pneumonia呼吸系統(tǒng)肺炎全英文-課件-

Contents（一）、pandect··········································3（二）、Pneumoniaingeneral····················8（三）、Etiology··········································13（四）、Signs···············································34（五）、Treatment······································49（六）、Prevention·····································582022/12/20RespiratorySystemContents（一）、pandect···········1RespiratorySystemnose（nas/o

ORrhin/o）larynx(laryn/o)Lungs(pneumon/oORpulmo

)bronchus(bronch/o)diaphragm(diaphragm/o)mediastinum（一）pandectOrgansRespiratorySystemnose（nas/oO23

FunctionsBreathingprocessExchangeofOxygenandCarbonDioxideEnablespeechproductionoxygencarbon

dioxideAlveolar/0-HyperpneaCyanosis02co2RespiratorySystem（一）pandect3FunctionsBreathingprocess34

TheinfluencingfactorsofrespiratorydiseasesRespiratorySystem（一）pandect

AirpollutionandsmokingInhaledallergensThevariationofetiologyandDrugresistanceincreases

4TheinfluencingfactorsResp4

SignsandsymptomsCoughLaryngitis/bronchitis/bronchialasthma/chronicobstructivepulmonarydisease(COPD)/lungcancerExpectoration

Lungabscess/bronchiectasis/pneumoniaHemoptysis

pulmonaryTuberculosisDyspnea

Pneumothorax/pleuraleffusion/leftheartfailureStethalgia

hemothorax/PulmonarythromboembolismRespiratorySystem（一）pandectSignsandsymptomsCoughRespir5

LabandotherinspectionBloodtestsantigenskintest

phlegm

examinationpleuraleffusionthoracicopunctureradioexamination

RespiratorySystem（一）pandectbronchoscopyThoracoscopelungobiopsysupersonicinspectionrespiratoryfunctiontestPulmometry

LabandotherinspectionBlood6DefinitionPneumoniaisanacuteinfectionoftheparenchyma[p?'re?k?m?]ofthelung,肺炎是肺實質的急性感染

，(lower-respiratorytract)下呼吸道causedbymicroorganism[ma?kr??'?:g?n?z?m]

由微生物引起,comeswithfever,focalchestsymptoms,shadowingonCXR（chestX-ray胸部x線檢查）.伴隨發(fā)熱，局灶性胸部癥狀，胸片陰影。RespiratorySystemDefinitionRespiratorySystem72022/12/20Defensemechanism[di'fens'mek?niz?m]oftherespiratorytract（呼吸道防御機制）

Filtration[fil'trei?n]anddeposition['dep?'z??n]

濾除及沉積（nasalfunction鼻功能）pathogens['p?θ?d??ns]intheupperairways上呼吸道病原體Coughreflex咳嗽反射Mucociliary[mju:k??'s?l??r?]clearance黏液纖毛清除macrophages['m?kr?fe?d?]巨噬細胞Humoral['hju:m?r?l]andcellular['selj?l?(r)]immunity體液及細胞的免疫Oxidative['?ks?de?t?v]metabolism[m??t?b?l?z?m]ofthe

neutrophils中性粒細胞的氧化代謝RespiratorySystem（二）、Pneumoniaingeneral2022/12/16Defensemechanism[d82022/12/20

鼻炎咽炎耳炎扁桃體炎喉炎細支氣管炎RespiratorySystemSinus/-itis['sa?n?'sa?t?s]鼻竇炎Pharyng/-itis[.f?r?n'd?a?t?s]咽炎Laryng/-itis[l?r?n'd?a?t?s]喉炎Bronch/-itis[br??'ka?t?s]支氣管炎2022/12/1692022/12/20rootmeaningexamplePneum(o)-Lung,airpneumothorax[nju:m?'θ?:r?ks]氣胸pneumonia肺炎pneumatic[nu:'m?t?k]充氣的pneumocystis[n'ju?m?s?st?s]肺囊蟲pneumonectomy[nju:m?'nekt?m?]肺切除術pneumonrrhagia[nju:m?'rei:d???]肺出血pneumograph['nju:m?grɑ:f]呼吸描計議pneumocyte[nju:m?'s?t]肺細胞pneumatocele['nju:m?t??si:l]肺膨出Pulmo(o)-Pulmonary['p?lm?n?ri]肺的,肺病的Path(o)-pathologyPathobiology[p?θ?ba?'?l?d??]病理學Pathogen[‘p?θ?d??n]病原體Pathogenesis[p?θ?‘d?en?s?s]發(fā)病機理pathologist[p?’θ?l?d??st]病理學家Muc(o)-SlimeMucoid['mju:k??d]粘液樣的mucociliary[mju:k??'s?l??r?]黏液纖毛的mucositis[m'ju:k?sa?t?s]黏膜炎Myx(o)-Myxoma[m?ks'??m?]粘液瘤myxobacteria[m?ks?b?k't??r??]黏細菌myxiod粘液樣的Bronch(o)-bronchiBronchogenic[br?nk?d'?en?k]支氣管原的bronchoscopy[b'r?nt??sk?p?]支氣管鏡檢查術bronchitis[br??’ka?t?s]支氣管炎bronchospasm['br??k?sp?z?m]支氣管痙攣Bronchoconstriction[br?nt'???k?nstr?k?n]支氣管狹窄2022/12/16rootmeaningexamplePn102022/12/20rootmeaningexampledys-有病的、不正常的、有障礙的dyspnea（呼吸困難）[d?s'pni:?]

、dyscrasia（惡病質）[d?s'kre?zj?]

、dysentry（痢疾）['d?sntr?]

、dysplasia（發(fā)育異常）[d?s'ple???]

pnea呼吸eupnea（呼吸正常）[ju:p'ni:?]

、tachypnea（呼吸急促）[t?k?p'ni:?]

hyper-超出、在······之上、高于、過度hyperadenosis（腺增大）[ha?p?r?d?'n??s?s]

、hyperaemia（充血）[ha?p?'ri:m??]

、hyperinsulinism（胰島素分泌過多）[ha?p?'?ns?l?n?z?m]

、hyperpiesia（血壓過高）[ha?p?(:)pa?'?zj?]

、hyperthyroid（甲狀腺功能亢進）[ha?p?'θa?r??d]

hypo-在······下、次于、不足hypothermia（低體溫）[ha?p?‘θ?:mi?]

、hypoglottis（舌下部）[ha?p?'gl?t?s]

、hypoacidity（胃）酸過少[h?p???'s?d?t?]

、hypocalcemia（低血鈣）[ha?p??k?l'si:m??]

、hypoglycemia（低血糖）[ha?p??gla?'si:m??]

RespiratorySystem2022/12/16rootmeaningexampledy112022/12/20Etiology病因Therearetwofactorsinvolvedintheformationofpneumonia,參與肺炎形成的兩個因素，includingpathogensandhostdefenses.包括病原體和宿主防御RespiratorySystem2022/12/16Etiology病因Therea122022/12/20Causativeorganisms致病微生物Bacteria細菌Mycobacteria分枝桿菌Chlamydiae衣原體Mycoplasma支原體Fungi真菌Parasites寄生蟲Viruses病毒rootmeaningexamplegerm-病菌germicide殺菌劑[’d??:m?sa?d]

bacteri-細菌bacteriology細菌學bacteriemia菌血癥[b?kt?'r??mj?]

bactericide殺菌劑[b?k't??r?sa?d]

bacill-桿菌bacillemia桿菌血癥[b?s?'li:m??]

-coccus球菌diplococcus雙球菌[d?pl??'k?k?s]

、gonococcus淋球菌['g?n??'k?k?s]

strept-鏈streptococcus鏈球菌屬[strept?'k?k?s]

staphyl-葡萄staphylococcus葡萄球菌屬[st?f?l?'k?k?s]

、staphyloma葡萄腫[st?f?'l??m?]

monil-念珠菌moniliasis念珠菌病[m?n?'la??s?s]

fung-真菌fungoid似真菌的，狀的[f??g??d]

、fungicide殺真菌劑[f?ng?sa?d]

myc-霉菌mycoology霉菌學，真菌學antimycotic抗真菌的2022/12/16Causativeorganisms致132022/12/20Classification分類Classificationofanatomy按解剖分類Classificationofpathogen按病原體分類Classificationofacquiredenvironment按患病環(huán)境分類RespiratorySystem2022/12/16Classification分類Clas142022/12/20Classificationbyanatomy按解剖分類

Lobar大葉性

:Involvementofanentirelobe

一個完整的葉的參與Lobular小葉性

:Involvementofpartsofthelobeonly,segmentalorofalveolicontiguoustobronchi(bronchopneumonia支氣管肺炎).

只有部分的肺葉，節(jié)段性支氣管或相連的肺泡受累；Interstitial間質性[?nt?’st??l]

:Involvementoftheinterstitialtissueofthelungs肺間質組織參與

RespiratorySystem2022/12/16Classificationbyan152022/12/20Classificationbypathogen按病原體分類Pneumococcalpneumonia[,nju?m?'k?k?l]肺炎球菌肺炎Staphylococcalpneumoniast?f?l??'k?k?l]

葡萄球菌肺炎Mycoplasmalpneumonia肺炎支原體肺炎Chlamydiapneumonia[kl?’midi?]

肺炎衣原體肺炎Viralpneumonia病毒性肺炎Pulmonarycandidiasis{k?nd?'da??s?s]

肺念珠菌病Pulmonaryaspergillosis[?sp?d?i‘l?usis]

肺曲霉菌病klebsiellapneumonia[klebzi’el?]

克雷伯桿菌肺炎legionairesdisease[li:d??'ne?]

軍團菌肺炎RespiratorySystem2022/12/16Classificationbyp162022/12/20Classificationsbyacquiredenvironment

按患病環(huán)境分類

Community-acquiredpneumonia:社區(qū)獲得性肺炎：。

Occurincommunitywithin48hour.在社區(qū)48小時內發(fā)生

S.pneumoniaisthemostcommonCAPinpeopleolderthan60.Mostcommonduringwinterandspring.

60歲以上的老人中最常見肺炎鏈球菌肺炎，常發(fā)生在冬季和春季。

Hospital-acquiredpneumonia:醫(yī)院獲得性肺炎

CertainillnessmaypredisposeHAPbecauseof:Impaireddefensesorchronicillness;Coma昏迷,malnutrition營養(yǎng)不良,prolonghospitalization住院時間延長;Numerousintervention介入asendotrachealintubation

某些疾病導致醫(yī)院獲得性肺炎：受損的防御或慢性疾??；昏迷，營養(yǎng)不良住院時間延長；氣管插管等較多的介入治療。2022/12/16Classificationsbya172022/12/20Symptoms CoughDyspnea呼吸困難[d?s'pni:?]

Pleuritic肋膜炎的[pl??'r?t?k]

chestpain胸痛Feverorhypothermia發(fā)熱或低體溫Myalgias肌痛[ma?'?ld??]

Chills/Sweats發(fā)冷/出汗Fatigue疲勞[f?ti:ɡ]

HeadacheDiarrhea腹泄sinusitis鼻竇炎[sa?n?‘sa?t?s]

expectoration咳痰RespiratorySystem2022/12/16Symptoms CoughChills182022/12/20全身怕冷濕冷發(fā)青痰痰短氣胸膜炎的[pl??'r?t?k]

胸痛咳血[h?'m?pt?s?s]

疲勞[f?'ti:ɡ]

食欲差情緒波動血管的[v?skj?l?(r)]

惡心[n?:zi?]嘔吐

關節(jié)痛2022/12/16全身怕冷濕冷發(fā)青痰痰短氣胸膜炎的[pl?19Pneumococcalpneumonia

肺炎鏈球菌肺炎ThepneumoniathatiscausedbyStreptococcuspneumoniaenearlyhalfofcommunity-acquiredpneumonia(CAP）由肺炎鏈球菌引起的肺炎近一半是社區(qū)獲得性肺炎.

Thediseaseonsetisacute起病急andcanbeserious,accompanied伴有byhighfever,chills寒戰(zhàn),cough,bloodysputum痰中帶血andchestpain.RespiratorySystemPneumococcalpneumonia

肺炎鏈球菌肺炎20Thepathologicalchange病理變化isdividedintofourperiods,分為四個時期，i.e.congestivestage充血期,redhepatization紅色肝樣變,grayhepatization灰色肝樣變andresolution消散期.

121,dilatation擴張[da?l?‘te??n]andcongestion充血[k?n’d?est??n]ofthecapillaries毛細血管['k?p?l?r?z]

2,

thefibrinous纖維蛋白[‘fa?br?n?s]exudate滲出物['eks?de?t]

RespiratorySystemThepathologicalchange病理變化is21Thisisnotedclinicallyasoedema水腫[?‘di:m?]andcongestion充血inlung,

alveolarexudate肺泡滲出,hematid['hem?t?d]infiltration紅細胞浸潤,leukocyte['lu:k?sa?t]infiltration白細胞浸潤.Thenthebacterium細菌willbeeliminated消除throughleukocyticphagocytosis白細胞吞噬作用.Atlast,thefibrousprotein纖維蛋白isbrokendownandabsorbed,thealveolarinflatesagain肺泡重新充氣.這是臨床表現(xiàn)為肺水腫和肺充血，肺泡滲出，紅細胞浸潤，白細胞浸潤。然后細菌通過白細胞吞噬作用將被淘汰消除。最后，纖維蛋白分解和吸收，肺泡重新充氣。RespiratorySystemThisisnotedclinicallyasoe22Infact,earlytreatmentbyusingantibacterial抗菌的drugcausehepatization肝樣變inpathologicalstagedoesnothavepreciselimits.Wehadrarelyseenthistypicalpathologicalstageinclinical.事實上，通過使用抗菌藥物引起肝病理階段早期治療沒有確切的界限。我們很少看到這種典型的臨床病理分期。RespiratorySystemInfact,earlytreatmentbyus232022/12/20Etiologyandpathogenesis

organismS.pneumoniaeDynamicbalance

2022/12/16Etiologyandpathoge242022/12/20S.pneumoniaeasthegram-positivebacillus,capsule,itsvirulencesizerelatedtothestructureandcontentofcapsularpolysaccharide,indryphlegmcansurviveformonths,butdirectsunlightfor1hour,heat52degrees10mincanbekilled.RespiratorySystem2022/12/16S.pneumoniaeasth252022/12/20EtiologyandpathogenesisThebodykeepsadynamicequilbriumbetweentheorganismandS.pneumoniaeaswellastheinternalandexternalenvairoment,undernormalconditions,S.pneumoniaesentinthehunmanoralcavityandnasopharynx,theyarecalled“normalflora”.

RespiratorySystem2022/12/16Etiologyandpathoge262022/12/20EtiologyandpathogenesisthepathogenicityofS.pneumoniaeisduetothecapsuleinvadetheorganization,firstofall,causetohydropsofalveolarwalls,leukopedesis,overspreadingthelungsegmentandpulmonarylobe.RespiratorySystem2022/12/16Etiologyandpathoge272022/12/20Etiologyandpathogenesiswhenthebodyresistanceistooweakforthebodytoadapttoclimaticchange,whenS.pneumoniaeareexcessive,Whenthedynamicequilbriumisdamagedandcannotrestoredimmediately,S.pneumoniaewillbecomepathogenicfactorandleadtotheoccuranceofdisease.RespiratorySystem2022/12/16Etiologyandpathoge282022/12/20Streptococcuspneumoniaehigh-riskgroups：Smokers,dementia,ChronicBronchitis,bronchiectasis,cardiacfailure,chronicdisease,immunosuppressantsusers,theelderly,infantsandyoungchildren2022/12/16Streptococcuspneumo292022/12/20LaboratoryExaminations實驗室檢查WBC(whitebloodcell)白細胞PaO2(動脈血氧分壓Arterial動脈的[ɑ:‘t??r??l]Partial部分的PressureofOxygen)PaCO2(肺泡二氧化碳分壓Alveolar肺泡的PartialPressureofCarbonDioxide)2022/12/16LaboratoryExaminati302022/12/201.TheWBC:(10~30)x109/L,neutrophils中性粒細胞>80%;TheWBCcanbenormal,butneutrophilsmustbeincreased.2.TheBacteriologicalexamination細菌學檢查:directsmear直接涂片，

usesputumculture,

痰涂片

culturewithbloodorpleuraleffusion

血液或胸腔積液培養(yǎng).2022/12/161.TheWBC:(10~30)312022/12/203.Bloodgasanalysis血氣分析:PaO2canbedecreased,PaCO2canbenormalordecreased,metabolicacidosis代謝性酸中毒[met?’b?lik‘?sid?usis]

.2022/12/163.Bloodgasanalysi32Whatarepneumoniasymptomsandsigns?Initiallyhavesymptomsofacold（upperrespiratoryinfection,forexample,sneezing,sorethroat,cough）,whicharethenfollowedbyahighfever（sometimesashighas104F）,shakingchills,andacoughwithsputumproduction.Thesputumisusuallydiscoloredandsometimesbloody,shortnessofbreath.Theindividual’sskincolormaychangeandbecomedustyorpurplish（aconditionknownas“cyanosis”）duetotheirblood.Whatarepneumoniasymptomsan33SymptomsThispainisusuallysharpandworsenwhentakingadeepbreathandisknownaspleuriticpainorpleurisy.Aworseningcough,headaches,andmuscleachesmaybetheonlysymptoms.Childrenandbabieswhodeveloppneumoniaoftendonothaveanyspecificsignsofachestinfectionbutdevelopafever,appearquiteill,andcanbecomelethargic.SymptomsThispainisusuallys34Complications

Seriousandpotentiallylethal·Pleuraleffusionandempyema·Infectiveshock·Toxicmyocarditis·ARDS（AcuteRespiratoryDistressSyndrome)·Organizedpneumonia·Pleuritis·Meningocephalitis

ComplicationsSerious35Howispneumoniadiagnosed？Coarsebreathingorcrackingsoundswithastethoscope.Wheezingorthesoundsofbreathingmaybefaintinaparticularareaofthechest.AchestX-rayisusuallyorderedtoconfirmthediagnosisofpneumonia.Thelungshavelobes，usuallytwoontheleftandthreeontheright.Whenthepneumoniaaffectsoneoftheselobes，itisoftenreferredtoaslobarpneumonia.Howispneumoniadiagnosed？Coa36SputumSamplesSputumSamplescanbecollectedandexaminedunderthemicroscope.Pneumoniacausedbybacteriaorfungicanbedetectedbythisexamination.Aswehaveusedantibioticsinabroaderuncontrolledfashion,moreorganismsarebecomingresistanttothecommonlyusedantibiotics.Thesetypesofculturescanhelpindirectingmoreappropriatetherapy.SputumSamplesSputumSamplesc37AbloodtestThatmeasureswhitebloodcellcount.Anindividual’swhitebloodcellcountcanoftengiveahintastotheseverityofthepneumoniaandwhetheritiscausedbybacteriaoravirus.Anincreasednumberofneutrophils,onetypeofWBC,isseeninmostbacterialinfections.Whereasanincreaseinlymphocytes,anothertypeofWBC,isseeninviralinfections,fungalinfections,andsomebacterialinfections.AbloodtestThatmeasureswhit38HematologylaboratoryCompletebloodcount（CBC）Redbloodcellcount（RBC）Hemoglobin（Hgb）Hematocrit（Hct）Whitebloodcellcount（WBC）NeutrophilslymphocytesMonocytesPlateletcount,prothrombintimePartialthromboplastintimebloodglucoseHematologylaboratoryComplete39BronchoscopyBronchoscopyisaprocedureinwhichathin,flexible,lightedviewingtubeisinsertedintothenoseormouthafteralocalanestheticisadministered.Usingthisdevice,thedoctorcandirectlyexaminethebreathingpassages（tracheaandbronchi）.Simultaneously,samplesofsputumortissuefromtheinfectedpartofthelungcanbeobtained.BronchoscopyBronchoscopyisa40FluidcollectsSometimes,fluidcollectsinthepleuralspacearoundthelungasaresultoftheinflammationfrompneumonia.Thisfluidiscalledapleuraleffusion.Ifasignificantamountoffluiddevelops,itcanberemoved.Afternumbingtheskinwithlocalanestheticaneedleisinsertedintothechestcavityandfluidcanbewithdrawnandexaminedunderthemicroscope.Thisprocedureiscalledathoracentesis.FluidcollectsSometimes,fluid41Diagnosis1·PrecedinghistoryofcommoncoldorotherURI；2.Symptoms：abruptonset,

highfever,coughwitharustysputum,chestpain,dyspneaandcoughetc；3.Signs:remarkablemoistrale；

4.Bloodtest：leukocytosis；5.Radiologicstudy:Lobarconsolidation；6.Adefinitivediagnosisrequiresdemonstrationofpneumoniainsputumculture,blood,lungtissue.

UpperrespiratoryinfectionDiagnosisUpperrespiratoryinf42DiffuseinterstitialpneumoniaLobarpneumoniaDiffuseinterstitialpneumonia43Criteriaofseverepneumonia1.Respiratoryrate>30/min；2.Bloodpressure<90/60mmHg；3.Bloodgas:PaO2<60mmHg，

PaO2/FiO2

<300mmHg；4.BUN>7.1mmol/L(30mg/DL)；5.X-ray:twolobesareinvolved；NeedforvasopressorsRenalFailureCriteriaofseverepneumonia144Caseouspneumonia(lungtuberculosis）DifferentialdiagnosisApicallocationInsidiousonsetwithlowerfever，nightsweats，F(xiàn)atigueandweightlossNotrespondtoantibioticsSputumsmearfortuberclebacilli(+)Caseouspneumonia(lungtubercu45DifferentialdiagnosisLungabscessCopiouspurulentfoul-smellingsputumDifferentialdiagnosisLungab46DifferentialdiagnosisObstructivepneumoniasuperimposedhilarshadowrecurrentpneumoniaatthesamesitehappendedinpatientsover40,whichdoesnotrespondwelltotheantibiotictreatmentfiberopticbronchoscopyDifferentialdiagnosisObstruct472022/12/20TreatmentAntiinfectioustherapySupportivetherapyTherapyofcomplications2022/12/16Treatment482022/12/20

TreatmentThemoreseriouspneumonia,requiresantibioticssuchaspenicillin.2022/12/16TreatmentThemores492022/12/20TreatmentAllpatientswithsuspectedpneumococcalpneumoniashouldbetreatedaspromptlyaspossiblewithpenicillinGThedoseandrouteofdeliverymayhavetobeonthebasisofpatientsstatus/adverserea-ctionorcomplicationthatoccur2022/12/16TreatmentAllpatien502022/12/20TreatmentForpatientswhoarebelievedtobeallergictopenicillin(青霉素),onemayselectthefirstorsecondgenerationcephalosporin(頭孢菌素)oradvancedmacrolide(大環(huán)內酯物)+β

-lactam(β-內酰胺)orrespiratoryfluoroquinolone(氟喹諾酮)alone.2022/12/16Treatment512022/12/20TreatmentInsomecases,vancomycinmaybeused.Treatmentwithanyeffectiveagentshouldbegivenforatleast5to7dayorafterthepatientshavebeenafebrilefor2-3days2022/12/16Treatment522022/12/20Supportivemeasure

Supportivemeasurearegenerallyusedintheinitialmanagementofacutepneumo-coccalpneumonia,suchmeasuresinclude-Bedrest-Monitoringvitalsignsandurineoutput-Administeringanoccasionalanalgesic(止痛劑)torelievepleuritic(胸膜炎的)pain-Replacingfluids,ifthepatientisdehydrated(脫水的)

2022/12/16Supportivemeasure

532022/12/20SupportivemeasureCorrectingelectrolytes(電解質)Oxygentherapy2022/12/16Supportivemeasure542022/12/20Treatmentofcomplications

Empyema(膿胸)developsinappoximately5%ofpatientswithpneumococcalpneumonia,althoughpleuraleffusion(胸膜滲出物)commonlydevelopin10%-20%patientsChestX-raywithlateraldecubitus（側臥位）filmsareoftenusefulintheearlyrecognitionofpleuraleffusion,pleuralfluidthatisremovedshouldbesubjectedtoroutingexamination2022/12/16Treatmentofcomplic552022/12/20TreatmentofcomplicationsExtrapulmonary（胸部的）complicationssuchasarthritis（關節(jié)炎）,endocarditis（心內膜炎）mustbeexcluded,becausethetherapyrequireshigherdosages（劑量）

Treatmentofinfectionsshock2022/12/16Treatmentofcomplic562022/12/20PreventionThemostimportantpreventivetoolavailableisusingapneumococcalvaccine（疫苗）inthosewithchroniclungdiseases,chronicliverdiseases,splenectomy（脾切除術）,diabetesmellitus（糖尿病患者）andaged2022/12/16PreventionThemosti572022/12/20PreventionThegerms（微生物）thatcausemanyofthedifferenttypesofpneumoniacanbecontagious（有傳染性的）andarespreadthroughcoughingandsneezing.Youcanpreventpneumoniabyfollowinggoodhygienehabits,suchas:-Coughorsneezeintoatissue.-Useseparatedrinkingglassesandeatingutensils.-Washyourhandsfrequentlywithwarmsoapywater.2022/12/16PreventionThegerms（582022/12/20PreventionDonotvisitsickpatientswithpneumonia.Ifyouhavepneumonia,donotvisitolderpeople,visitolderpeople,babiesorsickpeople.2022/12/16Prevention592022/12/20PreventionImproveimmunity：

followthesewell-knownmeasurestostayhealthyandkeeptheimmunesystemready:-Eathealthy

-Sleepwell

-Avoidsmoking

-Exercise

-Reducestress

-Donotdrinkalcoholinexcess2022/12/16PreventionImproveim602022/12/20ThankYou!2022/12/16ThankYou!61Contents（一）、pandect··········································3（二）、Pneumoniaingeneral····················8（三）、Etiology··········································13（四）、Signs···············································34（五）、Treatment······································49（六）、Prevention·····································582022/12/20RespiratorySystemContents（一）、pandect···········62RespiratorySystemnose（nas/o

ORrhin/o）larynx(laryn/o)Lungs(pneumon/oORpulmo

)bronchus(bronch/o)diaphragm(diaphragm/o)mediastinum（一）pandectOrgansRespiratorySystemnose（nas/oO6364

FunctionsBreathingprocessExchangeofOxygenandCarbonDioxideEnablespeechproductionoxygencarbon

dioxideAlveolar/0-HyperpneaCyanosis02co2RespiratorySystem（一）pandect3FunctionsBreathingprocess6465

TheinfluencingfactorsofrespiratorydiseasesRespiratorySystem（一）pandect

AirpollutionandsmokingInhaledallergensThevariationofetiologyandDrugresistanceincreases

4TheinfluencingfactorsResp65

SignsandsymptomsCoughLaryngitis/bronchitis/bronchialasthma/chronicobstructivepulmonarydisease(COPD)/lungcancerExpectoration

Lungabscess/bronchiectasis/pneumoniaHemoptysis

pulmonaryTuberculosisDyspnea

Pneumothorax/pleuraleffusion/leftheartfailureStethalgia

hemothorax/PulmonarythromboembolismRespiratorySystem（一）pandectSignsandsymptomsCoughRespir66

LabandotherinspectionBloodtestsantigenskintest

phlegm

examinationpleuraleffusionthoracicopunctureradioexamination

RespiratorySystem（一）pandectbronchoscopyThoracoscopelungobiopsysupersonicinspectionrespiratoryfunctiontestPulmometry

LabandotherinspectionBlood67DefinitionPneumoniaisanacuteinfectionoftheparenchyma[p?'re?k?m?]ofthelung,肺炎是肺實質的急性感染

，(lower-respiratorytract)下呼吸道causedbymicroorganism[ma?kr??'?:g?n?z?m]

由微生物引起,comeswithfever,focalchestsymptoms,shadowingonCXR（chestX-ray胸部x線檢查）.伴隨發(fā)熱，局灶性胸部癥狀，胸片陰影。RespiratorySystemDefinitionRespiratorySystem682022/12/20Defensemechanism[di'fens'mek?niz?m]oftherespiratorytract（呼吸道防御機制）

Filtration[fil'trei?n]anddeposition['dep?'z??n]

濾除及沉積（nasalfunction鼻功能）pathogens['p?θ?d??ns]intheupperairways上呼吸道病原體Coughreflex咳嗽反射Mucociliary[mju:k??'s?l??r?]clearance黏液纖毛清除macrophages['m?kr?fe?d?]巨噬細胞Humoral['hju:m?r?l]andcellular['selj?l?(r)]immunity體液及細胞的免疫Oxidative['?ks?de?t?v]metabolism[m??t?b?l?z?m]ofthe

neutrophils中性粒細胞的氧化代謝RespiratorySystem（二）、Pneumoniaingeneral2022/12/16Defensemechanism[d692022/12/20

鼻炎咽炎耳炎扁桃體炎喉炎細支氣管炎RespiratorySystemSinus/-itis['sa?n?'sa?t?s]鼻竇炎Pharyng/-itis[.f?r?n'd?a?t?s]咽炎Laryng/-itis[l?r?n'd?a?t?s]喉炎Bronch/-itis[br??'ka?t?s]支氣管炎2022/12/16702022/12/20rootmeaningexamplePneum(o)-Lung,airpneumothorax[nju:m?'θ?:r?ks]氣胸pneumonia肺炎pneumatic[nu:'m?t?k]充氣的pneumocystis[n'ju?m?s?st?s]肺囊蟲pneumonectomy[nju:m?'nekt?m?]肺切除術pneumonrrhagia[nju:m?'rei:d???]肺出血pneumograph['nju:m?grɑ:f]呼吸描計議pneumocyte[nju:m?'s?t]肺細胞pneumatocele['nju:m?t??si:l]肺膨出Pulmo(o)-Pulmonary['p?lm?n?ri]肺的,肺病的Path(o)-pathologyPathobiology[p?θ?ba?'?l?d??]病理學Pathogen[‘p?θ?d??n]病原體Pathogenesis[p?θ?‘d?en?s?s]發(fā)病機理pathologist[p?’θ?l?d??st]病理學家Muc(o)-SlimeMucoid['mju:k??d]粘液樣的mucociliary[mju:k??'s?l??r?]黏液纖毛的mucositis[m'ju:k?sa?t?s]黏膜炎Myx(o)-Myxoma[m?ks'??m?]粘液瘤myxobacteria[m?ks?b?k't??r??]黏細菌myxiod粘液樣的Bronch(o)-bronchiBronchogenic[br?nk?d'?en?k]支氣管原的bronchoscopy[b'r?nt??sk?p?]支氣管鏡檢查術bronchitis[br??’ka?t?s]支氣管炎bronchospasm['br??k?sp?z?m]支氣管痙攣Bronchoconstriction[br?nt'???k?nstr?k?n]支氣管狹窄2022/12/16rootmeaningexamplePn712022/12/20rootmeaningexampledys-有病的、不正常的、有障礙的dyspnea（呼吸困難）[d?s'pni:?]

、dyscrasia（惡病質）[d?s'kre?zj?]

、dysentry（痢疾）['d?sntr?]

、dysplasia（發(fā)育異常）[d?s'ple???]

pnea呼吸eupnea（呼吸正常）[ju:p'ni:?]

、tachypnea（呼吸急促）[t?k?p'ni:?]

hyper-超出、在······之上、高于、過度hyperadenosis（腺增大）[ha?p?r?d?'n??s?s]

、hyperaemia（充血）[ha?p?'ri:m??]

、hyperinsulinism（胰島素分泌過多）[ha?p?'?ns?l?n?z?m]

、hyperpiesia（血壓過高）[ha?p?(:)pa?'?zj?]

、hyperthyroid（甲狀腺功能亢進）[ha?p?'θa?r??d]

hypo-在······下、次于、不足hypothermia（低體溫）[ha?p?‘θ?:mi?]

、hypoglottis（舌下部）[ha?p?'gl?t?s]

、hypoacidity（胃）酸過少[h?p???'s?d?t?]

、hypocalcemia（低血鈣）[ha?p??k?l'si:m??]

、hypoglycemia（低血糖）[ha?p??gla?'si:m??]

RespiratorySystem2022/12/16rootmeaningexampledy722022/12/20Etiology病因Therearetwofactorsinvolvedintheformationofpneumonia,參與肺炎形成的兩個因素，includingpathogensandhostdefenses.包括病原體和宿主防御RespiratorySystem2022/12/16Etiology病因Therea732022/12/20Causativeorganisms致病微生物Bacteria細菌Mycobacteria分枝桿菌Chlamydiae衣原體Mycoplasma支原體Fungi真菌Parasites寄生蟲Viruses病毒rootmeaningexamplegerm-病菌germicide殺菌劑[’d??:m?sa?d]

bacteri-細菌bacteriology細菌學bacteriemia菌血癥[b?kt?'r??mj?]

bactericide殺菌劑[b?k't??r?sa?d]

bacill-桿菌bacillemia桿菌血癥[b?s?'li:m??]

-coccus球菌diplococcus雙球菌[d?pl??'k?k?s]

、gonococcus淋球菌['g?n??'k?k?s]

strept-鏈streptococcus鏈球菌屬[strept?'k?k?s]

staphyl-葡萄staphylococcus葡萄球菌屬[st?f?l?'k?k?s]

、staphyloma葡萄腫[st?f?'l??m?]

monil-念珠菌moniliasis念珠菌病[m?n?'la??s?s]

fung-真菌fungoid似真菌的，狀的[f??g??d]

、fungicide殺真菌劑[f?ng?sa?d]

myc-霉菌mycoology霉菌學，真菌學antimycotic抗真菌的2022/12/16Causativeorganisms致742022/12/20Classification分類Classificationofanatomy按解剖分類Classificationofpathogen按病原體分類Classificationofacquiredenvironment按患病環(huán)境分類RespiratorySystem2022/12/16Classification分類Clas752022/12/20Classificationbyanatomy按解剖分類

Lobar大葉性

:Involvementofanentirelobe

一個完整的葉的參與Lobular小葉性

:Involvementofpartsofthelobeonly,segmentalorofalveolicontiguoustobronchi(bronchopneumonia支氣管肺炎).

只有部分的肺葉，節(jié)段性支氣管或相連的肺泡受累；Interstitial間質性[?nt?’st??l]

:Involvementoftheinterstitialtissueofthelungs肺間質組織參與

RespiratorySystem2022/12/16Classificationbyan762022/12/20Classificationbypathogen按病原體分類Pn