支气管扩张肺脓肿 杨侠ppt课件.pptVIP

同学们好！;支 气 管 扩 张 症  Bronchiectasis ;Definition;病因（Etiology）;发病机制（pathogenesis ）;Bronchial-pulmonary infection;Bronchial organic obstruction;bronchus external traction;Congenital and genetic factors ;病理（Pathology） ;病理（Pathology）;Clinical manifestations ; 静置后分三层 ;Clinical manifestations;clubbed fingers ; Imaging findings BronchoscopyPulmonary function testsBlood routine examinationSputum smear and sputum culture;chest radiograph： 早期轻症：局部肺纹理增多增粗 典型支气管扩张：蜂窝状透亮阴影，卷发状阴影，液平 少数患者：无异常;Chest high-resolution CT 用于支气管扩张的诊断，可显示管壁增厚的柱状扩张和成串成簇的囊状扩张 Bronchography 确定支气管扩张的病变类型和分布范围;;;;左侧支气管扩张 斜位片示左上叶及左下叶各段支气管有混合性扩张,呈囊状及柱状; BronchoscopyPulmonary function testsBlood routine examinationSputum smear and sputum culture ;Diagnosis and differential diagnosis ;Diagnosis and differential diagnosis;treatment ;体位引流具体方法;treatment;Prevention ;肺 脓 肿  Lung Abscess;Definition;Etiology 病原菌： 厌氧菌：产黑色素类杆菌、口腔类杆菌、核酸杆菌、消化球菌、消化链球菌等 需氧兼性厌氧菌：金黄色葡萄球菌、溶血性链球菌、肺炎克雷白杆菌、大肠杆菌、绿脓杆菌、变形杆菌、不动杆菌、军团菌等;Etiology and pathogenesis;吸入性肺脓肿（aspiration pulmonary abscess）;Etiology and pathogenesis;Etiology and pathogenesis;Pathology;;Clinical manifestations;Clinical manifestations;Clinical manifestations;Clinical manifestations;Laboratory and ancillary tests ;Laboratory and ancillary tests;Laboratory and ancillary tests; 早期 化脓性炎症阶段 X线征象为大片浓密度模糊炎性浸润阴影，边缘不清，分布在一个或数个肺段;肺脓肿形成后 大片浓密炎性阴影中出现圆形透亮区及液平面 消散期 脓肿周围炎症渐吸收，脓腔缩小而消失，最后残留少许纤维条索阴影。;;慢性肺脓肿：腔壁增厚，内壁不规则，周围炎症略消散，伴纤维组织显著增生，并有不同程度的肺叶收缩，胸膜增厚，健肺代偿性肺气肿。;; 血源性肺脓肿 多发性 一肺或两肺边缘 小??状炎症阴影 脓腔、气液平面;右肺下叶肿块型肺脓肿;肺脓肿CT表现;肺脓肿;肺脓肿;Laboratory and ancillary tests;Diagnosis and differential diagnosis;Diagnosis and differential diagnosis;differential diagnosis 细菌性肺炎 1.稽留热 2.多伴有口唇疱疹 3.痰呈铁锈色 4.X线片呈淡薄炎症病变，边缘模糊不清，没有空腔形成;大 叶 性 肺 炎;Diagnosis and differential diagnosis; 肺 结 核;Diagnosis and differential diagnosis;左下肺后基底段癌性空洞 多房性,内壁凹凸不平;Diagnosis and differential diagnosis;treatment;treatment;40岁男性，发烧38-39度，持续咳嗽咳痰;treatment;treatm