小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 顽固性咳嗽
- 发热
- 呼吸困难
- 哮鸣音
- 爆裂音
危险因素
- 意识水平下降（格拉斯哥昏迷量表评分小于 9）
- 病情加重
- 全身麻醉
- 年龄＞70 岁
- 男性
- 头部外伤
- 脑血管病
- 气管内插管或气管切开插管
- 吞咽困难
- 气道困难
- 钡餐
- 胃食管反流病
- 饲管
- 仰卧位
- 胃排空延迟
- 肥胖
- 降低食管括约肌张力的药物
诊断性检查
首要检查
- 胸部 X 线检查
需考虑的检查
- 胸部 CT
- 支气管镜检查及支气管肺泡灌洗
- 全血细胞计数 (FBC）
- 动脉血气
治疗流程
因胃内容物误吸所致的肺部炎症
因硫酸钡误吸所致的肺部炎症
48 小时后肺部炎症未消退
撰稿人
作者
Madison Macht, MD
Volunteer Clinical Faculty
Division of Pulmonary Sciences and Critical Care Medicine
University of Colorado Denver
Aurora
CO
利益声明
MM declares that he has no competing interests.
鸣谢
Dr Madison Macht would like to gratefully acknowledge Dr Kamran Mahmood, Dr Scott Shofer, Dr Septimiu Murgu, and Dr Henri Colt, previous contributors to this topic.
利益声明
KM, SS, SM, and HC declare that they have no competing interests.
同行评议者
Andrew Parfitt, MBBS, FFAEM
Clinical Director
Acute Medicine
Associate Medical Director
Consultant Emergency Medicine
Guy's and St Thomas' NHS Foundation Trust
Clinical Lead and Consultant
Accident and Emergency Medicine
St Thomas' Hospital
London
UK
利益声明
AP declares that he has no competing interests.
Momen M. Wahidi, MD, MBA
Director
Interventional Pulmonology
Division of Pulmonary, Allergy, and Critical Care Medicine
Assistant Professor of Medicine
Duke University Medical Center
Durham
NC
利益声明
MMW declares that he has no competing interests.
鉴别诊断
- 急性呼吸窘迫综合征
- 哮喘加重
- 囊性纤维化伴加重
更多 鉴别诊断指南
- 成人社区获得性肺炎的诊断和治疗：官方临床实践指南
- ACR 适用标准：吞咽困难
更多 指南
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明