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精品小儿呼吸系统解剖生理特点课件_14

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精品 小儿 呼吸系统 解剖 生理 特点 课件 _14
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Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 小儿呼吸系统解剖生理特点 上呼吸道感染 同济大学附属同济医院儿科 魏东 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 解剖特点 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 鼻 面骨发育不全 鼻和鼻腔相对短小 数月内几无下鼻道 4岁形成 没有鼻毛 缺乏海绵组织 少鼻衄 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 鼻窦 上颌窦和筛窦 新生儿极小 2yr后迅速增 大 12yr充分发育 额窦 2 3yr出现 12 13yr发育 蝶窦 3yr通鼻腔 6yr发育 粘膜相连 窦口较大 易发炎 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 鼻泪管和咽鼓管 鼻泪管短 瓣膜发育不全 咽鼓管宽 直 短 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 咽 咽后壁滤泡 咽后壁脓肿1yr内最显 新生儿扁桃体腺窝血管均不发达 狭小垂直 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 扁桃体发育规律 咽扁桃体6月已发育 腭扁桃体1yr末渐大 4 10高峰 10 15yr 退化 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 喉 相对较 成人长 漏斗状到圆柱状 软骨软 粘膜薄弱多血管 新生儿喉头3 4T 成人5 6T 前倾 婴儿环状软骨最窄 3岁开始变锐 10yr形成男性喉结 婴儿声带短 音高 12yr后 声带男长 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 气管切面 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 气管 新生儿长4cm 成人增加3倍 分叉新生儿3 4T 成人5T下 右直 易异物 新生儿末梢气道相对较宽 到成人 肺重 增加20倍 气管直径增加4倍 毛细支气管增加2倍 壁厚增加3倍 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 毛支平滑肌5月前薄少 3yr后明显发育 梗阻主要为肿胀和分泌物 气管壁缺乏弹力纤维 软骨柔弱 细支 气管无软骨 呼气易受压 胎儿气道发育早于肺 传到部分多于呼吸 部分 死腔 潮气量比例大 气道阻力与r4反比 阻力大 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 肺 肺泡直径早产儿75um 足月儿100um 成 人250 350um 肺泡数新生儿 2500万 为成人 2 6 平 均3亿 8 毛细支气管2月内逐渐增多 肺泡增加8yr 停止 平均每天增加10万多 肺泡面积 初生时2 8m2 8yr32m2 成人 75m2 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 2yr后出现Kohn氏孔 气道梗阻时侧支作 用 2yr内肺小叶单房囊的原始状态较多 6 7 岁结构近于成人 7 12yr发育完善 2yr内肺叶裂隙常不明显 婴幼儿右肺的上 中叶常未分开 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 呼吸肌与胸廓 生后圆形 2yr内渐椭圆 初生软骨 渐钙化 肋脊直角 呼吸肌不发达 主要腹式呼吸 受腹胀影响 隔横位 斜度小 胸廓内陷 呼吸效率低 胸壁柔软 吸气负压大易凹陷 限制肺扩 张 耐疲劳肌纤维少 早产儿不到10 足月 儿30 1yr50 60 成人水平 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 纵膈 胸膜薄 纵膈相对大 周围组织柔软疏散 限制呼吸 易移位 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 各年龄小儿呼吸 脉搏 次数 分 年龄龄 呼吸脉 搏呼吸 脉搏 新生儿40 45120 1401 3 2岁岁 pH值值7 35 7 457 35 7 457 35 7 45 Pa02 kPa 8 1210 6 13 310 6 13 3 PaC02 kPa 4 00 4 67 4 00 4 67 4 67 6 00 HC03 mmol L 20 2220 2222 24 BE mmol L 6 2 6 2 4 2 Sa02 90 9795 9796 98 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 免疫特点 天然免疫 特异性免疫 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 检查方法 体格检查 血气分析 影像学检查 纤支镜 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 上颌窦炎 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 上呼吸道感染 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 病因 病毒 细菌 支原体 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial TABLE 381 1 Infectious Agents Associated with the Common Cold Category Agents Common viruses that Rhinoviruses usually cause common colds Parainfluenza viruses Respiratory syncytial virus Coronaviruses Common agents that occasionally Adenoviruses cause symptoms of the common Enteroviruses cold Influenza viruses Parainfluenza viruses Reoviruses Mycoplasma pneumoniae Agents that rarely cause symptoms Coccidioides immitis of the common cold Histoplasma capsulatum Bordetella pertussis Chlamydia psittaci Coxiella burnetii Adapted from Cherry JD The common cold In Feigin RD Cherry JD eds Textbook of Pediatric Infectious Diseases Philadelphia WB Saunders 1998 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 流行病学 全年发生 冬春较多 婴幼儿最多 学龄 儿童减少 飞沫传播 直接接触 肠道 流行或散发 传染期轻症最初几天 重症较长 激发细 菌更长 对病毒免疫力较短 1 2月或稍久 也可达 数年 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 病理变化 血管扩张 单核细胞清润 粘膜下水肿 中性细胞清润 上皮细胞受损剥脱 痊愈修复 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 临床表现 局部症状 轻症 鼻塞 流涕 喷嚏 干咳 咽部不适 咽痛 3 4天自愈 全身症状 重症 发热 烦躁 头痛 全身不适 乏力 食欲不振 消化道症状 婴幼儿全身症状为主 热程2 3d至1w左右 高热惊厥 年长儿局部症状为主 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 体征 咽充血 扁桃体肿大 淋巴结肿大 肺部正常 肠道病毒感染多皮疹 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 疱疹性咽峡炎 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 2 4mm灰白色疱疹 1 2d后破溃成小溃疡 可见其他部位 1w痊愈 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 眼结合膜热 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 高热 咽痛 眼部刺痛 咽充血 分泌物 滤泡性结膜炎 淋巴结肿大 1 2w痊愈 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 急性扁桃体炎 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 急性喉炎 临床表现 分度 活动后吸气喉鸣 呼吸困难 安静时吸气喉鸣 呼吸困难 发绀 大汗 呼吸音低 心率快 心音低 衰竭 昏睡 面色苍白 呼吸音 消失 心律不齐 心音钝 弱 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 并发症 中耳炎 鼻窦炎 咽后壁脓肿 咽炎 扁 桃体周围脓肿 颈淋巴结炎 气管炎 肺炎 肾炎 风湿热 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 实验室检查 血常规 病因检查 直接和间接 链球菌感染2 3w后ASO升高 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 鉴别诊断 流感 急性传染病早期 阑尾炎 过敏性鼻炎 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 治疗 一般治疗 抗感染治疗 对证治疗 喉炎治疗 保持气道通畅 雾化 控制感染 激素 对症 吸氧 镇静 吸痰 止咳祛痰 气管切开 以上 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial v r oXlTiQeNbK8G5D2A x t qZnVnVkShPdMaI7F7F4C0z w s pXmUjRfOcL9H6E2B y u r oWlThQeNbJ8G5D1A w t qYnVkSgPdLaI7F3C0z v s pXmUiRfOcK9H6E2B x u rZoWlThQeMbJ8G4D1A w t qYnVjSgPdLaI6F3C0y v s pXlUiRfNcK9H5E2A x u rZoWkThPeMbJ7G4D1z w t qYmVjSgOdLaI6F3B0y v s pXlUiQfNcK8H5E2A x u rZnWkThPeMaJ7G4C1z w t pYmVjRgOdL9I6E3B0y v s oXlTiQfNbK8H5D2A x u qZnWkShPeMaJ7F4C1z w t pYmUjRgOcL9I6E3B y v r oXlTiQeNbK8G5D2A x t qZnVkShPdMaI7F4C0z w s 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