呼吸系统疾病6.1-肺炎ppt课件.ppt

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1、DepartmentofPathologySouthernMedicalUniversity呼吸系统疾病（一）RespiratorySystemDisease梁莉9/18/20211FlusymptomArewereadytomeetbirdfluchallenge?SARS-themysteryillnessPneumonia-howcommonitis!Pulmonarytuberculosis-olddiseaseContinuingWagingwaronlungcancer9/18/20212Respiratorysystemanatomi

2、calchart9/18/202139/18/20214Bronchi9/18/202159/18/20216Blood-airbarrier9/18/20217TypesofrespiratorysystemdiseaseChronicObstructivePulmonaryDisease(COPD)慢性支气管炎Chronicbronchitis肺气肿Pulmonaryemphysema支气管扩张症BronchiectasisPneumonia大叶性肺炎Lobarpneumonia小叶性肺炎Lobularpneumonia病毒性肺炎Viralpn

3、eumoniaSevereAcuteRespiratorySyndrome(SARS)ChroniccorpulmonalePneumoconiosisTumorsofrespiratorysystem9/18/20218Pneumonia--Acuteexudativeinflammation75.5%ofacuteinfectivedeathratioofrespiratorysystem5thinvarioustypesofdeathetiology9/18/20219TypesofpneumoniaEtiologyPlaceandslope

4、CharacterBiologicalfactors:Bacterial,Viral,MycoplasmalPhysicalandchemicalfactors:LobarpneumoniaLobularpneumoniaInterstitialpneumoniaSegmentalpneumonia9/18/202110LobarpneumoniaIntroductionEtiology&PathogenesisPathologicalchangesClinicalrelations9/18/202111Diffusefibrinousinflam

5、mationinalveoliYoungtomiddleagedpersonsClinicalcharacters:Rapid;chill,highfever,chestpain,cough,rustysputum,dyspnea;consolidationoflung;WBCNaturalcourseofdisease:5-10daysIntroduction9/18/202112浆液性渗出物细菌在肺泡中繁殖肺泡孔呼吸细支气管带菌渗出液大叶间蔓延叶支气管邻近肺组织机体抵抗力↓呼吸道防御能力↓→细菌感染(肺炎球菌)→变态反应性炎→血管扩张，通透性↑

6、→浆液、纤维素渗出肺炎链球菌Ⅲ（1,2,3,7型）金黄色葡萄球菌溶血性链球菌90％Etiology&Pathogenesis9/18/202113Mostlylaterallung，inferiorlobeofleftorrightlungAlsomorethantwopulmonarylobesFourstages，5-10daysPathologicalchanges★9/18/202114一、充血水肿期（1－2天）★肉眼：肿大重量增加暗红镜下：肺泡壁毛细血管扩张、充血肺泡腔大量浆液,少红、中性粒、巨噬细胞,大量细菌高热、咳嗽，毒血症湿性啰音、

7、淡薄阴影9/18/2021159/18/202116二、红色肝样变期（3－4天）★肉眼：大、质实、灰红镜下：肺泡壁毛细血管扩张充血，肺泡腔大量RBC渗出，少数WBC、纤维素发绀、咳嗽、铁锈色痰、胸痛、支气管呼吸音、湿性罗音、致密阴影9/18/2021179/18/202118Thisstageisreferredtoas“Redhepatization”inlobarpneumonia.Thealveolicontainmoreredcellsandserumandlessneutrophils.Arteriolesandcapillariesar

8、ehighlycongested.9/18/2021199/18/202120三、灰色肝样变期(5-6天)★肉眼：大、重量