WEBVTT00:00:00.160 --> 00:00:03.460天啊我们跟大家一起分享一下00:00:03.560 --> 00:00:06.700呼吸系统感染疾病的预防和治疗00:00:06.840 --> 00:00:08.960那么主要从下面六个方面00:00:08.960 --> 00:00:11.340一个是呼吸系统感染的一些概数00:00:11.560 --> 00:00:12.840第二个他的预防措施00:00:12.840 --> 00:00:14.980第三个常见的治疗方法00:00:15.040 --> 00:00:16.940第四个是护理的特点00:00:17.040 --> 00:00:19.240第五是一个关于专业的医疗干预00:00:19.240 --> 00:00:20.800第六个是个健康教育00:00:20.800 --> 00:00:23.260从这六个方面给大家阐述一下00:00:24.160 --> 00:00:27.340那么这个疾病的类型和特点00:00:27.480 --> 00:00:29.640那么这个呢疾病呃00:00:29.640 --> 00:00:31.440我们常见的可以看到是一个00:00:31.440 --> 00:00:32.460有一个流感00:00:32.600 --> 00:00:34.280就是一个流感病毒的感染00:00:34.280 --> 00:00:36.620第二个呢就是一个支原体的感染00:00:36.720 --> 00:00:37.840那么支原体感染00:00:37.840 --> 00:00:39.560一般是由肺炎支原体引起的00:00:39.560 --> 00:00:40.540一个咳嗽00:00:40.880 --> 00:00:41.800以及一些呃00:00:41.800 --> 00:00:44.340有些病人有些肌肉酸痛的种表现00:00:44.880 --> 00:00:48.000那么一般的我们环因素呢00:00:48.000 --> 00:00:50.300主要是包括一个环境的因素00:00:50.360 --> 00:00:52.000那么包括空气污染啊00:00:52.000 --> 00:00:53.800一些干燥寒冷的环境啊00:00:53.800 --> 00:00:56.300比较容易诱发这个呼吸道的感染00:00:56.600 --> 00:00:58.780第二个呢就是一个不良的习惯00:00:58.800 --> 00:01:01.300譬如他容易是一个吸烟的00:01:01.320 --> 00:01:03.980那么特别是吸烟时比较长的病人00:01:04.080 --> 00:01:05.520第二呢就是容易熬夜00:01:05.520 --> 00:01:07.160那么机体免疫功能下降00:01:07.160 --> 00:01:09.140也比较容易引起呼吸道感染00:01:09.360 --> 00:01:09.960第三个呢00:01:09.960 --> 00:01:12.480就是缺乏运动和一些00:01:12.480 --> 00:01:13.400也会增加一些00:01:13.400 --> 00:01:15.180他的一个感染的一个风险00:01:15.560 --> 00:01:16.800那么还有就是老人啊00:01:16.800 --> 00:01:19.060儿童啊这些易感的人群00:01:19.080 --> 00:01:22.420那么都是他的一个高发的一个因素00:01:22.880 --> 00:01:23.320还有一个00:01:23.320 --> 00:01:25.240就是一个个人的一个饮食习惯00:01:25.240 --> 00:01:27.260那么啊卫生习惯00:01:27.320 --> 00:01:28.880那么主要就是一个00:01:28.880 --> 00:01:30.800大家知道到公共场所以后呢00:01:30.800 --> 00:01:31.960要勤洗手00:01:31.960 --> 00:01:34.100那么养成一个洗手的一个习惯00:01:34.320 --> 00:01:35.560那么特别是现在00:01:35.560 --> 00:01:37.880那么大家应该通过一个有一个00:01:37.880 --> 00:01:39.000这个新冠以后00:01:39.000 --> 00:01:42.080大家对洗手这概念已经是很深入了00:01:42.080 --> 00:01:42.760已经洗手啊00:01:42.760 --> 00:01:43.840六步法啊对吧00:01:43.840 --> 00:01:45.540嗯都已经比较熟悉了00:01:45.840 --> 00:01:47.200第二个呢就是要戴口罩00:01:47.200 --> 00:01:48.820特别在公共的场所00:01:48.880 --> 00:01:51.160那么密集的人群的这种地方00:01:51.160 --> 00:01:52.520一定要戴好口罩00:01:52.520 --> 00:01:54.220做好一个个人的防护00:01:54.920 --> 00:01:57.140那么还有呢就是一个免疫的接种00:01:57.320 --> 00:01:58.400那么免疫接种呢00:01:58.400 --> 00:02:00.380我们现在有很多一些疫苗00:02:00.560 --> 00:02:03.240那么我们可以进行一个接种疫苗00:02:03.240 --> 00:02:05.420来增加机体的一个免疫力00:02:05.440 --> 00:02:06.760那么有效的预防00:02:06.760 --> 00:02:08.780呼吸系统的一个感染的疾病00:02:09.040 --> 00:02:10.280那么我们可以定期接种00:02:10.280 --> 00:02:11.460一个流感疫苗00:02:11.560 --> 00:02:13.480那么现在已经基本上老人00:02:13.480 --> 00:02:16.020小孩都可以进行预防接种00:02:16.280 --> 00:02:17.860还有就是一个群体免疫00:02:18.120 --> 00:02:21.120那么提高机体的一个群体免疫水平00:02:21.120 --> 00:02:23.660那么这样可以减少疾病的传播00:02:23.760 --> 00:02:25.440那么保护一些易感人群00:02:25.440 --> 00:02:27.380特别在流感高发的季节00:02:27.480 --> 00:02:29.980尽量避免去人群密集的地方00:02:30.040 --> 00:02:30.760那么这样呢00:02:30.760 --> 00:02:32.700就可以避免一个交叉的感染00:02:35.080 --> 00:02:35.800那么接下来00:02:35.800 --> 00:02:37.600就像我们讲一个药物治疗00:02:37.600 --> 00:02:38.440那么药物治疗00:02:38.440 --> 00:02:39.360一般我们说00:02:39.360 --> 00:02:41.700第一个就是一个抗菌素的使用00:02:41.880 --> 00:02:44.760那么抗菌素使用一般我们呃00:02:44.760 --> 00:02:46.160如果有条件的话00:02:46.160 --> 00:02:48.220都要进行一些病原体的检测00:02:48.360 --> 00:02:50.840那么到底是什么细菌感染00:02:50.840 --> 00:02:52.720那么使用一个呃00:02:52.720 --> 00:02:56.060抗菌的一个合适的一个抗菌素00:02:56.240 --> 00:02:59.000那么但是抗菌素一定要遵循呃00:02:59.000 --> 00:03:00.200一定要遵循一个原则00:03:00.200 --> 00:03:01.180不能滥用00:03:01.240 --> 00:03:03.040那么滥用抗菌素来说00:03:03.040 --> 00:03:05.460也容易对机体产生一个耐药性00:03:05.800 --> 00:03:07.280那么第二个就是抗病毒00:03:07.280 --> 00:03:10.280那么由于一个有效的病毒的治00:03:10.280 --> 00:03:12.600抗病毒治疗那么也是很关键的00:03:12.600 --> 00:03:15.120那么现在我们有流感病毒的药物00:03:15.120 --> 00:03:16.400以及新冠病毒的药00:03:16.400 --> 00:03:18.600物或者支原体的一些硬物00:03:18.600 --> 00:03:19.960那么我们都已经有了00:03:19.960 --> 00:03:21.820那么都可以针对性的治疗00:03:22.560 --> 00:03:24.600还有就是一个很重要的一个00:03:24.600 --> 00:03:26.920就是我们在呼吸系统疾病里面00:03:26.920 --> 00:03:28.980往往可以采取一个物理治疗00:03:29.560 --> 00:03:31.680那么物理治疗的手段呢00:03:31.680 --> 00:03:34.140我们第一个就是一个呼吸机的训练00:03:34.200 --> 00:03:34.840那么这种00:03:34.840 --> 00:03:37.360往往在慢性支气管炎的病人当中00:03:37.360 --> 00:03:38.840或者慢阻肺的病人00:03:38.840 --> 00:03:40.580往往我们医生都会叫他00:03:40.600 --> 00:03:41.880要进行一个呼吸机的00:03:41.880 --> 00:03:43.460一个定期的一个训练00:03:43.520 --> 00:03:45.100改善他的呼吸功能00:03:45.480 --> 00:03:46.080那么第二个呢00:03:46.080 --> 00:03:47.900就是要做一个体胃的引流00:03:47.960 --> 00:03:48.680那么有时候00:03:48.680 --> 00:03:50.800我们一个体胃的改变以后00:03:50.800 --> 00:03:53.160更加有利于痰液的排出00:03:53.160 --> 00:03:54.440那么保持一个气道00:03:54.440 --> 00:03:55.780气道的一个通畅00:03:55.960 --> 00:03:57.340那么还有就拍背00:03:57.520 --> 00:03:58.600这是一个很重要的00:03:58.600 --> 00:04:00.900一个物理的一个治疗手段00:04:01.440 --> 00:04:04.020第三个就是一个要生活方式的调整00:04:04.120 --> 00:04:05.760那么生活方式的调整呢00:04:05.760 --> 00:04:07.000我们说第一个00:04:07.000 --> 00:04:10.280就是在这种高发的季节啊00:04:10.280 --> 00:04:12.080流感的高发季节00:04:12.080 --> 00:04:13.040我们大可以00:04:13.040 --> 00:04:15.480大家一个就是要充分的休息00:04:15.480 --> 00:04:18.540饮水那么特别是不能过度的劳累00:04:18.600 --> 00:04:21.280那么劳累的话可能会加重疾呃00:04:21.280 --> 00:04:22.420疾病的发生00:04:22.520 --> 00:04:24.460那么保持水分的摄入00:04:24.800 --> 00:04:26.960另外呢就是要增强一个免疫功能00:04:26.960 --> 00:04:28.880免疫力那么就是一个改善00:04:28.880 --> 00:04:31.440一个正常的一个健康的生活方式00:04:31.440 --> 00:04:32.580那么饮食00:04:33.680 --> 00:04:34.920饮食要均衡00:04:34.920 --> 00:04:36.320那么适当的运动00:04:36.320 --> 00:04:38.900那么保保证一个充足的睡眠00:04:38.920 --> 00:04:39.560那么这个呢00:04:39.560 --> 00:04:42.140来增强一个机体的一个免疫力00:04:46.720 --> 00:04:48.680那么第二就讲一个00:04:48.680 --> 00:04:50.860怎么样来进行一个观察00:04:50.880 --> 00:04:53.660那么这个呢我们一般说呃00:04:53.680 --> 00:04:56.960在如果是呃出现哪些症状00:04:56.960 --> 00:04:58.920那么第一个就是要观察00:04:58.920 --> 00:05:00.300一个体温的变化00:05:00.480 --> 00:05:01.120那么如果00:05:01.120 --> 00:05:02.640定期的测量体温00:05:02.640 --> 00:05:03.960那么一旦有发热00:05:03.960 --> 00:05:05.740那就应该叫及时的就诊00:05:05.840 --> 00:05:08.160第二个呢就是一个咳嗽的变化00:05:08.160 --> 00:05:09.280那么有的病人呢00:05:09.280 --> 00:05:11.420是经常有慢性咳嗽的00:05:11.480 --> 00:05:11.920那么呢00:05:11.920 --> 00:05:14.740他就是要看他的咳嗽的频率啊00:05:14.760 --> 00:05:16.280咳嗽的次数啊00:05:16.280 --> 00:05:18.580痰液的变化有没有一个改变00:05:18.840 --> 00:05:21.160如果出现咳嗽次数增多00:05:21.160 --> 00:05:22.960痰液粘稠不易咳出00:05:22.960 --> 00:05:24.640那么这时候就要警惕00:05:24.640 --> 00:05:26.980有一个急性的一个感染00:05:27.600 --> 00:05:28.600那么在家里00:05:28.600 --> 00:05:31.600一般呢就是我们在家庭用药方面呢00:05:31.600 --> 00:05:32.740就是第一个00:05:32.800 --> 00:05:35.240要严格遵守医生的一个医嘱00:05:35.240 --> 00:05:37.380来进行一个合理的用药00:05:37.560 --> 00:05:39.960那么因为药物总归有一定的副反应00:05:39.960 --> 00:05:42.200那么一旦如果出现了药物的副反应00:05:42.200 --> 00:05:44.360一般应该要立即停药00:05:44.360 --> 00:05:45.780那么及时的就诊00:05:47.040 --> 00:05:48.160那么在康复期00:05:48.160 --> 00:05:50.380还有一个很重要的就是一个护理00:05:50.440 --> 00:05:51.120那么我们说00:05:51.120 --> 00:05:52.640护理也是一个非常重要的00:05:52.640 --> 00:05:54.160特别在一些慢阻肺的病人00:05:54.160 --> 00:05:56.820慢性这种老慢期的病人当中00:05:57.160 --> 00:05:58.600如果保持嗯00:05:58.600 --> 00:06:00.720进行一个和嗯有效的一个护理00:06:00.720 --> 00:06:01.880如果护理得当00:06:01.880 --> 00:06:04.160那么可以减少他的感染的次数00:06:04.160 --> 00:06:05.400甚至可以嗯00:06:05.400 --> 00:06:08.420减少他的嗯感染的一个严重程度00:06:08.680 --> 00:06:11.060第一个就是保持一个空气的流通00:06:11.160 --> 00:06:12.920那么我们定期的开窗00:06:12.920 --> 00:06:14.000定期的进行滑00:06:14.000 --> 00:06:15.980室内的一个紫外线的消毒00:06:16.080 --> 00:06:17.400那么这是第一00:06:17.400 --> 00:06:19.460第二个就是一个合理的饮食00:06:19.520 --> 00:06:20.640那么一般我们说00:06:20.640 --> 00:06:22.640要提供一些营养丰富啊00:06:22.640 --> 00:06:24.620容易消化的清淡的食物00:06:24.800 --> 00:06:28.200那么特别是不能烟酒00:06:28.200 --> 00:06:29.560和一些刺激的食物00:06:29.560 --> 00:06:32.120那么这是一般我们所不不能够00:06:32.120 --> 00:06:34.780在发病期间是禁止食用的00:06:35.280 --> 00:06:37.680那么重症患者我们怎么来处理呢00:06:37.680 --> 00:06:39.940那么第一个就是一个紧急的治疗00:06:40.080 --> 00:06:41.120那么紧急治疗的00:06:41.120 --> 00:06:42.600话我们说一般就是一个00:06:42.600 --> 00:06:45.320如果一旦出现有呼吸缓慢00:06:45.320 --> 00:06:46.520或者有呼吸暂停00:06:46.520 --> 00:06:48.700那么及时的进行心肺复苏啊00:06:48.760 --> 00:06:51.100那么如果有落血要止血治疗00:06:51.200 --> 00:06:53.300那么及时的进行吸氧00:06:53.760 --> 00:06:55.460那么一个抗生素的使用00:06:56.960 --> 00:06:59.600另外呢就是要提高一个公众的意识00:06:59.600 --> 00:07:01.280那么现在我们做媒体呀00:07:01.280 --> 00:07:03.620包括一些科普讲座都很多00:07:03.760 --> 00:07:06.560那么要给大家普及一个呼吸系统00:07:06.560 --> 00:07:08.720一个疾病的一个预防症状00:07:08.720 --> 00:07:09.700治疗方法00:07:09.880 --> 00:07:11.540那么我们现在有很多科普00:07:11.560 --> 00:07:13.840包括很多的这种小讲座00:07:13.840 --> 00:07:16.640那么特别在社区卫生中心00:07:16.640 --> 00:07:19.320他们有定期的病患者教育啊00:07:19.320 --> 00:07:21.260患者在健康的宣传讲座00:07:21.280 --> 00:07:23.540那么这样就提高嗯00:07:23.600 --> 00:07:25.560普通人群的一个知晓度00:07:25.560 --> 00:07:27.820以及对这个疾病的认识度00:07:28.120 --> 00:07:29.000那么另外就是一个00:07:29.000 --> 00:07:31.180养成一个良好的卫生习惯00:07:37.800 --> 00:07:38.520另外就是00:07:38.520 --> 00:07:41.020我们在预防知识的普及当中00:07:41.040 --> 00:07:42.860主要是要勤洗手00:07:43.200 --> 00:07:44.020嗯00:07:44.040 --> 00:07:46.720普及那个勤洗手戴口罩这种00:07:46.720 --> 00:07:48.960那么预防的接种也是非常重要的00:07:48.960 --> 00:07:50.840对那么疫苗的一个接种00:07:50.840 --> 00:07:52.420那么嗯00:07:53.280 --> 00:07:54.160我们看看时间00:07:54.160 --> 00:07:56.680还比较还有一段时间啊00:07:56.680 --> 00:07:58.240那么我们再把前面的内容00:07:58.240 --> 00:08:00.380再补充一下那么00:08:01.720 --> 00:08:02.720特别是在这里00:08:02.720 --> 00:08:04.580我们看大家看一下啊00:08:04.640 --> 00:08:05.160就是在00:08:05.160 --> 00:08:08.080我们对于患者的药物治疗里面00:08:08.080 --> 00:08:09.400那么我稍微展开一下00:08:09.400 --> 00:08:11.100一个抗生素的使用00:08:11.200 --> 00:08:12.160那么抗生素呢00:08:12.160 --> 00:08:14.880我们说一般如果病人有发热的话00:08:14.880 --> 00:08:17.320一如果体温超过了38度00:08:17.320 --> 00:08:19.340那么一般我们要做一个血培养00:08:19.520 --> 00:08:22.480那么根据血培养来进行一个呃00:08:22.480 --> 00:08:23.640抗菌素使用00:08:23.640 --> 00:08:26.560那么一般我们说现在常见的一些呃00:08:26.560 --> 00:08:27.600比较难治的一些00:08:27.600 --> 00:08:28.800有一些玉脓杆菌啊00:08:28.800 --> 00:08:30.920或者呼吸道的甲单孢菌啊00:08:30.920 --> 00:08:31.960那么这个往往可以00:08:31.960 --> 00:08:33.480用一些舒巴坦类的00:08:33.480 --> 00:08:34.500头孢类的00:08:34.680 --> 00:08:36.720那么如果是一个支原体的感染00:08:36.720 --> 00:08:38.400那么可以用一些阿奇霉素啊00:08:38.400 --> 00:08:39.820氧氟沙星一类的00:08:39.920 --> 00:08:42.480那么在这个抗生素使用当中00:08:42.480 --> 00:08:43.960那么有很多病人00:08:43.960 --> 00:08:46.040特别是些慢阻肺的病人00:08:46.040 --> 00:08:49.540往往会出现一个对菌群的一个耐药00:08:49.600 --> 00:08:50.660那么如果00:08:53.160 --> 00:08:54.640如果就是如果00:08:54.640 --> 00:08:56.360如果出现耐药菌的话00:08:56.360 --> 00:08:57.200那么我们说00:08:57.200 --> 00:08:59.040他也可以出现一些厌氧菌的感染00:08:59.040 --> 00:09:00.580甚至一个真菌的感染00:09:00.600 --> 00:09:01.280那么这时候00:09:01.280 --> 00:09:03.520我们一般就要使用一些呃00:09:03.520 --> 00:09:04.600像太能之类的00:09:04.600 --> 00:09:06.860或者使用一些抗霉菌的药物治疗00:09:07.080 --> 00:09:07.920那么这个一般呢00:09:07.920 --> 00:09:09.880就是要一定要监测嗯00:09:09.880 --> 00:09:11.120他的肝肾功能00:09:11.120 --> 00:09:12.560那么特别是老年人00:09:12.560 --> 00:09:16.080我们还要进行一个等定期的一个嗯00:09:16.080 --> 00:09:17.640检测他的一个嗯00:09:17.640 --> 00:09:19.980病人的一个全身的情况00:09:20.160 --> 00:09:21.160那么第二个呢00:09:21.160 --> 00:09:24.300就是我们在呃老年人群当中00:09:24.320 --> 00:09:27.120那么如果病人出现了一个呼吸00:09:27.120 --> 00:09:29.560如果出现一个呼吸功能的一个不全00:09:29.560 --> 00:09:32.160那么这时候我们要进行一个嗯00:09:32.160 --> 00:09:34.060甚至要做一个支气管镜00:09:34.080 --> 00:09:36.480那么进行一个支气管镜以后00:09:36.480 --> 00:09:37.520做一个痰液的00:09:37.520 --> 00:09:39.320一个分泌物的一个培养00:09:39.320 --> 00:09:40.800那么来进行一个呃00:09:40.800 --> 00:09:41.900药物的治疗00:09:42.080 --> 00:09:44.400那么特别是在呃00:09:44.400 --> 00:09:45.720老年人群当中00:09:45.720 --> 00:09:46.640还有就是00:09:46.640 --> 00:09:49.560如果病人出现一个反复的感染以后00:09:49.560 --> 00:09:50.200那么有时候00:09:50.200 --> 00:09:53.060可能是他的一个慢性气道的阻塞00:09:53.120 --> 00:09:53.800那么这时候00:09:53.800 --> 00:09:55.960我们可能还要加用一些呃00:09:55.960 --> 00:09:57.140就是解禁药00:09:57.160 --> 00:09:58.200那么特别还有一些00:09:58.200 --> 00:09:58.720就是00:09:58.720 --> 00:10:01.640我们现在用的一些细物剂的吸入啊00:10:01.640 --> 00:10:04.360那么这样来改善它的一个肺功能00:10:04.360 --> 00:10:06.220那么这叫我们叫联合治疗00:10:06.480 --> 00:10:08.240甚至如果是一个重症感染00:10:08.240 --> 00:10:09.320可能我们还要进行00:10:09.320 --> 00:10:10.920一个机体的一个呃00:10:10.920 --> 00:10:12.120免疫的一个治疗00:10:12.120 --> 00:10:14.220那么可以用些剂量的丙球啊00:10:14.280 --> 00:10:15.520适当的摄入呃00:10:15.520 --> 00:10:17.780适当的补充一些白蛋白啊等等00:10:17.800 --> 00:10:19.240那么这样来嗯00:10:19.240 --> 00:10:21.920加快病人的一个炎症的吸收00:10:21.920 --> 00:10:23.740那么改善他的一个症状00:10:24.160 --> 00:10:25.600那么在抗病毒方面呢00:10:25.600 --> 00:10:26.760我们说呃00:10:26.760 --> 00:10:28.360现在我们说流感病毒00:10:28.360 --> 00:10:30.040我们现在可以用一些00:10:30.040 --> 00:10:31.380流感病毒的药物00:10:31.440 --> 00:10:32.760那么包括新冠00:10:32.760 --> 00:10:33.940有新冠的药物00:10:34.040 --> 00:10:35.440那么如果呃00:10:35.440 --> 00:10:36.720在药物使用时候00:10:36.720 --> 00:10:38.000我们也要监测一下00:10:38.000 --> 00:10:39.440它的一个血常规啊00:10:39.440 --> 00:10:40.460肝肾功能00:10:40.680 --> 00:10:42.960那么这是一个非常重要的00:10:42.960 --> 00:10:44.840往往在治疗的时候00:10:44.840 --> 00:10:46.920要同时进行一个全身的00:10:46.920 --> 00:10:48.300一个综合的治疗00:10:48.800 --> 00:10:48.840呃00:10:48.840 --> 00:10:51.840我们包括一些机体的一些辅助治疗00:10:51.840 --> 00:10:53.040包括一个营养啊00:10:53.040 --> 00:10:54.280营养的支持啊00:10:54.280 --> 00:10:55.840或者是相关疾病00:10:55.840 --> 00:10:57.040如果有糖尿病的00:10:57.040 --> 00:10:58.460那一定要控制血糖00:10:58.480 --> 00:11:00.520那么如果血糖过高的话00:11:00.520 --> 00:11:02.740也会影响他的一个呃00:11:02.760 --> 00:11:04.540炎症的一个预后00:11:04.560 --> 00:11:05.900吸收的一个治疗00:11:06.240 --> 00:11:06.920那么另外呢00:11:06.920 --> 00:11:09.560就是我们说在这个物理治疗方面呢00:11:09.560 --> 00:11:12.880我们说这个体位是一个非常重要的00:11:12.880 --> 00:11:15.040那么我们有经验的一些护士00:11:15.040 --> 00:11:17.120那么他就会引指导病人00:11:17.120 --> 00:11:19.260如何进行一个体位的改变00:11:19.440 --> 00:11:20.040那么这样呢00:11:20.040 --> 00:11:22.860就是有助于他的一个痰液的排出00:11:23.000 --> 00:11:24.920那么包括我们呃00:11:24.920 --> 00:11:26.840护理人员的一个拍背00:11:26.840 --> 00:11:28.740那么如何正确的拍背00:11:28.800 --> 00:11:31.980那么对于病人的预后是非常重要的00:11:32.120 --> 00:11:33.560如果你护理得当的话00:11:33.560 --> 00:11:35.280痰液能够引流通畅00:11:35.280 --> 00:11:37.540那么它的炎症就吸收比较快00:11:37.600 --> 00:11:39.680那么病人的康复也就比较快00:11:39.680 --> 00:11:42.720那么对于一些特别是一些老嗯00:11:42.720 --> 00:11:44.240重症老年的病人00:11:44.240 --> 00:11:45.520那么我们在等00:11:45.520 --> 00:11:47.560重症监护室里面的一个护士00:11:47.560 --> 00:11:50.160护士那个勤翻身开背00:11:50.160 --> 00:11:51.720以及一个体位的一个改00:11:51.720 --> 00:11:53.360变那么这个呢00:11:53.360 --> 00:11:56.960如果嗯在护理得当的话00:11:56.960 --> 00:11:58.600那么对于病人的预后时00:11:58.600 --> 00:12:00.300起到很关键的作用00:12:00.520 --> 00:12:01.720那么第三个呢00:12:01.720 --> 00:12:04.400就是我们讲的一个生活方式里面00:12:04.400 --> 00:12:04.960现在很多00:12:04.960 --> 00:12:07.520为什么有时候出现一些年轻人00:12:07.520 --> 00:12:09.040也会出现一些嗯00:12:09.040 --> 00:12:10.160严重的感染00:12:10.160 --> 00:12:12.700那其实就是和他们的一个熬夜00:12:12.720 --> 00:12:15.880一个就是不正规的一个不饮食00:12:15.880 --> 00:12:17.440有的人可能就是呃00:12:17.440 --> 00:12:18.640饮食不当啊00:12:18.640 --> 00:12:21.000或者就是有时候吃有时候不吃00:12:21.000 --> 00:12:24.200那么在这种人群当中会出现一个00:12:24.200 --> 00:12:25.760也是会出现一个重症感染00:12:25.760 --> 00:12:28.000特别像这次我们在新冠时候00:12:28.000 --> 00:12:30.520也是年轻人也会出现一个重症的00:12:30.520 --> 00:12:31.760那么可能就跟他的一个00:12:31.760 --> 00:12:34.020机体的免疫功能下降00:12:34.040 --> 00:12:36.800以及他的一个不合理的一个饮食00:12:36.800 --> 00:12:38.900那么都有很大的一个关系00:12:40.560 --> 00:12:42.120另外呢就是在呃00:12:42.120 --> 00:12:44.020我们在观察症状方面00:12:44.040 --> 00:12:46.640那么大家一定要注意一个发热00:12:46.640 --> 00:12:48.960那么但是在老年人群当中00:12:48.960 --> 00:12:52.200很多病人是反而是体温不升00:12:52.200 --> 00:12:54.160那么其实体温不升00:12:54.160 --> 00:12:56.780不预示着他的炎症不严重00:12:56.800 --> 00:12:57.720往往有的时候00:12:57.720 --> 00:13:00.680病人反而是提示他有个重症感染00:13:00.680 --> 00:13:02.880他倒没有出现一个发热的症状00:13:02.880 --> 00:13:04.280那么特别是在老年人00:13:04.280 --> 00:13:05.420我们一定要注意00:13:05.560 --> 00:13:07.640不发热不等于他没有炎症00:13:07.640 --> 00:13:09.800那么一定要进行一个呃00:13:09.800 --> 00:13:11.440及时的进行一个呃00:13:11.440 --> 00:13:12.680血液系统的一个检查00:13:12.680 --> 00:13:13.600血常规啊00:13:13.600 --> 00:13:15.000一些c反应蛋白啊00:13:15.000 --> 00:13:16.820这些炎症指标的检测00:13:16.880 --> 00:13:17.520那么00:13:17.520 --> 00:13:20.260或者甚至是一个肺部的一个检查00:13:20.280 --> 00:13:21.120往往有时候00:13:21.120 --> 00:13:22.680往往病人感染已经很重了00:13:22.680 --> 00:13:23.900但是他没有发热00:13:24.320 --> 00:13:25.560他就是一个咳嗽00:13:25.560 --> 00:13:28.460甚至出现一个呼吸功能的一个不全00:13:28.480 --> 00:13:29.840那么这时候嗯00:13:29.840 --> 00:13:30.760大家要注意了00:13:30.760 --> 00:13:32.760不说不发热不等于没00:13:32.760 --> 00:13:34.440有感染那么另外呢00:13:34.440 --> 00:13:36.800就是一个咳嗽咳痰的症状00:13:36.800 --> 00:13:38.880那么特别是痰液的颜色啊00:13:38.880 --> 00:13:41.040或者是他的咳嗽的这种声音啊00:13:41.040 --> 00:13:42.000有时候也提示00:13:42.000 --> 00:13:44.640病人的一个炎症的情况00:13:44.640 --> 00:13:46.440那么有经验的医生也会知道呦00:13:46.440 --> 00:13:48.640这个病人老病人也会知道00:13:48.640 --> 00:13:49.600咳嗽多了00:13:49.600 --> 00:13:50.600痰闷脓了00:13:50.600 --> 00:13:51.720或者不易咳出了00:13:51.720 --> 00:13:53.360有时候伴有点喘气了00:13:53.360 --> 00:13:55.400那么往往可能他的一个病变00:13:55.400 --> 00:13:56.380有所加重00:13:58.320 --> 00:14:01.040另外呢就是我们一些就刚刚讲了00:14:01.040 --> 00:14:02.480一个重症患者里面00:14:02.480 --> 00:14:04.180我们说呃00:14:04.240 --> 00:14:05.480在紧急处理里面00:14:05.480 --> 00:14:06.800我们很多病人00:14:06.800 --> 00:14:09.440早期就给他使用一个白帕的00:14:09.440 --> 00:14:10.360一个呼吸00:14:10.360 --> 00:14:11.880那么呼吸机的使用00:14:11.880 --> 00:14:13.320那么肺功能改善了00:14:13.320 --> 00:14:16.180他的炎症也就会很快的好转00:14:16.440 --> 00:14:18.320那么所以我们很多重症病人00:14:18.320 --> 00:14:21.160早期就及时的给予一个呼吸机的00:14:21.160 --> 00:14:22.800一个辅助的一个通气00:14:22.800 --> 00:14:25.340那么特别我们现在用白帕用了很多00:14:25.400 --> 00:14:26.160那么这样呢00:14:26.160 --> 00:14:28.160就是早期的肺功能改善了00:14:28.160 --> 00:14:30.060那么他的炎症也就控制了00:14:30.240 --> 00:14:32.680所以这一步是非常很重要的一个00:14:32.680 --> 00:14:35.160对重症患者来说嗯00:14:35.160 --> 00:14:37.600早期使用呼吸机的辅助通气00:14:37.600 --> 00:14:39.220也是很重要的00:14:39.440 --> 00:14:41.600另外呢就是我们要给他一个嗯00:14:41.600 --> 00:14:44.580及早的使用一个规范的抗生素00:14:44.640 --> 00:14:47.640那么对于患者的了早期的一个治疗00:14:47.640 --> 00:14:48.520那么还有就是00:14:48.520 --> 00:14:50.900要早期要预防霉菌感染00:14:51.280 --> 00:14:53.040嗯如果一旦出现霉菌感染00:14:53.040 --> 00:14:53.720真菌感染00:14:53.720 --> 00:14:55.720那有时候也会嗯00:14:55.720 --> 00:14:58.000对他的预后也会影响很大的00:14:58.000 --> 00:15:00.040有时候病人就是一个细菌合并的00:15:00.040 --> 00:15:00.880真菌感染00:15:00.880 --> 00:15:02.160那么反复的感染00:15:02.160 --> 00:15:03.640不不育00:15:03.640 --> 00:15:05.620那么这时候我们说就要找00:15:05.720 --> 00:15:07.760就要看考虑到这方面的00:15:07.760 --> 00:15:08.120那么00:15:08.120 --> 00:15:11.260及时的给他进行一个细菌学的检查00:15:11.360 --> 00:15:13.920那么能够早期的就是及时的00:15:13.920 --> 00:15:16.780给他一个合理的一个抗菌治疗00:15:18.320 --> 00:15:19.720另外呢就是最呃00:15:19.720 --> 00:15:21.860最后最关键的就是我们说00:15:21.880 --> 00:15:22.480还有就是00:15:22.480 --> 00:15:24.980大家一个对大家的一个预防00:15:25.080 --> 00:15:26.140那么普及00:15:26.480 --> 00:15:29.560那么有的人喜欢脱早期有点咳嗽啊00:15:29.560 --> 00:15:30.520他不重视00:15:30.520 --> 00:15:33.000那么现在我们随着一个呃00:15:33.000 --> 00:15:33.960对老年人00:15:33.960 --> 00:15:36.840他自己对自我的一个呃意识的加强00:15:36.840 --> 00:15:37.400以后00:15:37.400 --> 00:15:39.640很多老年人一旦有些轻微的咳嗽00:15:39.640 --> 00:15:42.180痰多了他就会及时的来就诊00:15:42.400 --> 00:15:43.360那么这样的话呢00:15:43.360 --> 00:15:46.960那么早期的给他用药和早期的干预00:15:46.960 --> 00:15:48.880那么对于他的预后00:15:48.880 --> 00:15:50.880可以缩短他的一个疗程00:15:50.880 --> 00:15:52.520那么有时候病人一个礼拜00:15:52.520 --> 00:15:54.020病情就恢复了00:15:54.160 --> 00:15:56.680那么早期的再使用些解禁药物啊00:15:56.680 --> 00:15:58.000针对他一些老慢支啊00:15:58.000 --> 00:15:59.400一些气道的00:15:59.400 --> 00:16:01.640这种改善气道的一个环境00:16:01.640 --> 00:16:02.840那么这样的话呢00:16:02.840 --> 00:16:04.360对治疗的预后呃00:16:04.360 --> 00:16:06.460也是有很明显的改善00:16:06.520 --> 00:16:09.720所以说对于医疗普及00:16:09.720 --> 00:16:11.680所以现在我们说有很多小红书啊00:16:11.680 --> 00:16:14.240抖音上都有这种普及的一个知识00:16:14.240 --> 00:16:16.200那么很多人看了以后00:16:16.200 --> 00:16:19.600其实对这些疾病的认识越来越加强00:16:19.600 --> 00:16:21.360那么对他的自我的管理00:16:21.360 --> 00:16:22.600也就越来越好00:16:22.600 --> 00:16:25.440所以很多病人会及时的戒烟啊00:16:25.440 --> 00:16:28.040戒酒啊那么来改善他的00:16:28.040 --> 00:16:28.640有的病人00:16:28.640 --> 00:16:30.600可以早期的进行一些呼吸机00:16:30.600 --> 00:16:32.440自我的呼吸机的锻炼00:16:32.440 --> 00:16:33.160那么这样呢00:16:33.160 --> 00:16:35.760他的一个发病的时间就会延长00:16:35.760 --> 00:16:38.280那么发病的间隔时间就会延长00:16:38.280 --> 00:16:39.740那么对他的预后00:16:39.760 --> 00:16:42.340呼吸功能的恢复也会明显的改善00:16:42.800 --> 00:16:44.160呃所以说呃00:16:44.160 --> 00:16:46.240大家以后对这一方面的呃00:16:46.240 --> 00:16:47.520预防知识的普及啊00:16:47.520 --> 00:16:49.660科普教育还是要重视的00:16:50.000 --> 00:16:51.900好今天我们就讲到这里00:16:51.960 --> 00:16:53.460感谢大家的聆听