• / 25
  • 下载费用:25 金币  

流行性腮腺炎课件_7

关 键 词:
流行性腮腺炎课件 流行性腮腺炎 流行性腮腺炎PPT 流行性腮腺 炎
资源描述:
单击此处编辑母版标题样 式 单击此处编辑母版副标题样式 * * * * 1 1 流行性腮腺炎 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society n由腮腺炎病毒侵犯腮腺引起的急性呼吸传 染病 n并可侵犯各种腺组织或神经系统及肝、肾 、心脏、关节等器官 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 流行病学 u传染源 早期患者及隐性感染者 腮肿前6天至腮肿后9天均可自病人唾液中分离出病毒,因 此在这两周内有高度传染性。 u传播途径 呼吸道 在唾液中通过飞沫传播,其传染力较麻疹、水痘为弱。 u易感者 人类普遍易感,感染后获得持久免疫 u流行特征 冬春多见 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 临床表现 n潜伏期8-30天,平均16-18天 n全身症状 有发热、畏寒、头痛、咽痛、食欲不佳、 恶心、呕吐、全身疼痛等,数小时腮腺肿 痛,逐渐明显,体温可达39℃以上, With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society n唾液腺炎 特征:时间、部位、形状 1.腮腺炎 腮腺肿胀最具特征性。 • 部位 一般以耳垂为中心,向前、后、下发展 , • 形状 状如梨形,边缘不清;局部皮肤紧张, 发亮但不发红,触之坚韧有弹性,有轻触痛; • 言语、咀嚼(尤其进酸性饮食)时刺激唾液分 泌,导致疼痛加剧;通常一侧腮腺肿胀后1~4 天累及对侧,双侧肿胀者约占75%。 • 腮腺导管口 开口处早期可有红肿,挤压腮腺 始终无脓性分泌物自开口处溢出。 n腮腺肿胀大多于1~3天到达高峰,持续4~5天逐 渐消退而回复正常。 n全程约10~14天。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 颌下腺肿大 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 2.颌下腺炎颌下腺肿大,表现为颈前下 颌肿胀并可触及肿大的腺体。 3.舌下腺炎舌下腺肿大可见舌及口腔底 肿胀,并出现吞咽困难。 n颌下腺和舌下腺也可同时受累,或单独出 现。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 腮腺及颌下腺肿大 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 腮腺导管开口 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 并发症 n神经系统 • 脑膜脑炎、脑炎 • 耳聋 • 多发性神经炎 n腺体组织 • 胰腺炎 • 睾丸炎 • 卵巢炎 n其它 肾炎、心肌炎 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 并发症 n 1、无菌性脑膜炎脑膜脑炎、脑炎:为常 见的并发症,尤多见于儿童患者男孩多于 女孩。脑膜脑炎症状一般多在肿后1周内出 现。脑脊液和症状与其他病毒性脑炎相仿 ,头痛呕吐等,急性脑水肿表现较明显。 脑电图可有改变但不似其他病毒性脑炎明 显结合临床,以脑膜受累为主。预后多良 好。个别脑炎病例也可导致死亡。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society n2、胰腺炎:常发生于腮腺肿胀后3、4天至 1周以中上腹剧痛和触痛为主要症状。伴呕 吐、发热腹胀、腹泻或便秘等,有时可扪及 肿大的胰腺,胰腺炎症状多在一周内消失。 血中淀粉酶不宜作诊断依据,血清脂肪酶值 超过1.5U/dl(正常为0.2~0.7U/dl)提示最 近发生过胰腺炎。脂肪酶通常在发病后72 小时升高,故早期诊断价值不大近年来随着 儿童患者病情越来越重,胰腺炎的并发症也 随之增高。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society n3、睾丸炎:常发生在腮腺肿大1周左右开始消退 时突发高热、寒战、睾丸胀痛伴剧烈触痛,症状 轻重不一,一般约10天左右消退阴囊皮肤水肿也 显著,鞘膜腔内可有黄色积液。病变大多侵犯一 侧,由于病变常为单侧,即使双侧也仅部分曲精 管受累故很少引致不育症。附睾炎常合并发生。 n4、卵巢炎:约占成人女性患者的5%~7%症状 较轻,不影响受孕,偶可引起提前闭经卵巢炎症 状有下腰部酸痛,下腹部轻按痛,月经周期失调 严重者可扪及肿大的卵巢伴压痛。迄今尚未见因 此导致不育的报告。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society n5、耳聋:为听神经受累所致发病率虽 不高(约1/15 000),但可成为永久性 和完全性耳聋,所幸75%为单侧性故 影响不大。 n6、偶有腮腺炎后1~3周出现多发性 神经炎脊髓炎,预后多良好。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 检 查 n(一)血象:白细胞计数正常或稍低,后 期淋巴细胞相对增多。有并发症时白细胞 计数可增高。 (二)血清和尿淀粉酶测定:90%患者的 血清淀粉酶有轻度和中度增高,有助诊断 。淀粉酶增高程度往往与腮腺肿胀程度成 正比。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society n(三)血清学检查。 1.中和抗体试验:低滴度如1:2提示特异 免疫反应。中和抗体特异性强,但不作常规应用 。 2.补体结合与血凝抑制试验:早期及恢复期 双份血清测定补体结合及血凝抑制抗体,有显著 增长者可确诊(效价4倍以上)。国外采用酶联免 疫吸咐法及间接荧光免疫检测IgM抗体,可作早 期诊断。 3.病毒分离:早期患者可在唾液、尿、血、 脑脊液中分离到病毒。 4.尿 肾脏受累时可出现尿蛋白、红白细胞 等,甚至类似肾炎尿的改变。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 诊断 n1.疑似病例 发热,畏寒,疲倦,食欲不振,1~2 日后单侧或双侧非化脓性腮腺肿痛或其他唾液腺 肿痛。 n2.确诊病例 n ①腮腺肿痛或其他唾液腺肿痛与压痛,吃酸 性食物时胀痛更为明显。腮腺管口可见红肿。白 细胞计数正常或稍低,后期淋巴细胞增加。 n ②发病前1~4 周与腮腺炎病人有密切接触史 。 n 临床诊断:疑似病例加①参考②项。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 鉴别诊断 n1.化脓性腮腺炎 常为一侧性,局部红肿压痛明显,晚期 有波动感,挤压时有脓液自腮腺管流出,血象中白细胞总 数和中性粒细胞明显增高。 n2.颈部及耳前淋巴结炎 肿大不以耳垂为中心,局限于颈 部或耳前区,为核状体,较坚硬,边缘清楚,压痛明显, 表浅者活动。可发现与颈部或耳前区淋巴结相关的组织有 炎症,如咽峡炎、耳部疮疖等,白细胞总数及中性粒细胞 增高。 n3.症状性腮腺肿大 在糖尿病、营养不良、慢性肝病中, 或应用某些药物如碘化物、保泰松,异丙肾上腺素等可引 致腮腺肿大,为对称性,无肿痛感,触之较软,组织检查 主要为脂肪变性。 n4.其他病毒所引起的腮腺炎 已知1.3型副流感病毒,甲型 流感病毒,A型柯萨奇病毒,单纯疱疹病毒,淋巴脉络膜 丛脑膜炎病毒,巨细胞病毒均可引起腮腺肿大和中枢神经 系统症状,需作病原学诊断。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 预 防 n及早隔离患者直至腮腺肿完全消退为止。接触者 一般不一定检疫,但在集体儿童机构(包括医院、 学校)、部队等应留验3周,对可疑患者,应立即 暂时隔离。 n接种流行性腮腺炎减毒活疫苗:其预防感染的效 果小儿可达97%,成人中可达93%,腮腺炎活 疫苗与麻疹、风疹疫苗同时联合使用(麻腮风疫 苗),结果满意,三者之间互不干扰。免疫后, 腮腺炎病毒的中和抗体至少可保持9.5年。 n 流行性腮腺炎活疫苗的免疫途径除皮内注射 、皮下注射外,还可采用喷鼻或气雾吸入(在气雾 室内进行)效果也良好。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 治疗 n一般治疗 n中医中药 n抗病毒治疗 n激素治疗 n其他治疗 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 治 疗 n(一)一般护理:隔离患者使之卧床休息 直至腮腺肿胀完全消退。注意口腔清洁, 饮食以流质或软食为宜,避免酸性食物, 保证液体摄入量。 n(二)抗病毒治疗 轻症口服板蓝根、抗病 毒口服液等,重者可用病毒唑、干扰素等 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society n(三)对症治疗:宜散风解表,清热解毒。必要 时内服去痛片、阿斯匹林等解热镇痛药。 (四)并发症的治疗 重症并发脑膜脑炎、严重睾 丸炎、心肌炎时,可短期使用肾上腺皮质激素。 睾丸炎治疗:成人患者在本病早期应用乙烯 雌酚,每次数1mg,一日三次,有减轻肿痛之效 。 脑膜脑炎治疗:可按乙型脑炎疗法处理。高 热、头痛、呕吐时给予适量利尿剂脱水。 胰腺炎治疗:禁饮食、输液、反复注射阿托 品或山莨菪碱,早期应用皮质激素。 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society n(三)外治法 1.青黛散以醋调敷腮部,每日3—4次 。 2.紫金锭(玉枢丹)或金黄散以水调匀后 敷患部。 3.天花粉、绿豆各等分,研成细末, 加入冷开水调成糊状,外敷患部,每日3~ 4次。 4.鲜蒲公英、鲜马齿苋、鲜荚蓉花叶 、鲜丝瓜叶,任选一种,捣烂外敷患部。
展开阅读全文
  麦档网所有资源均是用户自行上传分享,仅供网友学习交流,未经上传用户书面授权,请勿作他用。
0条评论

还可以输入200字符

暂无评论,赶快抢占沙发吧。

关于本文
本文标题:流行性腮腺炎课件_7
链接地址:https://www.maidoc.com/p-15689331.html
关于我们 - 网站声明 - 网站地图 - 资源地图 - 友情链接 - 网站客服 - 联系我们

[email protected] 2018-2020 maidoc.com版权所有  文库上传用户QQ群:3303921 

麦档网为“文档C2C模式”,即用户上传的文档所得金币直接给(下载)用户,本站只是中间服务平台,本站所有文档下载所得的金币归上传人(含作者)所有。
备案号:蜀ICP备17040478号-3  
川公网安备:51019002001290号 


收起
展开