Pneumonia课件PPT推荐.ppt

Pneumonia课件PPT推荐.ppt

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Pneumonia,Definition,Pneumoniaisanacuteinfectionoftheparenchymaofthelung（肺实质）,causedbybacteria,fungi（真菌）,virus,parasite（寄生虫）etc.PneumoniamayalsobecausedbyotherfactorsincludingX-ray,chemical,allergen,Epidemiology,Themorbidityandmortalityofpneumoniaarehighespeciallyinoldpeople.,Etiology,Therearetwofactorsinvolvedintheformationofpneumonia,includingpathogensandhostdefenses.,Classification,ClassificationofanatomyClassificationofpathogenClassificationofacquiredenvironment,.Classificationbypathogen,Pathogenclassificationisthemostusefultotreatthepatientsbychoosingeffectiveantimicrobialagents,Bacterialpneumonia,

（1）AerobicGram-positivebacteria,suchasstreptococcuspneumoniae,staphy-lococcusaureus,GroupAhemolyticstreptococci

（2）AerobicGram-negativebacteria,suchasklebsiellapneumoniae,Hemophilusinfluenzae,Escherichiacoli（3）Anaerobicbacteria,Atypicalpneumonia,IncludingLegionnaiespneumonia,Mycoplasmalpneumonia,chlamydiapneumonia.,Fungalpneumonia,Fungalpneumoniaiscommonlycausedbycandida（念珠菌）andaspergilosis（曲菌）.pneumocystisjiroveci（肺孢子虫）,Viralpneumonia,Viralpneumoniamaybecausedbyadenoviruses,respiratorysyncytialvirus,influenza,cytomegalovirus,herpessimplex,Pneumoniacausedbyotherpathogen,Rickettsias（afeverrickettsia）,（立克次体）parasites（寄生虫）protozoa（原虫）,.Classificationbyanatomy,1.Lobar（大叶性）:

@#@Involvementofanentirelobe2.Lobular（小叶性）:

@#@Involvementofpartsofthelobeonly,segmentalorofalveolicontiguoustobronchi（bronchopneumonia）.3.Interstitial（间质性）,Lobarpneumonia,Lobularpneumonia,Interstitialpneumonia,Classificationbyacquiredenvironment,Communityacquiredpneumonia，CAP（社区获得性肺炎）Hospitalacquiredpneumonia，HAP，NP（医院获得性肺炎）Nursinghomeacquiredpneumonia,NHAP（护理院获得性肺炎）Immunocompromisedhostpneumonia,（ICAP）（免疫宿主低下肺炎）,Diagnosis（诊断步骤）,GiveadefinitediagnosisofpneumoniaToevaluatethedegreeofthepneumoniaTodefinitethepathogenofthepneumonia,Diagnosis,Historyandphysicalexamination（5W）X-rayexaminationPathogenidentification,Differentiation,PulmonarytuberculosisLungcancerAcutelungabecessPulmonaryembolismNoninfectiouspulmonaryinfiltration,Pathogenidentification,Sputum:

@#@Morethan25whitebloodcells（WBCs）andlessthan10epithelialcells.NasotrachealsuctioningBAL,ETA,PSB,LABloodcultureorpleuraleffusioncultureSerologictesting（immunologicaltesting）MolecularTechniques,Theprincipaloftherapy,SelectantibioticsAccordingtoguideline,Therapy,Thetherapyshouldalwaysfollowconfirmationofthediagnosisofpneumoniaandshouldalwaysbeaccompaniedbyadiligentefforttoidentifyanetiologicagent.Empirictherapy,（4-8h）Combinedempirictherapytotargettherapy,Itisimportanttoevaluatetheseveritydegreeofpneumonia,Thecriticalmanagementdecisioniswhetherthepatientwillrequirehospitaladmission.Itisbasedonpatientcharacteristics,comorbidillness,physicalexaminations,andbasiclaboratoryfindings.,Thediagnosticstandardofseverpneumonia,AlteredmentalstatusPa0230/minBloodpressure90/60mmHgChestX-rayshowsthatbilateralinfiltration,multilobarinfiltrationandtheinfiltrationsenlargemorethan50%within48h.Renalfunction:

@#@U20ml/h,and80ml/4h,CAP（社区获得性肺炎）,CAPreferstopneumoniaacquiredoutsideofhospitalsorextended-carefacilities.Streptococcuspneumoniaeremainsthemostcommonlyidentifiedpathogen.OtherpathogensincludeHaemophilusinfluenzae,mycoplasmapneumoniae,Chlamydophiliapneumoniae,Moraxellacatarrhalisandects.Drugresistancestreptococcuspneumoniae（DRSP）,Clinicalmanifestation,TheonsetisaccuteRespiratorysymptomsExtrapulmonarysymptoms,signs,ConsolidationsignsMoistralesRespiratoryrateorheartrate,Laboratoryexamination,WBCX-rayfeatures,Diagnosis,ClinicaldiagnosisPathogendiagnosisEvaluatetheseveritydegreeofpneumonia,Therapy,Antiinfectioustherapy（Combinedempirictherapytotargettherapy）Supportivetherapy,Empirictherapy

（1）,Outpatient60yearsoldandnocomorbiddiseasesCommonpathogens:

@#@Spneumoniaes,Mpneumoniae,Cpneumoniae,Hinfluenzaeandviruses,AnewgenerationmacrolideAbeta-lactam:

@#@thefirstgenerationcephlosporinAfluoroquinolone,Empirictherapy

（2）,Outpatient65yearsoldorhavingcomorbiddiseasesorantibiotictherapywithinlast3monthsCommonpathogens:

@#@Spneumoniae（drug-resistant）,Mpneumoniae,Cpneumoniae,Hpneumoniae,Hinfluenzae,Viruses,Gram-negativebacilliandSaureus,AfluoroquinoloneAbeta-lactam/beta-lactamaseinhibitorThesecondgenerationcephalosporinorcombinationofamacrolide,Empirictherapy（3）,Inpatient:

@#@Notseverelyill.Commonpathogen:

@#@Spneumoniae,Hinfluenzae,polymicrobial,Anaerobes,Saureus,Cpneumoniae,Gram-negativebacilli.,ThesecondorthirdgenerationcephalosporinplusAmacrolideAbeta-lactam/betalactamaseinhibitor.Anewerfluoroquinolone,Empirictherapy（4）,InpatientseverelyillCommonpathogens:

@#@Spneumoniae,Gram-negativebacilli,Mpneumoniae,Saureusandviruses,Thesecondorthird