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呼吸與危重癥醫學科

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  呼吸外科自建院以來顛末不時的成長,現在已構成具備相稱范圍、具備本身氣概和形式、順應時期成長請求的學科之一,呼吸疾病的綜合診治才能已處于省內進步前輩水平,同時承當在校中專生、大先生的相干講授使命。呼吸外科具備一支連合向上、主動朝上進步、經心全意為患者辦事的年青的醫療步隊,全科現有醫護職員 30人,大夫12人。此中具備高等職稱的大夫4人,主醫師、傳授2人,副主醫師2人,主治醫師4人。周一至周六上午設有專業門診和專家門診。

(二)  專業特點
慢性梗阻性肺疾病(包含慢性支氣管炎、肺氣腫等)的診斷和醫治

支氣管哮喘的診斷和醫治
肺部沾染性疾病(包含肺炎、肺膿腫、支氣管擴大及肺結核等)的診治

肺栓塞的診斷和溶栓及抗凝醫治

肋膜疾病(包含 胸腔積液、氣胸等)的診斷和醫治

肺部腫瘤的診斷和醫治

肺間質性疾病的診斷和醫治

急、慢性呼吸衰竭的處置

(三)  專業舉措措施

1.
電子支氣管內鏡診療室

我科呼吸內鏡診療室備有進步前輩的支氣管電子內鏡及高頻電刀裝備,今朝展開以下多項新手藝,先容以下:
1)診斷方面

肺部沾抱病原學的診斷:針對院內難治性肺部沾染,展開經支氣管鏡掩護毛刷(PSB)及掩護性肺泡灌洗(PBAL)手藝。

肺部暗影的診斷:對性質不明的肺部暗影,除主動停止病灶活檢手藝,還展開對腔外病灶的經支氣管透壁針吸活檢(TBNA)手藝。

滿盈性肺部疾病的診斷:對肺間質纖維化、結節病、肺泡癌等滿盈性肺部疾病,展開支氣管肺泡灌洗(BAL)及經支氣管壁透壁肺活檢 (TBLB)手藝。

2)醫治方面

支氣管內鏡的腔內醫治:對腫瘤、結核、慢性炎癥、支氣管淀粉樣變、支氣管軟化癥等所形成的氣管、支氣管狹小等疾病,能夠停止電燒醫治、支架植入等醫治。

內鏡下取氣管、支氣管內異物。

內鏡下肺部灌洗醫治藥物療效欠佳的肺膿腫、支氣管擴大并沾染等疾病。

2
、外科胸腔鏡室

外科胸腔鏡首要用于診斷,同時也能夠停止局部胸腔內醫治。它的首要順應證為:(1)不明緣由的胸腔積液;(2)肺癌或肋膜間皮瘤的分期;(3)對惡性積液或復發性良性積液患者停止滑石粉肋膜牢固醫治;(4)對自覺性氣胸中的期和期,局部醫治是外科胸腔鏡的順應證;(4)別的順應證包含須要在膈肌、縱隔和心包停止活檢的病例。

3、呼吸重癥急救病房

  裝備專業的醫護職員和各種呼吸機、性命監護裝備、多功效病床等進步前輩裝備,勝利急救500余例危重癥,包含支氣管哮喘、肺芥蒂、重癥肺炎、敗血癥、ARDS、大咯血、呼吸衰竭、多器官功效衰竭等,救治勝利率高。

4CT指導下經皮肺針吸活檢術

  對病變位于肺四周區,纖支鏡查抄不能到達的病灶,停止CT指導下經皮肺針吸活檢術。

5 肺功效室
我科的肺功效室裝備有進步前輩的肺功效診斷體系,今朝已展開了多項查抄,使臨床肺功效查抄到達了較高的水平。先容以下:
1.
肺通氣功效與肺活量的查抄:包含時候肺活量、每分鐘最大通宇量、流速容量環及吝嗇道功效查抄等。

2. 展開呼氣負壓檢測呼氣流速受限手藝,對嚴峻COPDCOPD歸并肺大泡等一局部慣例手藝沒法檢測的患者停止檢測,明白診斷及評價疾病嚴峻水平、醫治結果。是國際多數幾家能展開呼氣負壓檢測手藝的病院之一。
3.
肺彌散功效及殘宇量的查抄。
4.
支氣管舒張嘗試:首要用于支氣管哮喘等氣道高反映性疾病的診斷。
5.
支氣管激起嘗試:首要用于支氣管舒張嘗試陽性病人的診斷。
查抄時候:周一至周五,門診病人不必預定,隨來隨做。
(
四)  特點辦事
1
.專家門診 請閱讀專家先容。
2
.專業門診
慢性梗阻性肺疾病( COPD)門診:
支氣管哮喘門診:
3
.院內外呼吸體系疾病會診。
4
.承當急診呼吸體系危沉痾的急救使命。
5
.每周二、三、五上午做氣管鏡(應事前帶患者及胸片來本科門診預定)遇有急診時隨時可做。
6
.肺功效查抄 周一至周五,隨來隨做(門診病人不必預定)。

                  Respiratory Medicine Department

 With a continuous development since the hosipital established, respiratory medicine department now has formed fairly with his size, style and mode, adapting to the requirements of the development of discipline. Its comprehensive treatment of respiratory diseases is already in advanced ability, and it undertake the relevant teaching task of secondary specialized students and undergrduates. The respiratory medicine department has a united and positive, and the service wholeheartedly for patients and medical teams of young people. It has medical personnel 30 people, the doctor 12 people currently, four doctors has titles of senior professional post. Two of them are chief physicians and professors, the other two are accociate chief physicians. four doctors are attending doctors. There are professional clinic and expert outpatient service on Monday to Saturday moring.

2 Major characteristic

 Diagnosis and treatment of chronic obstructive pulmonary disease (including chronic bronchitis and emphysema)

 Diagnosis and treatment of bronchial asthma

 Diagnosis and treatment of pulmonary infectious disease (including pneumonia, lung abscess, bronchiectasis and pulmonary tuberculosis  etc.)

 Diagnosis, thrombolysis and anticoagulant therapy of pulmonary embolism

 Diagnosis and treatment of pleural diseases (including pleural effusions pneumothorax etc.)

 Diagnosis and treatment of lung cancer

 Diagnosis and treatment of interstitial lung disease

 Therapy of acute or chronic respiratory failure

3 Professional facilities

⑴.Electronic bronchial endaoscopic consulting room

The electronic bronchial endoscopic consulting room in our department is equipped with advanced bronchial video endoscope and high-frequency electrotome equipment, many new technologies was carry on, as follows:

  diagnosis

a、          The etiologic diagnosis of pulmonary infection: bronchoscopy protection brush(PSB) and protective alveolar lavage (PBAL) technologies are developed for refractory nosocomial infection of the lung.

b、          The diagnosis of lung shadow: for an lung shadow, The needle aspiration biopsy through bronchial tube(TBNA) technology is developed as well as actively lesions biopsy technology.

c、          The diagnosis of diffuse lung disease: broncho-alveolar laage (BAL) technology and the bronchial wall lung biopsy through walls(TBLB) technology are developed for diffuse lung diseases such as pulmonary fibrosis, sarcoidosis, alveolar carcinoma and so on.

  treatment

a The bronchial endoscopic treatment of lumen: The diseases such as tumor, tuberculosis, chronic inflammation, bronchial amyloid, bronchial osteomalacia caused trachea and bronchial stenosis, can be treated by electric coagulator treatment, stenting etc.

b The trachea and bronchus foreign bodies can be taken out through endoscopy.

c The diseases such as lung abscess and bronchiectasis combines with infection which the drug efficacy are poor can be treated by lung lavage treats on endoscopy.

⑵.Internal thoracoscope room

It is Mainly used for diagnosis of internal thoracoscope ,also undertaken part intrathoracic treatment. Its major indications are for: the unexplained pleural effusion,lung cancer or pleural mesothelioma staging,talcum power pleural fixed treatment used for malignant or recurrent benign pleural effusion patients. For the period or of spontaneous pneumothorax ,local treatment is the internal vats indication. The other indications include the cases which need to take biopsy in diaphragm, mediastinum and pericardium.

respiratory critical rescue ward

It is equipped with professional medical care personnel and sophisticated equipment such as all kinds of respiratorslife monitoring equipmentsmultifunction ward beds etc. 500 cases of severe diseases are rescued successfully include bronchial asthma, pulmonary heart disease, severe pneumonia, sepsis, ARDS, hemoptysis, respiratory failure, multiple organ failure and so on . The cure rate is high.

⑷.CT guided percutaneous pulmonary needle aspiration biopsy

For lesions, which bronchoscopy check cannot achieve, located surrounding lung areas, CT guided percutaneous pulmonary needle aspiration biopsy can be used.

⑸、Pulmonary function room

The pulmonary function room is equipped with advanced lung function diagnostic system in our department. Currently we has launched many examinations, which make the clinical pulmonary function reached higher level. Introduces are as follows:

①、The pulmonary ventilation function and vital capacity examinationsThese examinations include time vital capacity, maximum minute ventilation, TBFV and small airway function examination.

②、Expiratory negative pressure detecting technology testing expiratory flow of limited has been conducted. For serious COPD, COPD with pulmonary big bubble which conventional technology cannot be detected such patients, expiratory negative pressure detecting technology can carry through for clarifying a diagnosis and evaluating severity of diseases or therapeutic effect. Our hospital becomes one of the hospitals which can conduct expiratory negative pressure detecting technology.

③、Pulmonary dispersion function and residual volume inspection.

④、Bronchial dilation test: It is mainly used for diagnosis of airway high responsiveness diseases such as bronchial asthma and so on.

⑤、 Bronchial provocation test: It is mainly used for the patients whose bronchial dilation test is negative.

Inspection timeMonday to Friday, outpatient can do the test without appointment.

4characteristic service

⑴.Expert’s outpatient clinic: please browse the introduction of the experts to obtain details.

⑵.Specialty outpatient clinic:

   The outpatient clinic of chronic obstructive pulmonary disease

   The outpatient clinic of bronchial asthma

⑶.Our departments undertake the consultation of respiratory system disease inside or outside the hospital.

⑷.Our departments also undertake rescue work of emergency respiratory system critical illness.

   ⑸.Bronchoscope can be used for patients on every tuesday wednesday and Friday.(The patients please take the chest radiograph to make an appointment in our outpatient department in prior.) Bronchoscope can be used for emergency treatment at any time.

  ⑹.From monday to friday, outpatients can do the pulmonary function examination without appointment.