带状疱疹三区终极版课件.pptVIP

人员介绍 会诊医师 consulting staff 查房目的 Round Goals 提升护理人员的英文水平和学习兴趣 会诊 group consultation Dermatology consultation: cluster red papules on examination found that left back, a diagnosis of herpes zoster. External use: Qing peng ointment. Take orally: Three times a day galloway hydrochloric acid; Three times a day vitamin B1; Three times a day a piece of cobalt amine; Two times a day lyrica capsule. 诊断 Diagnosis 从水疱液中分离chu病毒或检测VZV，HSV抗原或DNA是鉴别诊断唯一可靠的方法。 Find the vzv、the HSV antigen or DNA is the only reliable reason for the diagnoise. 病因及发病机制Etiology and pathogenesis 典型表现General manifestation 前驱症状：轻度乏力、低热、纳差等全身症状，患处皮肤自觉灼热感或者神经痛，触之有明显的痛觉敏感，持续1～3天，亦可无前驱症状即发疹。 Weak,low-grade fever,poor appetite,loucal burning heat sensation or neuralgia,obvious sense of pain last 1-3 days, before blister,also blister with no formanifestation. 典型表现General manifestation 出疹特点：首先出现潮红斑，很快出现粟粒至黄豆大小的丘疹，簇状分布而不融合，继之迅速变为水疱，疱壁紧张发亮，疱液澄清，外周绕以红晕，各簇水疱群间皮肤正常。 Red spot firstly, papule soon,and then the blister with circumambient flush. 典型表现General manifestation 皮损特点：沿某一周围神经呈带状排列，多发生在身体的一侧，一般不超过正中线。 Zonation Injury along some of peripheral nerve, always one of the side of the body ,not cross the midline. 典型表现General manifestation 神经痛，可在发病前或伴随皮损出现，老年患者常较为剧烈。 病程一般2～3周，水疱干涸 、结痂脱落后留有暂时性淡 红斑或色素沉着。 Neuralgia before the blister or following the skin injury,especially the older. Course of the diease always 2-3 weeks, temporary erythema. 特殊表现 Special manifestation 眼带状疱疹 三叉神经眼支受累，眼睑红肿，结膜充血，可累及角膜形成溃疡性角膜炎，疼痛剧烈。 herpes zoster ophthalmicus Eyelids red swollen、 conjunctival congestion and maybe the ulcerative keratitis with severe pain by suffering from the eye branch of trigeminal. 特殊表现 Special manifestation 耳带状疱疹 病毒侵犯面神经及听神经所致，表现为外耳道或鼓膜疱疹。可出现面瘫、耳痛及外耳道疱疹三联症，称为Ramsay—Hunt综合征。 herpes zoster oticus 特殊表现 Special manifestation 带状疱疹后遗神经痛 ? 带状疱疹常伴有神经痛，在发疹前、发疹时以及皮损痊愈后均可发生，但多在皮损完全消退后或者1个月内消失，少数患者神经痛可持续超过1个月以上。 minority Neuralgia lasts more than 1 month. 特殊表现 Specia