呼吸困难—课件.PPT

肺源性呼吸困难 产生原因： 呼吸系统疾病引起肺通气和（或）肺换气功能障碍，导致缺氧和（或）二氧化碳潴留 常见类型： 吸气性呼吸困难 呼气性呼吸困难 混合型呼吸困难 肺源性呼吸困难 吸气性呼吸困难 产生原因 喉、大气道狭窄与阻塞 常见于 喉炎、喉水肿、喉癌、气管内异物 特点 吸气费力、吸气时间延长 吸气时出现“三凹征” 常伴干咳及高调吸气性喉鸣 肺源性呼吸困难 呼气性呼吸困难 产生原因 肺组织弹性减弱或细支气管痉挛、狭窄 常见于 慢性喘息型支气管炎、支气管哮喘、肺气肿 特点 呼气费力 呼气时间明显延长或缓慢 常伴哮鸣音 肺源性呼吸困难 混合型呼吸困难 产生原因 呼吸面积减少，影响换气功能 常见于 大面积肺炎、弥漫性肺纤维化、大量胸腔积液、气胸 特点 呼吸浅快 吸气与呼气均感费力 常伴呼吸音减弱或消失 可有病理性呼吸音 肺源性呼吸困难 心源性呼吸困难与肺源性呼吸困难鉴别 呼吸困难对患者的反应 活动耐力下降 日常生活活动受影响 严重呼吸困难者不能与人交谈 呼吸困难分度 轻度：可平地行走，登高或上楼时气急，中度或重度体力活动后出现呼吸困难 中度：平地慢走需中途休息，轻体力活动时出现呼吸困难 重度：洗脸、穿衣，甚至休息时也感到呼吸困难，日常生活完全依赖他人帮助 病案分析 男 78岁 因气急3周入院，伴咳嗽咳痰，夜间能平卧，无热，尿量正常，有慢支史30余年。 　体检：神清，自由体位，桶状胸，二肺呼吸音低，呼吸困难发作时二肺可及哮鸣音，颈静脉无明显充盈，BP HR正常，下肢无浮肿。 　实验室检查：胸片：桶状胸，心影不大，心彩超：心脏结构基本正常，心功能正常。 　 呼吸困难原因？ He Lixian * PER No significant improvement in mortality over past several decades In fact, a significant but small increase in mortality Factors: increasing age of population antibiotic resistance comorbidity issues [diabetes, liver and renal disease, neoplastic disease] poor penetration of pneumococcal vaccination into susceptible population He Lixian * PER No significant improvement in mortality over past several decades In fact, a significant but small increase in mortality Factors: increasing age of population antibiotic resistance comorbidity issues [diabetes, liver and renal disease, neoplastic disease] poor penetration of pneumococcal vaccination into susceptible population He Lixian * PER No significant improvement in mortality over past several decades In fact, a significant but small increase in mortality Factors: increasing age of population antibiotic resistance comorbidity issues [diabetes, liver and renal disease, neoplastic disease] poor penetration of pneumococcal vaccination into susceptible population He Lixian * PER No significant improvement in mortality over past several decades In fact, a significant but small increase in mortality Factors: increasing age of population antibiotic resistance comorbidity issues [d