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1、同学们好！,呼吸系统疾病Respiratory System Disease,湘雅医院儿科 郑湘榕,婴幼儿上感、2种特殊类型上感的特点支气管肺炎临床表现、重症肺炎特点 支气管肺炎的诊断、治疗支气管哮喘的临床表现、诊断和治疗,重点,Introduce,In pediatric outpatient, 6o% patients are acute respiratory infections. In pediatric ward, 25% patients are Pneumonia. The first cause of childrens death in China is Pneumonia
2、. Pneumonia is the worlds leading cause of death among children. It kills nearly two million children under age five every year.,Why children are so susceptible to acute respiratory infections,?,anatomic physiological features,The childrens respiratory lumens are narrow,blood flow is abundant. The c
3、hildrens repertory ability is low. The childrens local immunity is low.,Children Respiratory System Physiologic Feature,Respiratory rate,Neonate 40-44/min 60次/分 心率突然增快 婴儿180次/分幼儿160次/分 突然烦躁不安、面色发灰 心音明显低钝，奔马率，颈静脉怒张 肝大肋下3cm以上 尿少、下肢浮肿,Clinical manifest,nerval system,Light hypoxia： irritability，lethargy
4、,Sever hypoxia： hydrocephalus,digestive system,alimentary canal bleeding,Poisoning intestine palsy,Severesymptomatic,Clinical manifest,DIC,Bp,四肢凉，脉速弱， 出血,SLADH,Na + 130mmol/L 渗透压 270mOsm/L,Edema,Severesymptomatic,Complications,Complication,pneumatocele,pyopneumothorax,empyema,Laboratory data,Blood,bloodroutine,bacteria infect：WBC、N left shift of nucleus virus infect：WBC、L abnormal lymph cell,bacteria infect ： CRP virus infect ：CRP normal,CRP,NBT,bacteria infect ： 10% virus infect ： 10%,Pathogeny,virus separate,Germiculture,sputum for Gram stain and culture,Laboratory data,
