传染性非典型肺炎图文ppt课件.ppt

A 46-year-old health care worker presented with 2-day 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 ill-defined consolidation in periphery of left lower zone Figure 1 - CXR on admission showed ill-defined 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 34-year-old presented with 3-day history of fever, chills and malaise Figure 1 - CXR at the time of diagnosis showed ill-defined air space opacification in right lower zone Figure 2 - CXR after 3 days showed partial resoulation of consolidatve changes in right lower zone. There is a new finding of ill-defined air space opacification in left lower zone Figure 3 - CXR after another 4 days showed progressive resolution of the changes in both lower zones A 31-year-old health-care worker presented with 2-day history of fever, chills and myalgia. SARS的临床诊断标准（5） 5. 抗菌药物治疗无明显效果。 — 回顾性（滞后性） — 不确定性 SARS的诊断标准 疑似诊断标准：符合1+2+3条 或 2+3+4条 临床诊断标准：符合1.1+2+4条 或 1.2+2+4,再加3或5条 1）流行病学资料: 1.1—硬证据, 1.2—软证据； 2）症状和体征； 3）血象； 4）胸部X线检查； 5）抗菌药无效 SARS的鉴别诊断 普通感冒，流行性感冒 细菌性或真菌性肺炎，AIDS合并肺部感染 支原体肺炎，军团病，一般病毒性肺炎 肺结核 流行性出血热 肺部肿瘤 非感染性间质性肺疾病 肺水肿、肺不张、肺栓塞 肺嗜酸性粒细胞浸润症 肺血管炎 其它临床表现类似的肺部疾患 重症SARS诊断标准 符合以下1条即可诊断重症SARS： 呼吸困难，呼吸频率30次/分； 低氧血症，吸氧3-5升/分时，PaO2＜70mmHg/SpO2＜93%；或已可诊为急性肺损伤（ALI）或ARDS； 多叶病变或X线胸片显示48小时内病灶进展50%； 休克； 多器官