文檔從互聯(lián)網(wǎng)中收集，已重新修正排版，文檔從互聯(lián)網(wǎng)中收集，已重新修正排版，word格式支持編輯，如有幫助歡迎下載支持。#word格式支持編輯，如有幫助歡迎下載支持。詢問病史12casehistoryYouneedtogetadetailedhistoryincludingthetimingandacuityofonset,exacerbatingandalleviatingfactorsandenvironmenttriggerstohelpyouconfirmadiagnosisordiscardotherdiseases/developadifferentialdiagnosis.Askyourpatientwhetherthereisahistoryoftobaccouse,orothertoxicandenvironmentalexposuresandhisoccupationalhistory.General/biographical[,baiau'gr無fik,-kal]data傳記,marital婚姻status,nativity出生,occupation,informant提供消息的人,timeofadmissionandrecord,chiefcomplaint,historyofpresentillness,previoushealthstatus(well,ordinaryorbad),anyinfectiousdiseases,allergichistory,historyoftraumaorsurgery,smoking(abouthowmanyyears,averagehowmanypiecesperday,ceasedforhowmanyyears),alcoholintake(occasionalorfrequent),spouse’s[spaus]配偶healthstatus,menorrhea[,men9'ri：9]月經(jīng)(menarche[me'na：ki：,m?-]初潮age,cyclelastingforhowmanydays,menstrualcycle,lastmenstruationperiodorageofmenopause,anymenstrual['menstru?l]月經(jīng)周期painorirregularcycle),childbearingorpregnancy(times,naturallabor,abortions流產(chǎn)，premature[,prem?'tju?,,pri：-]delivery早產(chǎn)，stillbirths死產(chǎn),difficultlabor,familyhistory(anycongenital先天性diseases,fatherandmother:stillalive,illness,orcauseofdeath,siblings兄弟姐妹andchildren)常用的癥狀symptomsfeverCough咳嗽Sputum(dry,purulent['pju?rjul?nt]膿性的，copious['k?upi?s]greensputum大量綠色痰，tenacious[ti'neij?s,t?-]yellowsputum黃粘痰，frothywhitesputum白色泡沫痰，rustysputum鐵銹色痰wheezingDyspneaduringexertion[ig'z?J?n]oratrest呼吸困難Orthopnea[o：'0opni9]端坐呼吸Paroxysmal[,p%r?k'sizm?l]nocturnal[nok't?：n?l]dyspnea夜間陣發(fā)性呼吸困難Shortnessofbreath(SOB)Chesttightness胸部緊迫感Exerciseintolerancepleuriticchestpain胸膜型胸痛Pharyngalgia[f出rin'g出ld3i?];pharyngodynia[,f無rin'godini?]咽痛Hemoptysis咯血Bucking嗆咳Sneeze噴嚏snore打鼾malaise[m到eiz]不舒服myalgia[mai'%ld3i?]肌痛insomnia[in'somni?]失眠h(yuǎn)oarseness聲嘶dysphonia[dis'f?uni?]發(fā)聲困難常見的體征physicalsignsclubbedfingers杵狀指:increasedlongitudinal[,lond3i'tju：din?l]andtransverse橫向curvature[卜?"?叮?]彎曲,lossofconcave['konkeiv]凹面的nailfoldangle,bogginessofnailbedandincreasedsofttissuebulkofdistalphalanx['在l無qks,'fei-]趾骨,指骨,drumstick-likenicotinestainingcyanosis[,sai'nusis]發(fā)紺:bluediscolourationofmucosalmembranesandskin,causedwhenmeancapillaryconcentrationofdeoxyhemoglobin[di：Qksi'hemu,glubin去氧血紅蛋白morethan5g/dl,O2saturationlessthan85%,PaO2lessthan8KPaperipheral[p'rifrl]外圍的，次要的cyanosis:coldblueperipheries,e.g.nailbedsduetocoldexposurescentralcyanosis:warmperipheries,bluetongueorlipshandflap:duetoCO2retention潴留asterixis撲翼樣震顫papilloedema視乳頭水腫chemosis球結(jié)膜水腫enlargedsupraclavicula鎖骨上的r[kl%'vikjul]andaxillary[%k'silri]腋窩lymphnodesincreasedrespiratoryratetachycardia心動(dòng)過速pulsusparadoxus:>10mmHg]oninspiration(seeninsevereasthma)barrelchesthyperexpanded,decreasedexpansionkyphosis[kai'fusis]駝背，脊柱后凸Inspection:tachypnea[,t出kip'ni：]呼吸急促accessorymusclesofrespiration[,resp'reifn]:sternocleidomastoid['st:nu,klaid'mastoid]胸鎖乳突肌muscle,armsupport,alaeflaringwideornarrowintercostal[,int'kostl]肋間的spacetactile觸覺的vocal聲音的fremitus震顫觸覺語顫subcutaneouscrepitus皮下捻發(fā)感Percussion:resonance清音dullness濁音flatness實(shí)音hyperresonance過清音tympany/timpZni/鼓音lowerborders:scapular['sk出pjul]肩胛的lineXleft/rightintercostal[,int'kostl]肋間的spacerangeofmobility[mu'bilti]移動(dòng)Auscultation],o：skl'teifn]:聽診vocalresonance語音共振ronchi:wheeze,stridor['straid]喘鳴，crackles['k儂kl]發(fā)出細(xì)碎的爆裂聲，Velcro-likesoundesmoistrales:coarse粗的,medium中等的，fine好的，crepitus捻發(fā)音pleuralfrictionrubscompleteabsenceofbreathsoundsankleedemaweightloss，cachexia[k'keksi]惡病質(zhì)，cachectic[k'kektik]惡病質(zhì)的decreasedfoodappetite,lossofappetite,anorexia[，出n'reksi]食欲減退常做的檢查examinationsorlaboratoryfindings(totake,undergo,perform,receiveorhave)temperaturecharts體溫圖(takeone’sbodytemperature)sputumpot痰盂Blood/urine/stoolroutine,occult['okAlt/bloodtest潛隱血試驗(yàn)BloodbiochemistrySputum/bloodcultureanddrugsensitivitytestsputumcytology[sai'told3i]細(xì)胞學(xué)Pulseoximeter[ok'simit]脈氧計(jì)：continuousmonitoringofbloodoxygensaturationArterialbloodgasanalysis(ABG):arterialbloodsampling,radial/femoral['femrl]股骨的arterypuncture穿刺PaCO2:partialpressureofcarbondioxideinarterialbloodhypercarbiaPaO2:partialpressureofoxygeninarterialbloodhypoxemia[,haipok'si：mi]血氧不足respiratoryfailure:type1:decreasedO2supply,PaO2<60mmHg(millimetersofmercury['m:kjuri]汞)duetodiffusionfailureorV/Qdismatch(ventilation-perfusion(quotient)ratio)pulmonaryedema,pneumonia,infarction,fibrosis,orpulmonaryembolism，pulmonaryhypertension,shunttype2:decreasedCO2removal,PaCO2>50mmHg(millimetersofmercury)duetoalveolarventilationfailureobstructive:COPD,asthma,bronchiectasisrestrictive:neuromuscular[,njuru'mASkjul]神經(jīng)肌肉(sedatives['ssdtiv]鎮(zhèn)靜劑myasthenia[,mais'0i：ni]肌無力),structural['strAktfrl]結(jié)構(gòu)的(ankylosingspondylitis[，無nki'luzijspndi'laitis]強(qiáng)直性脊柱炎),pleuraldiseases,obesityChestX-ray/radiograph:reticulo-nodularshadowing(reticular[ri'tikjul]網(wǎng)狀的，linear['lini]線狀的,militarynodules粟粒樣結(jié)節(jié))coinlesions硬幣樣cavities空腔:amphoric['%mfrik]空翁音的(breathinglikeblowingoverabottletop)opacification[u,p出sifi'kei[n]渾濁:consolidation(airspaceinfiltrate):confluent['konflunt]支流的，匯合的shadowingandairbronchogramf支氣管造影collapse:lobar(upper,middle/lingual,lower)segmentalatelactasis肺不張pleuraleffusionmediastinal[,mi：di出s'tainl]縱隔mass:thyroid,thymoma[0ai'mum]胸腺瘤，teratoma[,ter'tum]畸胎瘤,TBlymphnodes,terriblediagnosesincludinglymphoma[lim'fum]淋巴瘤andaneurysm動(dòng)脈瘤ChestCTscan(computedtomography)HeadMRI(magneticresonanceimaging)PET-CTofthewholebody(positron-emissiontomography)['pozitron]正電子Abdominalultrasound['Altr$2口門~]超聲skinpricktest皮膚點(diǎn)刺試驗(yàn)(dustmites塵螨，pollen花粉，cockroach蟑螂)tuberculinskintest(purifiedproteinderivative[di'rivtiv]純蛋白衍生物(oftuberculin)test,PPDtest)Pulmonaryfunctiontest:Spirometry[spai'romitri]呼吸量測定法，肺量測定法obstructivelungdiseases:airflowlimitationFEV1/FVCFVCRVandTLCKCO<0.71Mrestrictivelungdiseases:decreasedlungcomplianceandsmalllungvolumesintraparenchymal>0.751111extraparenchymalvariable111normalFEV1:forcedexpiratory[iks'pairtri/volumein1secondFVC:forcevitalcapacityTLC:totallungcapacityRV:residualvolumeKCO:transferfactor(diffusionrate)PEFR:peakexpiratoryflowrateflow-volumeloop(inspirationandexpiration[,ekspi'reifn])bronchoprovocation/challengetest[,prov'keifn]支氣管激發(fā)試驗(yàn)：histamine['histmmin]組胺ormethacholine乙酰甲膽堿-inhalation[,inh'leifn]bronchodilatation[,dail'teifn]支氣管舒張?jiān)囼?yàn):salbutamol沙丁胺醇[s匈'bju：tmo(：)l]fiberopticbronchoscopy[bron'koskpi]:biopsy['bai,opsi]活組織檢查bronchialbrushsamplesforpathologicalexamation,bronchialwashings)bronchoalveolarlavage(BAL)protectedspecimenbrush(PStransthoracic[,tr^ns0'r出sik,]經(jīng)胸廓的percutaneousneedleaspiration[，出sp'reifn]吸引術(shù)percutanousneedlebiopsyunderCTguidance(forperipheraltumours)video-assistedthoracoscopic-guided[03'r^kskup]胸腔鏡lungbiopsyopenlungbiopsypleuralbiopsybiopsyofenlargedlymphnodesD-Dimerselectrocardiogram(ECG>N電圖echocardiogram超聲心動(dòng)圖V/Qisotope['aisutup]同位素scan(ventilation/perfusionscanning)spiral螺旋CT/MRA(MagneticResonanceAngiography[,^nd3i'ogrfi]血管造影術(shù))pulmonaryangiographyDoppler['dopl]多普勒USSthigh[Bai]大腿andpelvis['pelvis]骨盆(USS:ultrasoundscanning)cardiacmonitorPSG(polysommography)常見的病名diseasesacuteupperrespiratorytractinfection急性上呼吸道感染commoncold普通感冒influenza流感「討廿6門2]pharynigitis咽炎pharyngalgia[f出rin'g出ld3i]咽痛acutebroncho-bronchitis急性氣管-支氣管炎pneumonia肺炎communityacquiredpneumonia(CAP)社區(qū)獲得性肺炎hospitalacquiredpneumonia(HAP)醫(yī)院獲得性肺炎nosocomicalpneumonia(NP)醫(yī)院內(nèi)肺炎bronchiectasis支氣管擴(kuò)張chornicbronchitis慢性支氣管炎pulmonaryemphysema肺氣腫chronicobstructivepulmonarydisease(acuteexacerbating)AECOPDCOPD急性發(fā)作bronchialasthma支氣管哮喘allergicrhinitis[rai'naitis]過敏性鼻炎respiratoryfailure呼吸衰竭lungabscess肺膿腫pulmonarytuberculosis肺結(jié)核病lungcancer:肺癌primarybronchogeniccarcinoma原發(fā)性支氣管肺癌squamous['skweims]cellcarcinoma鱗癌adenocarcinoma腺癌['%dnu,ka：si'num]bronchoalveolarcellcarcinoma支氣管肺泡細(xì)胞癌smallcelllungcarcinoma(SCLC)小細(xì)胞肺癌pulmonarymetastasis肺轉(zhuǎn)移瘤[m't出Stsis]pulmonaryembolism(PE)肺栓塞pulmonarythromboembolism(PTE)肺血栓栓塞癥[,Brombu'emblizm]pulmonaryinfarction肺梗死deepvenousthrombosis,DVT深靜脈血栓形成empyema膿胸[,empai'i：m]pneumothorax氣胸pyopneumothorax膿氣胸['paiu,nju：mu'0cr^ks]chronicsuppurativedisease慢性化膿性疾病['SApjurtiv,-reitiv]congenitalcyanoticdisease先天性紫紺性心臟病[,sai'notik]corpulmonale肺源性心臟病['ko：,pum'n匈i]pulmonaryhypertension肺動(dòng)脈高壓pulmonaryencephalopathy肺性腦病[en,sef'lop0i]rightheartfailure;right-sidedheartfailure右心衰竭pulmonaryvasculardiseases肺血管疾病interstitiallungdisease,ILD彌漫性間質(zhì)性肺疾病idiopathicpulmonaryfibrosis,IPF特發(fā)性肺纖維化[,idi'p無Bik]cryptogenic[,kriptu'djenik]隱源性的fibrosingalveolitis,CFA隱源性纖維化性肺泡炎connectivetissuerelatedlungdiseases結(jié)締組織相關(guān)性肺疾病systemiclupus['lju：ps]狼瘡erythematosus,SLE系統(tǒng)性紅斑狼瘡rheumatoidarthritis,RA類風(fēng)濕性關(guān)節(jié)炎systemicsclerosis,SSc系統(tǒng)性硬化scleroderma硬皮病sjoren’ssyndrome感知綜合征polymyositis多發(fā)性肌炎dermatomyositis皮肌炎sarcoidosis結(jié)節(jié)病[,sa：koi'dusis]Pulmonaryalveolarproteinosis[,prutii'nusis],PAP肺泡蛋白沉積癥Idiopathicpulmonaryhemosiderosis['hi：mu,sid'rusis,,hem-]特發(fā)性肺含鐵血黃素沉著病Langerhanscellgranulomatosis朗格漢斯細(xì)胞肉芽腫病['gr無nju,lum'tusis]Eosinophilicgranuloma嗜酸性肉芽腫[,i：sin'filik]HistiocytosisX組織細(xì)胞增多癥XWegenergranulomatosisWegener肉芽腫extrinsicallergicalveolitis外源性過敏性肺泡炎pneumoconiosis塵肺['nju:m,kuni'usis]drug-inducedlungdisease藥物性肺病aspergillosis[%,sp：dji'lusis]曲菌?。篴llergicbronchopulmonaryaspergillosis(ABPA)pleuraldisease胸膜疾病broncho-pleuralfistula支氣管胸膜瘺['fistjul]oralcandidiasis口腔念珠菌病，鵝口瘡[,k%ndi'daisis]osteoporoticbonechange骨質(zhì)疏松樣改變glaucoma青光眼cataract白內(nèi)障acutelunginjury，ALI急性肺損傷acuterespiratorydistresssyndrome,ARDS急性呼吸窘迫綜合征urticaria蕁麻疹eczema濕疹hypertension高血壓diabetes糖尿病常用的藥物drugsoragentsbeadministered,treatsb.withempirical經(jīng)驗(yàn)性的,prophylactic[,profi'底ktik,,pru-]預(yù)防性,remedial[ri'mi：dil]治療性Expectorant祛痰藥[eks'pektrnt]Mucolytics粘液溶解劑[,mju:ku'litik]bronchodilator支氣管擴(kuò)張劑[,bronkudai'leit]B2-agonists['%gnist興奮劑：short-acting:salbutamol沙丁胺醇[s匈'bju：tmo(：)l]long-acting:salmeterol沙美特羅muscarinic[,mAsk'rinik]毒蕈堿樣的antagonists[%n't出gnist對(duì)抗劑Ll:ipratropiumbromide['brumaid]異丙托溴胺aminophylline氨茶堿[,mi：nu'fili：n]steroids['stiroid]類固醇inhaled:budesonide布地奈德，beclomethasone[,beklu'meQsun]倍氯米松，fluticasone氟替卡松systemic:prednisolone['pred'nislun]強(qiáng)的松po(peros).,hydrocortisone[,haidru'ko：tizun]氫化可的松iv.mastcellstabilizers:cromoglycatesodium色甘酸鈉leukotriene[,lju：ku'trai川白三烯receptorantagonists:montelukast孟魯司特respiratorystimulants:lobelinenikethamide［ni'ke0maid,-mid］尼可剎米cardiactonic強(qiáng)心劑diuretics利尿劑［,daiju'retik］albumin白蛋白［'%Ibjumin］antitussiveagents鎮(zhèn)咳藥［，出nti'tASiv］ammoniumchloride氯化銨［'munjm］銨［'klo：raid］氯化物ambroxol氨溴索(mucosolvan沐舒坦)Pantoloc潘妥洛克常用的治療措施loworhighflowoxygen:nasalcannulae［'k%njuli：］鼻導(dǎo)管，Venturi［ven'tjuri］文里氏face-masknebulizer［'nebjulaiz］噴霧器：finerparticlesize(3to20um)allowstracheobronchialdepositionmetereddoseinhaler(乂口1)定量霧化吸入器continuouspositiveairwaypressure(CPAP)-tight-fittingmask(non-invasive)intermittentpositive-pressureventilation(IPPV)non-invasivepositive-pressureventilation(NIPPV)mechanicalventilation:non-invasiveorinvasive(viaintubation［,intju：'beifn］插管，tracheostomy［,tr%ki'ostmi,,trei-］氣管造口術(shù)，tracheotomy［,tr^ki'otmi,,trei-］氣管切開術(shù))synchronizedintermittentmandatoryventilation,SIMV同步間歇指令通氣pressuresupportventilation,PSV壓力支持通氣thoracocentesis胸腔穿刺術(shù)［,Bo：rksen'tesis］chestdrain/drainage引流術(shù)chemotherapy化療radiationtherapy放療pneumonectomy肺切除術(shù)［,nju：mu'nektmi］lobectomyoflung，pulmonarylobectomy肺葉切除術(shù)［lu'bektmi］葉切除術(shù)thoracotomy開胸術(shù)，胸廓切開術(shù)［,0O：r'kotmi］pleurodesis胸膜剝脫術(shù)pleurectomy胸膜切除術(shù)pleuraladhesion胸膜粘連術(shù)thromboendarterectomy血栓動(dòng)脈內(nèi)膜切除術(shù)inferiorvenacavafilter下腔靜脈過濾器常見的疾病chornicbronchitis:procuctivecough,mostdaysof3monthsoftheyear,foratleast2consecutiveyears,coughwithwhiteorpurulentsputumbronchiectasis:cystic［'sistik］囊性的/varicose［'v%rikus］曲張樣/cyclindrical柱狀-tram-tracks軌道樣hemoptysisphysiotherapy:chestwallpercussionwirhhead-downpostural［'post［rl］drainagelongtermoxygeninhalation:topreventcorpulmonalemedical:bronchodilators,mucolytics,rotatingcoursesofantibioticssurgical:resection,arteryembolizationforhemoptysislungabscessusuallyonrightside,asrightbronchusisshorterandmorevertical;inthesupine['sju：pain]仰臥卜patient,abscessdevelopsinapicallowerlobeorposterialupperlobe.pneumothoraxaccumulationofairinpleuralspace,withsecondarypartialcollapseofsubpleural胸膜下的bleb也心切大皰rupture['rAptf]破裂lactrogenic:positivepressureventilation,bronchoscopy[broq'koskpi]支氣管鏡檢查,esp.biopsytypes:closed,open,tensionmediastinaldeviation:tracheaandapex['eipeks]尖端shiftcontralaterally對(duì)立的旁邊CXR:translucency[tr出nz'lju：snsi]半透明+collapse倒塌：visiblerim邊緣betweenlungandchestwall>2cm(centimeter)=>50%lungvolumelossaspiration[，出sp'reifn]吸弓[術(shù)，intercostaldrainrefractoryorrecurrent周期性的:pleurodesis胸膜固定術(shù),pleurectomy[plu'rektmi]胸膜切除術(shù),bulla['bul]大皰stapling裝訂orlasering激光pleuraleffusionchestpainandprogressivelyworseningofshortnessofbreathTransudate[,tr出nsju'deit]漏出液：redistributionofStarlingforcesacrossmicrocirculation,diuretics[,daiju'retik]利尿齊Llcanresultinrapidresolution,protein<30g/L(gram/litre['li：t])orpleura:serum['sirm]血清protein<1/2orpleura:serumLDH<2/3;oftenseenincardiacfailure,hypoalbuminemia[,haipu出l,bju：m'ni：mi]低蛋白血癥,embolism,superiororinferiorvenacavaobstruction,hypothyroidism.[,haipuEairidizm]甲狀腺功能低下Exudate['eksjudeit]滲出液：capillarypermeability[,p：mi'biliti]滲透increasesorlymphdrainagedecreasesoftenseenininfection,neoplasia[,ni：u'pleizi,-3i]瘤形成，surgeryortrauma.CXR:meniscus[mi'nisks]彎液面-shaped,risestowardsaxilla[%k'sil]腋溫Appearance:clear,straw淡黃色的-coloured:suggeststransduateturbid['t:bid]渾濁的,green:indicatesexudates(pus[pAS]膿cells)orempyema[,empai'i：m]積膿癥(bacterialinfection)bloody(haemothorax[,hi：mu'Bor出ks]血胸):tumor,pulmonaryembolism,acutepancreatitis['p出nkri'taitis]胰腺炎，traumawhite(chylothorax[,kailu'-or出ks]乳糜胸)：lymph,blockedthoracic[Bo：'r%sik,]duct胸導(dǎo)管,usuallyduetotumourTherapy:transudate:diureticsexudates:repeateddrainage(thoracocentesis)intrathoracic[,intr-'儂sik]胸廓內(nèi)的streptokinase[,streptu'kaineis]鏈球菌激酶viachestdrain:tolyse[lais]溶解fibrinous['faibrins]纖維蛋白的adhesions[d'hi：3n]粘合pleuraladhesion:tetracycline[,tetr'saiklain]四環(huán)素.bleomycin[,bli：u'maisin]博萊霉素lungcancerhoarseness:duetoleftrecurrent屢發(fā)的laryngeal[,l出rin'd3i：l]喉的nervepalsy['po：lzi]W痹dysphagia[dis'feid3i，-d3i]吞咽困難pancoasttumorinfiltratesT1stellate['stelit,-leit]星形的ganglion['g無nglin抻經(jīng)節(jié)resultinginHornersyndromehypertrophicpulmonaryosteoarthropathy[QStiua：'0rup骨關(guān)節(jié)病superiorvenacavaobstruction(SVCO):headache,shortnessofbreath;conjunctivaledema,[,kond3AQk'taiv]結(jié)膜plethora['ple0r],veindilation,pericardialtamponade[,t出mp'neid＞心'包填塞(JVPf,ABPI,quietHSparaneoplasticsyndromes:endocrine(ACTH:Cushing’s;B-HCG:gynaecomastiaandbodyhairloss;PTH:hypercalcaemiaespeciallysquamouscellcarcinoma),skin(dermatomyositis)immunocompromisede.g.shingles帶狀皰疹squamouscellcarcinoma:30%ofallprimarylungtumours,butdecreasingincidence,relativelygoodprognosisiflocalized,squamousmetaplasiawithkeratinwhorls,centrallocation,clubbing,hypercalcemia(PTH-rpsecretion)adenocarcinoma:30%,increasingincidence,esp.women,lessassociationwithsmoking,poorprognosis,metastasisearly,gland-likeandmucin-secretion,peripherallocation,pleuraleffusions,hypercoagulablestatesmallcellcarcinoma:20%,poorprognosis,metastasisoccurearly,smallAUPDcellswithneurosecretorygranules,centrallocation,paraneoplasticsyndromescommonbronchoalveolarcellcarcinoma:variantofadenocarcinomathatisassociatedwithchroniclunginflammation,e.g.fibrosing,copiousclearmucoidsputumNSCLC:surgicalresectionpossibleatfirst,adjuvantchemotherapySCLC:radiotherapy+chemotherapy(etoposide+cisplatin)secondarylungcancer:breast,oesophago/gastric/head-neck(+coloniflivermetastasis),melanoma,bone(sarcoma),thyroid,renal,prostate,ovary,choriocarcinoma,testesetc.obstructivesleepapnoeaobstructionofupperairwayoccursatnightwithlossofmuscletoneinsleep,snoring,sleepinessduringday,aponeicspells(O21,patientawakesfromsleep),awakeningwithnocturia,daytimesomnolence,decreasedmemoryandattention,increasedaccidentrisk,polycythaemia,systemichypertensionandpulmonaryhypertensionCauses:centralobesity(fatdepositionaroundupperairwayleadstoairwaynarrowing,abdominalfatelevatesdiaphragm),structuralfeaturesofupperairway(nasalobstruction:rhinitis,polyps,deviatedsputum;adenotonsillarhypertrophy,micrognathia;macroglossiaduetohypothyrodism/amyloid/Down’s;cervicalmasses: goiter,laryngealstenosis),smoking(exacerabateshypoxia),alcohol(actsasasedativetherebyreducingupperairwaytone),neuromuscularorCNSdiseasesPSG(polysommography):overnightsleepstudyTherapy:conservative:weightloss,avoidalcohol/smoking/sedatives,avoidsupinepositioncontinuouspositiveairwaypressure(CPAP)mandibularadvancementdevice(MAD)adenoidectomy(curativeinchildren)uvulopalatopharyngoplasty懸雍垂-腭-咽成形術(shù)maxillomandibularosteotomyobesity-hypoventilationsyndrome:collapseofalveoliatend-expiration,decreasedcomplianceduetoweightofabdomenandchestwall,centralrespiratorydrive]常用的化療藥cisplatin順鉑Gemcitabine吉西他濱：Gemzar（鹽酸吉西他濱注射劑）paclitaxel;taxinol紫杉醇（Taxol泰素）docetaxel多西他賽（泰素帝）常見的抗生素beta-lactamantibiotics:inhibitcellwallsynthesispenicillinskintestamoxicillin阿莫西林piperacillin/tazobactamsodium哌拉西林/他唑巴坦鈉ticarcillin/clavulanatepotassium替卡西林/克拉維酸鉀cephamycin頭孢菌素類cefradine頭孢拉啶cefaclor頭孢克洛cefoperazone/sulbactam頭孢哌酮/舒巴坦ceftriaxone頭孢曲松cefpiramide頭孢吡啶ceftazidime頭孢他定ceftizoxime頭孢唑污carbopenems碳青霉烯類azactam氨曲南meropenem美羅培南imipenemandsodiumcilastatin亞胺培南/西司他丁鈉（泰能tienam）Glycopeptides糖肽類inhibitcellwallassemblyvancomycin萬古霉素norvancomycin去甲萬古霉素teicoplanin替考拉林Macrolides大環(huán)內(nèi)酯類： inhibitproteinsynthesisroxithromycin羅紅霉素clarithromycin克拉霉素azithromycin阿奇霉素erythromycin紅霉素Aminoglycosideantibiotics:氨基糖苷類reno-andototoxicinhibitinitiationandelongationprocessduringproteinsynthesisamikacin阿米卡星（丁胺卡那）gentamicin慶大霉素streptomycin鏈霉素Sulfamido磺胺類sulfamethoxazolecompound（SMZ.CO）Quinolones喹諾酮類：inhibitDNAgyrasenorfloxacin諾氟沙星ofloxacin氧氟沙星levofloxacin左氧氟沙星gatifloxacin加替沙星moxifloxacin莫西沙星ciprofloxacin環(huán)丙沙星Tetracycline四環(huán)素類minocycline美滿霉素Nitromidazole硝基咪唑類metronidazole甲硝唑tinidazole替硝唑ornidazole奧硝唑Antitubercularagents抗結(jié)核藥rifampicin利福平rifapentine利福噴丁isoniazide,isonicotinichydrazideacidINH異煙肼pyrazinamide吡嗪酰胺ethambutol乙胺丁醇Antifungal/antimycoticdrug抗真菌藥nystatin制霉菌素amphotericin兩性霉素Bfluconazole氟康唑voriconazole伏立康唑itraconazole伊曲康唑Antivirusagentsribavirin利巴韋林oseltamivir奧司他韋acyclovir阿昔洛韋ganciclovir更昔洛韋valaciclovir伐昔洛韋foscarnetsodium,phosphonoformicacid膦甲酸鈉（可耐）lamivudine拉米夫定entecavir恩替卡韋常見的病原微生物microorganism,microbe微生物bacterium細(xì)菌lipopolysaccharide（LPS）脂多糖antibiotics抗生素pyrogen致熱原exotoxin外毒素endotoxin內(nèi)毒素Gramstain革蘭染色Colonyformingunit,CFU集落形成單位antibacterialagents抗菌藥resistance耐藥性ESBLs：extendedspectrumB-lactamases超光譜B內(nèi)酰胺酶MRSA：methicillin-resistantstaphylococcusaureus耐甲氧西林金黃色葡萄球菌bacteremia菌血癥toxemia毒血癥endotoxemia內(nèi)毒素血癥septicaemia敗血癥pyemia膿毒血癥pathogen致病原pathogenicity致病性virulence毒力medianlethaldose(LD50)半數(shù)致死量medianinfectivedose(ID50)半數(shù)感染量virus病毒replication復(fù)制viremia病毒血癥normalmicrobiota,microflora,normalflora,physiologicalmicrobiota正常微生物群floradisequilibrium菌群失調(diào)dysbacteriosis菌群失調(diào)癥opportunisticinfection機(jī)會(huì)性感染conditionedinfection條件致病性感染endogenousinfection內(nèi)源性感染exogenousinfection外源性感染antimicrobialsusceptibilitytesting藥物敏感試驗(yàn)minimuminhibitoryconcentration(MIC)最小抑菌濃度minimumbactericidalconcentration(MBC)最小殺菌濃度disinfection消毒sterilization滅菌asepsis無菌aseptictechnique無菌技術(shù)bacteriostasis抑菌antisepsis防腐disinfectant消毒劑bacteriostaticagent抑菌劑bactericide殺菌劑autoclavingorsteamunderpressuresterilization高壓蒸汽滅菌法ultravioletradiation,UV紫外線isolationprecaution隔離預(yù)防artificialactiveimmunization人工主動(dòng)免疫vaccination疫苗接種killed/inactivatedvaccine死/滅活疫苗attentuatedlivevaccine減毒活疫苗toxoid類毒素artificialpas