Lung abscess sums up _'s general knowledge

Lung abscess sums up _'s general knowledge
Lung abscess Lung abscess is the lung caused by many kinds of reasons to organize suppurative pathological change. Diagnosis First. Clinical manifestation: (divide three kinds of types) 1. Sucking lung abscess: (1) There can be decayed teeth, tooth's socket to overflow in oral cavities such as suppuration, tonsillitis and nasal sinusitis,etc. and a purulent venereal disease cooking stove of nasopharynx, or there are oral cavities, nasopharyngeal operation, go into a coma, the medical history that general anesthesia and foreign matter are sucked,etc.. (2) Onset relatively worried, can have generate heat, cold quiver and the intersection of person who cough and symptom, companion weak failing by appetite whole body have. Abscess was broken to the bronchus routedly 1-2 weeks later, phlegm quantity increased suddenly, could reach 300-500ml every day, presented suppuration phlegm or suppuration blood phlegm, there is stench flavor more, if the anaerobe has stench to infect. Can cause the chest to ache while infringing the pleura. (3) Physical examination: Pathological change range little lying lung to be when the dark department difficult to find physical sign. When pathological change range large, chest percussion present voiced sound, language quiver to strengthen, the respiration subsides, can hear and bronchus respiration or wet rale. 2. Blood source lung abscess: (1) There can be skin wound infecting, furuncle, carbuncle, osteomyelitis, infecting, medical history such as membrane inflammation in bacterial heart postpartum. (2) Many to have, have illness coming on the intersection of fear and cold, the intersection of whole body and the intersection of suppuration and malicious the intersection of blood and symptom of disease of generating heat etc. cooking stove cause originally first, appear coughing, cough up phlegm etc. later, there is little bad smell phlegm quantity of suppuration, seldom spit blood. (3) Physical examination: Lung positive physical sign rare, abscess break can get bronchus hearing and wet rale while being routed. 3. Then sending lung abscess: (1) Present pneumonia symptom in early days. When abscess takes shape, the body temperature increases and presents the relaxation one type continuously; Phlegm quantity increased suddenly, suppuration, companion's stench, could spit blood; There are chests that ache while accompanying and taking place pleurisy and empyema. (2) Physical examination: Percussion voiced sound or flatness of pathological change district. The alveolus respiration of auscultation is weakened, and there are wet rales. Hear and bronchus indicate that there are large cavities, the drum sound of percussion at the respiration. Two. Auxiliary examination 1. Blood routine: The leucocyte is counted and classified and counted to increase. 2. Phlegm slide and cultivation: Can find pathogens. Should make anaerobe to train. 3. The blood is trained: Acute one is positive to lead slightly tallly (should also make anaerobe to train) . 4. X-ray examination: Lung inflammation infiltration and consolidation, and with the flat cavity of the liquid. It last lung under right more sucking the pathological change of the lungs abscess or at leaf back segment and under last end leaf. Continue taking place lung abscess and take place in the original pneumonia focus. Blood source lung abscess is shown as one pair of lungs is scattered in the little blocky inflammation venereal disease cooking stove, or the spherical focus not of uniform more size than the neat one of edge, among them can see the bright district or liquid level. 5. The fibrous bronchus mirror is checked: Contribute to diagnosis of cause of disease and differential diagnosis. Treat First. Antibacterial drug therapy 1. Should amalgamate and employ effective antibiotic to anaerobe in the healing solution: First-selected penicillin, the intersection of dosage and 200-1000u day, include to the intersection of anaerobe and effective medicine while being other: First the intersection of nitre and thiazole, Klim mould and plain banking up south,etc. with earth by the intersection of very beginning and the intersection of spore and west man and inferior amine. Should notice some medicines such as first nitre thiazole only having better curative effect on anaerobe, can't use alone. 2. Because the antibacterial course of treatment of lung abscess is long, should choose the medicine that toxicity and side effect are low, should also make phlegm train and medicine sensitive to test, change medicines in time regularly, by avoiding able to bear the medicine fungus being chosen out. Two. The phlegm liquid is guided 1.Body posture guide, make, carry and employ, eliminate the phlegm medicine. 2.Employ the fibrous bronchus mirror to irritate and wash. Three. Surgery treatment Chronic lung abscess (more than 8-12 weeks) ,Remain suppuration, bronchiectasis, spits blood repeatedly and the infeted's feasible surgery treatment. Four. Complication treatment Erupting empyema and suppuration pneumothorax simultaneously can do the thorax and puncture and smoke the liquid or guide the treatment.
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