湘雅儿科精品医疗课件小儿腹泻.ppt

湘雅儿科精品医疗课件小儿腹泻;Vocabulary ;小 儿 腹 泻 Infantile Diarrhea;目的要求 Objective;概述 Summary;病因 Etiology;病因 Etiology;病因 Etiology;肠毒素;Enterotoxin ;糖类分解吸收障碍;Carbohydrate decomposition absorption disorder;;胃内食物积滞，胃酸少，肠道下段细菌上移繁殖;Gastric stanated food，less gastric acid, lower intestinal bacteria up-moving propagation;临床表现 Clinical Menifestations;三 根据病因分类 Classified by pathogeny 轮状病毒肠炎 Rotavirus enteritis，大肠杆菌肠炎 Escherichia coli enteritis 空肠弯曲菌肠炎 Campylobacter jejuni enteritis, 耶尔森菌小肠结炎 Yersinia enterocolitis 四 抗生素诱发的肠炎 Antibiotic provocative enteritis 金黄色葡萄球菌肠炎 Staphylocaccus aureus enterocolitis , 伪膜性小肠结肠炎 pseudomembranous enterocolitis , 真菌性结肠炎 fungal colonitis ;诊断和鉴别诊断 Diagnosis Differential Diagnosis ;治疗原则 Principle of Treatment;小 儿 液体疗法Infantile Liquid Therapy ;目的要求 Objective;概述 Summary;小儿体液平衡的特点;Characteristic of Infantile Body Fluid Balance;小儿体液平衡的特点 Characteristic of Infantile Body Fluid Balance;三 水代谢的特点 Water metabolism 1. 水的需要量大，交换率快，不显性失水多（为成人2倍）。婴儿每日水交换量为细胞外液量的1 / 2 ，成人仅为1 / 7。 Large water requirements, swift water exchange, unobvious water loss (double adult’s amount ). Infant’s water exchange amount is 1 / 2 of ECF , the adult’s is just 1 / 7. 体液调节功能不成熟，小儿肾脏的浓缩和稀释功能不成熟。 Immature body liquid regulating function , immature concentration and dilution function of infantile. ;水电解质酸碱平衡紊乱;Disturbances of Water, Electrolyte Acid-base Balance;水电解质酸碱平衡紊乱;Type of dehydration;水电解质酸碱平衡紊乱 Disturbances of Water, Electrolyte Acid-base Balance;（二） 分度 Degree 轻度 Mild HCO3- 18~13 mmol / L 中度 Moderate HCO3- 13~9 mmol / L 重度 Severe HCO3- 9 mmol / L ;水电解质酸碱平衡紊乱 Disturbances of Water, Electrolyte Acid-base Balance;（二） 临床表现 Clinical menifetation 1. 神经——精神萎靡 Nervous system ——depressed 2. 肌肉 骨骼肌——四肢肌乏力，肌张力↓，严重迟缓性瘫痪，呼吸肌麻痹 Muscle——inertia of limbs，muscular tension down，severely retardant paralysis，respiratory muscle paralysis;3. 心脏 心率↑，心律失常，阿－期综合症，房室传导阻滞， 心肌纤维变性，局限性坏死，心肌收缩乏力，心音低钝