Monday, June 22, 2020

Is pneumonia really a minor illness? How to judge the severity of pneumonia?

Although pneumonia is a common disease, for most people, the understanding is very shallow, even narrow. Therefore, I often hear some people say "how to get pneumonia and die in the hospital, it must be a medical accident!" and other very ridiculous words. Here, I tell you with a fairly professional level that pneumonia ranks first among the causes of direct death of inpatients!

To give a few simple examples, there is a high incidence of cardio-cerebrovascular disease and a large number of deaths. For example, stroke. More than 80% of stroke patients die not from stroke itself, but from lung infection-pneumonia! Like some patients who died after surgery, nearly 50% died from the complication of lung infection. The most intuitive example is that according to World Health Organization statistics, 2002-2003 SARS (atypical pneumonia caused by a coronavirus) had 8,422 global infections, 919 deaths and nearly 11% mortality. In addition, pneumonia is also the number one cause of child death.

Pneumonia refers to inflammation of the terminal airways, alveoli, and interstitial lung. The mortality rate of pneumonia is directly related to the type and risk factors of pneumonia, severity, treatment and intervention sooner or later, especially in severe pneumonia, the mortality rate is 22%-54%. Therefore, how to determine the severity of pneumonia early is particularly important. There are some clinical methods for evaluating the condition of pneumonia, such as PSI and CURB-65, which are more professional. But we can generally make a preliminary judgment from the following aspects:

Chest radiograph:

One of the direct diagnoses of pneumonia is based on imaging. The most common is chest radiography. Generally, pneumonia is usually limited to a lobe or a lung segment of the lung. If there are many leaves or extensive pneumonia, it usually indicates that the inflammation is more serious or the infection is more complicated, which should be paid attention to.

Blood image:

Going to the hospital to see a doctor, blood analysis is the most common test. The degree and type of inflammatory infection can be preliminarily judged by the blood picture. Bacterial infections are often accompanied by an increase in blood image (white blood cell count) and left shift of the nucleus. The higher the blood image, the greater the degree of infection. However, the blood images of viruses and other atypical pathogens are not high or low, which may lead to severe pneumonia.

body temperature:

Common bacterial pneumonia often shows symptoms of chills and fever, and sometimes shows persistent high fever. However, the higher the body temperature does not mean the more serious the condition. On the contrary, the occurrence of hypothermia or persistent body temperature does not necessarily mean that it is severe pneumonia, and must be hospitalized in a timely manner.

age:

The age factor plays an important role in the development of pneumonia. Data from some regions indicate that pneumonia is the first cause of death for people over 80 years of age. The older the age, the lower the body's immunity and the inflammation cannot be controlled, and the older the age, the less typical the clinical manifestations of pneumonia, which are easily overlooked.

blood pressure:

Normal blood pressure is a necessary condition for maintaining normal blood flow of human organs. When the lung infection cannot be controlled, it is easy to cause septic shock, a drop in blood pressure, and even sepsis and sepsis may occur.

breath rate:

Pneumonia is mainly inflammation of the lungs, and the lungs are an important organ in respiratory function. When the lungs are obviously damaged, respiratory function can be impaired, affecting the supply of oxygen and the discharge of carbon dioxide in the body, and through the feedback mechanism, the changes in respiratory frequency are affected. When the breathing rate is very fast (passing more than 30 times/min) or becomes shallower and slower (<12 times/min), the condition may be very dangerous.

Basic illness:

The occurrence and development of diseases are interrelated and influence each other. Especially some chronic diseases have a great influence on the outcome of lung inflammation. Such as diabetes, lupus erythematosus, etc. Due to the existence of these basic diseases, changes in the body's internal environment and the cause of decreased immunity, inflammation is easy to spread and progress, treatment is very difficult, and it is likely to be transformed into severe pneumonia, which must be paid special attention.

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