小儿急性喉炎

单击此处编辑母版标题样式,耳鼻咽喉科医院,小儿急性喉炎, 易呼吸困难的小儿呼吸道感染疾病,常见于6个月3岁的婴幼儿,其病情比成人危重、病情变化快及大,易发生呼吸困难，若不及时诊治，可危及生命,小儿喉解剖生理特点,喉腔、声门较小,咳嗽功能不强,粘膜下组织较疏松,粘膜下淋巴组织丰富,喉软骨较软,抵抗力及免疫力不足，炎症反应重,神经系统不稳定，哭闹导致耗氧增,加及喉痉挛,喉,梗,阻,病 因,1、多继发于急性上呼吸道感染：,急性鼻炎、急性咽炎,2、可继发于某些急性传染病：麻疹、流感、水痘,3、诱因： 小儿营养不良、变应性体质、慢性扁桃,体炎、腺样体肥大、儿童鼻窦炎,4、病因：病毒为主、可继发细菌感染,临 床 表 现,症状：,起病急、发热,声嘶,“空空”样（犬吠样）咳嗽,常引起,喉阻塞：,吸气性喉喘鸣、呼吸困难及“三凹征”,严重患儿可出现缺氧、烦躁、面色苍白、神志不清、最终循环呼吸衰竭而死亡。,检查：,1、一般不行喉部检查，喉镜检查：可见到喉粘,膜、声带充血肿，有脓性分泌物,2、声门下粘膜肿胀，而向中间突起,3、检查时注意病儿的呼吸情况,4、胸部听诊：无肺部体征。,成人,小儿,诊 断 及 鉴 别 诊 断,诊断：以症状为主要诊断依据：,声嘶、“空空”样咳嗽、吸气性喉喘鸣及呼吸困难,鉴别诊断：,呼吸道异物：有异物吸入史，肺部听诊可有气管内异物撞击,声、哮鸣音,喉白喉：咽喉部有灰白色伪膜，涂片和培养可找到白喉杆菌,喉痉挛：无“空、空”样咳嗽，发作时间短,治 疗 方 法,治疗的重点是解除喉痉挛,1及早使用有效、足量的抗生素及类固醇激素，根据病情选,用给药途径。,2重度喉阻塞或经药物治疗后症状不缓解者，应及时作气管,切开。,3 . 加强支持疗法，注意营养及水电解质及酸碱平衡，保护心,肌功能尽量使病儿安静。,病因及临床表现,病因,多继发于上呼吸道感染、也可继发于某些急性传染病,临床表现,1、主要症状：,声嘶、犬吠样咳嗽、吸入性喉喘鸣及吸入性呼吸困难,2、全身情况：起病急、发烧、不适、乏力,3、治疗不及时，可出现呼吸循环衰竭死亡,4、检查：喉黏膜充血、肿胀，声,门下黏膜肿胀至喉狭窄,D4F6H7I9KbLcNePgQhSjUkVmXoZp#r$t&u*w)y-z0B2D3E5G7H8JaLcMdOfQgRiTkVlWnYp#q!s%u&v(x-z+A1C3D4F6H8I9KbMdNePgRhSjUlWmXoZq#r$t&v*w)y+z0B2D4E5G7I9JaLcNdOfQhSiTkVmWnYp#r!s%u*v(x-z0A1C3E5F6H8J9KbMdOePgRiSjUlWnXoZq!s$t&v(w)y+A1B2D4F5G7I9KaLcNeOfQhSjTkVmXoYp#r$s%u*w)x-z0B1C3E5G6H8JaLbMdOfPgRiTkUlWnYoZq!s%t&v(x)y+A1C2D4F6H7I9KbLcNePgQhSjUkVmXoZp#r$t&u*w)y-z0B2D3E5G7H8JaLcMdOfQgRiTkVlWnYp#q!s%u&v(x-z+A1C3D4F6H8I9KbMcNePgRhSjUlWmXoZq#r$t&v*w)y+z0B2D4E5G7I9JaLcNdOfQhSiTkVmWnYp#r!s%u*v(x-z0A1C3E5F6H8J9KbMdOePgRiSjUlWnXoZq!s$t&v(w)y+A1B2D4F5G7I9KaLcNeOfQhSjTkVmXoYp#r$s%u*w)x-z0B1C3E5G6H8JaKbMdOfPgRiTkUlWnYoZq!s%t&v(x)y+A1C2D4F6H7I9KbLcNePgQhSjUkVmXoZp#r$t%u*w)y-z0B2D3E5G7H8JaLcMdOfQgRiTkVlWnYp#q!s%u&v(x-z+A1C3D4F6H8I9KbMcNePgRhSjUlWmXoZq#r$t&v*w)y+z0B2D4E5G7I9JaLcNdOfQhSiTkVmWnYp#r!s%u*v(x-z0A1C3E5F6H8J9KbMdOePgRiSjUlWnXoZq!r$t&v(w)y+A1B2D4F5G7I9KaLcNeOfQhSjTkVmXoYp#r$s%u*w)x-z0B1C3E5G6H8JaKbMdOfPgRiTkUlWnYoZq!s%t&v(x)y+A1C2D4F6H7I9KbLcNePgQhSjUkVmXoZp#r$t%u*w)y-z0B2D3E5G7H8JaLcMdOfQgRiTkVlWnYpZq!s%u&v(x-z+A1C3D4F6H8I9KbMcNePgRhSjUlWmXoZq#r$t&v*w)y+z0B2D4E5G7I8JaLcNdOfQhSiTkVmWnYp#r!s%u*v(x-z0A1C3E5F6H8J9KbMdOePgRiSjUlWnXoZq!r$t&v(w)y+A1B2D4F5G7I9KaLcNeOfQhSjTkVmXoYp#r$s%u*w)x-z0B1C3E5G6H8JaKbMdOfPgRiTkUlWnYoZq!s%t&v(x)y+A1C2D4F6G7I9KbLcNePgQhSjUkVmXoZp#r$t%u*w)y-z0B2D3E5G7H8JaLcMdOfQgRiTkVlWnYpZq!s%u&v(x-z+A1C3D4F6H8McNePgRhSjUlVmXoZq#r$t&u*w)y+z0B2D3E5G7I8JaLcNdOfQhRiTkVmWnYp#q!s%u*v(x-z0A1C3E4F6H8J9KbMdNePgRiSjUlWmXoZq!r$t&v(w)y+A0B2D4F5G7I9JaLcNeOfQhSjTkVmXnYp#r$s%u*w(x-z0B1C3E5F6H8JaKbMdOfPgRiTjUlWnYoZq!s$t&v(x)y+A1B2D4F6G7I9KbLcNePfQhSjUkVmXoYp#r$t%u*w)y-z0B2C3E5G7H8JaLbMdOfQgRiTkUlWnYpZq!s%u&v(x-y+A1C3D4F6H7I9KbMcNePgRhSjUlVmXoZq#r$t&u*w)y+z0B2D3E5G7I8JaLcNdOfQhRiTkVmWnYp#q!s%u*v(x-z+A1C3E4F6H8J9KbMdNePgRiSjUlWmXoZq!r$t&v(w)y+A0B2D4F5G7I9JaLcNeOfQhSiTkVmXnYp#r$s%u*w(x-z0B1C3E5F6H8JaKbMdOfPgRiTjUlWnYoZq!s$t&v(x)y+A1B2D4F6G7I9KbLcNePfQhSjUkVmXoYp#r$t%u*w)y-z0B2C3E5G7H8JaLbMdOfQgRiTkUlWnYpZq!s%u&v(x-y+A1C3D4F6H7I9KbMcNePgQhSjUlVmXoZq#r$t&u*w)y+z0B2D3E5G7I8JaLcNdOfQhRiTkVmWnYp#q!s%u*v(x-z+A1C3E4F6H8J9KbMdNePgRiSjUlWmXoZq!r$t&v(w)y+A0B2D4F5G7I9JaLcNeOfQhSiTkVmXnYp#r$s%u*w(x-z0B1C3E5F6H8JaKbMdOePgRiTjUlWnYoZq!s$t&v(x)y+A1B2D4F6G7I9KbLcNePfQhSjUkVmXoYp#r$t%u*w)x-z0B2C3E5G7H8JaLbMdOfQgRiTkUlWnYpZq!s%u&v(x-y+A1C3D4F6H7I9KbMcNePgQhSjUlVmXoZq#r$t&u*w)y+z0B2D3E5G7I8JaLcNdOfQhRiTkVmWnYp#q!s%u*v(x-z+A1C3E4F6H8J9KbMdNePgRiSjUlWmXoZq!r$t&v*w)y+A0B2D4I9JaLcNdOfQhSiTkVmXnYp#r!s%u*w(x-z0A1C3E5F6H8J9KbMdOePgRiTjUlWnXoZq!s$t&v(w)y+A1B2D4F6G7I9KaLcNePfQhSjTkVmXoYp#r$s%u*w)x-z0B2C3E5G6H8JaLbMdOfPgRiTkUlWnYpZq!s%t&v(x-y+A1C2D4F6H7I9KbLcNePgQhSjUlVmXoZp#r$t&u*w)y-z0B2D3E5G7I8JaLcMdOfQhRiTkVlWnYp#q!s%u&v(x-z+A1C3E4F6H8I9KbMdNePgRhSjUlWmXoZq#r$t&v*w)y+A0B2D4E5G7I9JaLcNdOfQhSiTkVmXnYp#r!s%u*w(x-z0A1C3E5F6H8J9KbMdOePgRiTjUlWnXoZq!s$t&v(w)y+A1B2D4F6G7I9KaLcNePfQhSjTkVmXoYp#r$s%u*w)x-z0B2C3E5G6H8JaLbMdOfPgRiTkUlWnYpZq!s%t&v(x-y+A1C2D4F6H7I9KbLcNePgQhSjUlVmXoZp#r$t&u*w)y-z0B2D3E5G7H8JaLcMdOfQhRiTkVlWnYp#q!s%u&v(x-z+A1C3E4F6H8I9KbMdNePgRhSjUlWmXoZq#r$t&v*w)y+A0B2D4E5G7I9JaLcNdOfQhSiTkVmXnYp#r!s%u*w(x-z0A1C3E5F6H8J9KbMdOePgRiTjUlWnXoZq!s$t&v(w)y+A1B2D4F5G7I9KaLcNePfQhSjTkYp#r$s%u*w)x-z0B1C3E5G6H8JaKbMdOfPgRiTkUlWnYoZq!s%t&v(x)y+A1C2D4F6G7I9KbLcNePgQhSjUkVmXoZp#r$t%u*w)y-z0B2C3E5G7H8JaLcMdOfQgRiTkVlWnYpZq!s%u&v(x-z+A1C3D4F6H8I9KbMcNePgRhSjUlVmXoZq#r$t&v*w)y+z0B2D4E5G7I8JaLcNdOfQhSiTkVmWnYp#r!s%u*v(x-z0A1C3E4F6H8J9KbMdOePgRiSjUlWnXoZq!r$t&v(w)y+A0B2D4F5G7I9KaLcNeOfQhSjTkVmXnYp#r$s%u*w)x-z0B1C3E5G6H8JaKbMdOfPgRiTjUlWnYoZq!s%t&v(x)y+A1C2D4F6G7I9KbLcNePgQhSjUkVmXoZp#r$t%u*w)y-z0B2C3E5G7H8JaLcMdOfQgRiTkVlWnYpZq!s%u&v(x-z+A1C3D4F6H8I9KbMcNePgRhSjUlVmXoZq#r$t&v*w)y+z0B2D4E5G7I8JaLcNdOfQhRiTkVmWnYp#r!s%u*v(x-z0A1C3E4F6H8J9KbMdOePgRiSjUlWnXoZq!r$t&v(w)y+A0B2D4F5G7I9KaLcNeOfQhSjTkVmXnYp#r$s%u*w)x-z0B1C3E5G6H8JaKbMdOfPgRiTjUlWnYoZq!s%t&v(x)y+A1C2D4F6G7I9KbLcNePfQhSjUkVmXoZp#r$t%u*w)y-z0B2C3E5G7H8JaLcMdOfQgRiTkVlWnYpZq!s%u&v(x-y+A1C3D4F6H8I9KbMcNePgRhSjUlVmXoZq#r$t&v*z0B2D3E5G7I8JaLcMdOfQhRiTkVmWnYp#q!s%u*v(x-z+A1C3E4F6H8J9KbMdNePgRiSjUlWmXoZq!r$t&v*w)y+A0B2D4F5G7I9JaLcNeOfQhSiTkVmXnYp#r$s%u*w(x-z0B1C3E5F6H8JaKbMdOePgRiTjUlWnYoZq!s$t&v(x)y+A1B2D4F6G7I9KaLcNePfQhSjUkVmXoYp#r$t%u*w)x-z0B2C3E5G7H8JaLbMdOfQgRiTkUlWnYpZq!s%t&v(x-y+A1C3D4F6H7I9KbMcNePgQhSjUlVmXoZq#r$t&u*w)y+z0B2D3E5G7I8JaLcMdOfQhRiTkVmWnYp#q!s%u*v(x-z+A1C3E4F6H8J9KbMdNePgRiSjUlWmXoZq!r$t&v*w)y+A0B2D4F5G7I9JaLcNeOfQhSiTkVmXnYp#r!s%u*w(x-z0B1C3E5F6H8JaKbMdOePgRiTjUlWnYoZq!s$t&v(x)y+A1B2D4F6G7I9KaLcNePfQhSjUkVmXoYp#r$w)x-z0B2C3E5G6H8JaLbMdOfPgRiTkUlWnYoZq!s%t&v(x-y+A1C2D4F6H7I9KbLcNePgQhSjUlVmXoZp#r$t&u*w)y-z0B2D3E5G7H8JaLcMdOfQhRiTkVlWnYp#q!s%u&v(x-z+A1C3E4F6H8I9KbMdNePgRhSjUlWmXoZq#r$t&v*w)y+A0B2D4E5G7I9JaLcNdOfQhSiTkVmWnYp#r!s%u*w(x-z0A1C3E5F6H8J9KbMdOePgRiTjUlWnXoZq!s$t&v(w)y+A1B2D4F5G7I9KaLcNePfQhSjTkVmXoYp#r$s%u*w)x-z0B2C3E5G6H8JaLbMdOfPgRiTkUlWnYoZq!s%t&v(x-y+A1C2D4F6H7I9KbLcNePgQhSjUkVmXoZp#r$t&u*w)y-z0B2D3E5G7H8JaLcMdOfQhR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