2021年结核性胸膜炎.ppt

文档介绍：Anatomy：
解剖学：
Visceral pleura
脏层胸膜
Parietal pleura
壁层胸膜
Latent space
潜在腔隙
概 述
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: Mycobacterium tuberculosis
病因：结核分枝杆菌
病因和发病机制
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Discovered by in 1882
于1882年发现
Acid-fast 抗酸染色性
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Pathogenesis :two theories
发病机制：两种学说
Delayed hypersensitive reaction
迟发性高敏反应
Pleural infection
胸膜感染
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congestion with cell infiltration, unilateral in most cases.
胸膜充血，细胞浸润，多数病例累及单侧胸膜
病 理
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In the early stage, polymorphs predominate.
早期以多型核细胞为主
Typically, lymphocytes predominate.
典型表现以淋巴细胞为主
2. Tuberculous nodules 结核结节
3. Exudative effusion 渗出液
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临床表现
Symptoms 症状
Age, often seen in young people, but also in elderly people
1. 年龄，多见于年轻人，但也可见于老年人
Fever, typically 37～38C, but can be >39C
2. 发热，典型者37-38C，但也有>39C者
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Chest pain, more severe when there is only little fluid.
3. 胸痛，胸水少时明显
Breathlessness, when there is a lot of fluid.
4. 气短，胸水多时明显
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Physical signs 体征
Inspection: fullness of chest in the involved side.
1. 视诊：患侧胸廓饱满
2. Palpation: trachea shifts to the other side, weakness of vocal fremitus .
2. 触诊：气管向健侧移位，触觉语颤减低
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: dullness in the involved side.
3. 叩诊：患侧实音
:disappearance of breathing sound
4. 听诊：患侧呼吸音消失
干性胸膜炎典型体征：胸膜摩擦音
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