最后审阅: 29 十月 2021
最后更新: 25 五月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 咳嗽伴痰增多
  • 呼吸困难
  • 发热
  • 危险因素

其他诊断因素

  • 胸痛
  • 胸腔不对称扩张
  • 共振减少
  • 听诊异常
  • 心动过速
  • 不适感/厌食

危险因素

  • 感染控制/手部卫生不佳
  • 插管和机械通气
  • 多重耐药菌
  • 误吸
  • 抑酸药物
  • 意识障碍
  • 胸部或上腹部手术

诊断性检查

首要检查

  • 氧饱和度
  • 胸部 X 线检查
  • 全血细胞计数
  • 血气
  • C 反应蛋白
  • 肝肾功能检查
  • 痰、鼻咽拭子或气管抽吸物培养

需考虑的检查

  • 胸部 CT 扫描
  • 胸腔超声
  • 胸腔穿刺术和胸水培养
  • 尿抗原检测
  • PCR 和/或血清学检查,包括针对 SARS-CoV-2 的检查

治疗流程

撰稿人

专家顾问

Jonathan Bennett, MD

Honorary Professor of Respiratory Sciences

University of Leicester

Respiratory Consultant

Glenfield Hospital

Leicester

UK

简介

JB is Chair of the British Thoracic Society.

利益声明

JB declares that he has no competing interests.

Claire Vella, MD, MRCP

Clinical Fellow Lung Cancer and Interventional Pulmonology

Glenfield Hospital

University Hospitals of Leicester NHS Trust

Leicester

UK

利益声明

CV declares that she has no competing interests.

Acknowledgements,

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Forest W. Arnold, DO MSc, FIDSA

Associate Professor of Medicine

Division of Infectious Diseases

Department of Medicine

School of Medicine

University of Louisville

Louisville

KY

利益声明

FWA declares that he has no competing interests.

同行评议者

Jeremy Brown, MBBS, MRCP, PhD

Professor of Respiratory Infection/Honorary Consultant

University College London

London

UK

利益声明

JB was a member of the NICE pneumonia guidelines committee.

编辑

Helena Delgado-Cohen,

Section Editor, BMJ Best Practice

利益声明

HDC declares that she has no competing interests.

Rachel Wheeler,

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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