得呃00:07:09.840-->00:07:11.080得了感冒以后啊00:07:11.080-->00:07:12.560晚上啊嗓子痒00:07:12.560-->00:07:14.060然后嗯00:07:14.640-->00:07:15.740容易咳嗽00:07:16.000-->00:07:17.640一晚上不好好休息00:07:17.640-->00:07:20.640那使用这个蒸汽吸入呢00:07:20.640-->00:07:22.640就可以湿滑气道啊00:07:22.640-->00:07:26.760局部的就是呃组织的这个红肿呃00:07:26.760-->00:07:29.020干痒呢就会有所缓解00:07:31.160-->00:07:33.000还有就是热敷啊00:07:33.000-->00:07:34.680在喉咙和胸部啊00:07:34.680-->00:07:38.300使用热敷带可以缓解肌肉的疼痛00:07:38.400-->00:07:40.200促进血液循环啊00:07:40.200-->00:07:42.340以减轻感染的症状00:07:43.120-->00:07:44.560这个倒没试过的00:07:44.560-->00:07:46.760可以到时候万一自己感冒了00:07:46.760-->00:07:48.100可以尝试一下00:07:48.200-->00:07:50.100确实是第一次听说00:07:50.880-->00:07:53.600嗯还有就是盐水的一个00:07:53.600-->00:07:54.840漱口啊00:07:54.840-->00:07:56.200使用盐水漱口啊00:07:56.200-->00:07:57.780可以清洁口腔00:07:57.880-->00:08:00.380减少咽部部位的细菌00:08:00.400-->00:08:03.700有助于啊缓解喉咙痛和不适00:08:04.440-->00:08:05.480就是漱口00:08:05.480-->00:08:06.600这个去缓解00:08:06.600-->00:08:08.760就是咽部的一个炎症的话00:08:08.760-->00:08:10.280其实非常有必要的00:08:10.280-->00:08:12.620尤其是对于一些扁00:08:12.640-->00:08:14.780容易扁桃体发炎的一些00:08:14.880-->00:08:16.540呃一些病人00:08:17.160-->00:08:18.860因为口腔的定制菌00:08:18.960-->00:08:21.260他会在你感冒了以后00:08:21.400-->00:08:25.040局部的免疫力下降以后疯狂的生长00:08:25.040-->00:08:27.780然后导致的二次感染的一个表现00:08:28.240-->00:08:31.580所以漱口这一个确实是非常有必要00:08:35.600-->00:08:37.200药物治疗的选择的话00:08:37.200-->00:08:39.800就是如果是细菌感染的话00:08:39.800-->00:08:41.600我们对于细菌感染的烧00:08:41.600-->00:08:42.560呼吸道感染呢00:08:42.560-->00:08:45.220医生可以开具一些抗生素00:08:45.800-->00:08:46.840说阿莫西林00:08:46.840-->00:08:50.340或者是一代或者是两代的头孢类00:08:50.440-->00:08:53.240嗯那如果小孩子的话还可以00:08:53.240-->00:08:55.200如果相关药物过敏的话00:08:55.200-->00:08:58.020还可以用一些阿奇霉素这样子00:08:58.760-->00:09:01.200嗯还有就是病毒感染的话00:09:01.200-->00:09:02.160病毒感染的话00:09:02.160-->00:09:04.400其实我们很多病毒00:09:04.400-->00:09:06.740其实都没有很好的特效药00:09:07.440-->00:09:10.120目前为止我们常见的流感00:09:10.120-->00:09:11.120还有新冠的00:09:11.120-->00:09:12.680它是确实是有新00:09:12.680-->00:09:14.140就是有特效药的00:09:14.680-->00:09:15.440呃那它呢00:09:15.440-->00:09:16.760可以呃00:09:16.760-->00:09:21.000就是缩短那个发病的一个病程00:09:21.000-->00:09:21.600并且呢00:09:21.600-->00:09:25.360减少一些重症患者的一个病死率00:09:25.360-->00:09:27.860呃减少一个并发症的发生00:09:28.640-->00:09:32.000所以像这种病毒感染发烧的病人呢00:09:32.000-->00:09:35.320就是最好还是早期尽早的测一下00:09:35.320-->00:09:37.220相关的就是检测00:09:38.000-->00:09:40.500像新冠抗原或者是流感抗原00:09:41.240-->00:09:41.920这些检测呢00:09:41.920-->00:09:43.180现在也很方便00:09:43.680-->00:09:47.000外卖叫一下就很快小哥就送到家了00:09:47.000-->00:09:47.920帮前测一测00:09:47.920-->00:09:49.180如果阳性的话00:09:49.240-->00:09:52.580就赶紧用上相关的一个抗病毒药物00:09:52.720-->00:09:54.200如果都是阴性的话00:09:54.200-->00:09:55.360可以反复检测00:09:55.360-->00:09:58.380因为毕竟一次也不一定测得出来00:09:58.880-->00:10:01.540嗯那反复检测都是阴性的00:10:01.840-->00:10:03.480可能是其他病毒的话00:10:03.480-->00:10:05.580那其实也没有什么特别好的00:10:05.720-->00:10:06.960呃抗病毒药物00:10:06.960-->00:10:08.400那我们就是相对的00:10:08.400-->00:10:09.700就是对症处理00:10:10.640-->00:10:13.480呃如果出现了一些就是咳嗽啊00:10:13.480-->00:10:15.840咳痰咳黄痰的情况呢00:10:15.840-->00:10:17.660呃还是呃00:10:17.680-->00:10:19.680加上就是抗生素00:10:19.680-->00:10:22.520毕竟来和病毒和细菌00:10:22.520-->00:10:24.780常常他们是相伴而行的00:10:25.000-->00:10:25.440呃00:10:25.440-->00:10:28.020单纯的病毒感染确实还是比较少00:10:29.080-->00:10:31.000呃解热镇痛药呢00:10:31.000-->00:10:32.440就是这些药物呢00:10:32.440-->00:10:34.000就是可以缓解患者的00:10:34.000-->00:10:37.020当时的一些不适的症状00:10:37.160-->00:10:39.000包括全身酸痛啊00:10:39.000-->00:10:40.640高热啊呃00:10:40.640-->00:10:42.740可以让病人觉得舒适00:10:42.800-->00:10:44.680但是接着镇痛疗的话00:10:44.680-->00:10:47.480一般我们不提倡在一些低温00:10:47.480-->00:10:49.840或者体温不是很高的情情况下00:10:49.840-->00:10:50.640来使用00:10:50.920-->00:10:53.700因为发热它可以去化就是白细胞00:10:53.840-->00:10:56.620呃来听出病毒吧00:10:56.800-->00:10:59.960所以如果不是体温特别高啊00:10:59.960-->00:11:01.320或者是体温高一点的00:11:01.320-->00:11:03.400也没有明显的不适的情况下00:11:03.400-->00:11:06.680我们是不主张就是呃00:11:06.680-->00:11:08.300使用解热镇痛药00:11:09.000-->00:11:11.600呃还有就是这种解热镇痛药的话00:11:11.600-->00:11:14.500一定要注意尽量不要不食用00:11:14.520-->00:11:15.880因为这些药物对胃00:11:15.880-->00:11:17.740胃黏膜的刺激还是很大00:11:18.240-->00:11:20.640还有就是不要大量的服用00:11:20.640-->00:11:23.080尤其是像对乙酰氨基酚这样的药物00:11:23.080-->00:11:24.240它的呃00:11:24.240-->00:11:26.300肝毒性其实是很强的00:11:26.560-->00:11:28.220经常会碰到有的病人00:11:29.200-->00:11:30.480对乙酰氨基酚以后00:11:30.480-->00:11:31.920肝功能不好啊00:11:31.920-->00:11:34.540出现肝功能不好的情况来看病的00:11:36.040-->00:11:38.480还有就是局部的一个喷雾剂啊00:11:38.480-->00:11:42.320这个呢就是呃吸入性的这种激素啊00:11:42.320-->00:11:44.400喷到鼻子里可以缓解局部的00:11:44.400-->00:11:46.700一个鼻黏膜的一个充血00:11:46.760-->00:11:47.800可以缓解鼻塞00:11:47.800-->00:11:49.360改善呼吸这样子00:11:49.360-->00:11:51.160还有就是鼻塞的一个00:11:51.160-->00:11:52.620另外一个呢就是00:11:55.440-->00:11:55.640还有00:11:55.640-->00:11:56.040还有一种00:11:56.040-->00:11:58.520反正滴的药就是效果还蛮好的00:11:58.520-->00:12:00.140Bisaf会马上缓解00:12:05.040-->00:12:05.240嗯00:12:05.240-->00:12:06.440还有一些中药治疗00:12:06.440-->00:12:07.640确实不得不说00:12:07.640-->00:12:09.120有些中药的效果00:12:09.120-->00:12:12.680呃也是临床上证实是有有效的00:12:12.680-->00:12:14.260而且效果也不错00:12:14.360-->00:12:15.400像嗓子痛的话00:12:15.400-->00:12:17.560我们一般服用像蓝芩口服液00:12:17.560-->00:12:19.260这样子的呃00:12:19.320-->00:12:20.960确实是喝了以后睡一觉00:12:20.960-->00:12:23.220第二天醒来有明显的改善00:12:23.920-->00:12:24.360对吧00:12:24.360-->00:12:25.880那它它主要中药的话00:12:25.880-->00:12:26.800主要是针用00:12:26.800-->00:12:28.880一个辨证失治的一个方法00:12:28.880-->00:12:30.440它会根据患者的体质00:12:30.440-->00:12:34.300病情去选用适合的中药方剂00:12:34.320-->00:12:38.900呃风热感冒的用跟鞘散00:12:39.040-->00:12:41.740呃风寒感冒的用桂枝汤00:12:42.480-->00:12:43.840中中成药的应用呢00:12:43.840-->00:12:46.480选用中成药的板蓝根颗粒啊00:12:46.480-->00:12:47.980感冒侵入颗粒等00:12:48.280-->00:12:50.500方便快捷且副作用小00:12:50.760-->00:12:53.740适合就是轻中度的上呼吸道感染00:12:55.160-->00:12:57.120还有中药的汤剂啊00:12:57.120-->00:12:57.960虽然难喝00:12:57.960-->00:13:00.360但是还是有点效果的00:13:00.360-->00:13:02.600还有外外外治的00:13:02.600-->00:13:04.580去腐外治去腐度00:13:04.800-->00:13:08.080结合外法卤中药熏00:13:08.080-->00:13:09.680熏蒸服帖等00:13:09.680-->00:13:11.800增强局部的治疗效果00:13:11.800-->00:13:12.860缓解症状00:13:15.760-->00:13:16.120呃00:13:16.120-->00:13:17.960预防上呼吸道感染00:13:17.960-->00:13:20.780呃一主要是保持一个良好的习惯00:13:20.800-->00:13:22.900我们要勤洗手00:13:22.960-->00:13:26.040还有就是正确的咳嗽礼仪00:13:26.040-->00:13:27.600这个确实是很重要00:13:27.600-->00:13:30.960因为如果在公共场合打喷嚏00:13:30.960-->00:13:32.500或者是咳嗽00:13:32.600-->00:13:36.700没有任何的一个就是防护的话00:13:36.840-->00:13:39.620很容易把自己的病毒传给别人00:13:39.760-->00:13:42.380还有就是一个定期的清洁和消毒00:13:44.600-->00:13:46.840啊避免接触感染源啊00:13:46.840-->00:13:48.280勤洗手保持手卫生00:13:48.280-->00:13:49.760这个是毋庸置疑的00:13:49.760-->00:13:51.160然后就去公共场合00:13:51.160-->00:13:52.520尤其是流感季节00:13:52.520-->00:13:53.560病毒高发季节00:13:53.560-->00:13:55.180我们要佩戴一个口罩00:13:57.720-->00:13:58.240口罩呢00:13:58.240-->00:14:00.200可以阻挡就是飞沫传播00:14:00.200-->00:14:02.780防降低感染上呼吸道疾病的风险00:14:02.880-->00:14:05.780还有就是避免人群密集的场所00:14:06.240-->00:14:07.160第三个就是00:14:07.160-->00:14:09.120接下来就是要增强抵抗力00:14:09.120-->00:14:11.360就是要加强营养呃00:14:11.360-->00:14:12.940均衡的一个饮食00:14:13.280-->00:14:14.820还有就是规律的运动00:14:14.920-->00:14:15.880比如说快走00:14:15.880-->00:14:18.380游泳瑜伽来增强体质00:14:18.440-->00:14:20.960还有就是一个充足的睡眠00:14:20.960-->00:14:22.440休息是非常重要的00:14:22.440-->00:14:25.420有助于免疫系统的一个恢复和强化00:14:25.600-->00:14:27.060减少感染风险00:14:27.920-->00:14:28.880那第五个呢00:14:28.880-->00:14:31.560就是环境与生活的习惯00:14:31.560-->00:14:35.400保持室内环境的一个适宜00:14:35.400-->00:14:37.020我们要定期通风00:14:37.120-->00:14:38.520控制室内的湿度00:14:38.520-->00:14:40.980然后就是清洁卫生00:14:43.960-->00:14:46.380还有就是对于环境的影响00:14:46.640-->00:14:48.220室内空气的流通啊00:14:48.240-->00:14:50.300呃避免接触污染物啊00:14:50.480-->00:14:53.760还有就是湿度的一个控制啊00:14:53.760-->00:14:55.360均衡饮食与适量运动00:14:55.360-->00:14:57.200这个其实是老生常谈了00:14:57.200-->00:14:58.460前面也提到过00:14:58.840-->00:14:59.840维生素c呢00:14:59.840-->00:15:02.320就是可以预防增强免疫力00:15:02.320-->00:15:03.440增强免疫力00:15:03.440-->00:15:04.840预防上呼吸道感染00:15:04.840-->00:15:05.920比如说我们橙子啊00:15:05.920-->00:15:10.040草莓等还有就是适量的体育活动00:15:10.040-->00:15:12.880呃定期的一个呃快呃00:15:12.880-->00:15:13.360锻炼呢00:15:13.360-->00:15:16.240可以增强的增强我们的身体素质00:15:16.240-->00:15:18.260减少少吸道感染风险00:15:18.880-->00:15:20.880还有就是呃00:15:20.880-->00:15:22.360避免的过度劳累啊00:15:22.360-->00:15:24.600这个确实是很重要00:15:24.600-->00:15:26.240休息不好的话又劳累00:15:26.240-->00:15:27.600那这期的免疫力00:15:27.600-->00:15:29.500适量会必然会下降的00:15:29.560-->00:15:32.100这就会增加就是感染的机会00:15:33.200-->00:15:33.480好00:15:33.480-->00:15:34.700今天就讲这些00:15:34.720-->00:15:35.580谢谢大家