WEBVTT00:00:02.280 --> 00:00:03.240大家晚上好00:00:03.240 --> 00:00:04.480我是来自上海00:00:04.480 --> 00:00:06.200复旦大学附属金山医院00:00:06.200 --> 00:00:07.580呼吸内科的陆医生00:00:07.680 --> 00:00:08.720那么今天晚上00:00:08.720 --> 00:00:10.740由我跟大家分享一个内容00:00:10.800 --> 00:00:12.520这个内容的名字就叫做00:00:12.520 --> 00:00:13.780上呼吸道感染00:00:14.120 --> 00:00:15.720我们知道在春秋季节00:00:15.720 --> 00:00:17.740特别是一个呃00:00:18.440 --> 00:00:20.560天气变换转冷的时候00:00:20.560 --> 00:00:22.720那么上呼吸道疾病就比较多00:00:22.720 --> 00:00:24.960很多人会出现说咳嗽00:00:24.960 --> 00:00:26.600咽痛流涕等等00:00:26.600 --> 00:00:27.820甚至一些发热00:00:27.840 --> 00:00:28.680那么这个时候00:00:28.680 --> 00:00:30.980大家可能是会比较焦虑00:00:31.040 --> 00:00:33.380那么这是不是一个上呼吸道感染的00:00:33.480 --> 00:00:34.400那么也有可能是00:00:34.400 --> 00:00:35.200也可能不是00:00:35.200 --> 00:00:35.880那么接下来00:00:35.880 --> 00:00:39.000我就针对上呼吸道感染这个内容00:00:39.000 --> 00:00:41.300对大家进行一个宣教00:00:46.760 --> 00:00:48.440那么主要呢从这几个方面00:00:48.440 --> 00:00:50.660一个是上呼吸道感染的定义00:00:50.960 --> 00:00:53.140再一个是上呼吸道感染症状00:00:53.240 --> 00:00:54.780上呼吸道感染的原因00:00:54.920 --> 00:00:56.540上呼吸道感染的治疗方法00:00:56.560 --> 00:00:58.720以及上呼吸道感染的预防00:00:58.720 --> 00:00:59.080同时00:00:59.080 --> 00:01:01.700这五个方面进行一个内容的讲解00:01:02.440 --> 00:01:04.720那么首先是什么是上呼吸道感染00:01:04.720 --> 00:01:06.840第一他是不是说有咽痛咳嗽00:01:06.840 --> 00:01:09.660有发热这就是个上呼吸道感染的00:01:10.080 --> 00:01:10.760那么首先00:01:10.760 --> 00:01:12.960我们从他的一个解剖结构来说00:01:12.960 --> 00:01:16.620那么上呼吸道感染包括他一个鼻腔00:01:16.760 --> 00:01:18.380咽部和喉部00:01:18.480 --> 00:01:20.660那么是空气进入一个肺部00:01:20.800 --> 00:01:22.080呃前的一个通道00:01:22.080 --> 00:01:23.040他到一个声门00:01:23.040 --> 00:01:24.240这个地方为截止00:01:24.240 --> 00:01:26.060分为上呼吸道和下呼吸道00:01:26.400 --> 00:01:27.600那么上呼吸道的病原体呢00:01:27.600 --> 00:01:28.620其实有很多00:01:28.680 --> 00:01:29.240那么很多00:01:29.240 --> 00:01:31.820大多时候往往是一个病毒感染引起00:01:31.880 --> 00:01:34.200那么像一些目前可能是甲乙瘤00:01:34.200 --> 00:01:36.160新冠包括以前一些00:01:36.160 --> 00:01:37.860像一些禽流感等等00:01:38.080 --> 00:01:39.920那么也有可能像一些细菌感染00:01:39.920 --> 00:01:41.540它也会引起一个上呼吸道感00:01:41.640 --> 00:01:42.480甚至有一部分病人00:01:42.480 --> 00:01:43.000他可能是00:01:43.000 --> 00:01:44.700先有一个病毒感染00:01:44.760 --> 00:01:46.200然后会激发一个细菌感染00:01:46.200 --> 00:01:47.740呈现一个混合性的感染00:01:48.160 --> 00:01:51.320那么所以说这病毒细菌00:01:51.320 --> 00:01:53.040或者两者同时感染00:01:53.040 --> 00:01:54.900都是可能存在的00:01:56.160 --> 00:01:57.600那么从它的部位来说00:01:57.600 --> 00:02:00.300首先是一个鼻腔和鼻窦部00:02:00.560 --> 00:02:02.120那么我们鼻腔和鼻窦部呢00:02:02.120 --> 00:02:04.420是上呼吸道感染最常见的一个部位00:02:04.560 --> 00:02:06.160那么如感冒是常见的鼻塞00:02:06.160 --> 00:02:08.080流鼻涕等等00:02:08.080 --> 00:02:09.960那么就是他主要是部位00:02:09.960 --> 00:02:11.900是在一个鼻腔和鼻窦00:02:12.080 --> 00:02:13.720那么有的病人呢00:02:13.720 --> 00:02:14.640他属感染以后00:02:14.640 --> 00:02:16.300他会数住一个咽痛00:02:16.360 --> 00:02:17.000咽部有痰00:02:17.000 --> 00:02:17.800咽痒难受00:02:17.800 --> 00:02:20.280咳嗽那么这个时候他的感染部位00:02:20.280 --> 00:02:21.080可能会导致00:02:21.080 --> 00:02:22.760就是在一个颌部00:02:22.760 --> 00:02:25.060那么他会导致一个喉咙痛00:02:25.120 --> 00:02:27.800那么特别是有些碰见困难00:02:27.800 --> 00:02:29.960那像以前我们甲瘤乙瘤新冠感染后00:02:29.960 --> 00:02:31.920他一个刀片少00:02:31.920 --> 00:02:32.960那么就是他说明00:02:32.960 --> 00:02:34.560他这个部位是在一个感和00:02:34.560 --> 00:02:35.660在咽喉部位00:02:35.720 --> 00:02:37.280那么常见于一个咽喉炎00:02:37.280 --> 00:02:39.300或急性扁桃体发炎00:02:39.560 --> 00:02:40.720那么再一个就是声带00:02:40.720 --> 00:02:42.720那么因为我们好多病人感染以后00:02:42.720 --> 00:02:45.660他会说我近期出现一个声音嘶哑00:02:45.800 --> 00:02:47.320对吧声音发不出来00:02:47.320 --> 00:02:48.080那么这个时候00:02:48.080 --> 00:02:49.320可能就是一个声带感染00:02:49.320 --> 00:02:50.940引起来一些的症状00:02:50.960 --> 00:02:51.840那么甚至有一些00:02:51.840 --> 00:02:54.200可能会有一些急性喉炎的时候00:02:54.200 --> 00:02:56.240他会声带充血水肿00:02:56.240 --> 00:02:57.840甚至会影响一个呼吸00:02:57.840 --> 00:02:59.140导致呼吸困难00:02:59.320 --> 00:03:00.780那么再一个的话是气道00:03:00.800 --> 00:03:01.960那么气管感染的时候00:03:01.960 --> 00:03:03.240患者会经历咳嗽00:03:03.240 --> 00:03:05.320咳痰甚至一个呼吸困难00:03:05.320 --> 00:03:07.040那么像一些急性支气管炎等等00:03:07.040 --> 00:03:07.960他会有发热00:03:07.960 --> 00:03:10.540有黄脓痰等这些症状00:03:15.720 --> 00:03:16.440那么第二部分内容00:03:16.440 --> 00:03:17.880就是上呼吸道感染症状00:03:17.880 --> 00:03:20.680那么我正常人00:03:20.680 --> 00:03:22.160在一个呼上呼吸道感染以后00:03:22.160 --> 00:03:23.160他会表现会怎么00:03:23.160 --> 00:03:24.380样的一个情况呢00:03:25.280 --> 00:03:25.960那么首先00:03:25.960 --> 00:03:27.820这我们最常见的是一个咽痛00:03:27.880 --> 00:03:29.560那么前面也讲到了00:03:29.560 --> 00:03:31.560他感染部位在咽喉部的时候00:03:31.560 --> 00:03:33.820他会出现一个喉咙的肿痛00:03:33.920 --> 00:03:35.100吞咽的困难00:03:35.520 --> 00:03:37.240甚至出现刀片上的情况00:03:37.240 --> 00:03:38.160那么再一个00:03:38.160 --> 00:03:39.920如果是这个病毒刚刚也讲过了00:03:39.920 --> 00:03:42.280如果是正好感染在一个鼻腔00:03:42.280 --> 00:03:43.120或鼻的部分00:03:43.120 --> 00:03:45.460那它会出现一个鼻塞00:03:45.480 --> 00:03:48.800流鼻涕那有的时候初始的时候00:03:48.800 --> 00:03:50.040它可能是个病毒性感染00:03:50.040 --> 00:03:52.340它可能会出现流清水样的鼻涕00:03:52.400 --> 00:03:53.320那么随着激发00:03:53.320 --> 00:03:54.440可能细菌感染以后00:03:54.440 --> 00:03:56.600它会出现一些严重的鼻塞00:03:56.600 --> 00:03:57.760脓鼻涕啊00:03:57.760 --> 00:04:01.140鼻涕蔫不容易醒出等等一些症状00:04:01.360 --> 00:04:02.800那么再一个的话是咳嗽啊00:04:02.800 --> 00:04:04.200那上呼吸道感染00:04:04.200 --> 00:04:06.460最常见的一个症状就是咳嗽00:04:06.480 --> 00:04:08.440那么它可以表现为干咳00:04:08.440 --> 00:04:10.200或者是伴一个痰液00:04:10.200 --> 00:04:12.980那么这是一个机体的肠炎的防御期00:04:13.040 --> 00:04:14.120甚至严重时候00:04:14.120 --> 00:04:15.800它可能会出现一些气喘00:04:15.800 --> 00:04:17.840或者像一个哮喘一样的发作等等00:04:17.840 --> 00:04:19.980它都可以表现出来00:04:22.000 --> 00:04:23.520那么从患者来说00:04:23.520 --> 00:04:25.120每个病人患者感染以后00:04:25.120 --> 00:04:27.100他的症状有轻也有会重00:04:27.160 --> 00:04:28.240那么从症状来说00:04:28.240 --> 00:04:29.840我们轻度的感染的话00:04:29.840 --> 00:04:31.880他可能可能仅表现为00:04:31.880 --> 00:04:33.240一个轻微的咳嗽00:04:33.240 --> 00:04:34.880和鼻塞那甚至有的人00:04:34.880 --> 00:04:37.660可能就觉得一些稍微喉咙点痒啊00:04:37.880 --> 00:04:40.000或者说稍微有点流鼻涕啊00:04:40.000 --> 00:04:41.420或者清除鼻塞啊00:04:41.520 --> 00:04:43.280那么他就可能会症状的症状00:04:43.280 --> 00:04:44.360从是一到两天以后00:04:44.360 --> 00:04:45.740他可能自行缓解00:04:45.960 --> 00:04:47.040那么如果有一部分病人00:04:47.040 --> 00:04:48.040他有免疫力相机00:04:48.040 --> 00:04:49.900他无症状会逐渐出现加重00:04:49.960 --> 00:04:52.240那么可表现为一个症咳嗽00:04:52.240 --> 00:04:53.520症状会逐渐的加重00:04:53.520 --> 00:04:56.140成为成一个中度持续的咳嗽00:04:56.200 --> 00:04:57.320包括他喉咙痛00:04:57.320 --> 00:04:58.960那么可能会引起主诉00:04:58.960 --> 00:05:00.960会有一个吃东西吞咽的时候00:05:00.960 --> 00:05:02.280可能会疼痛加重00:05:02.280 --> 00:05:04.280那么甚至一个刀片嗓的情况00:05:04.280 --> 00:05:06.300那么可能还会伴有些低烧00:05:06.360 --> 00:05:08.120那么体温可能在三十七度五以上00:05:08.120 --> 00:05:08.920到三十八度00:05:08.920 --> 00:05:10.220三十八度以下00:05:10.440 --> 00:05:11.520那么甚至和这个时候00:05:11.520 --> 00:05:14.460如果是我们通过一些饮水休息00:05:14.560 --> 00:05:16.080呃不能正常缓解的时候00:05:16.080 --> 00:05:18.800那我们可能要去呃医院就诊00:05:18.800 --> 00:05:21.680去使用一些清热解热性的药物00:05:21.680 --> 00:05:24.320或者是用些如果有细菌感染的话00:05:24.320 --> 00:05:26.680我们可能需要一些抗细菌类的药物00:05:26.680 --> 00:05:28.660或者是些抗病毒的药物00:05:28.800 --> 00:05:30.000那么如果说这个病人00:05:30.000 --> 00:05:31.200症状一直持续不好00:05:31.200 --> 00:05:32.000进一步加重的话00:05:32.000 --> 00:05:34.120那可能会出现一些重症的症状00:05:34.120 --> 00:05:36.420那比如说可能会一个持续的高烧00:05:36.520 --> 00:05:38.080出现在三十八度五以上00:05:38.080 --> 00:05:40.200甚至到三十九度以上等等00:05:40.200 --> 00:05:42.360那么出现一个顽固性的咳嗽00:05:42.360 --> 00:05:43.780日咳夜咳00:05:43.840 --> 00:05:46.500那么夜间症状可能会比较明显00:05:46.560 --> 00:05:49.140甚至咳嗽的时候会有喘息的症状00:05:49.240 --> 00:05:50.640伴一个呼吸困难00:05:50.640 --> 00:05:51.720那么这个时候00:05:51.720 --> 00:05:55.520那么呃我们如果碰到这种情况的话00:05:55.520 --> 00:05:58.000那必须要赶紧到医院进行就诊00:05:58.000 --> 00:06:02.160那么呃需要做检查的就要做检查00:06:02.160 --> 00:06:03.640那么如果说做出来00:06:03.640 --> 00:06:06.080有明确的细菌感染或者病毒感染的00:06:06.080 --> 00:06:06.560我们这时候00:06:06.560 --> 00:06:08.360就需要给他一些抗病毒药物00:06:08.360 --> 00:06:10.140或者是一个抗菌素的使用00:06:10.200 --> 00:06:12.000那么甚至说我出现高烧的时候00:06:12.000 --> 00:06:14.240我们要给他一些解热镇痛药00:06:14.240 --> 00:06:15.740以及一个退烧的作用00:06:15.840 --> 00:06:16.640那么流感以后00:06:16.640 --> 00:06:17.920我们知道上呼吸道感染00:06:17.920 --> 00:06:21.560如果是说呃初始我没有进重视00:06:21.560 --> 00:06:22.720或者我们进行干预后00:06:22.720 --> 00:06:23.920他没症状没有缓解00:06:23.920 --> 00:06:24.860进步加重00:06:24.880 --> 00:06:27.120可能会出现一些严重的并发症00:06:27.120 --> 00:06:28.760那比如说上呼吸道感染可能会引00:06:28.760 --> 00:06:29.560起一个中耳炎00:06:29.560 --> 00:06:31.520因为我们会经常碰到这一些病人00:06:31.520 --> 00:06:33.600说医生我感染以后00:06:33.600 --> 00:06:35.520鼻鼻塞流鼻涕以后00:06:35.520 --> 00:06:38.180我这两天我觉得听力下降00:06:38.400 --> 00:06:40.620耳朵痛会有些流脓的表现00:06:40.640 --> 00:06:41.640那么这个时候00:06:41.640 --> 00:06:43.480就可能会出现一个中耳炎00:06:43.480 --> 00:06:45.540甚至化脓性的中耳炎等等00:06:45.560 --> 00:06:46.400那么咽炎的病呢00:06:46.400 --> 00:06:49.080它会反复的一个脓鼻涕啊00:06:49.080 --> 00:06:50.360会醒不出来00:06:50.360 --> 00:06:52.720然后找严重的鼻塞00:06:52.720 --> 00:06:53.440那么这个是00:06:53.440 --> 00:06:55.560或者是我们副鼻窦区有压痛00:06:55.560 --> 00:06:56.720伴有持续的发热00:06:56.720 --> 00:06:59.100那么这个时候可能会出现一个啊00:06:59.640 --> 00:07:00.720鼻窦发炎的情况00:07:00.720 --> 00:07:02.760那么这个时候就是特别需要注意00:07:02.760 --> 00:07:03.280那么这个时候00:07:03.280 --> 00:07:04.800我们一定要到医院去进00:07:04.800 --> 00:07:06.180寻求医生的帮助00:07:07.600 --> 00:07:09.280那么症状的话也是婴儿也00:07:09.280 --> 00:07:10.280持续的时间也是婴儿00:07:10.280 --> 00:07:12.040有的人可能持续一到两天00:07:12.040 --> 00:07:14.020那有的人可能会持续一到两周00:07:14.120 --> 00:07:15.640那么在一些初次症状的时候00:07:15.640 --> 00:07:17.540我们上呼吸道感染初期的时候00:07:17.560 --> 00:07:19.400患者可能会经历一到两天的喉咙痛00:07:19.400 --> 00:07:20.760和一些轻微的咳嗽00:07:20.760 --> 00:07:21.680那么大部分病人00:07:21.680 --> 00:07:24.080可能通过这个一个初始时间00:07:24.080 --> 00:07:25.200与初期的时间以后00:07:25.200 --> 00:07:26.780可能症状会逐渐缓解00:07:26.840 --> 00:07:28.120那么随着呃00:07:28.120 --> 00:07:28.720这个病毒00:07:28.720 --> 00:07:30.600这个复制的一个持续的发生00:07:30.600 --> 00:07:32.520那么我们可能会造一个高峰00:07:32.520 --> 00:07:33.900持续持续期00:07:33.960 --> 00:07:35.320那么在感染的高峰期00:07:35.320 --> 00:07:36.600我们一些症状如何00:07:36.600 --> 00:07:38.640像一些流鼻涕打喷嚏的呢00:07:38.640 --> 00:07:40.760可能会连续持续的三到五天00:07:40.760 --> 00:07:42.420那甚至可能持续更久00:07:42.480 --> 00:07:44.840那么在患者感冒以后00:07:44.840 --> 00:07:46.980就说鼻塞流鼻涕好转以后00:07:47.480 --> 00:07:49.000呃特别是这些咽痛啊00:07:49.000 --> 00:07:50.400发热啊症状改善以后00:07:50.400 --> 00:07:51.600患者会有一个00:07:51.600 --> 00:07:52.400有一部分患者00:07:52.400 --> 00:07:54.380会出现一个持续的咳嗽00:07:54.400 --> 00:07:56.080那么甚至会持续到一到两周00:07:56.080 --> 00:07:57.960甚至一一到两个月不00:07:57.960 --> 00:08:00.160等那么这个时候我们来医院00:08:00.160 --> 00:08:02.320可能说我们去做些检查00:08:02.320 --> 00:08:03.400像一些血常规啊00:08:03.400 --> 00:08:04.160c反应蛋白啊00:08:04.160 --> 00:08:06.740pct啊可能都是个正常范围之内00:08:06.760 --> 00:08:08.760甚至我们去给他做拍一个胸部的ct00:08:08.760 --> 00:08:09.740或者胸片00:08:09.760 --> 00:08:10.880或者做一些肺功能00:08:10.880 --> 00:08:12.960一氧化的呼出吸氧化的测定00:08:12.960 --> 00:08:14.980可能都是一个在正常值范围之内00:08:15.000 --> 00:08:16.920那么这个时候我们就可能考虑他00:08:16.920 --> 00:08:17.280考虑00:08:17.280 --> 00:08:19.820他可能会出现一个感染后的咳嗽00:08:19.960 --> 00:08:21.000那么这时我们就给他00:08:21.000 --> 00:08:23.560只要对症支持治疗就可以了00:08:23.560 --> 00:08:25.440所以说我们感冒呃00:08:25.440 --> 00:08:28.860上呼吸道感染一个症状持续时间00:08:29.000 --> 00:08:31.560他可以跟病人个人而异00:08:31.560 --> 00:08:32.860每个人都不一样00:08:32.880 --> 00:08:34.200有的持续一到两天00:08:34.200 --> 00:08:35.080有的三到五天00:08:35.080 --> 00:08:36.120有的甚至一到两周00:08:36.120 --> 00:08:37.820甚至一到两个月都可以00:08:37.840 --> 00:08:39.880所以我们病人碰到这种情况的时候00:08:39.880 --> 00:08:42.260其实心里也不需要特别的焦虑00:08:42.720 --> 00:08:44.680你们你了解了这个情况以后00:08:44.680 --> 00:08:46.380那我心里也知道有个底00:08:48.880 --> 00:08:49.160那么00:08:49.160 --> 00:08:51.380我们上呼吸道感染的原因有哪些呢00:08:52.640 --> 00:08:54.920首先是我们从它的病原体来说00:08:54.920 --> 00:08:57.480那么最常见的是一个病毒性感染00:08:57.480 --> 00:09:00.340包括我们常见的甲瘤乙硫00:09:00.480 --> 00:09:02.240或者是一些新型冠状病毒00:09:02.240 --> 00:09:03.120和一个腺病毒00:09:03.120 --> 00:09:04.760包括人病病毒等等00:09:04.760 --> 00:09:05.520它们都是会00:09:05.520 --> 00:09:06.640引起一个上呼吸道感染的00:09:06.640 --> 00:09:07.740主要病原体00:09:07.840 --> 00:09:08.840那么另外一个00:09:08.840 --> 00:09:11.020当患患者00:09:11.200 --> 00:09:13.080接受病毒感染性感染以后00:09:13.080 --> 00:09:15.040他身体的免疫力会下降00:09:15.040 --> 00:09:17.880那么他的身体容易受到细菌的侵袭00:09:17.880 --> 00:09:18.280这时候00:09:18.280 --> 00:09:21.160可能往往会伴发一个细菌的感染00:09:21.160 --> 00:09:21.640出现之后00:09:21.640 --> 00:09:22.200喉咙痛啊00:09:22.200 --> 00:09:22.880化脓痰啊00:09:22.880 --> 00:09:24.260发热啊等症状00:09:24.280 --> 00:09:26.880那么这个时候那么就会有一些链00:09:26.880 --> 00:09:27.760比如说链球菌00:09:27.760 --> 00:09:28.580葡萄球菌00:09:28.800 --> 00:09:30.120那么这个些细菌呢00:09:30.120 --> 00:09:32.400往往会导致一个咽喉炎00:09:32.400 --> 00:09:33.920急性化脓性扁桃体炎等的00:09:33.920 --> 00:09:35.540这个上呼吸道感染的症状00:09:35.600 --> 00:09:37.540那么这个时候我们就需要去鉴别00:09:37.560 --> 00:09:40.240如果出现一些细菌性感染的症状00:09:40.240 --> 00:09:40.680那个时候00:09:40.680 --> 00:09:43.060我们就需要给他一些抗生素的治疗00:09:47.600 --> 00:09:50.060那么它的传播传播途径有哪些呢00:09:51.000 --> 00:09:52.520一个是一个飞沫传播00:09:52.520 --> 00:09:54.000那我们可以通过呃00:09:54.000 --> 00:09:56.080一些上呼吸道感染的病人的咳嗽00:09:56.080 --> 00:09:57.820打喷嚏时候产生的一个飞沫00:09:57.840 --> 00:09:59.800那么这个是是一个上呼吸道感染00:09:59.800 --> 00:10:00.800常见的传播方式00:10:00.800 --> 00:10:02.360因为过往病毒也好00:10:02.360 --> 00:10:02.880细菌也好00:10:02.880 --> 00:10:05.540它可能是通过吃脓胶进行一个传播00:10:05.560 --> 00:10:06.800那么再一个说啊00:10:06.800 --> 00:10:08.160是一个接触传播00:10:08.160 --> 00:10:09.680那么通过我们就是说00:10:09.680 --> 00:10:11.940病人打喷嚏或流鼻涕00:10:12.280 --> 00:10:14.880他从这个污染的接触污染以后00:10:14.880 --> 00:10:15.960他一个物体的表面00:10:15.960 --> 00:10:18.520那我们去手触摸这些污染源以后00:10:18.520 --> 00:10:20.920我们不用没有去通过洗手消毒00:10:20.920 --> 00:10:23.900那么直接去接触我们的眼耳00:10:24.320 --> 00:10:26.760口鼻眼等等这些淹没的地方00:10:26.760 --> 00:10:28.900那么可以可能会导致感染00:10:29.000 --> 00:10:30.720那么再一个就是空气传播00:10:30.720 --> 00:10:33.680那么在一个封闭的密封环境下面00:10:33.680 --> 00:10:36.040那么如果有上呼吸道感染的病人00:10:36.040 --> 00:10:36.600在里面00:10:36.600 --> 00:10:39.320那么他病毒可以通过一些空气中00:10:39.320 --> 00:10:40.200微小颗粒00:10:40.200 --> 00:10:41.400长时间悬浮00:10:41.400 --> 00:10:42.080那么你这时候00:10:42.080 --> 00:10:43.680在一个密闭的空间里面00:10:43.680 --> 00:10:44.880时间待的长了以后00:10:44.880 --> 00:10:47.420那么就可以容易被传播被感染00:10:47.920 --> 00:10:48.680那么再一个的话00:10:48.680 --> 00:10:50.600是一个患者的直接接触啊00:10:50.600 --> 00:10:52.000比如说与一个上呼吸道感染00:10:52.000 --> 00:10:54.200进行我们面对面的一个交流00:10:54.200 --> 00:10:56.780或者是一个拥抱等等00:10:56.840 --> 00:10:59.280那么我们也是他通过一些感染原因00:10:59.280 --> 00:11:01.640接触我们的一些黏膜部位以后00:11:01.640 --> 00:11:04.380也会引起的上呼吸道感染一个传播00:11:06.440 --> 00:11:07.880那么一般正常人和00:11:07.880 --> 00:11:09.080在免疫力正常的时候00:11:09.080 --> 00:11:11.760我们就是说有一个正常的防御机制00:11:11.760 --> 00:11:13.640那么可能会对这种病毒00:11:13.640 --> 00:11:14.520或细菌的侵害00:11:14.520 --> 00:11:16.460它有一定的预防防御作用00:11:16.480 --> 00:11:17.760那么不大容易感染00:11:17.760 --> 00:11:18.000但是00:11:18.000 --> 00:11:21.140对于一些本身存在一些特殊人群00:11:21.160 --> 00:11:23.440那么像一些儿童或老年人来说00:11:23.440 --> 00:11:25.720因为他们本身的免疫系统比较弱00:11:25.720 --> 00:11:27.680那么容容易受到一些病毒00:11:27.680 --> 00:11:28.860或细菌的侵袭00:11:28.880 --> 00:11:29.600那么再一个的话00:11:29.600 --> 00:11:29.840就是00:11:29.840 --> 00:11:32.300像一些我们本身患有慢性支气管炎00:11:32.320 --> 00:11:34.340或者是说有支气管扩张00:11:34.400 --> 00:11:35.760或者是有一些哮喘00:11:35.760 --> 00:11:37.040或者是糖尿病00:11:37.040 --> 00:11:38.800或者某些冠心病或者肿瘤00:11:38.800 --> 00:11:41.400这些病的情来说00:11:41.400 --> 00:11:42.160这部分人群00:11:42.160 --> 00:11:43.840他本身的自身免疫功能00:11:43.840 --> 00:11:45.820也是比较比正常的降低00:11:45.840 --> 00:11:46.120那么00:11:46.120 --> 00:11:48.460他也是容易受到一些病毒的侵害00:11:48.520 --> 00:11:49.560那么再一个的话就是说00:11:49.560 --> 00:11:51.320我们可能说有一些病人00:11:51.320 --> 00:11:53.040他本身是在使用性免疫制剂00:11:53.040 --> 00:11:54.340或者是营养不良00:11:54.360 --> 00:11:57.160或者长期暴露于一个污染环境的00:11:57.160 --> 00:11:59.360一个吸烟二手烟环境当中的时候00:11:59.360 --> 00:12:00.480那么这部分人群00:12:00.480 --> 00:12:03.160他也是容易得到一个上呼吸道感染00:12:03.160 --> 00:12:06.300感染的机会呢比正常人要高哎00:12:08.960 --> 00:12:10.440那么最后第四部分呢00:12:10.440 --> 00:12:12.600就是一个上呼吸道感染的治疗方法00:12:12.600 --> 00:12:14.440那我们得获了一个上呼吸道感染00:12:14.440 --> 00:12:16.840以后有什么方法去可以治疗呢00:12:16.840 --> 00:12:17.440那么接下来00:12:17.440 --> 00:12:19.740我就给大家简单的介绍一下00:12:20.160 --> 00:12:22.300那么首先的话是一个药物治疗00:12:22.360 --> 00:12:24.400那么我们知道我们要去区分啊00:12:24.400 --> 00:12:26.260这个病人到底是一个上呼00:12:26.560 --> 00:12:27.280是一个病毒感染00:12:27.280 --> 00:12:28.300还有细菌感染00:12:28.320 --> 00:12:30.000如果患者是一个病毒性感染00:12:30.000 --> 00:12:30.480那么00:12:30.480 --> 00:12:32.760通常往是由一个病毒感染引起来的00:12:32.760 --> 00:12:33.760那么我们这个时候如00:12:33.760 --> 00:12:35.640果在症状发生的00:12:35.640 --> 00:12:36.960四十八到七十二小时内00:12:36.960 --> 00:12:39.660以内我们应该呃00:12:40.160 --> 00:12:41.800快速的给予一个抗病毒治疗00:12:41.800 --> 00:12:43.040如果使用甲硫乙硫00:12:43.040 --> 00:12:45.220那我们要去给他使用些奥司他韦00:12:45.280 --> 00:12:47.400马布洛沙韦等等这些抗病毒药物00:12:47.400 --> 00:12:48.960如果你是一个新冠病毒感染00:12:48.960 --> 00:12:50.260那我们可以使用一些00:12:50.280 --> 00:12:52.240三cl的小分子抗病毒药物00:12:52.240 --> 00:12:54.720等等那么如果是说呃00:12:54.720 --> 00:12:57.560患者嗯和同时合并有些细菌感染00:12:57.560 --> 00:12:59.380比如说你有黄脓痰00:12:59.520 --> 00:13:00.660咳嗽发热00:13:00.800 --> 00:13:02.320血相白细胞很高00:13:02.320 --> 00:13:03.320c反应蛋白增高00:13:03.320 --> 00:13:04.240pc增高00:13:04.240 --> 00:13:07.480那么这个时候我们要去针对一些呃00:13:07.480 --> 00:13:09.020常见的病原体00:13:09.120 --> 00:13:11.360细菌的病原体给他去抗细菌治疗00:13:11.360 --> 00:13:12.800比如说像青霉素类的00:13:12.800 --> 00:13:14.600头孢类的等等啊00:13:14.600 --> 00:13:16.900我们这个时候就需要抗菌治疗00:13:16.960 --> 00:13:18.540那么再一个的话00:13:18.680 --> 00:13:19.760从症状来说00:13:19.760 --> 00:13:22.520如果你症状咽痛比较明显00:13:22.520 --> 00:13:25.420那我们可以去给他一些使用一些呃00:13:25.480 --> 00:13:27.560就是说缓解咽喉痛的一些药物00:13:27.560 --> 00:13:29.860如果你有发热00:13:30.200 --> 00:13:31.680体温超过三十八度五的情况下00:13:31.680 --> 00:13:33.760我们也可以去用一些解毒镇痛药物00:13:33.760 --> 00:13:35.480去缓解这个病人本身00:13:35.480 --> 00:13:37.540那些发烧或者积痛的情况00:13:37.600 --> 00:13:38.360那么再一个的话00:13:38.360 --> 00:13:41.880如果你鼻塞流鼻涕非常的严重00:13:41.880 --> 00:13:43.900那我们可以去使用一些鼻喷剂00:13:44.000 --> 00:13:45.040这些收敛剂00:13:45.040 --> 00:13:47.720去收缩鼻腔内的毛细血管00:13:47.720 --> 00:13:49.320那么减少患者的鼻塞00:13:49.320 --> 00:13:50.660或者流涕的症状00:13:50.840 --> 00:13:52.300改善患者的通气00:13:55.640 --> 00:13:57.280那么对于一些非药物治疗来说00:13:57.280 --> 00:13:58.800就是我们首先第一个00:13:58.800 --> 00:14:00.380肯定是要保持良好的00:14:00.680 --> 00:14:01.520良好的休息00:14:01.520 --> 00:14:02.540充足的睡眠00:14:02.640 --> 00:14:03.960那么因为我们知道00:14:03.960 --> 00:14:05.280在机体免疫力低的时候呢00:14:05.280 --> 00:14:07.080他身体是不容易恢复的00:14:07.080 --> 00:14:08.680但你给他保证一个充足的休息00:14:08.680 --> 00:14:09.920充足睡眠以后那00:14:09.920 --> 00:14:11.960么有利于一个身体的恢复00:14:11.960 --> 00:14:14.540减少了一个病情值症状的加重00:14:14.680 --> 00:14:16.640那么第二个我们一定要多饮水00:14:16.640 --> 00:14:17.560因为我们很多病人00:14:17.560 --> 00:14:19.280可能会出现一种高热00:14:19.280 --> 00:14:20.040脱水的情况00:14:20.040 --> 00:14:21.440那么你这个支架00:14:21.440 --> 00:14:23.380正适当的增加一个水00:14:23.800 --> 00:14:24.600水分的补充00:14:24.600 --> 00:14:26.160那么对于机体来说00:14:26.160 --> 00:14:28.640是一个很很良好的一个补充方法00:14:28.640 --> 00:14:31.000那么再一个我们要保持通风00:14:31.000 --> 00:14:32.320保持室内的湿度00:14:32.320 --> 00:14:36.420那么可以缓解患者一个呃鼻干咽干00:14:36.440 --> 00:14:37.760喉咙干燥等等00:14:37.760 --> 00:14:39.140减轻咳嗽的症状00:14:39.320 --> 00:14:39.800那么再一个00:14:39.800 --> 00:14:43.520如果患者说我他一个咳嗽痰很咽00:14:43.520 --> 00:14:45.240或者说鼻腔内分泌比较多00:14:45.240 --> 00:14:48.580鼻咽我们可以使用些蒸汽吸入00:14:48.600 --> 00:14:50.160或者是盐水漱口00:14:50.160 --> 00:14:53.360甚至我们可以用一些呃海盐水00:14:53.360 --> 00:14:55.180进行一个冲鼻啊00:14:55.320 --> 00:14:57.840打通那个呼吸鼻腔内的症状00:14:57.840 --> 00:14:59.860那么减轻患者的鼻塞的症状00:14:59.880 --> 00:15:03.220那么再一个的话就是我们其实说呃00:15:03.240 --> 00:15:05.440也可以通过一些鼻喷剂等等00:15:05.440 --> 00:15:07.460可以呃收敛剂00:15:07.480 --> 00:15:09.400那么减少一个鼻腔内的充血00:15:09.400 --> 00:15:11.500那改善那个鼻塞流鼻的症状00:15:15.240 --> 00:15:16.400那么这些也是的啊00:15:16.400 --> 00:15:16.800就是说00:15:16.800 --> 00:15:19.480我们可以用用一些非处方的药物00:15:19.480 --> 00:15:21.160那么特别是高热的时候00:15:21.160 --> 00:15:22.680我们可以用非菜的药00:15:22.680 --> 00:15:23.820像一些布洛芬00:15:23.880 --> 00:15:25.540或者是对乙酰胺胺等等00:15:25.640 --> 00:15:28.100可以减轻患者发热的症状00:15:29.640 --> 00:15:31.200那么对一些并发症的处理的话00:15:31.200 --> 00:15:33.260其实也是一样的啊00:15:33.280 --> 00:15:35.320那么主要是一个00:15:35.320 --> 00:15:37.640如果是有一个中耳炎或者鼻窦炎00:15:37.640 --> 00:15:39.920那么这个时候就需要一些呃00:15:39.920 --> 00:15:41.440止痛药或者是消炎药00:15:41.440 --> 00:15:42.620进行对症处理00:15:42.720 --> 00:15:45.800那么嗯如果是耳朵内发脓00:15:45.800 --> 00:15:47.560那我们就局部要使用一些00:15:47.560 --> 00:15:48.840抗生素的滴剂00:15:48.840 --> 00:15:51.600那么是一个保持对一个患者00:15:51.600 --> 00:15:53.540一个细菌方面的进行一个00:15:53.560 --> 00:15:56.100强烈的抗菌抗细菌的治疗00:15:58.920 --> 00:15:59.960那么最后一个内容呢00:15:59.960 --> 00:16:02.220是一个上呼吸道感染的预防措施00:16:02.880 --> 00:16:03.600那么首先呢00:16:03.600 --> 00:16:05.520个人卫生习惯也是非常重要啊00:16:05.520 --> 00:16:07.760首先我们要做一个勤洗手00:16:07.760 --> 00:16:11.520那特别是你在公共场合接触一些呃00:16:11.520 --> 00:16:12.560公共物品之后00:16:12.560 --> 00:16:14.320或者是你跟一些呃00:16:14.320 --> 00:16:16.100上呼吸道感染病人接触之后00:16:16.120 --> 00:16:18.200那我们进行一定要进行勤洗手00:16:18.200 --> 00:16:18.960那么因为洗手00:16:18.960 --> 00:16:22.040是一个对预防上呼吸道感染00:16:22.040 --> 00:16:24.040或者是一个预防细菌病毒感染00:16:24.040 --> 00:16:25.540是一个最有效的方法00:16:25.600 --> 00:16:27.520第二个我们应该使用00:16:27.520 --> 00:16:29.620学会一个正确的咳嗽和打喷嚏时候00:16:30.280 --> 00:16:31.920打喷嚏的一个方法00:16:31.920 --> 00:16:33.640我们咳嗽或打喷嚏的时候00:16:33.640 --> 00:16:35.120应该用纸巾或肘部00:16:35.120 --> 00:16:37.660或者手部遮住口鼻00:16:37.760 --> 00:16:39.520避免飞沫传播00:16:39.520 --> 00:16:42.100来减少一个他人的一个感染的风险00:16:44.240 --> 00:16:46.080最后就是说一个环境因素啊00:16:46.080 --> 00:16:47.840首先我刚前面也讲到了00:16:47.840 --> 00:16:48.880你一定要保持一个00:16:48.880 --> 00:16:49.920室内的空气的流通00:16:49.920 --> 00:16:52.340定期的开窗啊通风00:16:52.360 --> 00:16:54.320那么使用空气净化器00:16:54.320 --> 00:16:57.160那么减少室内一个病毒00:16:57.160 --> 00:16:58.120病菌的积聚00:16:58.120 --> 00:16:59.280来预防上呼吸道感染00:16:59.280 --> 00:17:02.200那么再一个的话是使用一些加湿器00:17:02.200 --> 00:17:04.160那么控制室内的温度和湿度00:17:04.160 --> 00:17:06.900来避免空气过于干燥或者潮湿00:17:06.920 --> 00:17:08.040那么也是可以缓解00:17:08.040 --> 00:17:09.160上呼吸道感染病呢00:17:09.160 --> 00:17:11.740还有口干鼻干这些症状00:17:11.920 --> 00:17:12.560那么再一个的是00:17:12.560 --> 00:17:14.720我们一定要避免一个二手烟00:17:14.720 --> 00:17:16.540减少暴露于空气污染00:17:16.560 --> 00:17:18.360和一个化学物质当中00:17:18.360 --> 00:17:21.780降低呼吸道疾病的风险啊00:17:24.400 --> 00:17:25.160那么再一个的话00:17:25.160 --> 00:17:26.840就是我们可以通些一些药物00:17:26.840 --> 00:17:28.400那对于一些特殊来选00:17:28.400 --> 00:17:29.600像儿童或者老年人00:17:29.600 --> 00:17:32.260或者是一些经常呃00:17:32.840 --> 00:17:34.180免疫力比较低的00:17:34.280 --> 00:17:35.880合并慢性病基础病的00:17:35.880 --> 00:17:36.800病人来说00:17:36.800 --> 00:17:38.480那么我们适时的给他接触一些00:17:38.480 --> 00:17:40.080流感疫苗00:17:40.080 --> 00:17:42.100或者是一些肺h疫苗00:17:42.160 --> 00:17:44.840那也是预防患者及上呼吸道感染的00:17:44.840 --> 00:17:46.780一个非常有用的措施00:17:47.120 --> 00:17:48.880那么所以说我们老年人儿童的话00:17:48.880 --> 00:17:52.320在一些流感流行剂或者冬天的时候00:17:52.320 --> 00:17:55.300我们要适时的去给他接种一些疫苗00:17:57.880 --> 00:17:59.520那么最后我就感谢大家00:17:59.520 --> 00:18:01.280我分享的内容就到此结束00:18:01.280 --> 00:18:02.180谢谢大家