《非典型肺炎》ppt課件-文庫吧
2025-01-06 21:57 本頁面
【正文】 發(fā)熱及相關(guān)癥狀 – 常無上呼吸道卡他癥狀 。 – 可有咳嗽 ， 多為干咳 、 少 痰 ， 偶有血絲痰； – 可有胸悶 ， 嚴重者出現(xiàn)呼吸加速 ,氣促 ,或呼吸窘迫 。 – 肺部體征常不明顯 ， 部分病人可聞少許濕羅音 ， 或有肺實變體征 。 —— 呼吸系統(tǒng)癥狀 臨 床 特 點 SARS的臨床診斷標準（ 3） –外周血白細胞計數(shù)一般不升高 ， 或 降低 ； –常有淋巴細胞計數(shù) 減少 ； –部分病例發(fā)病數(shù)天 PLT減少或處正常低限 – T淋巴細胞計數(shù) CD4減少 臨 床 特 點 SARS的臨床診斷標準（ 4） 4. 胸部 X線檢查 –肺部有不同程度的片狀 、 斑片狀浸潤陰影或 呈網(wǎng)狀改變 ， 有時進展迅速 ， 呈大片狀陰影； –陰影常為雙側(cè)改變 ， 消散吸收較慢 。 –肺部陰影與癥狀體征可不一致 。 –若 X線胸片檢查陰性 ， 條件允許可安排 CT檢查以發(fā)現(xiàn)肺部早期輕微病變 ， 或每 12天復查 X線胸片 。 Fig 13: (day 5 after onset of symptoms) Multifocal confluent areas of airspace opacities in both lungs Fig 14: (day 6 after onset of symptoms) Diffuse and widespread consolidative changes in both lungs (patient is intubated) A 46yearold health care worker presented with 2day history of fever, chills and myalgia. Figure 1 CXR on admission was normal Figure 3 CXR after another 4 days showed progressive multi focal consolidation in mid and lower zones of both lungs Figure 2 CXR after 3 days showed illdefined consolidation in periphery of left lower zone Figure 1 CXR on admission showed illdefined air space opacification in periphery of right lower zone Figure 2 CXR 3 days later showed progression of air space opacification in right lower zone and a new finding of similar changes in left mid and lower zones after initial treatment Figure 3 CXR another 3 days showed marked resolution of the consolidative changes in both lungs after treatment A 34yearold presented with 3day history of fever, chills and malaise Figure 1 CXR at the time of diagnosis showed illdefined air space opacification in right lower zone Figure 2 CXR after 3 days showed partial resoulation of consolidatve changes in righ
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