当前位置：首页>PPT>肺部感染并呼吸衰竭病人疑难病例讨论【PPT展示】

肺部感染并呼吸衰竭病人疑难病例讨论【PPT展示】

  • 2026-07-19 16:35:29
肺部感染并呼吸衰竭病人疑难病例讨论【PPT展示】
肺部感染并呼吸衰竭病人疑难病例讨论3
复制黄底字到医护资料平台搜索下载此PPT
那个病人是59岁女性，因胸闷气促半月，晕厥一次收入EICU，之后转到我们科。既往高血压、高血压性心脏病、心律失常多年。入院时血气结果让人倒吸一口气——PH只有7.18，PaCO2高达126.6，PaO2只有62。典型的II型呼吸衰竭，严重的CO2潴留。经过无创呼吸机辅助通气、控制血压等治疗，意识有所好转。但3月18号病情再次波动，心率最高冲到180，呼吸急促，血氧往下掉，紧急给予强心、利尿、无创通气支持。
血气分析的数值往往能揭示病程演变的轨迹。在呼吸衰竭的诊断中，必须区分I型和II型。PaO2小于60、PaCO2正常或偏低，属于I型呼衰，病理基础是换气功能障碍，肺泡塌陷或弥散屏障增厚，氧气过不去。PaO2小于60同时PaCO2大于50，属于II型呼衰，通气障碍，CO2排不出去，气道物理阻塞或呼吸肌驱动不足导致。两者治疗思路完全不同，高流量氧疗对I型患者可能合适，但对II型患者而言，高浓度给氧可能导致呼吸驱动被抑制，二氧化碳潴留进一步加重。
CO2潴留的临床表现有时不明显，容易被忽视。失眠、烦躁、昼睡夜醒、球结膜水肿，这些都是CO2麻醉的早期信号。部分患者可能表现为性格改变或反应迟钝。血压升高、心率增快、肺小动脉收缩，CO2在体内滞留的时间越长，影响越深。当PaCO2超过80mmHg时，呼吸中枢反而被抑制，通气进一步减少，形成恶性循环。
这个病例也提示了胸腔积液的处理。双侧胸腔积液压迫肺组织，限制了肺的扩张，肺活量下降，通气不足。再加上肺部感染，气道分泌物增多，痰液堵塞，气体交换效率进一步降低。有效引流积液、控制感染、保持气道通畅，这三方面需要同步推进。
护理诊断的优先级需要重新梳理。气体交换受损排第一，这是直接威胁生命的。肺部感染、肺泡通气量不足、胸腔积液共同作用，导致氧合无法维持。清理呼吸道无效排第二，痰液分泌多、咳嗽无力、气道堵塞，通气阻力增大。营养失调和活动无耐力紧随其后，长期卧床、疾病消耗、摄入不足，营养状态持续下降会导致呼吸肌疲劳，呼吸驱动的物理基础会进一步削弱。
感染控制的用药过程值得关注。入科时用美罗培南，广覆盖、强效。3月9号改为哌拉西林他唑巴坦，3月11号换成阿奇霉素加左氧氟沙星。每一次调整都对应着病原学结果或者临床反应。抗感染方案不是一成不变的，根据药敏结果和病情演变动态调整，才是精准治疗。
缓解胸闷的处理思路要分急性期和缓解期。急性期以控制感染、通畅气道、纠正缺氧和CO2潴留为主。稳定期则转向呼吸肌功能训练、对症处理、免疫力增强。急性期卧床休息，保证充足睡眠，减少耗氧。胸闷严重者取半卧位或坐位，利用重力减轻肺淤血，辅助膈肌下移。
营养支持的细节有时容易被忽略。高热量、高蛋白、高维生素、低盐、清淡易消化饮食。水肿、少尿的患者需要限制水钠摄入。肠内营养制剂可以补充能量，静脉输注白蛋白也有帮助。准确记录出入量，水电解质平衡不能出问题。
皮肤护理的重点在于早期干预。长期卧床、营养不良、循环功能减退，都是压疮的高危因素。每两小时翻身拍背、骨隆突处按摩、保持床单位清洁干燥、温水擦浴促进循环，这些措施看起来常规，但在卧床时间较长的患者身上，往往能决定皮肤屏障能否维持。
心理支持的对象不单是病人，也包括家属。呼吸困难带来的濒死感、反复住院的经济压力、对预后的不确定感，都会引发焦虑甚至抑郁。多巡视、多沟通、多倾听，家属的情绪稳定了，病人的安全感也会增加。
我印象最深的是这个病例中PaCO2的数值。126.6，这个数值意味着CO2已经对中枢神经系统产生了明显的抑制作用。很多医护人员看到这样的数值，第一反应是"赶紧给氧"。但对于II型呼衰，给氧必须慎重——呼吸中枢已经对高CO2麻木了，完全依赖低氧刺激维持呼吸，高浓度给氧会直接消除这个驱动力，呼吸可能停止。
这个病例也让我重新思考了无创通气的管理。患者入院后使用无创呼吸机辅助通气，意识好转。但病情反复时，心率冲到180，血氧下降，提示通气支持可能不足或者感染控制不够。无创通气的效果评估不能只看血气数值，还要观察呼吸频率、辅助呼吸肌动用情况、意识状态等综合指标。一旦无创通气无法维持氧合和通气，就要考虑气管插管。
胸腔积液引流后，肺部复张情况要持续追踪。肺不张会导致通气血流比例失调，氧合改善受限。配合呼吸训练，帮助肺组织重新膨胀。
出院后的长期管理也要提前规划。家庭氧疗的流量和时间要明确，呼吸功能训练要教会，营养支持要跟上，控制基础病、防感染、定期复查，每一条都关系到再次住院的风险。
经验是一点一点积累的，这个病例给我们的启示不只是治疗本身，更是对疾病进展和护理介入时机的把握。呼吸衰竭不是单一的生理异常，它是通气、换气、循环、代谢等多个环节共同作用的结果。痰液通畅了、感染控制了、营养跟上了、活动耐受改善了，每一步都做对了，病情才能稳定下来，患者才能平稳度过危险期。
本文来自网友投稿或网络内容，如有侵犯您的权益请联系我们删除，联系邮箱：wyl860211@qq.com 。

深圳都市圈,可能是全国最大的PPT工程!

已经70页PPT了,全部针对孵化私教们提的真实问题

最新文章

随机文章

基本 文件 流程 错误 SQL 调试
  1. 请求信息 : 2026-07-22 03:55:07 HTTP/2.0 GET : https://h.sjds.net/a/541372.html
  2. 运行时间 : 0.100038s [ 吞吐率：10.00req/s ] 内存消耗：4,358.70kb 文件加载：140
  3. 缓存信息 : 0 reads,0 writes
  4. 会话信息 : SESSION_ID=4daab0fea6d5d22bd13246fda1613d26
  1. /yingpanguazai/ssd/ssd1/www/h.sjds.net/public/index.php ( 0.79 KB )
  2. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/autoload.php ( 0.17 KB )
  3. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/composer/autoload_real.php ( 2.49 KB )
  4. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/composer/platform_check.php ( 0.90 KB )
  5. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/composer/ClassLoader.php ( 14.03 KB )
  6. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/composer/autoload_static.php ( 4.90 KB )
  7. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-helper/src/helper.php ( 8.34 KB )
  8. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-validate/src/helper.php ( 2.19 KB )
  9. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/helper.php ( 1.47 KB )
  10. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/stubs/load_stubs.php ( 0.16 KB )
  11. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Exception.php ( 1.69 KB )
  12. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-container/src/Facade.php ( 2.71 KB )
  13. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/symfony/deprecation-contracts/function.php ( 0.99 KB )
  14. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/symfony/polyfill-mbstring/bootstrap.php ( 8.26 KB )
  15. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/symfony/polyfill-mbstring/bootstrap80.php ( 9.78 KB )
  16. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/symfony/var-dumper/Resources/functions/dump.php ( 1.49 KB )
  17. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-dumper/src/helper.php ( 0.18 KB )
  18. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/symfony/var-dumper/VarDumper.php ( 4.30 KB )
  19. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/App.php ( 15.30 KB )
  20. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-container/src/Container.php ( 15.76 KB )
  21. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/psr/container/src/ContainerInterface.php ( 1.02 KB )
  22. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/provider.php ( 0.19 KB )
  23. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Http.php ( 6.04 KB )
  24. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-helper/src/helper/Str.php ( 7.29 KB )
  25. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Env.php ( 4.68 KB )
  26. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/common.php ( 0.03 KB )
  27. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/helper.php ( 18.78 KB )
  28. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Config.php ( 5.54 KB )
  29. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/app.php ( 0.95 KB )
  30. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/cache.php ( 0.78 KB )
  31. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/console.php ( 0.23 KB )
  32. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/cookie.php ( 0.56 KB )
  33. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/database.php ( 2.48 KB )
  34. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/facade/Env.php ( 1.67 KB )
  35. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/filesystem.php ( 0.61 KB )
  36. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/lang.php ( 0.91 KB )
  37. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/log.php ( 1.35 KB )
  38. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/middleware.php ( 0.19 KB )
  39. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/route.php ( 1.89 KB )
  40. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/session.php ( 0.57 KB )
  41. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/trace.php ( 0.34 KB )
  42. /yingpanguazai/ssd/ssd1/www/h.sjds.net/config/view.php ( 0.82 KB )
  43. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/event.php ( 0.25 KB )
  44. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Event.php ( 7.67 KB )
  45. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/service.php ( 0.13 KB )
  46. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/AppService.php ( 0.26 KB )
  47. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Service.php ( 1.64 KB )
  48. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Lang.php ( 7.35 KB )
  49. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/lang/zh-cn.php ( 13.70 KB )
  50. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/initializer/Error.php ( 3.31 KB )
  51. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/initializer/RegisterService.php ( 1.33 KB )
  52. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/services.php ( 0.14 KB )
  53. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/service/PaginatorService.php ( 1.52 KB )
  54. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/service/ValidateService.php ( 0.99 KB )
  55. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/service/ModelService.php ( 2.04 KB )
  56. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-trace/src/Service.php ( 0.77 KB )
  57. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Middleware.php ( 6.72 KB )
  58. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/initializer/BootService.php ( 0.77 KB )
  59. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/Paginator.php ( 11.86 KB )
  60. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-validate/src/Validate.php ( 63.20 KB )
  61. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/Model.php ( 23.55 KB )
  62. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/model/concern/Attribute.php ( 21.05 KB )
  63. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/model/concern/AutoWriteData.php ( 4.21 KB )
  64. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/model/concern/Conversion.php ( 6.44 KB )
  65. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/model/concern/DbConnect.php ( 5.16 KB )
  66. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/model/concern/ModelEvent.php ( 2.33 KB )
  67. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/model/concern/RelationShip.php ( 28.29 KB )
  68. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-helper/src/contract/Arrayable.php ( 0.09 KB )
  69. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-helper/src/contract/Jsonable.php ( 0.13 KB )
  70. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/model/contract/Modelable.php ( 0.09 KB )
  71. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Db.php ( 2.88 KB )
  72. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/DbManager.php ( 8.52 KB )
  73. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Log.php ( 6.28 KB )
  74. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Manager.php ( 3.92 KB )
  75. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/psr/log/src/LoggerTrait.php ( 2.69 KB )
  76. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/psr/log/src/LoggerInterface.php ( 2.71 KB )
  77. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Cache.php ( 4.92 KB )
  78. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/psr/simple-cache/src/CacheInterface.php ( 4.71 KB )
  79. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-helper/src/helper/Arr.php ( 16.63 KB )
  80. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/cache/driver/File.php ( 7.84 KB )
  81. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/cache/Driver.php ( 9.03 KB )
  82. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/contract/CacheHandlerInterface.php ( 1.99 KB )
  83. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/Request.php ( 0.09 KB )
  84. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Request.php ( 55.78 KB )
  85. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/middleware.php ( 0.25 KB )
  86. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Pipeline.php ( 2.61 KB )
  87. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-trace/src/TraceDebug.php ( 3.40 KB )
  88. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/middleware/SessionInit.php ( 1.94 KB )
  89. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Session.php ( 1.80 KB )
  90. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/session/driver/File.php ( 6.27 KB )
  91. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/contract/SessionHandlerInterface.php ( 0.87 KB )
  92. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/session/Store.php ( 7.12 KB )
  93. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Route.php ( 23.73 KB )
  94. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/route/RuleName.php ( 5.75 KB )
  95. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/route/Domain.php ( 2.53 KB )
  96. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/route/RuleGroup.php ( 22.43 KB )
  97. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/route/Rule.php ( 26.95 KB )
  98. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/route/RuleItem.php ( 9.78 KB )
  99. /yingpanguazai/ssd/ssd1/www/h.sjds.net/route/app.php ( 1.72 KB )
  100. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/facade/Route.php ( 4.70 KB )
  101. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/route/dispatch/Controller.php ( 4.74 KB )
  102. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/route/Dispatch.php ( 10.44 KB )
  103. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/controller/Index.php ( 4.81 KB )
  104. /yingpanguazai/ssd/ssd1/www/h.sjds.net/app/BaseController.php ( 2.05 KB )
  105. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/facade/Db.php ( 0.93 KB )
  106. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/connector/Mysql.php ( 5.44 KB )
  107. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/PDOConnection.php ( 52.47 KB )
  108. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/Connection.php ( 8.39 KB )
  109. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/ConnectionInterface.php ( 4.57 KB )
  110. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/builder/Mysql.php ( 16.58 KB )
  111. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/Builder.php ( 24.06 KB )
  112. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/BaseBuilder.php ( 27.50 KB )
  113. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/Query.php ( 15.71 KB )
  114. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/BaseQuery.php ( 45.13 KB )
  115. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/TimeFieldQuery.php ( 7.43 KB )
  116. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/AggregateQuery.php ( 3.26 KB )
  117. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/ModelRelationQuery.php ( 20.07 KB )
  118. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/ParamsBind.php ( 3.66 KB )
  119. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/ResultOperation.php ( 7.01 KB )
  120. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/WhereQuery.php ( 19.37 KB )
  121. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/JoinAndViewQuery.php ( 7.11 KB )
  122. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/TableFieldInfo.php ( 2.63 KB )
  123. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-orm/src/db/concern/Transaction.php ( 2.77 KB )
  124. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/log/driver/File.php ( 5.96 KB )
  125. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/contract/LogHandlerInterface.php ( 0.86 KB )
  126. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/log/Channel.php ( 3.89 KB )
  127. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/event/LogRecord.php ( 1.02 KB )
  128. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-helper/src/Collection.php ( 16.47 KB )
  129. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/facade/View.php ( 1.70 KB )
  130. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/View.php ( 4.39 KB )
  131. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Response.php ( 8.81 KB )
  132. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/response/View.php ( 3.29 KB )
  133. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/Cookie.php ( 6.06 KB )
  134. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-view/src/Think.php ( 8.38 KB )
  135. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/framework/src/think/contract/TemplateHandlerInterface.php ( 1.60 KB )
  136. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-template/src/Template.php ( 46.61 KB )
  137. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-template/src/template/driver/File.php ( 2.41 KB )
  138. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-template/src/template/contract/DriverInterface.php ( 0.86 KB )
  139. /yingpanguazai/ssd/ssd1/www/h.sjds.net/runtime/temp/ad153693ed39fba6d1bda2fe72512cde.php ( 12.06 KB )
  140. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-trace/src/Html.php ( 4.42 KB )
  1. CONNECT:[ UseTime:0.000652s ] mysql:host=127.0.0.1;port=3306;dbname=h_sjds;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.000864s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000336s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000311s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000527s ]
  6. SELECT * FROM `set` [ RunTime:0.000235s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.000553s ]
  8. SELECT * FROM `article` WHERE `id` = 541372 LIMIT 1 [ RunTime:0.005441s ]
  9. UPDATE `article` SET `lasttime` = 1784663707 WHERE `id` = 541372 [ RunTime:0.002173s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 64 LIMIT 1 [ RunTime:0.000319s ]
  11. SELECT * FROM `article` WHERE `id` < 541372 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.000558s ]
  12. SELECT * FROM `article` WHERE `id` > 541372 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.000473s ]
  13. SELECT * FROM `article` WHERE `id` < 541372 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.000920s ]
  14. SELECT * FROM `article` WHERE `id` < 541372 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.000759s ]
  15. SELECT * FROM `article` WHERE `id` < 541372 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.010684s ]
0.101798s