胸壁、胸膜疾病课件

汇报人：xxx20xx-03-14胸壁、胸膜疾病ppt课件目录胸壁疾病概述常见胸壁疾病介绍胸膜疾病概述常见胸膜疾病介绍胸壁、胸膜疾病的影像学检查胸壁、胸膜疾病的治疗与预防01胸壁疾病概述胸壁由胸椎、胸骨、肋骨及肋间zu织等构成，为胸腔提供保护和支持。肋间zu织包括肋间肌、神经、血管和淋巴管，负责胸壁的运动和感觉。胸壁内衬以胸膜，与胸腔器官在形态结构和功能上相互关联。胸壁解剖与生理如漏斗胸、鸡胸等，影响胸廓形态和呼吸功能。胸壁畸形如肋软骨炎、肋间神经炎等，引起疼痛和ju部炎症。胸壁感染包括原发性肿瘤和转移性肿瘤，如肋骨肿瘤、胸壁肉瘤等。胸壁肿瘤胸壁疾病分类以下附赠各项管理制度英文版（不需要可删）急救药品、器材管理制度:1.Rescuedrugsandequipmentshouldbe"fivefixed"(fixedquantityandvariety,designatedplacement,designatedpersonstorage,regulardisinfectionandsterilization,regularinspectionandmaintenance)and"twotimely"(timelyinspectionandmaintenance,timelyreceiptandsupplementation).Theitemisclearlymarkedandcannotbeusedarbitrarily.2.Thenecessaryrescueequipmentiscomplete,ingoodperformance,andinstandbycondition.3.Therescuedrugsarecomplete,withcleardruglabelsandnodiscoloration,deterioration,expiration,ordamage.Theyshouldbeplacedandusedintheorderofdrugexpirationdates(fromrighttoleft).4.Emergencydrugsanditemsforeachdepartment'srescuevehicleshallbeuniformlyequippedaccordingtorequirements.Specializedemergencydrugsanditemsmustbereviewedandapprovedbythedepartmentdirectortodeterminethetype,quantity,specifications,anddosagetobeequipped.Rescuevehiclesmustbeplacedindesignatedlocationsandmanagedbydesignatedpersonneltoensuresafetyandeaseofuse.5.Afterusingrescuedrugsandequipment,theyshouldbefullyreplenishedwithin24hours.Iftheycannotbereplenishedduetospecialreasons,theyshouldbenotedonthehandoverregistrationformandreportedtotheheadnurseforcoordinationandresolutiontoensuretimelyuseduringpatientrescue.6.Thereisaregistrationbookfortheprovisionofdrugsandequipment.Ensureconsistencybetweenaccountsandmaterials,andhandoverbetweenshifts.7.Managementofsealedrescuevehicles:Beforesealing,theheadnurse(ornurseincharge)andanothernurseshallcountthedrugsandequipmentaccordingtotheregistrationbookofdrugandequipmentequipment,verifytheiraccuracy,andsealthemwithaseal.Twopeopleshallsignandfillinthesealingtime.Nurseschecktheconditionofthesealsoncepershiftandcompletethehandover.Theresponsiblenursescheckonceaweek,andtheheadnurseandresponsiblenursesopenthesealsandinspectthedrugsandequipmentintheambulanceonceamonth,withrecordskept.8.Nonsealedrescuevehiclemanagement:Eachshiftshallcountthedrugsandequipmentaccordingtotheregistrationbookandcompletethehandover.Theresponsiblenurseshallinspectonceaweek,andtheheadnurseshallinspectonceeverytwoweeksandkeeprecords,ensuringthattheaccountsmatchthematerials.护理文书书写制度:

1.Nursingstaffstrictlyfollowthelatestrequirementswhenwritingnursingmedicalrecords.2.Thecontentofnursingrecordsshouldbeobjective,truthful,accurate,timely,complete,andstandardized.3.Allnursingdocumentsshouldbewrittenwithablueblackorcarboninkpen.4.AllnursingdocumentsshouldbewritteninArabicnumeralsfordateandtime,withdatesinyears,months,anddays,usinga24-hoursystem,specifictominutes.5.WritingshoulduseChinese,medicalterminology,andcommonlyusedforeignlanguageabbreviations;Completerecorditems;Thetextisneat,thehandwritingisclear,andthelayoutisclean;Accurateexpression,fluentsentences,simpleandconcise:correctformatandpunctuation,notypos.6.Whenerrorsoccurduringthewritingprocess,doublelinethemonthewrongwords,keeptheoriginalrecordclearanddistinguishable,signthemodifier,indicatethemodificationtime,continuetowritethecorrectcontent,anddonotusescraping,sticking,paintingorothermethodstocoveruporremovetheoriginalhandwriting.Eachpageshouldbemodifiednomorethantwotimes,otherwisetheoriginalrecorderwillpromptlycopyagain(exceptformodificationsmadebysuperiors).7.Nursingrecordswrittenbyinternnurses,probationarynurses,orunregisterednursesshouldbereviewedandsignedbynurseswithlegalprofessionalqualificationsinthismedicalinstitution.8.Furthertrainingnursescanonlywritenursingdocumentsafterbeingrecognizedbythemedicalinstitutionreceivingthetrainingfortheirworkability.9.Superiornursingstaffhavetheresponsibilitytoreviewandmodifythewrittenrecordsofsubordinatenursingstaff.Whenmakingmodifications,reddoublelinesshouldbeusedtomarkerrors,writethemodifiedcontent,signandindicatethemodificationtime.10.Temperaturerecords,medicalorders,patientcarerecords,andsurgicalinventoryrecordsshouldbearchivedontime.先天性因素遗传因素、胚胎发育异常等导致胸壁畸形。后天性因素外伤、感染、肿瘤等引起胸壁疾病。危险因素长期吸烟、环境污染、职业暴露等增加患胸壁疾病的风险。发病原因及危险因素临床表现观察胸廓形态、触摸ju部肿块、听诊呼吸音等。体格检查影像学检查实验室检查01020403血常规、肿瘤标志物等检查可辅助诊断胸壁疾病。疼痛、呼吸困难、ju部肿块、胸廓形态改变等。X线、CT、MRI等检查可显示胸壁病变的位置和性质。临床表现与诊断方法02常见胸壁疾病介绍03先天性胸壁缺损先天性胸壁缺损是由于胚胎期胸壁发育障碍所致的一种罕见畸形。01漏斗胸胸骨中下部分向内凹陷，相邻肋软骨也随其凹陷，形成外观形似漏斗状的一种先天性胸廓畸形。02鸡胸胸骨向前隆起畸形，状如鸡、鸽子之胸脯，故称之为鸡胸，是前胸壁第二种常见的胸廓畸形。先天性胸壁畸形脂肪瘤、纤维瘤、神经纤维瘤、血管瘤、软骨瘤等。纤维肉瘤、神经纤维肉瘤、血管肉瘤、软骨肉瘤、骨肉瘤、骨软骨肉瘤及恶性骨巨细胞瘤等。胸壁肿瘤胸壁恶性肿瘤胸壁良性肿瘤疖、痈、皮下蜂窝织炎、急性乳腺炎、淋巴结炎、脓胸等。非特异性感染结核性胸膜炎、胸壁结核等。特异性感染胸壁感染胸壁创伤闭合性胸壁创伤皮肤完整，胸腔与外界不相通，但可合并胸内脏器损伤。开放性胸壁创伤胸壁有伤口，胸腔与外界相通，多伴有胸内脏器损伤。03胸膜疾病概述胸膜结构胸膜是一层薄而光滑的浆膜，分为脏层和壁层，脏层胸膜覆盖在肺表面，壁层胸膜贴附在胸壁内面。生理功能胸膜腔内含有少量浆液，起到润滑作用，减少呼吸时脏层和壁层胸膜之间的摩擦。胸膜解剖与生理如胸膜炎、结核性胸膜炎等，以胸膜充血、水肿、渗出为主要病理改变。炎症性疾病如胸膜间皮瘤、转移性胸膜肿瘤等，以胸膜细胞异常增殖为主要特征。肿瘤性疾病如气胸、胸腔积液、胸膜肥厚、胸膜粘连等。其他疾病胸膜疾病分类123细菌、病毒、真菌等病原体感染可引起胸膜炎症。感染性因素肿瘤、结缔zu织病、尿毒症等疾病可导致胸膜病变。非感染性因素吸烟、空气污染、职业暴露等可能增加胸膜疾病的发生风险。危险因素发病原因及危险因素临床表现胸膜疾病患者可出现胸痛、咳嗽、呼吸困难等症状，严重时可伴有发热、乏力等全身症状。诊断方法根据病史、体格检查、影像学检查（如X线、CT等）和实验室检查（如胸腔积液检查等）进行综合判断。临床表现与诊断方法04常见胸膜疾病介绍ABCD胸膜炎定义胸膜炎是指由致病因素（通常为病毒或细菌）刺激胸膜所致的胸膜炎症，又称“肋膜炎”。症状临床主要表现为胸痛、咳嗽、胸闷、气急，甚至呼吸困难。分类根据胸腔内有无液体积聚，可分为渗出性胸膜炎和干性胸膜炎。治疗治疗原则包括控制感染、引流胸腔积液以及促使肺复张、恢复肺功能等。定义分类症状治疗胸膜肿瘤胸膜肿瘤是指发生于胸膜上的肿瘤，包括原发性和转移性两种。临床表现因肿瘤类型和位置而异，常见症状包括胸痛、呼吸困难、咳嗽等。根据肿瘤性质，可分为良性肿瘤和恶性肿瘤。治疗原则包括手术切除、放疗、化疗等，具体方案需根据患者病情制定。胸腔积液是以胸膜腔内病理性液体积聚为特征的一种常见临床症候。定义根据积液性质，可分为漏出液和渗出液两种。分类临床表现因积液量和性质而异，常见症状包括呼吸困难、胸痛、咳嗽等。症状治疗原则包括针对病因的治疗和对症治疗，如胸腔穿刺抽液、胸腔闭式引流等。治疗胸腔积液气胸是指气体进入胸膜腔，造成积气状态，称为气胸。定义分类症状治疗根据发病原因，气胸可分为创伤性气胸和自发性气胸两种。临床表现因气胸类型和程度而异，常见症状包括胸痛、呼吸困难、刺激性咳嗽等。治疗原则包括排气疗法、防止复发措施、手术疗法及防治并发症等，具体方案需根据患者病情制定。气胸05胸壁、胸膜疾病的影像学检查特殊体位X线片如侧位、斜位等，有助于更好地观察胸壁、胸膜的病变情况。造影检查通过引入造影剂，增强病变组织与正常组织的对比度，提高病变的检出率。常规胸部X线片可以显示胸壁、胸膜的形态和位置，以及可能存在的钙化、气胸、胸腔积液等异常表现。X线检查增强CT通过注射造影剂，观察病变组织的血供情况，有助于鉴别诊断。三维重建技术利用CT数据进行三维重建，立体地展示胸壁、胸膜的形态和结构。高分辨率CT