1.鑶堢偤涓昏鐨勫懠鍚歌倢锛岃唸涓婃湁3鍊�(g猫)瑁傚瓟锛氫富鍕�(d貌ng)鑴堣瀛斻€侀绠¤瀛�銆佽厰闈滆剤瀛�銆�

涓诲嫊(d貌ng)鑴堣瀛旓細鍦ㄥ叐鍋�(c猫)鑶堣叧鑸囩12鑳告楂斾箣闁�锛屾湁涓诲嫊(d貌ng)鑴堝拰鑳稿皫(d菐o)绠￠€氶亷(gu貌)銆�

椋熺瑁傚瓟锛氱磩骞崇10鑳告锛屽湪涓诲嫊(d貌ng)鑴堣瀛旂殑宸﹀墠涓婃柟锛屾湁椋熺鍜岃糠璧扮缍�(j墨ng)閫氶亷(gu貌)銆�

鑵旈潨鑴堝瓟锛氱磩骞崇8鑳告锛屽湪椋熺瑁傚瓟鐨勫彸鍓嶄笂鏂圭殑涓績鑵憋紝鏈変笅鑵旈潨鑴堥€氶亷(gu貌)銆�

2.缍敓绱燗→鍚堟垚瑕栫传绱呰唱(zh矛)→杓曞害鏆楅仼鎳�(y墨ng)→杓曞害鏆楅仼鎳�(y墨ng)鐣板父鐩磋嚦澶滅洸鐧ャ€�

缍敓绱燚→淇冮€�(j矛n)閳�銆佺７鍚告敹→鍏掔浣濆儌銆佹垚浜洪杌熷寲銆�

缍敓绱燘1(纭兒绱�)→α-閰哀鍖栬劔缇ц紨閰�銆佸弮鑸囩缍�(j墨ng)鍌冲皫(d菐o)→鑵虫埃鐥�銆佹湯姊㈢缍�(j墨ng)鐐庛€�

缍敓绱燙→閭勫師鎬х墿璩�(zh矛)锛屼績閫�(j矛n)3鍍�(ji脿)閻佃綁(zhu菐n)鐐�2鍍�(ji脿)閻�锛屾槸褰㈡垚鑶犲師铔嬬櫧鎵€蹇呴渶鐨勭墿璩�(zh矛)→澹炶鐥�銆�

3.缍�(j墨ng)杓夐珨鐨勬槗鍖栨摯(ku貌)鏁ｇ殑瀵�(sh铆)渚嬶細钁¤悇绯�銆佹皑鍩洪吀閫�(j矛n)鍑虹窗(x矛)鑳�(灏ゅ叾鏄磪绱�(x矛)鑳�)銆�

鍘熺櫦(f膩)鎬т富鍕�(d貌ng)杞�(zhu菐n)閬�(y霉n)鐨勫(sh铆)渚嬶細Na+-K+娉�(鎶婁笁鍊�(g猫)Na+杞�(zhu菐n)閬�(y霉n)鍒拌優澶�锛屽叐鍊�(g猫)K+杞�(zhu菐n)閬�(y霉n)鍒拌優鍏�(n猫i))銆�

绻肩櫦(f膩)鎬т富鍕�(d貌ng)杞�(zhu菐n)閬�(y霉n)鐨勫(sh铆)渚嬶細钁¤悇绯�銆佹皑鍩洪吀鍦ㄨ吀涓婄毊鍜岃厧灏忕涓婄毊鐨勯噸鍚告敹(鍏剁洿鎺ュ嫊(d貌ng)鍔涙槸閳夋车娲诲嫊(d貌ng)閫犳垚鐨勮啘鍏╁伌(c猫)Na+婵冨害宸�)銆�

鑶滄场閬�(y霉n)杓�(鍑鸿優銆佸叆鑳�)鐨勫(sh铆)渚嬶細绁炵稉(j墨ng)鏈ⅱ閲嬫斁閬炶唱(zh矛)銆佺櫧绱�(x矛)鑳炲悶鍣窗(x矛)鑿�銆�

4.鑾㈣啘锛氫娇绱�(x矛)鑿屽叿鏈変镜瑗插姏锛屾槸閼掑垾绱�(x矛)鑿岀殑鎸囧緛涔嬩竴銆�

闉瘺锛氶亱(y霉n)鍕�(d貌ng)鍣ㄥ畼锛屾湁鎶楀師鎬э紝鍙互浣块灜姣涜弻瓒ㄥ悜鐕�(y铆ng)椁�(y菐ng)鐗╄唱(zh矛)鑰岄€冮伩鏈夊鐗╄唱(zh矛)銆�

5.琛€娑插湪娲婚珨蹇冭嚐鎴栬绠″収(n猫i)鐧�(f膩)鐢熷嚌鍥烘垨鏈夊舰鎴愬垎鍑濋泦锛屽舰鎴愬浐楂旇唱(zh矛)濉婄殑閬�(gu貌)绋嬬偤琛€鏍撳舰鎴�銆傝鏍撳嵆褰㈡垚鐨勫浐楂旇唱(zh矛)濉�銆�

鐧借壊琛€鏍撻儴浣嶏細琛€娴佽純蹇殑鐡ｈ啘锛屽欢绾�(x霉)鎬ц鏍撻牠閮�銆�

鐧借壊琛€鏍撻彙涓嬭锛氳灏忔澘鍜屽皯閲忕簴缍泲鐧�銆�

娣峰悎琛€鏍擄細鍙堢ū(ch膿ng)闄勫琛€鏍�銆佺悆鐙€琛€鏍撱€佸堡鐙€琛€鏍�锛屽欢绾�(x霉)鎬ц鏍撻珨閮�銆�

绱呰壊琛€鏍撻儴浣嶏細瀛樺湪闈滆剤鍏�(n猫i)锛屽欢绾�(x霉)鎬ц鏍撳熬閮�銆�

绱呰壊琛€鏍撻彙涓嬭锛氱簴缍泲鐧姐€佺磪绱�(x矛)鑳�銆佸皯閲忕櫧绱�(x矛)鑳�銆�

閫忔槑琛€鏍�(寰鏍�)閮ㄤ綅锛氬井寰挵(hu谩n)鐨勫皬琛€绠″収(n猫i)(姣涚窗(x矛)琛€绠�)銆�

閫忔槑琛€鏍撲富瑕佺敱绾栫董铔嬬櫧妲�(g貌u)鎴愶紝鍙堢ū(ch膿ng)绾栫董绱犳€ц鏍�銆傛渶甯歌(ji脿n)浜庡綄婕€ц绠″収(n猫i)鍑濊(DIC)銆�

6.澶辫鎬т紤鍏嬶細15鍒嗛悩鍏�(n猫i)澶辫瓒呴亷(gu貌)绺借閲忕殑20%(绱�1000ml)锛岃〃鐝�(xi脿n)鐐哄績鎺掕閲�銆佸钩鍧囧嫊(d貌ng)鑴堝涓嬮檷锛岀櫦(f膩)鐢熷け琛€鎬т紤鍏�銆�

鎰熸煋鎬т紤鍏�(鑶挎瘨鎬т紤鍏�)锛氬洜鐥呭師寰敓鐗�(濡傜窗(x矛)鑿�銆佺梾姣�銆佺湡鑿岀瓑)鎰熸煋鎵€寮曡捣鐨勪紤鍏�銆�

楂樺嫊(d貌ng)鍔涘瀷浼戝厠(楂樻帓浣庨樆鍨嬩紤鍏�銆佹殩浼戝厠)锛氳〃鐝�(xi脿n)鐐哄皯灏匡紝琛€澹撲笅闄�锛岀毊鑶氱矇绱呰壊銆佹韩?z茅)宀墜绋嶉敍鍙宕村秱鍗搁暅鍙�?/p>

浣庡嫊(d貌ng)鍔涘瀷浼戝厠(浣庢帓楂橀樆鍨嬩紤鍏�銆佸喎浼戝厠)锛氳〃鐝�(xi脿n)鐐哄洓鑲㈡繒鍐�銆佸皯灏挎垨鐒�(w煤)灏�銆佺毊鑶氳捈鐧�銆佽澹撴槑椤笅闄嶅強涔抽吀閰镐腑姣�銆�

閬�(gu貌)鏁忔€т紤鍏�(璁婃噳(y墨ng)鎬т紤鍏�)锛欼鍨嬭畩鎱�(t脿i)鍙嶆噳(y墨ng)(閫熺櫦(f膩)鍨嬭畩鎱�(t脿i)鍙嶆噳(y墨ng))锛屽父浼存湁鍛煎惛閬�銆佹秷鍖栭亾鍜岃晛楹荤柟鐨勯亷(gu貌)鏁忕櫏鐙€锛岀櫦(f膩)鐥呮€�銆�

蹇冩簮鎬т紤鍏嬬殑濮嬪嫊(d貌ng)鐠�(hu谩n)绡€(ji茅)鏄績娉靛姛鑳介殰绀欏皫(d菐o)鑷寸殑蹇冭几鍑洪噺杩呴€熸笡灏戙€�

7.鍛嬪绫虫槸楂樻晥鑳界殑琚㈠埄灏垮姂锛屼績閫�(j矛n)Na+銆丠2O鐨勬帓娉�锛屾笡灏戣瀹归噺锛岄檷浣庡績鑷熷墠璨�(f霉)鑽�锛屽緸鑰屾敼鍠勫績鍔熻兘銆備綔鐢ㄤ簬楂撹ⅱ鍗囨敮绮楁锛屾姂鍒禢aCl閲嶅惛鏀�銆�

琚㈠埄灏胯棩鑷ㄥ簥鎳�(y墨ng)鐢細棣栭伕娌荤檪鎬ユ€ц偤姘磋叓銆佽叇姘磋叓(鍚堝苟鍏呰鎬у績琛�→姗�(j墨)鍒剁偤鍛嬪绫冲彲闄嶄綆宸﹀鍓嶈矤(f霉)鑽�)銆備笉鑹弽鎳�(y墨ng)鐐烘槗鍑虹従(xi脿n)姘磋垏闆昏В璩�(zh矛)绱婁簜銆�

鍣诲棯椤�(l猫i)(涓晥鑳�)鍒╁翱鍔戠殑钘ョ悊浣滅敤锛氣憼鍒╁翱浣滅敤锛氭姂鍒禢aCl鐨勯噸鍚告敹;鈶￠檷澹撲綔鐢�銆傝嚚搴婃噳(y墨ng)鐢細鈶犲熀绀�(ch菙)闄嶅钘ョ墿涔嬩竴;鈶¤厧鎬у翱宕╃櫏鍙婂姞澹撶礌?z茅)o鏁堢殑鍨傞珨鎬у翱宕╃櫏銆�

8.鍌虫煋鐥呭垎椤�(l猫i)锛氭硶瀹氬偝鏌撶梾鍏辨湁40绋�锛屽彲鍒嗙偤鐢�銆佷箼銆佷笝涓夐(l猫i)銆傜敳椤�(l猫i)锛氶紶鐤�銆侀湇浜�;

9.灏婇噸鍘熷墖灏�(du矛)閱�(y墨)璀�(h霉)浜哄摗鐨勮姹傛槸锛氣憼骞崇瓑灏婇噸姣忎竴浣嶆偅鑰呭強瀹跺爆鐨勪汉鏍艰垏灏婂毚(y谩n);鈶″皧閲嶆偅鑰呯煡鎯呭悓鎰忓拰鑷富閬告搰鐨勬瑠(qu谩n)鍒�;鈶㈣灞ヨ骞姪銆佸嫺灏�(d菐o)锛岀敋鑷抽檺鍒舵偅鑰呬綔鍑轰笉鐣�(d膩ng)閬告搰鐨勬瑠(qu谩n)鍒�銆�

涓嶅偡瀹冲師鍓囧皪(du矛)閱�(y墨)璀�(h霉)浜哄摗鐨勮姹傛槸锛氣憼鏉滅禃鏈夋剰鍜岃铂(z茅)浠诲偡瀹�;鈶￠槻鑼冪劇(w煤)鎰忎絾鍙煡鐨勫偡瀹�锛屾妸鍙帶鍌峰鎺у埗鍦ㄦ渶浣庨檺搴︺€�

鏈夊埄鍘熷墖鎸囬啱(y墨)鍕�(w霉)浜哄摗瑕佹妸鐥呬汉鐨勫仴搴锋斁鍦ㄩ浣�锛屽垏瀵�(sh铆)鐐虹梾浜鸿瑎鍒╃泭銆�

鍏鍘熷墖锛氬叕姝ｅ師鍓囧垎鐐虹禃灏�(du矛)鍏(褰㈠紡鍏钩)鍜岀浉灏�(du矛)鍏(鍏�(n猫i)瀹瑰叕骞�)銆�

10.娆�(qu谩n)鍒╋細寰炰簨閱�(y墨)瀛�(xu茅)鐮旂┒銆佸(xu茅)琛�(sh霉)浜ゆ祦锛屽弮鍔犲皥(zhu膩n)妤�(y猫)瀛�(xu茅)琛�(sh霉)鍦�(tu谩n)楂�;鍦ㄥ煼(zh铆)妤�(y猫)娲诲嫊(d貌ng)涓�锛屼汉鏍煎皧鍤�(y谩n)銆佷汉韬畨鍏ㄤ笉鍙椾镜鐘�;鐛插彇宸ヨ硣鍫�(b脿o)閰拰娲ヨ布锛屼韩鍙�?ch膿)?gu贸)瀹惰(gu墨)瀹氱殑绂忓埄寰呴亣;渚濇硶鍙冭垏鎵€鍦ㄦ(j墨)妲�(g貌u)鐨勬皯涓荤鐞�銆�

11.鎱㈡€ц偤婧愭€у績鑷熺梾=鑰佸勾浜�+COPD绛夌梾鍙�+P2>A2+鍙冲績琛�(鑲濇筏琛€銆侀洐涓嬭偄姘磋叓銆侀牳闈滆剤鎬掑嫉銆佽倽闋搁潨鑴堝弽娴佸緛闄�(y谩ng)鎬�銆佷笁灏栫摚鍗€(q奴)鏀剁府鏈熼洔闊�)銆�

鍝枠=鏃㈠線鐧�(f膩)鐥呭彶+鍠樻伅銆佸懠姘ｆ€у懠鍚稿洶闆�+鑲洪儴寤ｆ硾鍝炒闊�+澶滈枔鍑屾櫒鍔犻噸+鑷绶╄В+鏀埃绠¤垝寮�?ji膩n)鍥�?y脿n)闄�(y谩ng)鎬�(FEV1杓冪敤钘ュ墠澧炲姞≥12%)+X绶�(xi脿n)绀哄叐鑲洪€忎寒搴﹀鍔犮€�

12.鑲虹値閺堢悆鑿岃偤鐐�=闈掑／骞�+鍙楁都銆佹穻闆�銆佷笂鎰熷彶+鍜抽惖閵硅壊鐥�+X绶�(xi脿n)鑲哄(sh铆)璁婂奖+鐥扮窗(x矛)鑿屽(xu茅)妾㈡煡妾㈠嚭鑲虹値閺堢悆鑿�(纰鸿ê渚濇摎(j霉))銆�

閲戦粌鑹茶憽钀勭悆鑿岃偤鐐�=涓€佸勾+鍜宠喛榛冪棸+X绶�(xi脿n)绌烘礊鎴栨恫姘ｅ泭鑵�(閲嶈鐗瑰緛)+鐥扮窗(x矛)鑿屽(xu茅)妾㈡煡妾㈠嚭閲戦粌鑹茶憽钀勭悆鑿�(纰鸿ê渚濇摎(j霉))銆�

鑲虹値鍏嬮浄浼】鑿岃偤鐐�=涓€佸勾+鍜崇绱呰壊鑶犲噸妯ｉ粡鐥�+鑳搁儴X绶�(xi脿n)澶氱櫦(f膩)鎬ц渹绐╃媭鑶胯叓锛岃憠闁撻殭鍛堝姬褰笅澧�+鐥扮窗(x矛)鑿屽(xu茅)妾㈡煡妾㈠嚭鑲虹値鍏嬮浄浼】鑿�(纰鸿ê渚濇摎(j霉))銆�

鑲虹値鏀師楂旇偤鐐�=闈掑皯骞�+闄ｇ櫦(f膩)鎬у埡婵€鎬у梿鍜�+X绶�(xi脿n)鑲洪枔璩�(zh矛)鏀硅畩锛屾枒鐗囩媭娴告饯(r霉n)褰�+鍐峰嚌闆嗚│椹�(y脿n)闄�(y谩ng)鎬с€�

鐥呮瘨鎬ц偤鐐�=鍏ㄨ韩鐧ョ媭+鍛煎惛閬撶櫏鐙€+WBC瑷�(j矛)鏁�(sh霉)姝ｅ父+鐗圭暟鎬gM鎶楅珨(+)+X绶�(xi脿n)鎴朇T姣涚幓鐠冨奖銆�

13.I鍨嬪懠琛拌?d煤)澶ユ不榘归暬aO2<60mmHg;PaCO2姝�?锛涜洺闄嗘媴顑遍鐛铻昋姘ｅ姛鑳介殰绀�(閫氭埃/琛€娴佹瘮渚嬪け琛�銆佸綄鏁ｉ殰绀欍€佽偤鍕�(d貌ng)-闈滆剤鍒嗘祦)鎵€鑷�锛屽父瑕�(ji脿n)浜庡毚(y谩n)閲嶈偤閮ㄦ劅鏌�(ARDS)銆�

II鍨嬪懠琛拌?d煤)澶ユ不榘归暬aO2<60mmHg;PaCO2>50mmHg;涓昏鐐鸿偤閫氭埃鍔熻兘闅滅(鑲烘场閫氭埃涓嶈冻)鎵€鑷�锛屽父瑕�(ji脿n)浜嶤OPD銆佽唸鑲岀櫛鐦�銆�

14.宸﹀績琛扮锛屼富瑕佸皫(d菐o)鑷磋偤寰挵(hu谩n)娣よ銆傗憼鐧ョ媭锛歛.鍛煎惛鍥伴洠锛屽嫗鍔涙€у懠鍚稿洶闆�(鏈€鏃�)锛岀鍧愬懠鍚�锛屽闁撻櫍鐧�(f膩)鎬у懠鍚稿洶闆ｏ紝鎬ユ€ц偤姘磋叓(鏈€閲�);b.鍜(鑲洪潨鑴堝鍔涘崌楂�)銆傗憽楂斿緛锛歛.鑲哄簳婵曞暟闊炽€俠.P2浜㈤€�(j矛n)锛岃垝寮�?ji膩n)缂欒瘨鎹寰嬨€�

鍙冲績琛扮锛屼富瑕佸皫(d菐o)鑷撮珨寰挵(hu谩n)娣よ銆傗憼鐧ョ媭锛氭秷鍖栭亾鐧ョ媭鏈€甯歌(ji脿n)锛屽鑳冭吀閬撳強鑲濊嚐娣よ銆傗憽楂斿緛锛歛.韬珨浣庡瀭閮ㄤ綅鍑虹従(xi脿n)姘磋叓(姣涚窗(x矛)琛€绠″収(n猫i)闈滄按澹撳崌楂樺皫(d菐o)鑷�);b.闋搁潨鑴堟€掑嫉锛岃倽闋搁潨鑴堝弽娴佸緛闄�(y谩ng)鎬�;c.鑲濆ぇ涓斿鐥�(鍙嚧蹇冩簮鎬ц倽纭寲锛屽爆?l脿i)?y谩n)閲嶅苟鐧�(f膩)鐧�)銆�

15.鎴块～鍙皫(d菐o)鑷撮珨寰挵(hu谩n)鏍撳锛屾爴瀛愪締(l谩i)鑷乏蹇冩埧锛岃叇鏍撳鍗卞鏈€澶�锛屼篃鍙櫦(f膩)鐢熷収(n猫i)鑷熷嫊(d貌ng)鑴堟爴濉�銆傚叾甯歌(ji脿n)楂斿緛鍙〃鐝�(xi脿n)鐐猴細鈶犵涓€蹇冮煶寮�(qi谩ng)寮变笉瀹�;鈶″績寰嬫サ涓嶈(gu墨)鍓�;鈶㈣剤鎼忕煭绲€銆�

瀹ら€熷績闆诲湒锛氣憼≥3鍊�(g猫)閫ｇ簩(x霉)瀹ゆ€ф湡鍓嶆敹绺�;鈶℃埧瀹ゅ垎闆�;鈶㈠績瀹�?ji脿n)Z鐛茶垏瀹ゆ€ц瀺鍚堟尝銆�

16.绌�(w臎n)瀹氬瀷蹇冪禐鐥涗互鐧�(f膩)浣滄€ц兏鐥涚偤涓伙細鈶犵敱楂斿姏鍕炲嫊(d貌ng)銆侀＝椁愩€佹儏绶掓縺鍕�(d貌ng)绛夎獦鐧�(f膩);鈶′富瑕佸湪鑳搁楂斿悗;鈶㈠杩€ф偠鐥�;鈶ｆ寔绾�(x霉)3锝�5鍒嗛悩锛屼竴鑸笉瓒呴亷(gu貌)30鍒嗛悩;鈶ゅ仠姝㈡椿鍕�(d貌ng)鎴栬€呰垖涓嬪惈鏈嶇閰哥敇娌规暩(sh霉)鍒嗛悩鍏�(n猫i)鍙珐瑙�銆�

17.浜屽皷鐡ｇ嫻绐�=棰�(f膿ng)婵曠啽鐥呭彶+鍛煎惛鍥伴洠+蹇冨皷閮ㄨ垝寮垫湡闅嗛殕妯ｉ洔闊�+P2浜㈤€�(j矛n)+姊ㄥ舰蹇�

浜屽皷鐡ｉ棞(gu膩n)闁変笉鍏�=鍛煎惛鍥伴洠+蹇冨皷閮ㄦ敹绺湡鍚归ⅷ(f膿ng)妯ｉ洔闊�/鍠€鍠囬煶+X绶�(xi脿n)绀鸿偤娣よ

18.鎬ユ€ц厧灏忕悆鑵庣値=閺堢悆鑿屾劅鏌撳悗1~3鍛�+鎬ユ€ц厧鐐庣稖鍚堝緛+琛€娓匔3涓€閬�(gu貌)鎬т笅闄�銆�

鑵庣梾缍滃悎寰佺殑瑷烘柗妯�(bi膩o)婧�(zh菙n)锛氣憼灏胯泲鐧�>3.5 g/d;鈶¤婕跨櫧铔嬬櫧<30 g/L;鈶㈡按鑵�;鈶ｉ珮鑴傝鐧�;鈶よ厧娲绘(纰鸿ê)銆傚叾涓憼鈶＄偤瑷烘柗鎵€蹇呭倷姊濅欢銆�

19.鑵庣檶=涓€佸勾+琛€灏�銆佺柤鐥�銆佽叓濉�+CT绀鸿厧瀵�(sh铆)璩�(zh矛)鍏�(n猫i)涓嶅潎璩�(zh矛)鑵+澧炲挤(qi谩ng)CT绀哄绮�銆佸澶氬拰绱婁簜鐨勮叓鐦よ绠�銆�

鑵庢瘝绱�(x矛)鑳炵槫=鍏掔(<5姝�)+鐒�(w煤)鐧ョ媭鑵归儴鑵銆�

鑶€鑳辩檶=涓€佸勾(鐢锋€у瑕�(ji脿n))+鐒�(w煤)鐥涙€ц倝鐪艰灏�+鑶€鑳卞埡婵€寰�(灏块牷銆佸翱鎬�銆佸翱鐥�)銆�

20.绯栧翱鐥呯殑瑷烘柗锛�“涓夊涓€灏�”琛ㄧ従(xi脿n)+闅ㄦ(j墨)琛€绯�≥11.1 mmol/L;鎴栫┖鑵硅绯�≥7.0 mmol/L;鎴朞GTT2灏忔檪(sh铆)琛€绯�≥11.1 mmol/L銆�

T1DM锛氬瑕�(ji脿n)浜庨潚灏戝勾锛屼笁澶氫竴灏戠櫏鐙€杓冨吀鍨�锛屽鏄撶櫦(f膩)鐢熼叜鐧ラ吀涓瘨銆傜櫦(f膩)鐥呭師鍥犳槸鑷韩鍏嶇柅浠嬪皫(d菐o)鑳板扯β绱�(x矛)鑳炴瘈澹�銆佽儼宄剁礌绲曞皪(du矛)鍒嗘硨涓嶈冻鎵€鑷�銆�

T2DM锛氬瑕�(ji脿n)浜庝腑鑰佸勾浜�锛屼笁澶氫竴灏戠櫏鐙€涓嶅吀鍨嬶紝涓嶆槗鐧�(f膩)鐢熼叜鐧ラ吀涓瘨(瑾樺洜涓嬪彲鐧�(f膩)鐢�)銆傜櫦(f膩)鐥呭師鍥犳槸鑳板扯绱犳姷鎶楀拰(鎴�)鑳板扯绱犲垎娉岄殰绀�锛岃儼宄剁礌鐩稿皪(du矛)涓嶈冻鎵€鑷�銆�

21.浣庨墍琛€鐧ョ殑鑷ㄥ簥琛ㄧ従(xi脿n)锛氳倢鐒�(w煤)鍔�(鏈€鏃�)銆佽粺鐧�銆佽叡鍙嶅皠娓涘急鎴栨秷澶�;鑵搁夯鐥�(鍘銆佸彛鑻�銆佹儭蹇�銆佸様鍚�銆佽吂鑴�銆佽吀锠曞嫊(d貌ng)娑堝け);蹇冭嚐绡€(ji茅)寰嬬暟甯�;闆昏В璩�(zh矛)(浠ｈ瑵鎬у牽涓瘨銆佸弽甯告€ч吀涓瘨);蹇冮浕鍦�(鍏稿瀷U娉�)銆�

楂橀墍琛€鐧ョ殑鑷ㄥ簥琛ㄧ従(xi脿n)锛氳叡鍙嶅皠娓涢€€鎴栨秷澶�;蹇冭嚐(绔囨€у績鍕�(d貌ng)閬�(gu貌)绶�銆佹埧瀹ゅ偝灏�(d菐o)闃绘化锛屾渶鍗遍毆(xi菐n)鐨勬槸蹇冨椤嫊(d貌ng)鎴栧績鎼忛鍋�);闆昏В璩�(zh矛)(浠ｈ瑵鎬ч吀涓瘨銆佸弽甯稿牽鎬у翱);蹇冮浕鍦�(鏃╂湡T娉㈤珮灏�锛孮T闁撴湡寤堕暦(zh菐ng);闅ㄥ悗QRS娉㈠瀵�锛孭R闁撴湡寤堕暦(zh菐ng))銆�

22.楠ㄦ姌鐨勬棭鏈熷苟鐧�(f膩)鐧ワ細浼戝厠銆佽剛鑲爴濉炵稖鍚堝緛銆侀噸瑕佸収(n猫i)鑷熷櫒瀹樻悕鍌�銆侀噸瑕佸懆?ch膿)顚孧绻旀悕鍌�銆侀绛嬭啘瀹ょ稖鍚堝緛銆�

23.姝ｄ腑绁炵稉(j墨ng)鎼嶅偡鍑虹従(xi脿n)鐨勯亱(y霉n)鍕�(d貌ng)闅滅锛氱尶褰㈡墜;鎷囨寚灏�(du矛)鎺岄殰绀欍€�

姗堢缍�(j墨ng)鎼嶅偡鍑虹従(xi脿n)鐨勯亱(y霉n)鍕�(d貌ng)闅滅锛氬瀭鑵�;浼歌厱銆佷几鎷�銆佷几鎸囬殰绀�銆�

鑵撶附绁炵稉(j墨ng)鎼嶅偡鍑虹従(xi脿n)鐨勯亱(y霉n)鍕�(d貌ng)闅滅锛氳笣鑳屼几銆佸缈诲姛鑳介殰绀�锛屽憟瓒冲収(n猫i)缈讳笅鍨�;浼歌竾銆佷几瓒惧姛鑳藉柂澶�銆�

24.鍗佷簩鎸囪吀娼扮槏甯歌(ji脿n)閮ㄤ綅鐐虹悆閮ㄥ墠澹�(鏄撶┛瀛�)鎴栧悗澹�(鏄撳嚭琛€)锛屽ソ鐧�(f膩)浜庨潚灏戝勾锛屼富瑕佹(j墨)鍒剁偤渚佃ゲ鍥犵礌澧炲挤(qi谩ng)锛岃吂鐥涜(gu墨)寰嬬偤鐤肩棝→閫�(j矛n)椋�→绶╄В锛岀壒榛�(di菐n)鏄椁撶棝銆佸闁撶棝锛屼竴鑸笉鐧�(f膩)鐢熺檶璁�銆�

鑳冩桨鐦嶅父瑕�(ji脿n)閮ㄤ綅鐐鸿儍瑙掑拰鑳冪珖灏忓綆鍋�(c猫)锛屽ソ鐧�(f膩)浜庝腑鑰佸勾锛屼富瑕佹(j墨)鍒剁偤榛忚啘灞忛殰淇濊(h霉)鍥犵礌娓涘急锛岃吂鐥涜(gu墨)寰嬬偤閫�(j矛n)椋�→鐤肩棝→绶╄В锛岀壒榛�(di菐n)鏄€�(j矛n)椋熺棝锛岀檶璁婄巼<1%銆�

25.鐥呮瘨鎬ц倽鐐庢槸鎴戝湅(gu贸)灏�(d菐o)鑷磋倽纭寲鏈€甯歌(ji脿n)鐨勭梾鍥�锛屼互涔欏瀷鑲濈値鐥呮瘨(HBV)鐐轰富銆�

鑲濆姛鑳芥笡閫€锛氬幁椋�銆佷箯鍔涖€佸嚭琛€鍜岃钵琛€銆佽倽鎺岃垏铚樿洓鐥ｃ€傞杸(m茅n)闈滆剤楂樺鐧ュ嚭鐝�(xi脿n)鑵硅厰绌嶆恫銆�

26.鎬ユ€х祼(ji茅)鐭虫€ц喗鍥婄値=椁愬悗/閫�(j矛n)椋熸补鑶╁彶+鍙充笂鑵圭柤鐥�锛屽憟闄ｇ櫦(f膩)鎬у姞鍔�锛屽悜鍙宠偐閮ㄦ斁灏�+Murphy寰侀櫧(y谩ng)鎬�/鍙充笂鑵瑰鐥�+B瓒呯ず鑶藉泭澹佸鍘氭垨姘磋叓锛屽彲鐧�(f膩)鐝�(xi脿n)鑶藉泭绲�(ji茅)鐭�銆�

27.鑵告闃�=鐥�銆佸悙銆佽劰銆佸仠姝㈡帓姘ｆ帓渚�+绔嬩綅鑵归儴X骞崇墖(棣栭伕)绀鸿吀鑵斿収(n猫i)鍑虹従(xi脿n)姘ｉ珨銆�

绲炵獎鎬ц吀姊楅樆=鎬ユ€ц捣鐥�+鎸佺簩(x霉)鎬ц吂鐥涢櫍鐧�(f膩)鎬у姞鍔�+鍚�銆佽劰銆佸仠姝㈡帓姘ｆ帓渚�+鑵硅啘鍒烘縺寰佸拰绉诲嫊(d貌ng)鎬ф縼闊抽櫧(y谩ng)鎬�+鑵圭┛鎶藉嚭琛€鎬ф恫楂�+X绶�(xi脿n)椤ず瀛ょ珛鎿�(ku貌)澶х殑鑵歌ⅱ+涓瘨鎬т紤鍏�銆�

28.缍�(j墨ng)鑵硅偂婧濈绐佸嚭鑰呯ū(ch膿ng)鐐烘枩鐤濓紝濂界櫦(f膩)浜庡厭绔ヨ垏闈掑／骞�;鍙€�(j矛n)鍏ラ櫚鍥�锛岀枬濉婂褰㈢偤姗㈠湏褰㈡垨姊ㄥ舰锛屾湁钂�;鐤濆鍥炵磵鍚庡浣忓収(n猫i)鐠�(hu谩n)鐤濆涓嶅啀绐佸嚭;绮剧储浣嶄簬鐤濆泭鍚庢柟;鐤濆泭闋镐綅浜庤吂澹佷笅鍕�(d貌ng)鑴堝鍋�(c猫);宓岄爴姗�(j墨)鏈�(hu矛)澶�銆�

鐢辩洿鐤濅笁瑙掔獊鍑鸿€呯ū(ch膿ng)鐐虹洿鐤濓紝濂界櫦(f膩)浜庤€佸勾;寰堝皯閫�(j矛n)鍏ラ櫚鍥�锛岀枬濉婂褰㈢偤鍗婄悆褰�锛屽熀搴曡純瀵�;鐤濆鍥炵磵鍚庡浣忓収(n猫i)鐠�(hu谩n)鐤濆浠嶅彲绐佸嚭銆�

29.缂洪惖鎬ц钵琛€=璨ц(钂肩櫧銆佷箯鍔�)+缂洪惖琛ㄧ従(xi脿n)+灏忕窗(x矛)鑳炰綆鑹茬礌鎬ц钵琛€+MCV銆丮CH銆丮CHC闄嶄綆+缍�(w菐ng)绻旂磪绱�(x矛)鑳炲崌楂�+绺介惖绲�(ji茅)鍚堝姏鍗囬珮+鏍歌€佹伎骞�銆�

鍐嶇敓闅滅鎬ц钵琛€=璨ц+鎰熸煋+鍑鸿+鍏ㄨ绱�(x矛)鑳炴笡灏�+缍�(w菐ng)绻旂磪绱�(x矛)鑳炵櫨鍒�?j菒n)?sh霉)<0.01+鑲濊劸涓嶅ぇ+楠ㄩ珦澶氶儴浣嶅鐢熼噸搴︽笡浣�锛岄楂撳皬绮掔┖铏�銆�

30鎬ユ€ф棭骞肩矑绱�(x矛)鑳炵櫧琛€鐥�(M3)=DIC+鏃╁辜绮掔窗(x矛)鑳炲湪楠ㄩ珦闈炵磪绯绘湁鏍哥窗(x矛)鑳炰腑≥30%+妫掔媭灏忛珨(Auer)+PAS(-)+MPO(+)+NSE(+)涓斾笉琚盁鍖栭垑(NaF)鎶戝埗銆�

鎱㈡€ч珦绯荤櫧琛€鐥�(CML)=鑴惧ぇ+楂旈噸涓嬮檷+鐧界窗(x矛)鑳炲楂�+鍡滈吀銆佸棞鍫挎€х矑绱�(x矛)鑳炲崌楂�+NAP娲绘€ф笡浣庢垨鍛堥櫚鎬у弽鎳�(y墨ng)+Ph鏌撹壊楂�(+)+BCR-ABL铻嶅悎鍩哄洜銆�

31.椤�(l猫i)棰�(f膿ng)婵曟€ч棞(gu膩n)绡€(ji茅)鐐�=鍏ㄨ韩銆佸皪(du矛)绋�(ch膿ng)銆佸洓鑲㈠皬闂�(gu膩n)绡€(ji茅)鑵棝+椤�(l猫i)棰�(f膿ng)婵曠祼(ji茅)绡€(ji茅)+琛€娓匯F鎴栨姉CCP鎶楅珨闄�(y谩ng)鎬�+鏅ㄥ兊>1灏忔檪(sh铆)+褰卞儚瀛�(xu茅)鏀硅畩

鐥涢ⅷ(f膿ng)=楂樺翱閰歌鐧�(琛€灏块吀>420 μmol/L)+绗�1璺栬毒闂�(gu膩n)绡€(ji茅)+鐥涢ⅷ(f膿ng)鐭�

32.涔欏瀷鑲濈値锛氶€氶亷(gu貌)姣嶅鍌虫挱(鎴戝湅(gu贸)涔欒倽閲嶈鐨勫偝鎾€斿緫)銆備篃鍙€氶亷(gu貌)姘村钩鍌虫挱銆佽娑�銆侀珨娑插偝鎾拰鎬ц鐐哄偝鎾�銆�

琛ㄩ潰鎶楀師(HBsAg)锛氶櫧(y谩ng)鎬у弽鏄犵従(xi脿n)鐧BV鎰熸煋锛屼絾闄版€т笉鑳芥帓闄BV鎰熸煋銆�

琛ㄩ潰鎶楅珨(鎶�-HBs)锛氫繚璀�(h霉)鎬ф姉楂�锛岄櫧(y谩ng)鎬ц〃绀哄皪(du矛)HBV鏈夊厤鐤姏銆�

e鎶楀師(HBeAg)锛氳〃绀虹梾姣掑京(f霉)鍒舵椿韬�锛屾湁杓冨挤(qi谩ng)鍌虫煋鎬с€�

鏍稿績鎶楀師(HBcAg)锛氬父瑕�(gu墨)鏂规硶涓嶈兘妾㈠嚭銆�

HBV DNA锛氱梾姣掑京(f霉)鍒跺拰鍌虫煋鎬х殑鐩存帴妯�(bi膩o)蹇椼€�

33.鍌峰瘨=鐧�(f膩)鐔�(绋界暀鐔�)+鐩稿皪(du矛)绶╄剤+鐜懓鐤�+鑲濊劸鑵ぇ+鐧界窗(x矛)鑳�銆佸棞閰哥矑娓涘皯+琛€鍜岄楂撳煿椁�(y菐ng)闄�(y谩ng)鎬�+鑲ラ仈(d谩)瑭﹂(y脿n)闄�(y谩ng)鎬�(O銆丠鎶楅珨鏁堝児(ji脿)鍗囬珮锛孷i涓嶉珮)+骞剁櫦(f膩)鐧�(鑵稿嚭琛€鏈€甯歌(ji脿n)锛岃吀绌垮瓟鏈€鍤�(y谩n)閲�)銆�

34.鐕掑偡闈㈢⿳瑷�(j矛)绠楋細涓湅(gu贸)鏂颁節鍒嗘硶锛�3;3;3锛�5;6;7锛�13;13;1锛�5;7;13;21銆�

娣衡叀搴︾噿鍌风疮鍙婅〃鐨敓鐧�(f膩)灞�+鐪熺毊涔抽牠灞�锛屾湁澶у皬涓嶄竴鐨勬按鐨板舰鎴�锛屽壍(chu脿ng)闈㈢磪娼�(r霉n)銆佹疆婵�銆佺柤鐥涙槑椤€傛繁鈪″害鐕掑偡绱強鐪熺毊娣卞堡锛屽壍(chu脿ng)闈㈢磪鐧界浉闁�锛岀棝瑕�(ju茅)閬查垗銆�

35.鏍规摎(j霉)鎴戝湅(gu贸)琛�(w猫i)鍋ュ瑕�(gu墨)瀹�锛屽湪1姝蹭互鍓嶅皬鍏掗渶瑕佸畬鎴愮殑鍩虹(ch菙)鍏嶇柅鍖呮嫭鍗′粙鑻椼€佷箼鍨嬭倽鐐庣梾姣掔柅鑻�(绨�(ji菐n)绋�(ch膿ng)涔欒倽鐤嫍)銆佽剨楂撶伆璩�(zh矛)鐐庝笁鍍�(ji脿)娣峰悎鐤嫍銆佺櫨鐧界牬娣峰悎鍒跺姂鍜岄夯鐤规笡姣掔柅鑻椼€傚嚭鐢熶箼鑲濆崱浠嬭嫍锛屼簩鏈堣剨鐏扮値姝ｅソ锛屼笁鍥涗簲鏈堢櫨鐧界牬锛屽叓鏈堥夯鐤规涔欒叇銆�

36.鎴块枔闅旂己鎼嶏細闆滈煶鐐鸿兏楠ㄥ乏绶ｇ2銆�3鑲嬮枔杩戣兏楠ㄦ梺2锝�3绱�(j铆)鍣村皠鎬ф敹绺湡闆滈煶;P2浜㈤€�(j矛n)銆佸憟鍥哄畾鍒嗚;鐒�(w煤)闇囬～;鍑虹従(xi脿n)鍙冲績鎴裤€佸彸蹇冨澶�;鑲洪儴X绶�(xi脿n)绀鸿偤閲庡厖琛€锛岃偤鍕�(d貌ng)鑴堟鍑稿嚭锛�“鑲洪杸(m茅n)鑸炶箞”寰�銆�

娉曟礇鍥涜伅(li谩n)鐧ワ細鎮ｈ€呭彲鍑虹従(xi脿n)闈掔传銆佽共韪炵従(xi脿n)璞�銆佹澋鐙€鎸�(瓒�)銆侀櫍鐧�(f膩)鎬х己姘х櫦(f膩)浣�(鑲哄嫊(d貌ng)鑴堟紡鏂楅儴鐙圭獎涓旂櫦(f膩)鐢熻倢閮ㄧ棛鏀�);闆滈煶鐐鸿兏楠ㄥ乏绶ｇ2锝�4鑲嬮枔2锝�3绱�(j铆)绮楃硻鍣村皠鎬ф敹绺湡闆滈煶銆�

37.绱�(x矛)鑿屾€ч櫚閬撶梾锛屾偅鑰呰〃鐝�(xi脿n)鐐哄垎娉岀墿澧炲锛岃紩搴︾槞鐧�锛岄櫚閬撳垎娉岀墿鐧借壊銆佸嫽璩�(zh矛)銆佽叆鑷懗锛岄櫚閬撻粡鑶滄甯革紝闄伴亾PH>4.5锛岃兒瑭﹂(y脿n)闄�(y谩ng)鎬�锛岄’寰彙妾㈡煡瑕�(ji脿n)澶ч噺绶�(xi脿n)绱㈢窗(x矛)鑳烇紝娌荤檪棣栭伕鐢茬鍞�銆�

澶栭櫚闄伴亾鍋囩挡閰垫瘝鑿岀梾锛岄櫚閬撳垎娉岀墿鍛堢櫧鑹�銆佽眴鑵愭福妯ｏ紝娌荤檪鎳�(y墨ng)浣跨敤鍞戦(l猫i)鎶楃湡鑿岃棩鐗�锛屽柈绱旀€VC鍙互閬哥敤鍏嬮湁鍞戞垨鍜悍鍞戜娇鐢�7澶�锛屾垨鑰呬娇鐢ㄥ埗闇夎弻绱犱娇鐢�14澶�;

婊磋煵(ch贸ng)闄伴亾鐐�锛岄櫚閬撳垎娉岀墿鑶挎€�銆佹场娌媭锛岄櫚閬撻粡鑶滄暎鍦ㄥ嚭琛€榛�(di菐n)锛岄櫚閬揚H>4.5锛岃兒瑭﹂(y脿n)闄版€�锛岄’寰彙妾㈡煡瑕�(ji脿n)姣涙淮锜�(ch贸ng)锛屾不鐧傞閬哥敳纭濆攽锛屾€т即渚堕渶瑕佸悓鏅�(sh铆)娌荤檪銆�

38.瀛愬闋哥檶=鎺ヨЦ鎬ч櫚閬撳嚭琛€+瀹牳鍙(ji脿n)鍒拌彍鑺辩媭銆佹伅鑲夌媭璐呯敓鐗╋紝绲勭箶鑴�锛岃Ц涔嬫槗鍑鸿+瀹牳绯滅垱

瀛愬鑲岀槫=缍�(j墨ng)閲忓澶�銆佺稉(j墨ng)鏈熷欢闀�(zh菐ng)+鏈堢稉(j墨ng)鍛ㄦ湡姝ｅ父+涓嶅瓡/娴佺敘(ch菐n)+瀛愬琛ㄩ潰涓嶈(gu墨)鍓囩祼(ji茅)绡€(ji茅)+鐧藉付澧炲+瀛愬澧炲ぇ

39.鍏�(n猫i)鍥婃悕鍌峰嚭鐝�(xi脿n)“涓夊亸”缍滃悎寰�(灏�(du矛)鍋�(c猫)鍋忕櫛銆佸皪(du矛)鍋�(c猫)鍋忚韩鎰熻(ju茅)闅滅銆佸叐鐪煎皪(du矛)鍋�(c猫)鍗婅閲庡悓鍚戝亸鐩层€�)

40.澶у嫊(d貌ng)鑴堢播妯ｇ‖鍖栧瀷鑵︽姝�=涓€佸勾浜�+瀹夐潨鎴栫潯鐪犱腑鐧�(f膩)鐥�+鎰忚瓨(sh铆)娓呴啋+灞€鐏舵€х缍�(j墨ng)绯荤当(t菕ng)鎼嶅琛ㄧ従(xi脿n)(濡�“涓夊亸寰�”銆佹墜瓒冲緪鍕�(d貌ng)銆佺溂鐞冮渿椤€佺湬鏆�銆佸洓鑲㈢櫛鐦撶瓑)+CT绀轰綆瀵嗗害鐏�銆�

蹇冩簮鎬ц叇鏍撳=涓潚骞翠汉+蹇冭嚐鐥呭彶+娲诲嫊(d貌ng)鎴栧畨闈滀腑鐧�(f膩)鐥�+鎰忚瓨(sh铆)娓呮/鍙即鐭檪(sh铆)鐨勬剰璀�(sh铆)闅滅+灞€鐏舵€х缍�(j墨ng)绯荤当(t菕ng)鎼嶅琛ㄧ従(xi脿n)+CT浣庡瘑搴﹀奖銆�

鑵﹀嚭琛€=涓€佸勾+婵€鍕�(d貌ng)鎴栨椿鍕�(d貌ng)鏅�(sh铆)绐佺櫦(f膩)椤卞収(n猫i)澹撳楂�+CT绀洪珮瀵嗗害褰�+绁炵稉(j墨ng)鍔熻兘缂烘悕琛ㄧ従(xi脿n)銆�

铔涚恫(w菐ng)鑶滀笅鑵斿嚭琛€=涓潚骞�+椤卞収(n猫i)澹撳崌楂�+鑵﹁啘鍒烘縺寰�+CT鐧�(f膩)鐝�(xi脿n)楂樺瘑搴﹀奖銆�

41.閷�(cu貌)瑕�(ju茅)锛屽皪(du矛)瀹㈣浜嬬墿姝洸鐨勭煡瑕�(ju茅)锛屽彲瑕�(ji脿n)浜庢甯镐汉锛岄尟(cu貌)瑕�(ju茅)澶氳(ji脿n)浜庡櫒璩�(zh矛)鎬х簿绁為殰绀欑殑璀鐙€鎱�(t脿i)銆�

骞昏(ju茅)锛屾矑(m茅i)鏈夌従(xi脿n)瀵�(sh铆)鍒烘縺浣滅敤浜庢劅瑕�(ju茅)鍣ㄥ畼鏅�(sh铆)鍑虹従(xi脿n)鐨勭煡瑕�(ju茅)楂旈(y脿n)锛屾槸涓€绋櫅骞荤殑鐭ヨ(ju茅)銆�

鎸佺簩(x霉)鏇存柊涓�……

灏忕法鎺ㄨ枽锛�

2021骞磋嚚搴婂姪鐞嗛啱(y墨)甯€冭│(浜岃│)鑰冮鍜岀瓟妗�(鑰冭│鍥炴喍)

濡傛灉閭勬兂浜嗚В鑷ㄥ簥鍔╃悊閱�(y墨)甯€冭│鐩搁棞(gu膩n)鍕�(d貌ng)鎱�(t脿i)锛岄倓鍙互 鍏嶈不(f猫i)闋�(y霉)绱勭煭淇℃彁閱�锛�2021骞翠簩瑭︽垚绺�(j墨)鏌ヨ(x煤n)鏅�(sh铆)闁�锛�2022骞磋嚚搴婂姪鐞嗛啱(y墨)甯牨(b脿o)鍚嶆檪(sh铆)闁�锛岀钩璨�(f猫i)鏅�(sh铆)闁�锛屾簴(zh菙n)鑰冭瓑鎵撳嵃鏅�(sh铆)闁擄紝鎴愮妇(j墨)鏌ヨ(x煤n)鏅�(sh铆)闁撳拰鑰冨墠娉ㄦ剰浜嬮爡(xi脿ng)绛夌浉闂�(gu膩n)淇℃伅灞嗘檪(sh铆)鏈�(hu矛)閫氶亷(gu貌)鎵嬫(j墨)鐭俊鍙婃檪(sh铆)鍛婄煡鎮�!

浠ヤ笂灏辨槸鐠�(hu谩n)鐞冪恫(w菐ng)鏍＄法杓偤澶у鏁寸悊鐨�“2021骞磋嚚搴婂姪鐞嗛啱(y墨)甯€冭│(浜岃│)鑰冮粸(di菐n)鍖附”鐩搁棞(gu膩n)鍏�(n猫i)瀹�锛屽ぇ瀹朵簡瑙ｆ竻妤氫簡鍡�?鍚屾檪(sh铆)鍙粸(di菐n)鎿婃枃绔犲簳閮ㄦ垨鑰呮枃绔犲彸鍋�(c猫)鐨勬寜閳�锛�鍏嶈不(f猫i)涓嬭級2021骞磋嚚搴婂姪鐞嗛啱(y墨)甯€冭│鐨勯珮闋昏€冮粸(di菐n)/妯℃摤瑭﹂绛夌簿璎涜硣鏂�銆�