精品小儿肺炎课件_13.ppt

小儿肺炎;小儿肺炎(pneumonia);[分类 病理分类];病因分类：;病程分类：;病情分类：;临床表现典型与否;发生肺炎的地点;支气管肺炎(bronchopneumonia);[病　因] ;A virus image from the International Committee on Taxonomy of Viruses, in The Big Picture Book o ;SARS;Transmission electron micrograph of adenovirus. Image courtesy of the US Centers for Disease Control ;肺炎链球菌纯培养的镜下形态（革兰染色）肺炎链球菌，俗称肺炎球菌，革兰阳性，呈矛头状，成双或链状排列，有荚膜；在痰标本中大多数成双排列 ;肺炎支原体 ;[病　理];间质性肺炎 ;肺呼吸道合胞体病毒肺炎插图显示一个典型的巨细胞，形状为圆形,带有粉红色胞质包涵体 ;Sputum Gram stain from a patient with a pneumococcal pneumonia. Note the numerous polymorphonuclear ;Pneumonia, community-acquired. Gram stain showing Streptococcus pneumoniae. ;Pneumonia, community-acquired. Gram stain showing Haemophilus influenzae ;Pneumonia, community-acquired. Gram stain showing Moraxella catarrhalis ;肺吸入性肺炎,高倍镜高倍镜下，可看到对吸入物质产生局部异物巨细胞反应 ;[病理生理] (一)呼吸功能不全;（二）循环系统;（三）中枢神经系统;（四）消化系统;（五）内环境紊乱;（五）内环境紊乱;[临床表现] (一) 呼吸系统症状; (一) 呼吸系统症状：呼衰;(一) 呼吸系统症状：呼衰;(二) 循环系统症状;婴幼儿肺炎合并心衰诊断标准：;(三) 神经系统症状;（四）抗利尿激素分泌异常综合症 （SIADH);（五）稀释性低钠血症;(六）酸碱平衡紊乱;(六）酸碱平衡紊乱;(七) 消化系统症状;（八）微循环障碍（休克或DIC);[并发症];Empyema caused by Streptococcus pneumoniae. Anteroposterior film. Courtesy of R. Duperval ;Bacterial pneumonia. Bilateral airspace infiltration secondary to community-acquired pneumonia, subs ;This patient developed a left tension pneumothorax during treatment of a severe pneumonia. Note the ;Pneumonia with multiple pneumatoceles ;实验室检查（一）病原学检查;（二）外周血检查;X线检查;Pneumonia, viral. Right-middle-lobe infiltrate in a 2-month-old boy with pneumonia due to respirator ;支气管肺炎;Pneumococcal pneumonia complicated by lung necrosis and abscess formation ;Lobar consolidation with pneumococcal pneumonia. Posteroanterior film. Courtesy of R. Duperval, MD ;Chest radiograph of a child with severe adenoviral pneumonia as an infant. The child ;诊断;鉴别诊断;治疗;(一) 一般治疗;（二）抗生素治疗;（二）抗生素治疗;　(三) 抗病毒药物治疗;(四) 对症治疗：1.祛痰止咳;2. 氧气疗法;3.镇静：;4.利尿：;5.抗心衰治疗：; 5.抗心衰治疗：洋地黄制剂; 5.抗心衰治疗：洋地黄制剂;6.退热;7.腹胀;（五）．肾上腺皮质激素的应用;几种不同病原菌肺炎的特点;一、腺病毒肺炎;一、腺病毒肺炎;一、腺病毒肺炎;二、合胞病毒肺炎;二、合胞病毒肺炎;二、合胞