Perforative otitis nyob rau hauv tib neeg tshwm sim nyob rau hauv tus txheej txheem ntawm cov teeb meem ntawm tus mob purulent daim ntawv ntawm tus kab mob no. Hauv qhov no, cov neeg mob soj ntsuam kev ua txhaum ntawm kev ncaj ncees ntawm lub pob ntseg, uas cais lub pob ntseg nruab nrab thiab sab nraud. Yog li ntawd, tib neeg muaj kev lag ntseg nrog rau kev hnov lus tsis zoo thiab tsis pom kev ntawm lub suab. Tus kab mob no txaus ntshai. Tawm tsam nws keeb kwm yav dhau los, kev kis kab mob thib ob tuaj yeem tshwm sim, uas tshwm sim vim perforation ntawm daim nyias nyias.
Rupture ntawm daim nyias nyias feem ntau tshwm sim nyob rau hauv qis qis. Qhov no yog qhov sib txawv ntawm daim duab peb sab, nws cov npoo tsis sib npaug, cov paug tuaj yeem tawm ntawm nws. Yog tias qhov no tshwm sim, tus kws kho mob yuav siv cov kua dej me me rau kev tshuaj xyuas cov kab mob bacteriological txhawm rau txiav txim siab tus neeg sawv cev ntawm tus kab mob thiab xaiv cov tshuaj tua kab mob. Qhov loj dua qhov perforation, qhov tsis hnov lus hnyav dua. Kev mob pob ntseg yuav qhia tau tias pob ntseg tawg.
Otitis tuaj yeem piav raws li hauv qab no:
- Kev mob sai sai, nce hauv lub cev kub txog 39 degrees.
- Mob pob ntseg tawg mus rau lub tuam tsev thiab cov hniav ntawm qhov cuam tshuam.
- hnov tsis hnov thiab tinnitus.
- Kev qaug zog thiab qaug zog.
Qhov laj thawj tseem ceeb ntawm pathology
Yam uas provoke perforated otitis tej zaum yuav muaj raws li nram no:
- mob rhiab heev uas cov paug tawm hauv pob ntseg, uas cuam tshuam rau pob ntseg, ua rau nyias nyias.
- khoom txawv teb chaws uas muaj kev puas tsuaj.
- kis kab mob los ntawm cov kab mob nyob ze: los ntawm oropharynx, maxillary sinuses, qhov ntswg thiab lwm yam.
- Kev ua tsis raug ntawm kev kho mob tsis raug.
- Kev raug mob ntawm pob txha taub hau.
- Kev kis cov ntshav ntws los ntawm tus mob khaub thuas, kub taub hau thiab lwm yam.
Tam sim no cia peb kawm seb cov tsev kho mob niaj hnub ua li cas thiaj kuaj tau tus kab mob no.
Kev kuaj kab mob
Kev kuaj mob ntawm perforated otitis yog ua los ntawm kev siv otoscopy, uas yog ua los ntawm tus kws kho mob tshwj xeeb. Nws yog cov txheej txheem yooj yim uas tsis muaj mob uas cov yas lossis hlau funnel tau muab tso rau hauv cov kwj deg sab nraud, thiab lub auricle raug rub los ua kom cov kwj deg thiab lub pob ntseg raug kuaj pom.
Tearing nws feem ntau tshwm sim nyob rau hauv qis qis. Yog muaj, tus kws kho mob yuav sivrau bacteriological tsom xam, ib tug me me npaum li cas ntawm cov kua los txiav txim lub hauv paus chiv keeb ntawm cov kab mob thiab kev xaiv ntawm antibacterial kev kho mob. Qhov loj ntawm qhov perforation, qhov loj dua tus neeg mob qhov kev hnov lus tsis zoo.
Tam sim no cia peb kawm seb cov cim qhia pom tus kab mob no hauv lub cev.
Symptomatics
Perforative otitis yog tus yam ntxwv los ntawm:
- Sudden pib muaj mob nrog lub cev kub nce mus rau peb caug- cuaj degrees.
- Mob pob ntseg uas tawg mus rau lub tuam tsev thiab cov hniav, feem ntau yog ntawm qhov cuam tshuam.
- hnov tsis hnov thiab suab nrov.
- Kev qaug zog thiab qaug zog.
Muaj cov kab mob hnyav dua.
Purulent otitis media thiab nws cov tsos mob
Purulent perforative otitis yog yam ntxwv los ntawm:
- Ntxub thiab mob hnyav heev.
- Nyob los yog tsis hnov lus ntawm sab cuam tshuam.
- tawm cov kua paug nrog cov ntxhiab tsw ntxhiab sib xyaw nrog cov ntshav los ntawm thaj chaw pob ntseg.
- Ringing, suab nrov thiab tsis xis nyob.
- kiv taub hau thiab xeev siab.
- Tshuaj mob los ntawm qhov tso kua dej tawm ntawm pob ntseg.
Qhov tawm ntawm huab cua los ntawm lub cev qhia txog kev tawg ntawm daim nyias nyias. Tom qab nws perforation, nrog kev ua tiav ntawm cov kua los ntawm lub pob ntseg nruab nrab, maj mam rov kho dua ntawm kev hnov mob rhiab heev tshwm sim. Ib qho me me ntawm tus mob suppurative perforated otitis media tuaj yeem kho ntawm nws tus kheej. Hauv lwm qhov xwm txheej, nws yog ib qho tsim nyog yuav tsum tau kho, saib xyuas qhov kev hloov pauv degenerative hauv qhov cuam tshuampob ntseg.
Acute otitis media
Ntawm no yog kab mob sib kis ceev heev ntawm pob ntseg. Daim duab kho mob ntawm tus kab mob muaj xws li muaj cov tsos mob tshwm sim nrog rau kev hnov mob congestion thiab suab nrov, hnov lus tsis hnov lus, qhov pom ntawm lub qhov hauv daim nyias nyias nrog ntxiv suppuration.
Raws li ib feem ntawm kev kuaj mob ntawm tus mob perforated otitis media, otoscopy thiab kuaj ntshav yog siv. X-ray ntawm lub pob txha taub hau thiab kev kuaj xyuas ntawm lub raj auditory yuav ua tau.
Kev kho mob dav dav yog ua nrog tshuaj tua kab mob, tshuaj tiv thaiv kab mob thiab tshuaj tiv thaiv kab mob. Raws li kev kho hauv zos, nws muaj nyob rau hauv tshuab raj lub suab, thiab, ntxiv rau, instillation ntawm tee, kev taw qhia ntawm proteolytic enzymes, thiab hais txog.
Nyob rau me nyuam
Ntau zaus cov menyuam yaus hnub nyoog qis dua peb xyoos raug kev txom nyem los ntawm kev mob otitis media, qhov no tau txhawb nqa los ntawm lawv cov yam ntxwv anatomical. Nyob rau hauv cov me nyuam mos, lub auditory raj yog luv luv thiab ntau kab rov tav dua li cov laus. Lawv tympanic kab noj hniav yog sau nrog ib tug peculiar connective cov ntaub so ntswg, uas predisposes rau txoj kev loj hlob ntawm o nyob rau hauv cheeb tsam no.
Cov menyuam yaus muaj kev tiv thaiv tsawg dua rau kev kis kab mob, ntxiv rau, lawv muaj lub cev tsis muaj zog. Cov kab mob xws li adenoids, mob tonsillitis thiab adenoiditis tsuas yog ua rau muaj kev rov tshwm sim ntau zaus thiab tshwm sim ntawm otitis media.
Nws yog ib qho tseem ceeb heev uas yuav tsum muaj sij hawm los saib xyuas cov tsos mob ntawm tus kab mob. Thaum tus me nyuam tseem tsis tau muaj ob xyoos, nws yuav pib qhia qhov mobnyob tsis tswm, tsis kam noj mov thiab quaj. Raws li ib feem ntawm lub siab ntawm pob ntseg tragus, lub suab quaj ntawm cov crumbs yuav hnyav zuj zus, uas yuav tsuas paub qhov kev kuaj mob.
Thaum lees paub tus kab mob no hauv tus menyuam, tsis muaj qhov yuav tsum tau tso dej nkag mus rau hauv pob ntseg. Qhov no tuaj yeem ua rau muaj teeb meem ntau yam, uas yog fraught nrog tsis hnov lus tag. Tam sim no cia saib cov kev kho mob.
Kev kho mob
Kev kho mob xws li perforated otitis media yuav tsum tau nqa tawm hauv tsev kho mob los ntawm kws kho mob otolaryngologist thiab tej zaum yuav suav nrog:
- Kev siv thaj chaw tshwj xeeb rau daim nyias nyias, uas pab kho nws txoj kev ncaj ncees.
- Kev kho pob ntseg nrog tshuaj loog hauv zos thiab tshuaj tua kab mob (peb tab tom tham txog Anauran, Otofe).
- Kho nrog tshuaj tiv thaiv ("Tavegil", "Cetrin", "Loratadine").
- Siv cov vasoconstrictor tee uas ua rau lub qhov ntswg ua pa thiab txhawb kom cov kua dej tawm hauv pob ntseg zoo dua (piv txwv li, Otrivin lossis Naphthyzin).
- Txoj kev kho cov tshuaj tua kab mob (tshwj xeeb tom qab kws kho mob kuaj mob).
- Tswv dej ib nrab cawv rau pob ntseg.
- Kev cuam tshuam kev phais yuav tsim nyog yog tias muaj qhov perforations loj lossis vim qhov tsis ua tiav ntawm txoj kev kho mob yav dhau los.
Kev kho mob ntawm perforated otitis media yog siv cov pob txha thaj ua rau thaj chaw perforation. Ib daim tawv nqaij yog muab los ntawm thaj chaw saum pob ntseg, ces nws yog sutured nrog absorbable nyias cov ntaub ntawv nroglub perimeter ntawm rupture ntawm daim nyias nyias. Tom qab ntawd, qhov chaw hloov pauv tau ntseeg tau siv cov hauv paus, thiab hnov, tig, yuav rov qab los.
Yog tias koj muaj cov tsos mob ntawm tus mob hnyav lossis perforated otitis media, koj yuav tsum hu rau tus kws kho mob otolaryngologist tam sim.
Kev Tiv Thaiv
Cov kev ntsuas no ua lub luag haujlwm tseem ceeb, tshwj xeeb tshaj yog rau cov menyuam yaus, txij li tus kab mob no, hmoov tsis zoo, nws yuav rov qab los. Yog li, koj xav tau:
- kho kom raug thiab sijhawm kho txhua yam kab mob nrog rau cov kab mob ntawm caj pas, pob ntseg thiab qhov ntswg.
- Tsis txhob siv cov khoom ntse los ntxuav koj lub pob ntseg.
- Tsis txhob tso suab nrov dhau lawm.
- xav tau kev txhawb nqa kev tiv thaiv.
- Nws yog ib qho tseem ceeb qhia koj tus menyuam kom txham thiab tshuab ntswg.
- Koj yuav tsum tiv thaiv lub ntsej muag sab nraud los ntawm qhov cuam tshuam ntawm lub suab nrov, piv txwv li, hnav lub pob ntseg tiv thaiv hauv lub dav hlau, nqus lub lollipop thaum tawm mus, thiab lwm yam.
txheej txheem mob ntawm pob ntseg nruab nrab yuav xav tau txoj hauv kev kom raug, thiab tib lub sijhawm, kho tam sim. Tus mob no tsis ua rau muaj kev hem thawj rau tus neeg mob lub neej, tab sis nws yog ib qho tseem ceeb uas yuav tsum ua raws li tag nrho cov kev tiv thaiv kom tsis txhob muaj qhov tshwm sim ntawm tus kab mob rov qab thiab muaj teeb meem ntawm tus kab mob.
