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小儿咳嗽诊疗新观点.ppt

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1、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller

2、and DS18B20 temperature sensor.小儿咳嗽诊疗新观点This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of

3、 the system are AT89C51 microcontroller and DS18B20 temperature sensor. 儿童呼吸系统解剖生理特点决定了儿童时期易患各种呼吸系统感染性疾病 呼吸道感染是儿科最常见的疾病 呼吸道感染约占儿科门诊 60 70,北方地区更高,冬春季更高 WHO统计:每年 5岁小儿死于急性呼吸道感染约 400万,是死亡第一原因。其中亚太地区约 45万 /年,中国占 2/3儿童咳嗽概述This paper mainly introduces the design of an intelligent temperature control system

4、 which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 咳嗽是机体的防御反射,有利于清除呼吸道分泌物和有害因子 咳嗽是呼吸道疾病的常见症状咳嗽伴随症状:咽痛、咽

5、干;耳痛;流涕;发热;胸痛; 咳痰: 白痰、黄痰、粘液痰、血性痰; 呼吸急促、呼吸困难、喘息 久治不愈影响患儿身心健康和学习生活,并给家长和社会带来额外经济负担儿童咳嗽概述儿童咳嗽常伴有咳痰This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B2

6、0 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.儿童呼吸系统特点小儿呼吸道解剖生理特点与病理生理变化的关系生理解剖特点 病理生理变化气道相对狭窄,直径较小 易致气道阻塞平滑肌、弹力组织发育 气道易萎陷或闭塞不完善 血管、间质丰富 肺含气量少,易致感染粘膜柔软、纤嫩 易感染粘液腺相对多 分泌多,易阻塞通气侧枝通道少 肺不张机会多死腔 /潮气量相对大 对通气不利 This paper mainly

7、 introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 tempe

8、rature sensor.咳嗽的作用反射性保护机制能清除粘液或异物保持呼吸道通畅阻止感染扩散This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core compon

9、ents of the system are AT89C51 microcontroller and DS18B20 temperature sensor.咳嗽与咳痰的机制 各类刺激物 咳嗽清除( 痰 、刺激物) 传入 传出相应肌群呼吸肌、膈肌、气管平滑肌感受器咳嗽中枢(延髓)迷走神经三叉神经舌咽神经脊髓神经迷走神经膈神经喉返神经This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measur

10、ement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痰的组成 主要成分是粘液,含有酸性糖蛋白 (岩藻粘蛋白 ),其粘稠度与糖蛋白含量有关(由气道粘液腺分泌 , 可分为二层,外层为凝胶层,含粘性成分,内层为水样层,粘性低,纤毛在粘液中摆动 ) 还含有电解质,其

11、中钙离子量与痰粘稠性有关,含钙量高则稠 正常痰液中 DNA含量很少,呼吸道感染时,由于上皮细胞破坏 ,DNA含量增高,粘稠性亦随之增高,其机制为 DNA抑制内源性蛋白水解酶 痰液受 PH影响, PH呈碱性,痰粘稠度降低This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature

12、 sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.痰液对病情的影响 痰液在气道久留,水分渐失变稠成痰栓 痰液刺激气道感受器,传入神经,加重咳嗽 痰液在气道存在,促使细菌繁殖,感染加重 痰、咳、喘互为因果,形成恶性循环 痰液量过多,可堵塞气道,起肺不张或肺气肿,影响通气功能 严重咳嗽,咳痰可传染环境(飞沫传染 ,气溶胶传播)This paper mainly intro

13、duces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature

14、 sensor.痰液排出系统 -粘液纤毛清除系统 (MC)的组成 纤毛细胞粘液层浆液层浆液分泌腺 杯状细胞 粘液毯3m6mThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. T

15、he core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.粘液纤毛清除系统在人体的分布 传导性气道鼻腔后 2/3、鼻窦鼻咽气管、支气管、细支气管 中耳咽鼓管This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by usin

16、g single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.传导性气道炎症的病理过程粘液纤毛清除功能下降非特异性免疫功能下降病原微生物不能被清除并大量繁殖破坏气道上皮释放细胞因子及粘附因子炎症反应炎症细胞释放炎症因子进一步损伤单纯抗感染治疗是不足够的This paper mainly introduces the

17、design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.与

18、MC异常有关的呼吸系统疾病 反复呼吸道感染 (UACS) 急、慢性气管 -支气管炎 支气管哮喘 COPD 以下情况会损害 MC功能气管插管吸入全麻This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip micr

19、ocomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 儿童呼吸系统发育尚不成熟 容易引起排痰不畅,痰液粘稠,痰液潴留儿童不能有效咳嗽,不易排出痰液生理反射发育不成熟This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement

20、and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 单用中枢性镇咳药会抑制延髓咳嗽中枢,不利于排痰,造成痰液潴留 在呼吸道感染早期就应及时排痰,避免反复感染带来的危害痰液潴留会对儿童带来严重危害This paper mainly introduces the desi

21、gn of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.咳嗽的分类

22、按病程分(小儿) 急性 咳嗽 :咳嗽时间 2周 亚急性咳嗽: 24个周 慢性 咳嗽 : 咳嗽症状持续大于 4周 按照咳嗽性质分 (为了有利于临床上的诊断和治疗, 09年版本 增加此内容) 干咳:指咳嗽时无痰或痰量甚少 湿咳: 指咳嗽时伴有痰液(气管渗出物)中华结核和呼吸杂志, 2009, 32( 6)This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and contr

23、ol by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.慢性咳嗽的病因分类UACS 上气道咳嗽综合征 既往诊断为鼻后滴漏(流)综 合征,又称 PNDsCVA 咳嗽变异性哮喘EB 嗜酸细胞性支气管炎GERC 胃食管返流性咳嗽感染后咳嗽、气道畸形其他: AC 变应性咳嗽、慢性支气管炎、支气管扩张

24、、结核咳嗽、心理性咳嗽 ,儿童还需注意异物吸入等中华结核和呼吸杂志, 2009, 32( 6)中华儿科杂志 2008年 2月第 46卷第 2期This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microc

25、omputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.不同年龄慢性咳嗽的常见病因年 龄 病因婴 儿期( 1周 岁 ) 呼吸道感染和感染后咳嗽、先天性气管肺发育异常、胃食管反流、肺结核、其他先天性心胸异常等幼儿期( 1-3周 岁 ) 呼吸道感染和感染后咳嗽、上气道咳嗽综合症、咳嗽变异性哮喘、气道异物、胃食管反流、肺结核等学 龄 前期( 3-6周 岁 ) 同幼儿期病因,此外尚有支气管扩张等学 龄 期( 6-青春期) 上气道咳嗽综合症、咳嗽变异性哮喘、

26、感染后咳嗽、肺结核、心因性咳嗽、气道异物、支气管扩张等中华儿科杂志 2008年 2月第 46卷第 2期常伴有咳痰This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The co

27、re components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.慢性咳嗽的诊断 根据病史、体格检查、辅助检查确立诊断 慢性咳嗽的病因诊断应遵循以下几条原则 重视 病史 ,包括耳鼻咽喉和消化系统疾病病史 根据病史选择有关 检查 ,由简单到复杂 先检查常见病,后少见病 诊断和治疗应同步或顺序进行。如不具备检查条件时,可根据临床特征进行诊断性治疗,并根据治疗反应确定咳嗽病因,治疗无效时再选择有关检查。治疗部分有效,但未完全缓解时,应除外复合病因。This paper mainly intro

28、duces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature

29、 sensor.慢性咳嗽辅助检查影像学 :胸片、 CT肺功能检测 : 通气功能,激发试验纤支镜诱导痰 检查呼出 NO检查过敏状态检测:变态原皮肤点刺,血清 IgE和或 SIgE测定中国儿童慢性咳嗽诊断程序 (0802)符合慢性诊断诊断标准病史和体检有明确病因线索特异性咳嗽鉴别诊断CXR+肺通气功能?未见异常观察随访 ENT就诊 支气管激发试验 诊断性治疗(按 UACS, CVA,GERC顺序进行感染后咳嗽确诊 上气道咳嗽综合症 CVA选择性检查鼻窦 X片, 24h食管 pH监测 ,支气管镜 ,CT、血清 IgE和 SIgE,皮肤过敏试验、诱导痰等明确诊断与治疗治疗无效有效有效确诊无效This

30、paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and D

31、S18B20 temperature sensor.This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system ar

32、e AT89C51 microcontroller and DS18B20 temperature sensor.非药物治疗避免接触过敏源、受凉、烟雾等环境;1. 对鼻窦炎的诊治,如鼻腔冲洗 减充血剂 ;2. 体位变化,改变食物性状、少量多餐对 GERC有效;3. 对气道异物则应及时取出异物;4. 药物反应性咳嗽需立即停药;5. 对心因性咳嗽予心理疗法 ;6. 及时接种疫苗,预防呼吸道传染病和呼吸道感染。This paper mainly introduces the design of an intelligent temperature control system which reali

33、zes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.药物治疗 祛痰药物 盐酸氨溴索 、 愈创木酚甘油醚 、 N一乙酰半胱氨酸 镇咳药 右美沙芬、可待因、 福尔 可 定 抗组胺药物 H

34、1受体拮抗剂 如 氯苯那敏 、氯雷他定、西替利嗪等。 抗菌药物 明确细菌、非典型病原菌,可用抗菌药物 平喘抗炎药 糖皮质激素、 2受体激动剂、 M2受体阻断剂、白三烯受体拮抗剂、茶碱、盐酸克仑特罗等。 消化系统药物This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature s

35、ensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.祛痰止咳药 主要通过稀释痰液或液化粘痰,使之易于咳出,从根本 上阻断咳嗽 宜先查明咳嗽、咳痰的原因,区别咳嗽性质和痰的形状, 有针对性地选择祛痰药 慢性咳嗽如伴有痰,应以祛痰为原则,不能单纯止咳,以免加重或导致气道阻塞 盐酸氨溴索是 目前临床上最安全有效的祛痰止咳成分 ,可用于各种原因引起的咳嗽 儿童慢性咳嗽诊断与治疗指南

36、 ,中华儿科杂志 2008年 2月第 2期 儿童呼吸安全用药专家共识:感冒和退热药 ,中国实用儿科杂志 2009年 6月第 6期 FDA monograph. 21 CFR 341.18, Docket No. 1976N0052G, June18, 2005.This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single b

37、us digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.祛痰和止咳 (水样层、凝胶层、纤毛运动、 DHA裂解)止咳对呼吸道刺激痰易于咳出稀释痰液 液化粘痰 纤毛运动This paper mainly introduces the design of an intelligent temperature control system

38、 which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.常用祛痰药成份 作用机理氯化胺 反射性刺激起到分泌增加(少用)愈创木酚甘油醚 稀释痰液,促进纤毛运动,促进

39、排痰 氨溴索(如沐舒坦 易坦静)粘液调节剂,液化粘痰乙酰半胱氨酸(如富露施) 痰液溶解剂,裂解 -SH基稀化粘素 (如吉诺通 ) 溶解粘液,刺激分泌This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip mic

40、rocomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.中枢性镇咳药 直接抑制延髓咳嗽中枢,产生镇咳作用;但因其能抑制咳嗽反射,有引起痰液潴留的危险 主要用于无痰干咳 慢性咳嗽尤其在未明确病因前不主张使用镇咳药,镇咳药不宜应用于婴儿 多痰或肺瘀血患儿应禁用;儿童必须禁用具有成瘾性的中枢镇咳药,如可待因及含可待因的复方制剂 儿童慢性咳嗽诊断与治疗指南 ,中华儿科杂志 2008年 2月第 2期 儿童呼吸安全用药专家共识:感冒和退热药 ,中国实用儿

41、科杂志 2009年 6月第 6期This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51

42、microcontroller and DS18B20 temperature sensor.常用镇咳药药名 分类 作用机制 特点可待因 中枢性镇咳药 直接抑制延髓咳嗽中枢,产生镇咳作用;有引起痰液潴留的危险有成瘾性右美沙芬 中枢性镇咳药 无成瘾性喷托维林 (咳必清 )中枢性镇咳药 适用 5岁以上福尔可定中枢镇咳药 作用与可待因相似,但成瘾性较弱苯丙哌啉麻醉性镇咳药 抑制咳嗽反射弧中的末梢感受器传入神经或传出神经的传导而起到镇咳作用使用 8岁以上This paper mainly introduces the design of an intelligent temperature contr

43、ol system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.常用抗组胺药(第一代)成份 药理作用苯海拉明 抗组胺作用,镇静作用氯苯那敏(扑尔敏) 同

44、上异丙嗪(非那更) 抗组胺、抗胆碱作用去氯羟嗪(去敏嗪) 抗组胺作用赛庚定 抗组胺、抗胆碱作用This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.常用抗组胺药(第二代)成份 药理作用阿司咪唑(息斯敏) 抗胆碱作用,无镇静特非那定(敏迪) 同上西替利嗪(仙达安) 长效抗胆碱及肥大细胞稳定剂氯雷他定(开瑞坦) 长效 1受体拮抗剂

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