课件：儿科肺炎.ppt

There is a 4.5 x 4.5 x 2.5 cm cystic mass posterior to the trachea and the mainstem bronchi. The mass causes marked narrowing of the left main bronchus. The esophagus is displaced to the patients right by the mass with flattening of the esophageal lumen. This mass is most likely a mediastinal bronchogenic cyst. An esophageal duplication cyst could have a similar appearance. The patient underwent surgical excision of the mediastinal mass via thoracotomy without complications. Pathology confirmed the mass to be a bronchogenic cyst. Wheezing and Respiratory Distress in a 7-Week Old The CXR showed cardiomegaly and possibly increased pulmonary vascular markings consistent with congestive heart failure (CHF). The femoral pulses were difficult to palpate. Measurement of blood pressures in the four extremities showed 126/86 (left arm), 132/92 (right arm), 69/41 (left leg), and 63/59 (right leg). An EKG was done. t is not easy to see the tracing of some of the precordial leads because they are very large. R2 (R wave of V2) extends into the tracing of V1. R4 is off the scale. Suffice it to say that all the R and S waves in V1-V6 are large. The axis of QRS is 90 degrees (roughly isoelectric in I and positive in AVF). This is a rightward axis. The large QRSs in V1-V6 meet voltage criteria for both LVH and RVH. This EKG shows biventricular hypertrophy. * 资料可以编辑修改使用 资料来源网络，如有侵权联系删除，不负法律责任谢谢 感谢您的观看和下载 资料仅供参考，实际情况实际分析 治 疗 抗感染 局部引流：胸腔引流 保持呼吸道通畅 营养及支持 葡萄球菌 PEN-S，OXA-S: 青霉素类、头孢菌类均敏感 首选:青霉素 备选:第一,二代头孢菌类 PEN-R，OXA-S: 不耐酶的青霉素类耐药 主要是细菌产生?内酰胺酶 首选:苯唑西林和氯唑西林 备选:第一,二代头孢菌类 PEN-R，OXA-R: 对所有?内酰胺类抗生素耐药 主要是细菌PBP2a变异所致 首选:万古霉素 备选:利福平 常见的肺部阴影 Case A Case B Case J Case L Case M Case N 病例2 10月 男孩 喘息、咳嗽1天，无发热、呕吐、腹泻 以往曾因咳嗽、喘息于1、3、4月龄住院治疗 轻度呼吸急促，双肺可闻喘鸣音和细湿罗音 给予沙丁胺醇喷雾吸入后，喘息症状明显缓解 主要信息： 假设： 10月 男孩 支气管哮喘 反复咳喘4次 毛细支气管炎 沙丁胺醇喷雾吸入有效 先