Asthma急性哮喘中英文.pptVIP

Respiratory Emergencies:呼吸道急诊： Acute Asthma 急性哮喘 Wheezes heard in any geriatric patient should be considered pulmonary edema until proven otherwise (especially in the absence of any history of COPD or asthma) 在任何老年患者听到的喘鸣声都应被考虑为肺部水肿，除非获得其他证明（尤其是不存在慢性阻塞性肺病或哮喘病史） Obstructive Lung Disease Asthma阻塞性肺疾病 哮喘 Abnormal ventilation usually from obstruction in the bronchioles 异常通气常源于细支气管的阻塞 Numerous changes are noted in the airways during an attack 哮喘发作时，在气道中可以观察到几种改变 The Ventilation Process通气过程 Normal inspiration - the working phase bronchioles naturally dilate 正常吸气 – 工作期 细支气管自然扩大 Normal exhalation - the relaxation phase bronchioles constrict 正常呼气 – 舒张期 细支气管收缩 Exhalation is active with obstructive airway disease 存在阻塞性气道疾病时，呼气运动活跃 Alveolar Sac and Capillaries肺泡囊和毛细血管 Asthma Chronic inflammatory disorder of the airways 气道的慢性炎症性疾病 Airflow obstruction and hyperresponsiveness are often reversible with treatment经过治疗，气流阻塞和气道高反应性常为可逆性 Triggers vary from individual to individual 触发原因因人而异 Asthma’s Two-Phase Reaction哮喘的两相反应 Phase one - within minutes 第一相 – 几分钟内发生 Release of chemical mediators (ie: histamine) 释放化学媒介（即：组织胺） contraction of bronchial smooth muscle (bronchoconstriction) 支气管平滑肌收缩（支气管收缩） leakage of fluid from bronchial capillaries (bronchial edema) 液体从支气管毛细血管渗漏（支气管水肿） Phase two - in 6-8 hours 第二相 - 6-8 小时内 Inflammation of the bronchioles from invasion of the mucosa of the respiratory tract from the immune system cells 从免疫系统细胞产生的粘液侵入呼吸道，引发细支气管的炎症反应 additional swelling edema of bronchioles 额外的细支气管肿胀和水肿 Assessment of Asthma哮喘评估 Presentation Dyspnea 表现 呼吸困难 Wheezing - initially heard at end of exhalation 喘鸣 – 初始时在呼气末听到 Cough - unproductive, persistent 咳嗽 – 无痰，持续 may be the only presenting symptom 可能为唯一存在的表现症状 Hyperinflation of chest - trapped air 胸部充气过度 – 残留空气 Tachypnea - an early warning sign of a 呼吸急促 – 呼吸道问题的早期警示体征respiratory problem Use of accessory muscles 使用副肌肉 Severe Asthma Attack严重的哮喘发作 One and two word dyspnea Tachycardia Decreased oxygen saturat