经典著作 《Fishman肺部疾病》于1980年首次出版，整合了呼吸疾病、重症医学的基础知识和临床应用，是呼吸医学及相关基础和应用科学的奠基之作。
内容翔实 本书阐述了正常和疾病状态下肺功能及其改变，并全面、详细介绍了多种呼吸系统疾病及其影响因素，其中包括阻塞性和限制性肺疾病、肺血管病、睡眠呼吸障碍、肺部肿瘤、呼吸道感染、呼吸衰竭等。全书共500万余字，2000余幅图，60个视频，18000条参考文献。
全面更新 本书第5版对以下内容进行了全面更新，以反映其在过去几年取得的*进展，包括：肺部分子医学的发展、干细胞和呼吸系统疾病、肺疾病遗传学与精准医疗、肺移植技术的进展、呼吸系统免疫学和免疫抑制的发展、肺高压的诊断和治疗、昼夜节律和睡眠生物学、肺部影像学包括功能显像的快速发展、现代介入支气管镜技术。同时涵盖了危重症医学领域的*进展，包括早期诊断和治疗脓毒症、多器官功能障碍综合征（MODS）、急性呼吸窘迫综合征（ARDS）、重症监护室中躁动和谵妄的管理、“慢性危重病”的新定义等。
【内容简介】
本书阐述了呼吸系统生物学、细胞学及分子机制、正常和疾病状态下的肺功能及相应的改变，并全面、详细介绍了多种呼吸系统疾病及其影响因素，其中包括阻塞性肺疾病和限制性肺疾病、肺血管病、睡眠呼吸障碍、肺部肿瘤、呼吸道感染、呼吸衰竭等。本书第5版对肺病医学的发展、干细胞和呼吸系统疾病、肺疾病遗传学与精准医疗等内容进行了更新。全书共500万余字，2000余幅图，60个视频，18000条参考文献。本书是呼吸科临床医生、实习生、肺部疾病研究人员必不可少的工具书。
【作者简介】
著者简介
Michael A.Grippi教授是美国宾夕法尼亚大学医学院副教授，Good Shepherd Penn Partners Specialty Hospital的首席医疗官。Michael A.Grippi教授是世界知名的呼吸科专家，担任本书第3版、第4版、第5版的主编。
【目录】
简 目
Contributors
Preface
Volume 1
Part 1: Perspectives
Part 2: Scientific Basis of lung Function in Health and Disease
Section 1 Genetic, Cellular, and Structural Basis of Normal Lung Function
Section 2 Physiological Principles of NormalLung Function
Section 3 The Lungsin Different Physiological States
Section 4 Lung Immunology
Section 5 Lung Injury and Repair
Part 3: Symptoms and Signs of respiratory Disease
Section 6 Clinical Approach to the Patient
Section 7 Diagnostic Procedures
Part 4: Obstructive Lung Diseases
Section 8 Chronic Obstructive Pulmonary Disease
Section 9 Asthma
Section 10 Other Obstructive Disorders
Part 5: interstitial and inflammatory lung Diseases
Section 11 Immunologic and Interstitial Diseases
Part 6: Drug-induced lung Diseases
Part 7: Other infiltrative and airspace Disorders
Part 8: Disorders of the Pulmonary Circulation
Volume 2
Part 9: Disorders of the Pleural Space
Part 10: Diseases of the mediastinum
Part 11: Disorders of the Chest Wall, Diaphragm, and Spine
Part 12: Occupational and environmental Disorders
Section 12 Occupational Disorders
Section 13 Environmental Disorders
Part 13: Pulmonary Complications of nonpulmonary Disorders
Part 14: Sleep and Sleep Disorders
Part 15: Surgical aspects of Pulmonary medicine
Part 16: Neoplasms of the Lungs
Section 14 Lung Cancer
Section 15 Lymphoproliferative Disorders
Part 17: infectious Diseases of the lungs
Section 16 General Concepts
Section 17 Common Syndromes in Pulmonary Infectious Diseases
Section 18 Major Pathogens in Pulmonary Infections
Part 18: Acute respiratory Failure
Section 19 Lung Failure
Section 20 Respiratory Pump Failure
Section 21 Management and Therapeutic Interventions
APPENDIXES
Appendix A terms and Symbols in respiratory Physiology
Appendix B normal Values for a Healthy 20-Year oldSeated man
Index
v
目 录
Contributors
Preface
Volume 1
Part 1: Perspectives
1 Milestones in the History of Pulmonary medicine
Part 2: Scientific Basis of lung Function in Health and Disease
Section 1 Genetic, Cellular, and Structural Basis of Normal Lung Function
2 Functional Design of the Human lung for Gas exchange
3 The respiratory muscles
4 Molecular regulation of lung Development
5 Pulmonary Surfactant and Disorders ofSurfactant Homeostasis
6 Mucociliary Clearance
7 The Genetic Basis of respiratory Disorders
8 Stem Cells and respiratory Disease:Prospects for the Future
9 Personalized Pulmonary medicine
Section 2 Physiological Principles of NormalLung Function
10 Pulmonary mechanics
11 Control of Ventilation
12 Circadian rhythms and Sleep Biology
13 Pulmonary Circulation
14 Ventilation, Pulmonary Blood Flow, and Ventilation–Perfusion relationships
15 Blood-Gas transport
16 Diffusion, Chemical reactions, and Diffusing Capacity
17 Acid–Base Balance
Section 3 The Lungsin Different Physiological States
18 Respiratory System response to exercise in Health
19 Aging of the respiratory System
Section 4 Lung Immunology
20 Innate and adaptive immunity in the lung
21 Lymphocyte- and macrophage-mediatedinflammation in the lung
22 Mast Cells and eosinophils
23 Leukocyte accumulation in Pulmonary Disease
24 Antibody-mediated lung Defenses and Humoral immunodeficiency
Section 5 Lung Injury and Repair
25 Tlymphocytes in the lung
26 Chemokines, adipokines, and GrowthFactors in the lung
27 Redox Signaling and oxidative Stress in lung Diseases
28 Fibroblasts in lung Homeostasis and Disease
Part 3: Symptoms and Signs of respiratory Disease
Section 6 Clinical Approach to the Patient
29 Approach to the Patient with respiratory Symptoms
Section 7 Diagnostic Procedures
30 Modern approach to thoracic imaging Diagnosis
31 Thoracic ultrasonography
32 Physiologic and metabolic Study of Pulmonary Disorders using Conventional imaging
techniques and Positron emission tomography
33 Pulmonary Function testing
34 Principles and applications of Cardiopulmonaryexercise testing
35 Diagnostic Bronchoscopy, transthoracicneedle Biopsy, and related Procedures
36 Interventional Bronchoscopy
37 Diagnostic thoracic Surgical Procedures:thoracoscopy, VatS, and thoracotomy
38 Evaluation of respiratory impairment and Disability
Part 4: Obstructive Lung Diseases
Section 8 Chronic Obstructive Pulmonary Disease
39 Pathology of Chronic obstructive Pulmonary Disease: Diagnostic Features and Differential Diagnosis
40 Chronic obstructive Pulmonary Disease: epidemiology,Pathophysiology, Pathogenesis, andα1-antitrypsin Deficiency
41 Cigarette Smoking and Smoking Cessation
42 Course and treatment of Chronic obstructivePulmonary Disease
43 Rehabilitation in Chronic obstructivePulmonary Disease and other respiratory Disorders
Section 9 Asthma
44 The Biology of asthma
45 Asthma: epidemiology
46 Asthma: Clinical Presentation and management
47 Aspirin- and exercise-induced asthma
48 Allergic Bronchopulmonaryaspergillosis (mycosis)
and Severe asthma with Fungal Sensitivity
Section 10 Other Obstructive Disorders
49 Upper airway obstruction in adults
50 Cystic Fibrosis
51 Bronchiolitis
52 Bullous Disease of the lung
53 Bronchiectasis
Part 5: interstitial and inflammatory lung Diseases
Section 11 Immunologic and Interstitial Diseases
54 Interstitial lung Disease: a Clinical
overview and General approach
55 Systemic Sarcoidosis
56 Idiopathic Pulmonary Fibrosis
57 Idiopathic interstitial Pneumoniasother than idiopathic Pulmonary Fibrosis
58 Hypersensitivity Pneumonitis
59 Radiation Pneumonitis
60 Pulmonary manifestations of the CollagenVascular Diseases
61 Pulmonary langerhans’ Cell Histiocytosis
62 Pulmonary lymphangioleiomyomatosis
63 Benign metastasizing leiomyoma
64 Depositional Diseases of the lungs
Part 6: Drug-induced lung Diseases
65 Pulmonary toxicity related toChemotherapeutic agents
66 Drug-induced Pulmonary Disease Due to nonchemotherapeutic agents
Part 7: Other infiltrative and airspace Disorders
67 The lungs in Patients with inborn errors of metabolism
68 Alveolar Hemorrhage Syndromes
69 Aspiration-related Pulmonary Disorders
70 Pulmonary alveolar Proteinosis Syndrome
71 The eosinophilic Pneumonias
Part 8: Disorders of the Pulmonary Circulation
72 Pulmonary arterial Hypertension
73 Pulmonary thromboembolic Disease
74 Pulmonary Vasculitis
75 Pulmonary arteriovenous malformations
Volume 2
Part 9: Disorders of the Pleural Space
76 Nonmalignant Pleural effusions
77 Malignant Pleural effusions
78 Pneumothorax
Part 10: Diseases of the mediastinum
79 Malignant mesothelioma and otherPrimary Pleural tumors
80 nonneoplastic Disorders of the mediastinum
81 Congenital Cysts of the mediastinum:Bronchopulmonary Foregut anomalies
82 Benign and malignant neoplasms of the mediastinum
Part 11: Disorders of the Chest Wall, Diaphragm, and Spine
83 nonmuscular Diseases of the Chest Wall
84 Effects of neuromuscular Diseaseson Ventilation
85 Management of neuromuscular respiratorymuscle Dysfunction
Part 12: Occupational and environmental Disorders
Section 12 Occupational Disorders
86 Asbestos-related lung Disease
87 Chronic Beryllium Disease andHard-metal lung Diseases
88 Coal Workers’ lung Diseases and Silicosis
89 Occupational asthma, Byssinosis, andindustrial Bronchitis
90 Acute and Chronic responses to toxic inhalations
Section 13 Environmental Disorders
91 Indoor and outdoor air Pollution
92 High-altitude Physiology and Clinical Disorders
93 Diving injuries and air embolism
94 Thermal lung injury and acute Smoke inhalation
Part 13: Pulmonary Complications of nonpulmonary Disorders
95 Noninfectious Pulmonary Complications of Hematopoietic Stem Cell and Solidorgan transplantation
96 Pulmonary Complications of Sickle Cell Disease
97 Pulmonary Disorders and Pregnancy
98 Pulmonary Complications of intra-abdominal Disease
Part 14: Sleep and Sleep Disorders
99 Sleep apnea Syndromes: Central and obstructive
100 Sleep-related Hypoventilation Syndromes
101 Changes in the Cardiorespiratory System During Sleep
102 Differential Diagnosis and evaluation of Sleepiness
Part 15: Surgical aspects of Pulmonary medicine
103 Perioperative respiratory Considerations inthe Surgical Patient
104 Acute respiratory Failure inthe Surgical Patient
105 Perioperative Care of the Patientundergoing lung resection 106 thoracic trauma
107 Lung transplantation
Part 16: Neoplasms of the Lungs
Section 14 Lung Cancer
108 Genetic and molecular Changes in lung Cancer: Prospects for a Personalized
Pharmacological approach to treatment
109 Epidemiology of lung Cancer
110 Approach to the Patient withPulmonary nodule
111 The Pathology of Bronchogenic Carcinoma
112 Clinical evaluation, Diagnosis, andLydia Chang / M. Patricia Rivera
113 Treatment of non–Small-Cell lung Cancer: Surgery
114 Treatment of non–Small-Celllung Cancer: Chemotherapy
115 Treatment of non–Small-Cell
116 Small Cell lung Cancer: Diagnosis, treatment,and natural History
117 Primary lung tumors other than BronchogenicCarcinoma: Benign and malignant
118 Extrapulmonary Syndromesassociated with lung tumors
119Pulmonary metastases: the role ofSurgicalreSection
Section 15 Lymphoproliferative Disorders
120 Lymphoproliferative and HematologicDiseases involving the lung and Pleura
Part 17:Infectious Diseases of the lungs
Section 16 General Concepts
121 Pulmonary Clearance of infectious agents
122 Approach to the Patient with Pulmonary infection
123 Pulmonary infection in immunocompromised Hosts
124 Microbial Virulence Factors in Pulmonary infections
125 Principles of antibiotic use and the Selection ofempiric therapy for Pneumonia
Section 17 Common Syndromes in Pulmonary Infectious Diseases
126 Infections of the upper respiratory tract
127 Aspiration, empyema, lung abscesses,and anaerobic infections
128 Acute Bronchitis and Community-acquiredPneumonia
129 Healthcare-acquired Pneumonia,including Ventilator-associated Pneumonia
Section 18 Major Pathogens in Pulmonary Infections
130 Viral infections of the lung and respiratory tract
131 Tuberculosis
132 Diseases due to nontuberculous mycobacteria
133 Aspergillus, Candida, and other opportunisticmold infections of the lung
134 Cryptococcosis and the endemic mycoses
135 Pneumocystis Pneumonia
136 Protozoan infections of the thorax
137 Helminthic Diseases of the Lungs
138 Zoonotic and Other Unusual
Part 18: Acute respiratory Failure
139 Respiratory Failure: an overview
Section 19 Lung Failure
140 Acute respiratory Distress Syndrome: Pathogenesis
141 Acute lung injury and the acute respiratory Distress Syndrome:Clinical Features, management, and outcomes
142 Sepsis, multiple organ DysfunctionSyndrome, and Chronic Critical illness
Section 20 Respiratory Pump Failure
143 Pump Failure: the Pathogenesis of Hypercapnic respiratory Failure in Patients
with lung and Chest Wall Disease
Section 21 Management and Therapeutic Interventions
144 Oxygen therapy and toxicity
147 Hemodynamic and respiratory monitoringin acute respiratory Failure
148 Principles of mechanical Ventilation
149 Nutrition in Pulmonary Disease
150 Diagnosis and treatment of Pain, agitation,and Delirium in the intensive Care unit
151 Early mobilization of Patients in the ICU
152 Organization of intensive Care units andlong-term acute Care Hospitals
153 Ethics and Palliative Care in Critical Care units
APPENDIXES
Appendix A Terms and Symbols in respiratory Physiology
Appendix B Normal Values for a Healthy 20-Year oldSeated man
Index
【前言】
前 言PREFACE
This, the fifth edition of Fishman’s Pulmonary Diseases and Disorders,represents a substantial departure in content and style from the previousfour editions. Notably, this is the first edition in which thefounding editor, Alfred P. Fishman (1918–2010), is no longer at thehelm. Dr. Fishman, a legend in pulmonary science and medicine,leaves a legacy based on a long and distinguished career. Incredibly,he served as sole editor of the first two editions of the textbook,which initially appeared in print in 1980. Subsequently, he enlisteda number of coeditors, including several from the current group.Those of us who had the opportunity to work with him on the prior
two editions remain grateful for his leadership, editorial style, andunrelenting commitment to excellence. His memory inspired us inpreparing the current volume. We can only hope that it measures upto his exacting standards.
While many of the elements of the book have changed, one aspectremains firmly entrenched: The book represents a coupling of thebody of knowledge of pulmonary and critical care medicine withthe underlying basic and applied science upon which the clinicalmaterial is based. The book is designed to appeal both to cliniciansand investigators who are interested in the science of medicine,including relevant respiratory biology and underlying cellular andmolecular mechanisms. We hope that readers will find it authoritative,well referenced, and a suitable platform from which to launchadditional inquiry.
The body of knowledge and level of detail in the fifth editionhave evolved substantially since the last edition, published in 2008.In virtually all areas of pulmonary medicine, notable advancementshave been made, and each is discussed in detail. For example,tremendous progress has occurred in our understanding of thegenetics of respiratory disease; indeed, the era of “personalizedmedicine” is upon us. A full chapter has been devoted to the geneticsof pulmonary disease and another to personalized pulmonarymedicine—additions from the previous edition. Similarly, growthin immunology and immunosuppressive management, along withtechnical advances in lung transplantation, has been amply documentedin the literature over the last 5 years and is presented indetail. Advances in the science and treatment of pulmonary hypertensionhave been noteworthy. This area, which was one of greatinterest to Dr. Fishman, is discussed in a comprehensive chapter onthe subject. In addition, the rapid evolution of cardiovascular and
pulmonary imaging techniques has been dramatic, and multipleexamples of such advanced imaging populate many of the chapters.Utilization of the technology and its attendant costs constitute thebasis for considerable debate and ongoing studies regarding applicabilityin screening patients for underlying pulmonary disease(e.g., lung cancer screening using low-dose CT scanning in at-riskpatients). Finally, as another example of noteworthy progress, developmentsin interventional bronchoscopic techniques continueto evolve and have become increasingly sophisticated over the last5 years. They are discussed in two related chapters on diagnostic andinterventional bronchoscopy.
Within the realm of critical care medicine, significant advanceshave been reported in the early diagnosis and management ofsepsis, multiple organ dysfunction syndrome (MODS), acute respiratorydistress syndrome (ARDS), and the newly defined entityof “chronic critical illness.” These advances have translated intoimproved survival of patients with disorders that, at one time, werelargely fatal. Patient survival, particularly in the setting of chronicand, sometimes, debilitating, organ dysfunction has generateddebate on the appropriateness of application of the technology andaffordability of the healthcare thereby engendered. Such considerations
inform a discussion of the organization of intensive care unitsand long-term acute care facilities, topics which have been includedin this edition.
Not all of the news has been good. For example, challenges in themedical management of advanced interstitial lung disease, particularlyidiopathic pulmonary fibrosis, have remained all too evident.Therapy has been disappointing. Notably, however, several recentlycompleted clinical trials have improved prospects for management.
Those responsible for generating the content of the fifth editioninclude 278 contributors. They are drawn from among the world’sexperts in the areas about which they have written. One hundredfifty-nine contributors are new from the last edition, including manyfrom outside the United States, reflecting the vast array of expertiseavailable globally in the areas of pulmonary science and medicine.
Organization and content are not the only metrics that havechanged with the fifth edition. Footnoted references are now incorporatedextensively. Supplemental content and illustrations aremade available by accessing QR codes embedded on the printedpages. Production constraints created by page limitations havebeen curtailed significantly. Notably, the fifth edition is being madeavailable in an electronic version accessed via the World Wide Web.
An additional technological advance over the prior edition isincorporation of a number of videos designed to complement and,at times, accentuate information contained within the text. Notsurprisingly, most of the videos relate to procedures or imaging.They are designed to reflect common or unique findings drawnfrom “real life” clinical experiences. They, too, are accessible usinga QR code reader.
With all of the technological advances in play, at the end of theday, the compilation and synthesis of the information containedwithin this textbook are a reflection of the commitment, untiringeffort, and professionalism of many contributing authors. The editorsare enormously grateful for their willingness to “dig deep” andgenerate authoritative discussions of the complex and expandingfields of pulmonary and critical care medicine.
These same, appreciative editors have, themselves, contributedenormous boluses of time in editing and authoring the chapters thatcomprise the book. Personally, I found the willingness of my colleaguesto step up and orchestrate its preparation extraordinarily gratifying.
Finally, on behalf of all of the editors, I wish to express ourthanks for the commitment of key individuals in preparing the fifthedition, including Brian Belval, Executive Editor at McGraw-Hill;Peter Boyle, Sr Project Development Editor; Priscilla Beer, Sr MediaProject Manager; and Sarah M. Granlund, Project Manager. Theirability to keep the train on the track was nothing short of exceptional.
Michael A. Grippi, MD
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