Siv lub tympanic membrane, pob ntseg muab faib rau hauv nruab nrab thiab sab nraud. Nws yog ib daim nyias nyias uas impermeable rau huab cua thiab kua, txoj kab uas hla yog kwv yees li 1 cm, thiab lub thickness yog hais txog 0.1 hli. Nws lub luag haujlwm tseem ceeb yog xa cov suab nthwv dej mus rau pob ntseg sab hauv, thaum nws lub luag haujlwm pabcuam yog los tiv thaiv kev hnov lus los ntawm kev nkag mus ntawm lub cev txawv teb chaws. Nyob rau hauv thaum yau, daim nyias nyias muaj cov duab ntawm lub voj voog ib txwm, nyob rau hauv ib tug neeg laus - ib tug ellipse. Kev mob ntawm lub tympanic membrane yog ib qho mob hnyav heev, uas, thaum tsis muaj kev kho mob txaus thiab raws sijhawm, tuaj yeem ua rau tsis hnov lus tiav.
Kev piav qhia ntawm pathology
Ntau tus neeg xav paub tias lub pob ntseg pob ntseg yog lub npe hu li cas. Qhov no yog miringitis. Nws yog cov txheej txheem inflammatory uas cuam tshuam rau cov ntaub so ntswg ntawm daim nyias nyias thiab, raws li txoj cai, yog nrog los ntawm cov kab mob provoked los ntawm cov kab mob uas tau nkag mus rau inflammatory tsom xam los ntawm cov hlab ntsha los yog nyob ib sab.fabrics.
Lub tshuab rau kev txhim kho ntawm qhov mob ntawm pob ntseg yog ib txwm ua qauv. Nyob rau theem pib ntawm kev puas tsuaj, lub cev tsim cov cytokines - cov protein sib txuas tshwj xeeb uas ua rau lub cev tsis muaj zog rau cov khoom puas. Raws li kev cuam tshuam ntawm cytokines, cov hlab ntsha nyob hauv lub pob ntseg nthuav dav. Los ntawm lawv cov phab ntsa, ntshav plasma nrog ib tus neeg zoo li lub hlwb nkag mus rau cov ntaub so ntswg. Yog li ntawd, hyperemia thiab o ntawm daim nyias nyias tshwm sim.
Kev txhim kho ntawm cov txheej txheem inflammatory yog nrog los ntawm qhov mob hauv pob ntseg, tsis xis nyob, zoo li lub suab nrov, qee zaum - hnov lus, kub taub hau. Thaum tus kab mob kis mus rau hauv lub hemorrhagic los yog nyob rau hauv lub sij hawm ntev, vesicles muaj cov kua paug thiab cov ntshav, bursting nrog tso tawm ntawm exudate.
Vim li cas pob ntseg pob ntseg tshwm sim?
Vim txoj kev loj hlob
Morphologically, daim nyias nyias yog ib feem ntawm cov kab noj hniav thiab cov kwj dej sab nraud. Ntawm ib sab tes, qhov chaw ntawm lub tympanic membrane yog them nrog epidermis, ntawm qhov tod tes, nws yog ib qho txuas ntxiv ntawm cov mucous hauv ob sab phlu tympanic kab noj hniav. Vim yog cov qauv no, myringitis raws li kev ywj pheej pathology yog qhov tsawg heev. Raws li txoj cai, daim nyias nyias yuav o vim lub fact tias cov txheej txheem pathological los ntawm cov kab mob nyob ib sab kis mus rau nws. Xws li cov txheej txheem pathological tuaj yeem yog:
- Kab mob, kis kab mob (tonsillitis, mob khaub thuas).
- Tshuaj khaub thuaskab mob.
- Kab mob ntawm pob ntseg nruab nrab lossis sab nraud.
Raws li tus kab mob ywj pheej, miringitis feem ntau tshwm sim nrog lub suab, thermal, tshuaj lom neeg, kev puas tsuaj rau daim nyias nyias. Myringitis tshwm sim los ntawm kev raug mob feem ntau tshwm sim hauv cov menyuam yaus, vim cov menyuam mos muab ntau yam khoom me me rau hauv pob ntseg.
Ntau yam uas ua rau tus kab mob no yog beriberi, noj tsis txaus thiab noj zaub mov tsis zoo, txo kev tiv thaiv.
Kev faib tawm
Cov kws tshaj lij txheeb xyuas peb hom kev mob pob ntseg:
- mob catarrhal. Nws feem ntau tsim los ntawm kev raug mob. Nws yog tus cwj pwm los ntawm cov tsos mob uas nce nrawm, tab sis qhov tshwm sim me me kuj yuav muaj. Kev kho raws sij hawm tso cai rau koj tshem tawm tus kab mob tag nrho.
- Ntawm. Nws yog hom kab mob feem ntau ntawm pathology. Raws li txoj cai, nws tshwm sim ua ke nrog lwm yam kab mob ENT. Cov cim tshwj xeeb tshaj plaws yog tsim ntawm bullae (vesicles) ntawm daim nyias nyias, uas muaj cov kua paug. Daim ntawv mob ntev ntawm miringin yog nquag rov qab los txawm tias tom qab kho tag nrho.
- Bullous (hemorrhagic). Nws yog ib qho teeb meem ntawm lwm yam kab mob, qee zaum nws yog qhov tshwm sim ntawm tus mob khaub thuas. Lub ntsiab qhov txawv ntawm hemorrhagic miringitis yog qhov tshwm sim ntawm bullae uas muaj cov ntshav exudate.
Dab tsi yog cov tsos mob tseem ceeb ntawm kev mob pob ntseg? Xav paub ntau ntxiv tom qab.
Symptomatics
Symptomatology ntawm miringitis nyob ntawm qhov xwm ntawm chav kawm thiab daim ntawv ntawm pathology. Nyob rau hauv thawj theem ntawm kev loj hlob ntawm tus kab mob, cov tsos mob yog me me. Nrog rau txoj kev loj hlob ntawm tus kab mob - hloov mus rau hemorrhagic, mob ntev, mob - lawv tshwm sim lawv tus kheej kom meej meej.
Nyob rau hauv mob myringitis, tus neeg mob muaj cov tsos mob hauv qab no:
- mob taub hau ntawm pob ntseg.
- kev tsis txaus siab.
- Ntshav, serous tso tawm (muaj li ntawm 60% ntawm tus neeg mob).
- Ua npaws (raws li txoj cai, nrog mob khaub thuas myringitis). Cov tsos mob no tshwm sim hauv ib nrab ntawm cov neeg mob.
- hnov tsis hnov, tinnitus.
- mob pob ntseg, tsis xis nyob (khaus pob ntseg, hnyav, hnov qhov pom ntawm qhov txawv txav, thiab ntxuav lub pob ntseg tsis tuaj yeem pab tau).
- pob ntseg congestion.
- Sudden mob thaum txham, hnoos.
Qee cov tsos mob tsis zoo ntawm qhov mob ntawm pob ntseg hauv daim duab tuaj yeem pom ntawm qhov muag liab qab.
ntse zoo
Exacerbated chronic and hemorrhagic miringitis yog nrog los ntawm cov tsos mob hauv qab no:
- mob, khaus khaus.
- tsis hnov lus me ntsis.
- Kev cais ntshav, kua paug tawm ntawm pob ntseg, nrog rau qhov pom ntawm tus ntxhiab tsw.
Lub pob ntseg pob ntseg kuaj tau li cas hauv tus menyuam lossis tus neeg laus?
Diagnosis
Lub luag haujlwm tseem ceeb hauv kev kuaj mob miringin yog los ntawm kev kuaj thiab nug tus neeg mob. Ib qho kev xeem tiav suav nrogsiv cov txheej txheem kuaj mob hauv qab no:
- Sau cov anamnesis, nug tus neeg mob. Tus kws kho mob tshwj xeeb tsom rau qhov kev hloov pauv ntawm cov kab mob pathology, ntu ntu, kev loj hlob ntawm tus kab mob, tsis muaj lossis muaj cov tsos mob zoo sib xws hauv lub sijhawm dhau los.
- Otoscopy. Nrog kev pab los ntawm ib tug otoscope, ib tug kws tshwj xeeb tshuaj xyuas nyob rau hauv kom meej lub xeev ntawm daim nyias nyias, tag nrho cov kev hloov pathological uas tau tshwm sim rau nws. Nrog catarrhal myringitis, liab, o ntawm lub pob ntseg tau pom. Qee zaum, me me ntawm serous exudate raug tso tawm. Nyob rau hauv daim ntawv ntawm tus kab mob, muaj ib tug protrusion thiab thickening ntawm daim nyias nyias, tsim ntawm granules nrog purulent txheem. Cov tsos ntawm bullae uas muaj serous-hemorrhagic exudate ua tim khawv rau hemorrhagic myringitis. Yog hais tias lub pathology yog herpetic keeb kwm, lub vesicles yog me me. Flu bullae loj heev.
- Kev tshawb fawb hauv chav kuaj. Lawv tso cai rau koj kom pom qhov nce hauv ESR thiab leukocytosis. Nrog rau tus kab mob etiology ntawm myringitis, 2-4 hnub tom qab pib ntawm pathology, qib ntawm leukocytes txo qis, thiab lymphocytosis tshwm sim. Txhawm rau txiav txim siab hom kab mob, kev tshawb fawb virological lossis bacteriological yog tsim nyog nrog kab lis kev cai ntawm cov smear coj los ntawm cov kwj dej sab nraud.
- Lub suab nrov audiometry. Lub hom phiaj ntawm txoj kev tshawb no yog txhawm rau txiav txim siab qhov tsis hnov lus thiab xaiv kev kho mob tactics. Lub ntsiab lus ntawm txoj kev tshawb no yog tsim cov suab paj nruag ntawm ntau yamkev siv lub cuab yeej tshwj xeeb (audiometer) thiab kev txiav txim siab ntawm lub suab coj los ntawm nruab nrab thiab pob ntseg.
- Differential diagnosis. Nws yog nqa tawm los cais myringitis los ntawm otitis media, otomycosis, thiab lwm yam kab mob otolaryngological. Txhawm rau sib txawv myringitis los ntawm otitis, txoj kev tshuab yog siv. Nws muaj nyob rau hauv qhov tseeb hais tias tus kws kho mob kis tau huab cua mus rau hauv lub tympanic kab noj hniav thiab lub auditory raj los ntawm lub nasopharynx, tom qab uas nws mloog cov txheej txheem los ntawm ib tug acoustic apparatus muaj ob lub raj. Nrog otitis media, Eustachian raj feem ntau raug thaiv. Nrog miringitis, nws tseem kis tau.
Kev kho pob ntseg pob ntseg
Kev kho mob miringitis muaj nyob rau hauv cov tsos mob, pathogenetic, etiotropic kev kho mob. Qee zaum, yuav tsum muaj kev cuam tshuam kev phais. Txoj kev kho mob zoo ib yam rau cov neeg laus thiab menyuam yaus. Qhov txawv tsuas yog thaum kho cov menyuam yaus, siv tshuaj tua kab mob maj mam (yog tias xav tau).
Txhawm rau tshem tawm cov tshuaj tiv thaiv kab mob thiab tshem tawm cov ntshav tawm hauv lub cev, cov tshuaj tua kab mob tau siv: "Chlorhexidine", "Miramistin", "Furacilin", boric acid, thiab lwm yam tshuaj zoo sib xws. Yog hais tias muaj ntau npaum li cas ntawm exudate raug tso tawm, sterile gauze swabs yuav tsum muab tso rau hauv pob ntseg thiab hloov raws sij hawm.
Dab tsi yog siv los kho pob pob ntseg? Antibacterial thiabCov tshuaj tiv thaiv kab mob tau pom zoo siv nyob ntawm ntau yam ntawm cov kab mob, tsim los ntawm kev tshawb fawb virological, bacteriological. Raws li txoj cai, tus neeg mob tau muab tshuaj amantadine derivatives (rau kev puas tsuaj ntawm kab mob), fluoroquinolones, cephalosporins ntawm tiam thib ob thiab thib peb, macrolides.
txhawm rau txhawm rau txhim kho cov txheej txheem, cov tshuaj tsis muaj zog (deelofalasone, diclofenac thiab lwm tus), zoo li glucocorticosteroids yog siv.
Thaum mob miringitis nrog rau kev qaug cawv, kev kho mob detoxification yog nqa tawm nrog infusions ntawm saline, 5% qabzib, qis molecular hnyav plasma hloov pauv.
Yuav kom tshem tawm hyperemia thiab o, nws raug qhia kom siv cov tshuaj tiv thaiv. Txhawm rau tshem tawm cov nti thiab adhesions, biostimulants thiab physiotherapeutic txoj kev tuaj yeem siv. Txhawm rau ntxiv dag zog rau cov kab mob hauv lub pob ntseg, cov kws kho mob otolaryngologist pom zoo kom cov neeg mob siv cov tshuaj vitamin complexes thiab cov tshuaj tiv thaiv kab mob.
kho mob phais
Thaum kev phais, cov bullae raug tho nrog rab koob tshwj xeeb nyias. Ua li no txhawm rau tshem tawm cov ntsiab lus ntawm purulent thiab hemorrhagic vesicles. Tom qab tho tus nyuj, cov exudate raug tshem tawm thiab thaj chaw raug kho nrog cov tshuaj tua kab mob.
mob pob ntseg: khohmoob kev kho mob
Qhov ua tau ntawm kev siv cov tshuaj pej xeem rau kev kho mob miringitis yuav tsum tau tham nrog kws kho mob ENT.
Cov kws kho mob ib txwm tau qhia kom siv cov dos zoo tib yam los tshem tawm miringitis. Ib lub dos yuav tsum tau tev, txiav tawm sab saum toj ntawm nws thiab ua ib qho me me indentation. Nws yog sau nrog cumin noob thiab them nrog ib tug txiav saum. Tom qab ntawd, dos yog ci nyob rau hauv qhov cub kom txog thaum nws ua mos. Tom qab ntawd, cov kua txiv yog squeezed tawm ntawm ci dos thiab siv los instill lub pob ntseg. Nws raug nquahu kom ua cov txheej txheem ob zaug hauv ib hnub.
Yuav Muaj Teeb Meem
Kev kho tsis txaus lossis nws qhov tsis tuaj yeem ua rau muaj kev cuam tshuam loj heev hauv daim ntawv ntawm sepsis lossis lag ntseg tag. Cov teeb meem tseem ceeb yog:
- Mastoiditis.
- Labyrinthite.
- facial paralysis.
- Kev nkag mus rau cov kua paug rau hauv cov hlab ntsha ntawm lub hlwb.
- Perforation, ua tiav kev puas tsuaj ntawm daim nyias nyias.
Huab cua, ntsuas kev tiv thaiv
ntsuas kev tiv thaiv suav nrog:
- Txoj kev tiv thaiv ib txwm muaj: kev kho cov tshuaj vitamin, tawv tawv, kev noj qab haus huv.
- Ua raws li cov lus qhia txog kev nyiam huv ntawm tus kheej.
- Kev zam khaub thuas, hypothermia.
- Kev kho raws sijhawm thiab ua tiav ntawm cov kab mob ntev uas tuaj yeem ua rau muaj kev loj hlob ntawm myringitis.
- Nkauj pob ntseg, zam kev raug mob.
Kev mob rau tus mob myringitis nyob ntawm etiology ntawm tus kab mob thiab qhov txaus ntawm kev kho mob siv. Mob catarrhal thiab hemorrhagic myringitis, raws li txoj cai, yog kho tag nrho. Daim ntawv mob ntev yog tus cwj pwm los ntawm kev hloov pauv ntawm exacerbations thiab remissions.
Peb tau saib cov tsos mob thiab kho pob ntseg pob ntseg.
