{"nowTime30":1782542446291,"lyBarModerator":null,"metaSearch":{"description":"肺不张表示肺的部分或完全无气，体积萎陷。肺不张是一个病征，而不是病名，故需寻找引起肺不张的病因。　　症状　　症状: 肺不张的临床表现差异较大，和肺不张的范围及其引起肺不张的病因密切相关，一侧性肺不张，常伴有明显的呼吸困难，体格检查常发现患侧胸廓变形、呼吸音消失、叩诊实音、气管向患侧移位等改变，而局限","keywords":"急性肺损伤肺不张表现_洞医","title":"急性肺损伤肺不张表现_洞医","channels":null},"identificate":{"id":"0300b4bddfaf11e6a61c00163e04584d","isDel":0,"createAt":1484985344390,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","realName":"赵玉","certifiedStatus":2,"phone":"111111111111","email":"2276635444@qq.com","hospitalId":"31c19c1b453011e69d4700163e005165","departmentId":"2000","illName":"","illId":"793a72a2bb5f11e6a61c00163e04584d","cardType":1,"cardImg":"http://01luntan.com/ly_img/1484985951761.jpg","idCardImg":"","identityType":2,"stop":0,"departmentName":"儿科","hospitalName":null},"canEdit":null,"adList":[],"lyBar":{"id":"1686","isDel":0,"createAt":1483439339685,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"北京协和医院胸外科","type":101,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":"110000","cityId":"110101","illId":null,"hospitalId":"15009","keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"description\":\"洞医为您提供:北京协和医院胸外科在哪院_北京协和胸外科诊室_北京协和胸外科医生、北京协和医院胸外科病友的治疗经验等相关信息，让您在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"北京协和医院胸外科在哪院_北京协和胸外科在哪_北京协和胸外科诊室_洞医\",\"title\":\"北京协和医院胸外科在哪院_北京协和胸外科在哪_北京协和胸外科诊室_洞医\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"4773","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"干细胞可防治肺组织损伤","content":"<p>&nbsp; &nbsp; &nbsp;第四军医大学西京医院呼吸内科赵峰博士完成的一项研究证实，干细胞可以防治肺组织损伤。这一研究将为今后临床治疗肺组织损伤提供有力的实验依据。<br/>　　赵峰博士利用骨髓间充质干细胞（mscs）成功地诱导分化出了肺组织细胞。mscs是骨髓中区别于造血干细胞的另一类干细胞，在一定条件下分化为软骨细胞、心肌细胞、神经细胞、肝细胞、支气管上皮细胞、肺泡上皮细胞等多个胚层来源的细胞，并具有取材容易、可体外大量扩增、免疫原性小、移植费用低廉、无伦理学影响等优点。因此，通过诱导mscs分化为肺泡上皮细胞以达到治疗肺损伤、恢复肺功能的目的，有可能成为一种治疗肺疾病的新方法。据赵博士称，上述 \n研究还仅仅是阶段性成果。&nbsp;</p><p><br/></p>","barId":"1686","topicTypeId":null,"topicThemeId":"1023","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":4},{"id":"4574","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"急性肺损伤无论体重如何最好予低潮气量通气","content":"<p>更新时间：2012-08-01 15:39:09　|　文章来源：有问必答健康社区</p><p>&nbsp;&nbsp;&nbsp; 2004年3月2日《内科学年鉴》（annals of internal \nmedicine）上的一项再次分析表明，低潮气量通气对急性肺损伤的超重和肥胖病人的益处与对正常体重者相似。</p><p>&nbsp;&nbsp;&nbsp; “尽管成人的肥胖很流行，但超重对重症病人后果的影响还没得到很好研究”，美国科罗拉多大学的奥伯利恩（james m. \no&#39;&#39;&#39;&#39;brien）和国立心、肺和血液研究所（nhlbi）的同行写道，“有人认为高潮气量通气对需要呼吸机的肥胖病人有益”。</p><p>&nbsp;&nbsp;&nbsp; \n他们检查了10家医疗中心招募来参加随机对照试验的902名急性肺损伤病人的资料：这些试验指定病人或接受较高（12ml/kg）或较低潮气量（6ml/kg）通气，部分人还使用了酮康唑、己酮可可碱或安慰剂。与体重正常的病人相比，肥胖病人肺损伤如创伤的间接原因更多。试验开始前，超重和肥胖病人因为设置的潮气量较高，气道平台压力更高。结果表明，体重与调整死亡危险增加、实现停用呼吸机或不用呼吸机的时间无关。</p><p>&nbsp;&nbsp;&nbsp; “超重和肥胖急性肺损伤病人的后果与体重指数（body mass \nindex，bmi）正常者相似”，作者写道，“这表明低潮气量对他们都有益”。“医生不应想当然地认为肥胖病人的状况差于正常病人”，他们说，但“将来还要研究对其它重症病人，过重是否增加了后果不良的危险”。</p><p><br/></p>","barId":"1686","topicTypeId":null,"topicThemeId":"1022","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":4},{"id":"4571","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"能不能做食道扩张手术","content":"<h2 style=\"margin: 0px; padding: 0px; font-size: 14px; color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; white-space: normal; font-weight: normal; background-color: rgb(252, 252, 252);\">食道溃疡引起食道狭窄，吃饭噎，<span style=\"color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; font-size: 14px; line-height: 32px; background-color: rgb(252, 252, 252);\">食道溃疡引起，只能吃半流动食物。</span></h2><p><span style=\"color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; font-size: 14px; line-height: 32px; background-color: rgb(252, 252, 252);\">能不能做食道扩张手术</span></p><p><br/></p>","barId":"1686","topicTypeId":null,"topicThemeId":"1020","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":4},{"id":"2754","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"肺水肿出现时的症状有哪些","content":"<p style=\"text-align: left;\">　　肺水肿这种疾病，是非常常见的，生活中大家不要忽视，以免造成呼吸困难，导致更多的危害出现，这疾病发生后，很多的患者会出现咳嗽，胸闷，呼吸困难，发冷汗，心动过速。那么肺水肿在出现时会有哪些常见症状呢?</p>\n<p>　<strong>　肺水肿的症状</strong></p>\n<p>　　肺水肿间质期，患者常有咳嗽、胸闷，轻度呼吸浅速、急促。查体可闻及两肺哮鸣音，心原性肺水肿可发现心脏病体征。肺水肿液体渗入肺泡后，患者可表现为面色苍白，紫绀，严重呼吸困难，咳大量白色或血性泡沫痰，两肺满布湿罗音。血气分析提示低氧血症加重，甚至出现CO2潴留和混合性酸中毒。</p>\n<p>　　典型的急性肺水肿，可根据病理变化过程分为4个时期，各期的临床症状、体征分述如下。</p>\n<p>　　间质性水肿期：主要表现为夜间发作性呼吸困难，被迫端坐位伴出冷汗及不安，口唇发绀，两肺可闻及干啰音或哮鸣音，心动过速，血压升高。</p>\n<p>　　肺泡性水肿期：主要表现严重的呼吸困难，呈端坐呼吸，伴恐惧窒息感，面色青灰。皮肤及口唇明显发绀，大汗淋漓，咳嗽，咳大量粉红色泡沫样痰，大小便可出现失禁。两肺满布突发性湿性啰音。</p>\n<p>　　休克期：在短时间内大量血浆外渗，导致血容量短期内迅速减少，出现低血容量性休克，同时由于心肌收缩力明显减弱，引起心源性休克，出现呼吸急促、血压下降、皮肤湿冷、少尿或无尿等休克表现，伴神志、意识改变。</p>\n<p>　　终末期：呈昏迷状态，往往因心肺功能衰竭而死亡。</p>\n<p>　　<strong>肺水肿的检查。</strong></p>\n<p>　　动脉血氧分压(PAO2)</p>\n<p>　　氧分压是表示溶解在血中的氧分子所产生的压力。因氧分压与细胞利用氧的情况有关。</p>\n<p>　　二氧化碳分压(PCO2，PCO2)</p>\n<p>　　二氧化碳分压又称二氧化碳张力，指血浆中溶解的二氧化碳所产生的压力。由于二氧化碳分子具有较强的弥散能力，故血液二氧化碳分压基本上反映了肺泡二氧化碳分压的平均值，即代表了呼吸成分。通常抽动脉血，用血气分析仪测定。二氧化碳分压测定主要用于判断是呼吸性酸中毒还是呼吸性碱中毒。</p>\n<p>　　胸部透视</p>\n<p>　　透视是病人置于X线管与荧光屏之间的直接检查。可做全面动态的直接观察，如心脏搏动、横隔活动、胃肠蠕动、关节活动等。也可在X线造影检查中用以定位观察、胃肠造影检查、指示诊疗操作，如心导管插管、骨折复位、异物摘除等。X线透视应用最多的部位是胸部，检查肺部、胸膜、纵隔及心脏、大血管病变。也可用于四肢骨、软组织、体腔内异物及气体、结石、避孕环等的检查。</p>\n<p>　　胸部平片</p>\n<p>　　胸部平片，也称胸部摄片检查。摄片检查所得的X线影像远比透视时清晰，其优势有：(1)受检部位的影像永久保留在胶片上，可供分析、讨论及复查对照;(2)可作为科研资料保存;(3) 摄片可显示微细结构，如2MM以上的早期病源较透视清晰。(4)摄片能够检查人体较厚部位，并使患者接受X线量较少。</p>\n<p>　　经过上述的专业分析之后，大家对于症状有了一定的了解，这种疾病会影响到肺部的健康，严重的时候还会导致死亡，因此若是出现了异常，患者应该积极的进行检查，合理的进行治疗，以免失去最佳治疗时间。</p>\n<p>&nbsp;</p>","barId":"1686","topicTypeId":null,"topicThemeId":"1016","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"3009","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"预防肺水肿不要误食了这几种药物","content":"<p>　　很多人会因为对于一些东西的不了解而导致一些疾病的发生，那么现在就让小编为大家介绍一些应该去注意的事项，肺水肿在我们日常生活中也是常见的疾病之一。预防肺水肿很重要。其实有好多人平时因为不了解肺水肿，而误食了一些药物诱发出肺水肿。那么都有哪些药物会导致人们患上肺水肿呢。在这里我就为大家介绍介绍吧。</p>\n<p><strong>　　1.产科药物</strong></p>\n<p>　　麦角新碱是一种麦角生物碱，对子宫平滑肌具有收缩作用，用于防止产后出血。曾有报道1例患者剖腹产术后应用麦角新碱时出现肺水肿。</p>\n<p>　　催产素具有收缩子宫平滑肌的特性，用于介导分娩和防止产后出血，静脉注射催产素可引起肺水肿。</p>\n<p>　　&beta;受体激动剂能松弛子宫平滑肌，抑制子宫收缩，部分患者可发生肺水肿，称为子宫收缩抑制剂相关性肺水肿，肺水肿的发生主要与心输出量增加、肺毛细血管后静脉收缩。</p>\n<p><strong>　　2.止痛剂</strong></p>\n<p>　　阿司匹林是一种非甾体类抗炎剂，具有较好的解热和肌肉骨骼镇痛作用，也可用于短暂缺血发作和冠状动脉综合征，非心源性肺水肿是水杨酸制剂常见并发症之一，可能与肺毛细血管膜通透性的增高有关。</p>\n<p>　　美沙酮是一种长效麻醉镇痛剂，用于治疗急性和慢性疼痛，也可用于麻醉成瘾的维持治疗，已有美沙酮引起肺水肿的报道。吗啡是一种鸦片类镇痛剂，应用麻醉制剂尤其是大剂量应用的病人容易诱发非心源性肺水肿，可能与免疫球蛋白和补体在肺内沉积或脑干神经反射引起的毛细血管通透性增高有关。</p>\n<p>　　丙氧芬(propoxyphene)也是一种鸦片制剂，口服或静脉注射尤其是大剂量应用时可引起肺水肿。</p>\n<p>&nbsp;</p>","barId":"1686","topicTypeId":null,"topicThemeId":"1015","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":4}],"pageObj":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":5,"pageNumber":0,"totalPage":0,"totalRow":0},"loginUser":null,"replies":[],"forumUserFans":null,"herfList":[],"only":"0","topic":{"id":"1401","isDel":0,"createAt":1486701655870,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","title":"急性肺损伤肺不张表现","content":"<p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp;肺不张表示肺的部分或完全无气，体积萎陷。肺不张是一个病征，而不是病名，故需寻找引起肺不张的病因。<br />　　症状<br />　　症状: 肺不张的临床表现差异较大，和肺不张的范围及其引起肺不张的病因密切相关，一侧性肺不张，常伴有明显的呼吸困难，体格检查常发现患侧胸廓变形、呼吸音消失、叩诊实音、气管向患侧移位等改变，而局限性的肺不张症状可不明显，临床体征也不典型。中心型肺癌引起的肺不张，常有刺激性咳嗽、咳血丝痰、呼吸困难等由肿瘤引起的临床改变。 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