Cov conjunctiva ntawm lub qhov muag yog ib daim nyias nyias nyias nyob rau hauv lub qhov muag anterior ntawm lub qhov muag. Nws lub luag haujlwm tseem ceeb yog los tiv thaiv lub cornea los ntawm cov khoom txawv teb chaws, cov kab mob thiab cov kab mob. Kab lus no yuav tham txog conjunctivitis: ua rau, cov tsos mob thiab kev kho mob ntawm tus kab mob no. Nws cov ntsiab lus yog nyob rau hauv kev txhim kho cov tshuaj tiv thaiv kab mob hauv lub conjunctiva raws li kev cuam tshuam ntawm ntau yam.
Type of conjunctivitis
Conjunctivitis, ua rau (kev kho mob yuav tham tom qab) uas feem ntau tshwm sim los ntawm qhov txhab ntawm tus kab mob thiab kab mob, yog hom kab mob qhov muag tshaj plaws. Raws li kev txheeb xyuas kev kho mob, ntau dua 67% ntawm cov neeg mob tig mus rau kws kho qhov muag nrog qhov kev kuaj mob no.
Kev faib tawm ntawm pathology yog ua raws li 2 lub ntsiab lus tseem ceeb - raws li chav kawm thiab ua rau mob conjunctivitis:
- kab mob sib kis (pneumococcal, streptococcal, diphtheria, gonococcal, chlamydial);
- kis tau los ntawm kev sib kisplhaub ntses, herpes, rubella, kab mob qhua pias, qhua pias thiab lwm yam kab mob;
- fungal, thaum cuam tshuam los ntawm fungi Sporotrichium, Rhinosporidium, Penicillium, Candida, actinomycetes, coccidia, aspergillus;
- ua xua (tshuaj kho mob, caij nplooj ntoos hlav keratoconjunctivitis, hay fever thiab lwm yam).
kab mob thiab kab mob feem ntau tshwm sim nrog cov kab mob sib kis ntawm nasopharynx, o ntawm pob ntseg, cov npoo ntawm daim tawv muag lossis cov kab mob paranasal, nrog rau qhov muag qhuav.
Nyob rau hauv cov menyuam yaus, tus kab mob no mob heev, thaum cov neeg laus thiab cov laus tuaj yeem ua mob ntev.
Symptoms
Cov cim qhia ntawm tus kab mob muaj raws li hauv qab no:
- mob, khaus ntawm qhov muag;
- muas lossis purulent paug;
- siab rhiab heev rau lub teeb;
- edema ntawm conjunctiva ntawm daim tawv muag;
- pronounced network ntawm cov hlab ntsha hauv lub qhov muag;
- nrawm qhov muag nkees;
- zaj movie.
Kev puas tsuaj rau sab xis thiab sab laug qhov muag tuaj yeem muaj qhov sib txawv ntawm qhov hnyav.
kab mob conjunctivitis
Qhov ntau ntawm cov kab mob conjunctivitis tau piav qhia los ntawm qhov tseeb tias nyob rau hauv lub qhov muag ntawm txhua tus neeg muaj ntau cov kab mob microbial (ntau dua 60). Cov yam ntxwv tshwj xeeb ntawm cov feem ntau pom muaj nyob hauv cov lus hauv qab no.
| Kev mob conjunctivitis | yam ntxwv |
Txoj kev ntws |
| Staphylococcal lossis streptococcal |
Nyob qhov muag tawm ntawm qhov muag, gluing plaub muag. Kev mob ntshav liab txo qis rau cov menyuam kawm ntawv. Mucus poob pob tshab |
Kab mob tuaj yeem kis mus rau lub cornea ua rau keratitis |
| Pneumococcal |
mob hnyav reddening ntawm conjunctiva. me me hemorrhages, greyish films tshwm rau ntawm daim tawv nqaij ntawm daim tawv muag |
Kev kis mob tshwm sim los ntawm kev sib cuag. Kev txhim kho ntawm keratitis |
|
daim ntawv Diphtheritic: thawj zaug tsim o thiab tuab ntawm daim tawv muag; purulent paug tshwm sim; tsaus grey zaj duab xis yog tsim, sib cais uas tawm los ntshav qhov txhab, nti. Croupous form: tsawg o, cov yeeb yaj kiab yog mos thiab tshem tawm yooj yim, lub pob txha tsis cuam tshuam. Catarrhal daim ntawv: tsuas yog liab thiab o ntawm qhov sib txawv sib txawv |
Kev kis kab mob - huab cua. Tus kab mob no feem ntau tshwm sim hauv cov menyuam yaus hnub nyoog 2-10 xyoo. Feem ntau muaj kev sib xyaw ua ke nrog catarrh ntawm txoj hlab pa sab sauv. Cov teeb meem tshwm sim: fusion ntawm daim tawv muag daim nyias nyias nrog lub qhov muag ntawm lub qhov muag, pob txha ulceration, inversion ntawm daim tawv muag, plaub muag loj hlob mus rau lub pob txha |
|
| YGonococcal | o ntawm daim tawv muag hnyav, tawm yog purulent thiab copious, lub conjunctiva yog ci liab thiab folds, nyob rau hauv cov me nyuam mos nwslos ntshav thaum nias | Qhov ua rau conjunctivitis hauv cov neeg laus yog kab mob sib deev. Cov menyuam mos yug tshiab kis tau tus kabmob thaum hla tus kwj dej yug menyuam. Cov teeb meem tshwm sim tau - o thiab ulceration ntawm pob kws, uas sai sai ua rau nws perforation |
| Chlamydia | Edematous conjunctiva tsim ntau lub hauv paus uas muaj cov kua dej huab. Tom qab ntawd, daim ntawv caws pliav, qhov muag pom kev txo qis | Lub sijhawm incubation yog 1-2 lub lis piam. Cov teeb meem tshwm sim: degeneration ntawm cov qog lacrimal, inversion ntawm daim tawv muag, corneal ulceration |
Kev kuaj mob yog nyob ntawm kev kuaj xyuas sab nraud thiab kuaj biomicroscopic ntawm smear.
tshuaj tua kab mob
Cov kab mob kab mob sib kis, ua rau thiab cov tsos mob ntawm cov npe saum toj no, yog kho nrog cov tshuaj hauv qab no:
- tshuaj tua kab mob qhov muag: Ciprofloxacin, Ofloxacin, Lomefloxacin, 1% erythromycin lossis tetracycline ointment;
- qhov muag tee uas muaj cov tshuaj tua kab mob thiab tshuaj tua kab mob: "Sulfacetamide", "Sulfamethoxypyridazine", "Miramistin", "Ophthalmo-septonex", "Tobrex";
- hauv kev kuaj mob staphylococcal lesions: qhov muag dauv "Gentamicin", "Tobramycin", "Fucitalmic", "Futuron";
- nrog streptococcalQhov xwm ntawm tus kab mob: tee "Chloramphenicol", "Levomycetin"
Tshuaj tua kab mob yog siv thaum hmo ntuj, thiab thaum tsis muaj cov paug tawm ntau - thaum nruab hnub.
Tseem muaj cov tshuaj ua ke uas muaj GCS thiab tshuaj tua kab mob:
- "Maxitrol";
- "Dexa-Gentamicin";
- "Tobrazon" thiab lwm tus.
Yog tus kab mob diphtheria conjunctivitis, tus neeg mob tau mus pw hauv tsev kho mob kis kab mob. Kev kho mob yog nqa tawm systemically, nrog antidiphtheria serum thiab intramuscular los yog intravenous tshuaj tua kab mob. Nrog rau tus kab mob chlamydial thiab gonococcal qhov xwm txheej, kev kho tshuaj tua kab mob kuj tau sau tseg.
YViral conjunctivitis: ua rau thiab kho
Txhua tus kab mob uas ua rau tib neeg muaj ntau yam kab mob (thiab muaj txog 500 ntawm lawv) tuaj yeem cuam tshuam rau qhov muag. Feem ntau ua rau mob conjunctivitis hauv cov neeg laus thiab cov menyuam yaus muaj npe nyob rau hauv cov lus hauv qab no.
| Kev kis tus kabmob | yam ntxwv tsos mob | Txoj kev ntawm tus kab mob | |
| Adenoviruses 3, 5, 7 serotypes | Airborne, contact | Hauv thaj tsam sab hauv ntawm daim tawv muag hauv qab, cov hauv paus hniav me me, hemorrhages, grey films tshwm. Parotid lymph nodes yog loj | Lub sijhawm incubation yog 1 lub lis piam. Feem ntaucov menyuam yaus hnub nyoog preschool thiab cov menyuam kawm ntawv theem pib raug mob. Ua ntej qhov pib ntawm conjunctivitis, muaj o ntawm lub pharynx, trachea, kua ntswg, bronchitis los yog otitis nrog kub kub. Tus mob yuav kav ntev li 2 lub lis piam |
| Adenovirus serotype 8 | Kev sib cuag, huab cua |
Nyob rau theem pib - cov tsos mob ntawm kev ua tsis taus pa. Cov qog ntshav hauv cheeb tsam loj tuaj thiab ua rau mob. me me follicles thiab hemorrhages, pinpoint infiltrates yog tsim, pom acuity txo |
Ntau tshaj 70% ntawm cov neeg mob tau kis tus kab mob hauv cov chaw kho mob. Lub sijhawm kis kab mob yog 14 hnub, tag nrho lub sijhawm ntawm tus kabmob yog mus txog 2 lub hlis |
| Enterovirus type 70 | Airborne | mob hnyav hauv qhov muag thiab photophobia, tsim cov hauv paus hniav, hemorrhages ntawm ntau qhov ntau thiab tsawg thiab duab. Me me dawb los yog daj me ntsis uas txhaws lub excretory ducts ntawm lub lacrimal qog. Kev mob ntawm cov qog ntshav qab zib anterior | Lub sijhawm ntawm tus kabmob yog qhov nruab nrab 1-2 lub lis piam |
| Herpes simplex viruses | Tiv tauj ncaj | Cov txheej txheem pathological cuam tshuam nrog daim tawv nqaij, cov npoo ntawm daim tawv muag, pob kws. Eruption ntawm herpetic vesicles ntawm lub conjunctiva thiab raws ntug ntawm daim tawv muag, nyob rau hauv qhov chaw ntawm erosion los yog ulcers tom qab daim ntawv | Tus kab mob no tshwm sim rau menyuam yaus. Kev xav rov qab los thiab kawm ntev |
| Molluscum contagiosum viruses | Hu rau tsev neeg | Cov nodules tuab ntawm qhov loj ntawm 2 mus rau 5 hli tshwm rau ntawm daim tawv nqaij. Lawv tsis mob thiab muaj kev nyuaj siab nyob hauv qhov chaw. Thaum nias, ib qho dawb tso tawm | Ntau zaus, cov npoo ntawm daim tawv muag ua rau mob |
Kab mob ntawm conjunctiva hauv kab mob qhua pias, qhua pias thiab rubella
Qhov ua rau mob conjunctivitis hauv cov menyuam yaus feem ntau cuam tshuam nrog "thaum yau" kis kab mob:
- kab mob qhua pias. Ua ntej, lub cev kub nce siab heev, ua pob liab liab tshwm sim. Ntawm cov tsos mob ntawm ophthalmic, cov nram qab no txawv: photophobia, liab ntawm lub conjunctiva, profuse lacrimation, tsim ntawm vesicles ntawm daim tawv muag, uas ulcerate thiab caws pliav. Cov paug tawm ntawm qhov muag yog thawj zaug mucous, thiab tom qab ntawd purulent.
- Measles. Qhov kub nce, cov pob dawb nrog lub npoo liab tshwm rau ntawm daim tawv nqaij ntawm lub puab tsaig thiab daim tawv muag, tom qab ntawd cov pob liab liab ua rau hauv daim ntawv me me nodules. Tus me nyuam tsim photophobia, twitching thiab o ntawm daim tawv muag, lub cornea ua o thiab eroded.
- Rubella. Ua ntej, cov tsos mob ntawm SARS tshwm sim, lymph nodes nce, kub nce, ib pob liab tshwm nyob rau hauv daim ntawv ntawm liab me ntsis. Kev mob ntawm conjunctiva feem ntau yog mob me.
Antivirals
Kev kho tus kab mob viral conjunctivitis yog ua los ntawm kev siv cov hauv qab no:
- tshuaj tiv thaiv qhov muag "Ophthalmoferon", "Idoxuridin", "Keretsid", "Okoferon", "Tobradex","Aktipol";
- qhov muag gels thiab tee uas txhawb kev tsim kho ntawm lub pob txha thiab mucosa - "Korneregel", "Solcoseryl", "Glekomen", "Taufon";
- tshuaj tiv thaiv kab mob siv tom qab daim tawv muag - Acyclovir, Bonafton, oxolinic, tebrofen;
- rau kev tiv thaiv kab mob thib ob - tshuaj tua kab mob tau piav qhia saum toj no;
- tshuaj tiv thaiv kab mob uas muaj glucocorticosteroids.
Yog tias qhov ua rau mob conjunctivitis hauv tus menyuam yog qhua pias, rubella lossis kab mob qhua pias, ces kev kho zoo sib xws yog ua:
- siv tshuaj tua kab mob rau hauv qhov muag - qhov muag te "Furacilin", "Sulfacetamide";
- siv cov tshuaj interferon lossis interferonogen daws;
- kev tswj hwm tshuaj tiv thaiv kab mob qhua pias gamma globulin hauv kev txhaj tshuaj thiab tee.
Thaum cov kab mob molluscum contagiosum, khawb lossis diathermocoagulation ntawm daim tawv nqaij tsim ntawm daim tawv muag, tom qab ntawd kev kho mob ntawm cov chaw no nrog cov ntsuab ntsuab zoo nkauj.
kab mob fungal
Kab mob ntawm lub cev tsis pom kev hauv tib neeg tuaj yeem ua rau kwv yees li 50 hom kab mob fungi. Feem ntau ua rau mob conjunctivitis hauv cov neeg laus thiab menyuam yaus yog 3 hom:
- yeast-zoo li nceb;
- pwm micromycetes;
- dermatophytes uas cuam tshuam rau ntawm daim tawv nqaij.
Fungi nkag mus rau hauv lub qhov muag los ntawm ib puag ncig lossis foci ntawm cov kab mob ntawm daim tawv nqaij, hauv qhov tsawg dua - los ntawm cov hlab ntsha. Qhov kev txiav txim siab nyob rau hauv txoj kev loj hlob ntawm tus kab mob yogkev puas tsuaj rau lub pob txha thiab daim tawv muag, nrog rau txo kev tiv thaiv.
Cov tsos mob ntawm fungal conjunctivitis yog raws li nram no:
- edema, liab ntawm conjunctiva thiab tsim ntawm ntom me me daj nplej ntawm nws nto;
- tsim cov hlwv uas muaj cov kua dej serous;
- thaum cuam tshuam los ntawm fungi ntawm genus Penicillium - rwj nrog lub ntsej muag ntsuab;
- nrog candidiasis - plaque ntawm conjunctiva.
Yog hais tias tus kab mob fungal muaj ib qho chaw sib txawv ntawm lub cev, tus neeg mob yuav tsim kev tsis haum rau tus kab mob.
Kev kho mob ntawm cov kab mob fungal
Kev kho cov kab mob fungal ntawm conjunctiva yog ua los ntawm kev siv cov lus hauv qab no:
- tshuaj "Amphotericin B" lossis "Nystatin";
- qhov muag poob "Okomistin", "Miramistin";
- tshuaj noj hauv qhov ncauj - Fluconazole, Itraconazole.
Rau qhov muag dav dav, Amphotericin B tau muab tso rau hauv cov hlab ntsha.
Allergic Conjunctivitis (ARC)
Allergic conjunctivitis yog qhov thib ob feem ntau tom qab kis kab mob. Nyob rau hauv xyoo tas los no, muaj kev nyiam ua kom muaj qhov tshwm sim, uas hauv cov menyuam yaus nce mus txog 40%.
Muaj ntau hom kab mob no:
- seasonal (hay fever);
- xyoo puag ncig (qhov mob tas mus li ntawm lub qhov muag; exacerbations tsis cuam tshuam nrog lub caij nyoog);
- professional;
- ntu (tsawg dua 4 hnub hauv ib lub lis piam lossis tsawg dua 4 lub lis piam hauv ib xyoos);
- mob ntev;
- mob me - cov tsos mob me ua rau muaj kev cuam tshuam ntawm kev pw tsaug zog lossis kev ua haujlwm nruab hnub, tus neeg mob tuaj yeem ua yam tsis tau kho;
- nruab nrab, uas lub neej zoo tsis zoo;
- mob hnyav - tus neeg mob tsis tuaj yeem ua haujlwm, kawm, tsaug zog ib txwm tsis tau kho.
Qhov ntau tshaj plaws ntawm kev ua npaws quav nyab tau sau tseg hauv thaj av Volga, Urals thiab Siberia (txog 80% ntawm tag nrho cov kab mob ua xua).
Caus ntawm pollinous conjunctivitis
Tus kab mob no tuaj yeem tshwm sim los ntawm kev ua xua ntau. Lawv muab faib ua 3 pawg loj:
- tsev neeg ua xua (pwm spores, kab laum, tsiaj thiab nroj tsuag, plua plav mites);
- kev tshaj lij, tshuaj, zaub mov ua xua;
- allergens los ntawm sab nraud (cov paj paj ntoo).
Qhov kawg yog qhov feem ntau. Paj ntoos los ntawm cua pollinated nroj tsuag yog lub teeb heev thiab tuaj yeem thauj mus tau ntev.
Qhov ua rau pollinous (hay) conjunctivitis nyob rau hauv nruab nrab ntawm Russia yog vim peb flowering peaks:
- Lub Peb Hlis-Tsib Hlis - alder, poplar, tshauv, hazel, aspen thiab lwm yam ntoo.
- Lub Rau Hli-Lub Xya Hli - cereals (wheatgrass, fescue, rye, timothy nyom thiab lwm yam).
- Lub Xya Hli-Lub Yim Hli - cov nroj tsuag (wormwood, quinoa, hemp) thiab Compositae (hnub ci thiab lwm yam) nroj tsuag.
Ntau tus lejthov kom hay fever poob rau peb ncov. Qee cov nroj tsuag uas tsis yog paj kuj tso tawm cov tshuaj tsis haum rau hauv huab cua hauv daim ntawv ntawm kua txiv. Kev tsis haum tshuaj kuj tuaj yeem tshwm sim los ntawm cov hmoov av tsub zuj zuj ntawm lawv nplooj.
ARC tsos mob
Cov cim tseem ceeb ntawm kev ua xua kab mob yog:
- rhinitis cov tsos mob - tshem tawm, txham, khaus, kub qhov ntswg, tsis hnov tsw;
- lacrimation;
- khaus qhov muag;
- hnoos, khawb lossis kub hnyiab caj pas;
- liab thiab o ntawm cov kab mob;
- vim ua pa tsis zoo, mob taub hau tshwm sim, lub suab hloov;
- stuffiness thiab hnyav hauv pob ntseg, hnov lus tsis hnov;
- thaum lub caij tawm, cov mucous rub tawm ntawm qhov muag yog ua tau.
Cov cim qhia no cuam tshuam nrog qhov ua rau muaj kab mob sib kis - sib cuag ncaj qha nrog cov tshuaj tsis haum. Cov xwm txheej zoo tshaj plaws rau kev faib paj paj yog nyob rau hauv huab cua qhuav. Hauv cov menyuam yaus, feem ntau pom muaj kev ua xua rau khoom noj khoom haus. Nrog rau cov kab mob fungal, cov neeg mob tsim kev tsis haum rau cov khoom noj uas muaj cov poov xab (kvass, qaub-mis nyuj cov khoom, thiab lwm yam), thiab cov mob hnyav zuj zus nyob rau hauv huab cua ntub los yog thaum nyob hauv chav da dej.
ARC pheej hmoo yam tseem ceeb
Qhov laj thawj tseem ceeb ntawm pollinous (hay) conjunctivitis yog cov txheej txheem immunopathological, uas yog raws li cov tshuaj tiv thaiv IgE-mediated. Nws tshwm sim thaum allergens nkag mus rau hauv lub mucous daim nyias nyias.ntog ntawm qhov ntswg thiab qhov muag.
Cov xwm txheej pheej hmoo ua rau muaj kev tsis haum tshuaj yog raws li hauv qab no:
- kab mob kis yav dhau los ua rau muaj kev nce siab hauv lub cev;
- genetic predisposition;
- kev ua neej nyob txom nyem, noj tsis taus;
- qhov xwm txheej tsis zoo ib puag ncig (huab cua muaj kuab paug);
- hypothermia;
- kev nyuaj siab.
Hauv cov menyuam yaus, qhov muaj feem ntau ntawm ARC cuam tshuam nrog cov hauv qab no:
- hluas nkauj niam;
- haus luam yeeb thaum cev xeeb tub;
- yug ntxov ntxov;
- khoom noj khoom haus;
- tsis muaj oxygen hauv tus menyuam mos thaum yug menyuam;
- Niam txiv siv cov khoom noj tsis haum thaum cev xeeb tub.
ARC kev kho mob
Cov tshuaj hauv qab no yog siv los kho cov kab mob ua xua:
- tshuaj tiv thaiv kab mob (qhov ncauj) - Desloratadine, Loratadine, Levocetirizine, Rupatadine, Fexofenadine, Cetirizine, Ebastin;
- Glucocorticosteroids rau kev siv tshuaj pleev (txhaj tshuaj thiab tshuaj tua qhov muag) - Beclomethasone, Budesonide, Mometasone, Fluticasone propionate lossis furoate, Dexamethasone, Hydrocortisone qhov muag tshuaj pleev;
- txhais tau tias tiv thaiv exacerbation - "Ketotifen" (sab hauv), "Kromoglikatsodium" (qhov muag tee thiab tshuaj tsuag qhov ntswg);
- khoom tsim kua muag tsim rau qhov muag qhuav - "Lacrisifi", "Slezin", "Defislez", "Vizmed", "Okutiarz", "Avizor" thiab lwm yam.
Kev ntsuas kom txwv tsis pub kis rau cov tshuaj tsis haum kuj tau pom zoo:
- siv sijhawm ntau hauv tsev thaum cov nroj tsuag tawg paj;
- kaw qhov rais thaum nruab hnub thiab qhib lawv thaum hmo ntuj (thaum lub sijhawm ntawm hnub no cov tshuaj tiv thaiv hauv huab cua txo qis);
- siv daim npog qhov ncauj thiab tsom iav;
- thaum tsav tsheb hauv tsheb, kaw qhov rais thiab qhib cua txias;
- txav mus rau thaj chaw huab cua sib txawv rau lub sijhawm paj.
Kev Kho Mob General
Rau txhua hom kab mob, cov lus qhia dav dav hauv qab no yuav tsum ua raws:
- Txoj kev nyiam huv ntawm tus kheej - ntxuav tes nquag nrog xab npum thiab dej, siv cov phuam so ib leeg thiab cov ntaub so pov tseg, cais cov pipettes rau txhua qhov muag.
- Tshem tawm cov paug tawm ntawm lub qhov muag los ntawm kev ntxuav nrog cov tshuaj tua kab mob uas tsis muaj qhov ntub hauv "Furacilin" (cov tshuaj npaj tau muaj nyob hauv cov khw muag tshuaj) lossis cov tshuaj tsis muaj zog ntawm poov tshuaj permanganate.
- Txhawm rau txhim kho qhov tso tawm ntawm cov zais zis uas muaj cov kab mob ntau, tsis txhob npog qhov muag.
- txhawm rau txo cov txheej txheem inflammatory, siv cov tshuaj glucocorticosteroids (GCS) - qhov muag tee "Dexamethasone", "Desonide", "Prenacid" lossis cov tshuaj NSAIDs (0.1% diclofenac sodium).
