(精选)【医学课件课件】呼吸系統病理学教学课件.pptVIP

SARS (2)(Severe Acute Respiratory Syndrome) 飛沫、接觸體液傳染 潛伏期3-7天、可能超過十天 症狀(Fig 11-6)，出現症狀後始具傳染力 X-ray and CT：肺部浸潤 Pathology: patchy organizing pneumonia, diffuse alveolar damage, respiratory distress syndrome (呼吸窘迫), respiratory failure (呼吸衰竭) 電子顯微鏡：SARS virus in type II pneumocytes No vaccine Mortality rate: 15% 吸入性肺炎(aspiration pneumonia) 氣體、液體、固體微粒 引起細菌感染、機械性阻塞及化學性傷害 溺水、酒醉、昏迷、虛弱、食道或神經病變的病患 污水、胃液和食物 多為支氣管肺炎 Aspiration pnemoniaSup. Segment, RLL 肺膿腫(pulmonary abscess) 局部化膿性病變 病因：口咽部手術、上呼吸道感染、頭頸部膿腫、支氣管擴張 併發症：胸膜炎、腦膜炎、腦膿腫、全身性感染 氣喘(asthma) 支氣管通道收縮引起的陣發性呼吸困難及wheezing，又稱支氣管氣喘(bronchial asthma) 心因性氣喘 氣喘(asthma)分類 外因性 過敏性原因，又稱allergic asthma 過敏原：花粉、塵螨、毛或微生物 兒童期開始反覆發病 IgE 非過敏性原因 Infectious asthma: 常為病毒感染 Occupational asthma: 有機或無機物質引起 內因性 可經由drugs, pressure, sport, chemical substance or infection引起 Mechanism: not clear 氣喘(asthma) 病理 小支氣管及細支氣管為黏液阻塞 黏液中可發現Eosinophil, Curschmann spiral, Charcot-Leyden crystal 管壁水腫及炎症細胞浸潤 管壁平滑肌spasm及肥大 黏膜下層黏液腺增大 Status asthmaticus 支氣管擴張症(bronchiectasis) 破壞管壁結構或增加外在牽引力 支氣管和細支氣管不正常且永久性的擴大 Etiology: TB, pneumonia, tumor, foreign body, asthma, chronic bronchitis, cystic fibrosis, congenital abnormality 局部性或瀰漫性 症狀：chronic productive cough, respiratory difficulty, clubbing finger, fever, pulmonary abscess, cyanosis, cor pulmonale, brain abscess, etc. 肺膨脹不全(atelectasis) 先天性 Premature baby Associated with hyaline membrane disease (neonatal respiratory distress syndrome, lack of surfactant) 後天性 因支氣管、肺臟或胸膜疾病引起的肺臟塌陷及無氣狀態 易引起感染 胸痛、呼吸困難、cyanosis；無咳嗽或咳血 肺氣腫(emphysema) 肺臟腺泡不正常且永久性的擴大 無纖維化現象 Larger pulmonary compliance than normal individuals Barrel chest Broader definition includes Senile emphysema, compensatory emphysema, obstructive overinflation, interstitial emphysema 肺氣腫(emphysema) Chronic Obstructive Pulmonary Disease (COPD) Respiratory difficulty and airway obstruction Emphysema, chronic bronchiolitis, brochiectasia, bronchial asthma Pink puffer Emphysema, older age, rapid and short respiration, adequate oxygenation, no cyanosis Blue bloater Chron