Tonsils lossis tonsils (lat. tonsillae) yog cov pob txha hauv lub pharynx ntawm thaj chaw ntawm cov ntaub so ntswg ntawm tus ciam teb ntawm qhov ntswg kab noj hniav thiab qhov ncauj. Lawv tsim lub nplhaib lymphoid (Waldeyer-Pirogov) thiab yog lub hauv paus txuas ntawm kev tiv thaiv. Thaum ua pa, lub nplhaib no dhau los ua thawj qhov cuam tshuam rau microbes, neutralizing lawv. Tsis tas li ntawd, cov tonsils tsim cov macrophages thiab lymphocytes - tiv thaiv lub cev tiv thaiv kab mob.
Lub nplhaib lymphoid no kuj muaj cov palatine tonsils, uas yog hu ua tonsillitis. Yog tias qhov mob no rov qab ntau dua 3 zaug hauv lub xyoo, cov txheej txheem yuav mob ntev.
Hauv tshuaj, purulent tonsillitis yog follicular lossis lacunar tonsillitis, nyob rau hauv uas ib zaj duab xis tshwm rau ntawm lacunae. Pirogov lub nplhaib tsuas muaj 6 tonsils: pharyngeal, lingual, ib khub tubal thiab palatine. Nws yog tag nrho tsim tsuas yog nyob rau hauv 5 xyoo. Hais txog qhov no yog qhov ntawdangina tsis kuaj pom hauv cov menyuam mos.
qauv ntawm tonsils
Lawv muaj cov kab mob mesh txuas cov ntaub so ntswg, uas yog permeated los ntawm ducts (lacunae). Nyob rau hauv txhua lub caj pas, muaj txog 20 xws li lacunae. Cov follicles qhib hauv lacunae, uas koom nrog kev puas tsuaj ntawm cov kab mob pathogenic. Follicles yog sau los ntawm lymphocytes. Cov tonsils muaj ntau cov hlab ntsha, yog li thaum lawv ua mob, caj pas mob.
Ua rau mob
Kab mob tuaj yeem yog:
- external - tiv tauj nrog cov neeg mob lossis tsev neeg, kev noj zaub mov noj ntawm tus kab mob;
- pib kis kab mob - cuam tshuam nrog kev poob qis hauv kev tiv thaiv, thaum cov kab mob kis tau zoo uas ib txwm muaj thiab txhua qhov chaw sawv thiab pib qhib, sib faib thiab tso cov co toxins.
Ua kom muaj qhov tshwm sim feem ntau muaj xws li hypothermia, soaked ko taw, SARS thiab lwm yam mob hauv lub nasopharynx, carious hniav, sinusitis, ua luam dej hauv dej txias, overheating tom qab haus dej txias, noj ice cream ntau, cua qhuav heev., huab cua ntub dej, cua ntsawj ntshab.
Tsis tsaug zog, ua haujlwm dhau, haus luam yeeb, kab mob ntev, hypovitaminosis tuaj yeem ua rau lub cev tsis muaj zog.
Hauv 90% ntawm cov neeg mob, lub ntsiab culprit ntawm angina hnub no yog beta-hemolytic pawg A streptococcus (GABHS). Tom qab ntawd los Staphylococcus aureus, pneumococci, rinaviruses, adenoviruses, fungi, chlamydia, thiab lwm yam.
Angina feem ntau tshwm sim nyob rau lub caij off-season - nyob rau lub caij nplooj ntoos hlav thiab lub caij nplooj zeeg. Me nyuam mobntau zaus thiab nyuaj.
mob tonsillitis
Yog tias mob tonsillitis tsis tau kho kom raug thiab ua tiav, ces cov txheej txheem yuav mob ntev. Nyob rau tib lub sijhawm, cov tonsils tau mob tas li, ntsaws nrog cov kua qaub tuaj yeem khaws cia hauv lacunae. Cov kab mob ib txwm muaj nyob ntawm no thiab tseem txo qis kev tiv thaiv kab mob. Tonsillitis dhau los ua "kev tswj tsis tau" qhov chaw ntawm tus kab mob, tas li exacerbating. Ntxiv mus, exacerbations ntawm tonsillitis ntev yog feem ntau purulent. Feem ntau, kom tsis txhob muaj kev cuam tshuam tsis zoo, cov tonsils yuav tsum tau muab tshem tawm.
Symptomatic manifestations
Purulent tonsillitis pib nrog mob caj pas, tom qab ntawd mob hnyav thaum nqos, ua npaws thiab ua daus no. Qhov kub nce mus txog 39 degrees thiab siab dua. Muaj lymphadenitis ntawm mandibular nodes nrog kev qaug cawv nrog mob taub hau, myalgia, tsis qab los noj mov, tsis muaj zog thiab malaise. Nyob rau hauv lub pharynx, o liab tonsils thiab cov tsos ntawm purulent plugs yog pom, uas yuav raug tshem tawm nrog siab. Nrog cov kua qaub los ntawm lub qhov ncauj, muaj cov ntxhiab tsw tsw, hnoos. Rhinitis, otitis feem ntau tuaj yeem tshwm sim.
Qhov tseem ceeb! Cov kab mob purulent tonsillitis tseem kis tau los ntawm thawj hnub thiab thaum muaj cov txheej txheem purulent hauv cov tonsils. Yog ib tug neeg mob caj pas ntawm nws ob txhais ceg, nws dhau los ua tus neeg nqa khoom.
Kev tshwm sim hauv cov neeg laus thiab menyuam yaus
Hauv cov neeg laus, tonsillitis tshwm sim yam tsis muaj kub taub hau, txawm tias muaj cov kab mob purulent. Lwm cov tsos mob: o thiab liab ntawm tonsils, mob caj pas.
Cov xwm txheej zoo li no hauv xyoo tas los notau ua ntau zaus. Qhov no feem ntau qhia txog kev tiv thaiv kab mob tsis muaj zog, uas tsis tuaj yeem tawm tsam tus kab mob. Cov kab mob tsuas tuaj yeem tuag ntawm qhov kub thiab txias. Tsis tas li ntawd, xws li cov kab mob tonsillitis tuaj yeem nrog: kab mob autoimmune, plawv tsis ua haujlwm, rog rog, nquag siv tshuaj tua kab mob, vasoconstrictors, thiab qaug zog ntawm lub cev.
Kev kho tus mob purulent tonsillitis hauv cov neeg laus uas tsis ua npaws kuj ua nrog tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob.
Hauv cov menyuam yaus, qhov peculiarity ntawm purulent tonsillitis yog qhov muaj peev xwm pib txheej txheem, piv txwv li, nrog otitis media, nrog qaug dab peg hauv cov menyuam mos, hypersalivation, ntuav, raws plab thiab mob plab. Cov menyuam yaus hnub nyoog qis dua 3 xyoos raug mus pw hauv tsev kho mob.
ntsuas ntsuas
Lub caj pas tau tshuaj xyuas nrog lub pharyngoscope, ib daim duab ntawm cov txheej txheem mob ntev tau tshwm sim. Ib qho smear ntawm Leffler yuav tsum tau txiav tawm kab mob diphtheria. Hauv kev kuaj ntshav, kuaj pom leukocytosis thiab nrawm ESR. Nws yog ib qho tsim nyog yuav tau siv lub swab los ntawm lub pharynx rau kab lis kev cai thiab kev txheeb xyuas cov kab mob, nrog rau kev txiav txim siab nws qhov kev nkag siab zoo rau cov tshuaj tua kab mob. Qhov no yuav siv sij hawm tsawg kawg yog 4 hnub. Yog li ntawd, thaum mus ntsib kws kho mob, nws xaiv cov tshuaj tua kab mob empirically, raws li nws qhov kev paub.
Cov teeb meem thiab qhov tshwm sim ntawm purulent chronic tonsillitis
Tus kab mob tonsillitis nws tus kheej twb yog ib qho teeb meem ntawm tus txheej txheem mob vim yog kev kho tsis raug lossis cov niam txiv pib xyaum ua. Qhov tshwm sim tsis zoo tshaj plaws ntawm cov kab mob purulent tonsillitis yog cov txheej txheem rheumatic nrog kev puas tsuaj rau pob qij txha, lub plawv thiablub raum.
Thaum tus kab mob streptococci nkag mus rau hauv lub plawv li qub, lawv ua rau lub plawv tsis xws luag, kis kab mob myocarditis, thiab lwm yam tuaj yeem txhim kho, lub raum ntsiag to thaum xub thawj, thiab tom qab ntawd kuaj pom cov txheej txheem mob ntev hauv lawv.
Cov teeb meem ntawm angina kuj suav nrog:
- collagenoses zoo li lub cev lupus erythematosus;
- vascular pathologies zoo li Raynaud tus kab mob;
- Ménière's syndrome (pathology ntawm pob ntseg sab hauv);
- retropharyngeal abscess;
- otitis media;
- laryngitis;
- sinusitis;
- pharyngitis;
- bronchitis;
- paj hlwb puas;
- septicemia (tsis tshua muaj tab sis tuag taus).
Txoj Cai Kho Mob
Kev kho mob ntawm cov kab mob purulent tonsillitis yuav tsum ua kom tiav thiab ua tiav hauv chav kawm tag nrho yam tsis muaj kev cuam tshuam. Kev kho cov kab mob tua kab mob yog qhov yuav tsum tau ua, muab tshuaj tsawg kawg 10 hnub.
Nws pab kom tsis txhob muaj teeb meem thiab ua kom rov zoo dua.
Txoj cai ntawm kev kho tshuaj tua kab mob
Tshuaj tua kab mob rau cov kab mob purulent tonsillitis tsuas yog yuav tsum tau muab thiab noj ua ntu zus. Kev txais tos yuav tsum tau saib xyuas tas li, txawm tias muaj kev txhim kho kho mob. Cov tshuaj tua kab mob tsis raug sau tseg rau kev tiv thaiv; lawv tsis muaj txiaj ntsig rau cov kab mob. Yog tias muaj mob hnyav heev, tus neeg mob yuav mus pw hauv tsev kho mob.
Txhua tus neeg mob raug kho tom tsev. Kev txiav txim siab noj cov tshuaj tua kab mob rau kev kho mob ntawm cov kab mob purulent tonsillitis yog ua los ntawm tus kws kho mob.
Txiv neej ib leeg ua tauxaiv cov koob tshuaj tsis txaus lossis cov tshuaj tua kab mob tsis raug, uas yuav ua rau muaj kev kis kab mob dav dav.
Cov Lus Qhia dav dav
Cov kev cai dav dav suav nrog cov haujlwm hauv qab no:
- Ua raws li lub txaj so rau ib lub lim tiam.
- Haus dej sov kom ntau los ntxuav thiab tshem tawm cov co toxins.
- Nyob tsuas yog thaum sov.
- Koj tsis tuaj yeem nyem tawm purulent plugs koj tus kheej, lawv yuav tawg thaum kho lawv tus kheej. Vim li cas koj yuav tsum tsis txhob nyem cov ntsaws rau koj tus kheej: koj tuaj yeem ua rau cov yeeb yaj kiab tiv thaiv ntawm lacunae, thiab tus kab mob tuaj yeem nkag mus rau hauv cov hlab ntsha yooj yim.
- Tsis txhob muab tshuaj loog ntawm qhov kub qis dua 38.5 degrees.
Tshuaj tua kab mob hauv kev kho mob purulent tonsillitis tau muab faib ua cov tshuaj ntawm kab thib 1 thiab thib 2. GABHS rhiab heev rau penicillins cephalosporins.
thawj kab
Cov no yog tshuaj penicillin. Lawv muaj txiaj ntsig zoo uas lawv kho mob caj pas thiab tiv thaiv kev txhim kho ntawm cov teeb meem hauv daim ntawv ntawm rheumatism.
Tab sis tam sim no cov tshuaj penicillins ntuj tau ploj mus rau hauv keeb kwm yav dhau, cov tshuaj penicillins siv ntau zaus. Cov no suav nrog Ampicillin, Oxacillin, Ampiox.
Inhibitor-tiv thaiv penicillins coj txoj hauv kev. Lawv muaj clavulanic acid thiab nyob twj ywm tiv taus microbial enzymes. Cov nyiaj no suav nrog: "Klavunat", "Sulbaktam", "Augmentin", "Amoxiclav", thiab lwm yam.
kab thib ob
Cov no yog macrolides ("Azithromycin", "Sumamed", thiab lwm yam) thiab cephalosporins 2, 3, 4tiam ("Cefalexin", "Ceftriaxone", "Cefamisin", thiab lwm yam).
Macrolides tau noj 5 hnub, tab sis lawv cov concentration hauv cov ntshav kav ntev li 10 hnub.
Tshuaj tua kab mob tsis tso tseg txawm tias koj hnov zoo dua. Thiab ib qho ntxiv: qhov ua tau zoo ntawm cov tshuaj tua kab mob hauv kev kho mob purulent tonsillitis raug soj ntsuam tom qab 3 hnub: yog tias qhov kub thiab txias, cov tshuaj tua kab mob hloov pauv.
Yog li ntawd, thawj 3 hnub kws kho mob yuav tsum mus ntsib tus neeg mob txhua hnub. Qhov no yog qhov tseeb tshwj xeeb hauv kev kho mob purulent tonsillitis hauv cov menyuam yaus.
kho mob
Yog li, kev kho mob muaj xws li noj cov tshuaj hauv qab no:
- Y Antipyretics - Nurofen, Ibuklin, Paracetamol, Panadol.
- Kev kho mob hauv zos ntawm tonsils: dej, lubrication ntawm cov tonsils, daim ntawv thov aerosol, yaug, resorption hauv lub qhov ncauj ntawm cov ntsiav tshuaj tshwj xeeb, lozenges, lozenges - tshuaj tua kab mob yog siv. Kev kho mob tsis hloov lossis txwv tsis pub siv tshuaj tua kab mob.
- Kev yaug thiab dej. Lawv txo qhov mob thiab mob hauv zos. Rau gargling tau sau tseg: infusions thiab decoctions ntawm tshuaj ntsuab (calendula, chamomile, thiab lwm yam), ethacridine lactate 0.1%, boric acid daws 1%, "Gramicidin", "Chlorhexidine", "Furacilin". Gargle txhua 4 teev.
- Rau dej: feem ntau hauv kev kho mob purulent tonsillitis hauv cov neeg laus, Furacilin, Iodinol, Chlorophyllipt, Miramistin, Camphomen yog siv,"Ingalipt", "Yoks", "Kameton", "Tantumverde thiab lwm tus"
- Kev nqus pa. Rau lub hom phiaj no, Bioparox tau siv rau ntau tshaj 55 xyoo. Qhov no yog tshuaj tua kab mob uas muaj fusafungin. Nws qhov zoo dua yog tias nws tsis nkag mus rau hauv cov ntshav thiab muaj kev cuam tshuam rau cov kab mob hauv zos. Tab sis tam sim no, Bioparox raug txwv nyob rau hauv Russia, liam tias yog vim muaj kev phiv ntawm cov tshuaj tua kab mob.
- Ib qho ntawm cov tshuaj uas tsis yog tshuaj kho mob purulent tonsillitis yog daim ntawv thov compresses rau hauv caj pas. Thaum cov ntsaws ruaj ruaj tseem nyob, nqus pa thiab compresses tsis siv.
- Cov ntsiav tshuaj Lossable - "Falimint", "Strepsils", "Pharingosept", "Septolete", "Gexor altabs" thiab lwm yam.
- Antihistamines. Yuav kom desensitize lub cev nyob rau hauv hnyav tonsillitis, Tavegil, Diazolin, Claritin, thiab lwm yam.
- Nco ntsoov haus dej sov - tshuaj ntsuab tshuaj ntsuab (chamomile, rosehip, sage, oregano), rhuab tseem ntxhia dej, compotes, txiv hmab txiv ntoo haus.
- Nws yog qhov yuav tsum tau ua hauv kev kho mob purulent tonsillitis los sau cov vitamins thiab cov tshuaj tiv thaiv kab mob, tshwj xeeb tshaj yog rau cov menyuam yaus uas nquag nquag - "IRS-19", "Immunal", "Ribomunil", thiab lwm yam.
- Thaum kawg ntawm cov tshuaj tua kab mob, probiotics tau muab tshuaj los kho cov hnyuv microflora: Linex, Bifidumbacterin, Lactobacterin.
- Nyob rau hauv kev kho mob ntawm purulent tonsillitis, physiotherapy thiab rinsing yog ua tau tom qabkub normalization. Ntau zaus tshaj li lwm tus, UHF, electrophoresis, laser, UVI, tube-quartz, ozocerite ntawm cov qog ntshav, aerosols nrog ultrasound siv lysozyme, hydrocortisone, 10 zaug yog siv.
Yuav ua li cas tshem plugs
Kev kho mob tonsillitis ntev nrog cov purulent plugs yuav tsum tsuas yog ua los ntawm kws kho mob. Siv phau ntawv ntxuav thiab ib lub cuab yeej tshwj xeeb. Nrog rau phau ntawv qhia, ib qho kev daws teeb meem yog nkag mus rau hauv lacunae: "Miramistin", "Furacilin", "Iodinol". Cov chav kawm yog 7-10 cov txheej txheem, kev txhim kho tau sau tseg tom qab 2-3 zaug.
Kev kho mob tonsillitis nrog cov ntsaws purulent kuj txhais tau tias tshem tawm cov ntsaws los ntawm lub tshuab nqus tsev tawm cov kua paug ntawm Tonsilor apparatus.
Tom qab ntawd, cov tonsils tau ntxuav nrog tshuaj tua kab mob thiab irradiated nrog tsawg zaus ultrasound. Hoob - 8 cov txheej txheem.
Kev tshem tawm
Yuav tsum muaj ib lub hlis tsis muaj exacerbations rau kev ua haujlwm.
Indications rau tonsillectomy:
- kev txhim kho ntawm cov teeb meem;
- zaus ntawm angina ntau dua 7 zaug hauv ib xyoos;
- tsis ua tiav ntawm kev saib xyuas kev noj qab haus huv;
- decompensated chronic tonsillitis, thaum nws dhau los ua qhov kis kab mob, thiab lwm yam.
Kev tshem tawm cov tonsils tsis tau lees tias yuav tsis muaj mob caj pas ntxiv (nco ntsoov lub nplhaib lymphoid).
Kev tshem tawm:
- ultrasonic tonsil tshem tawm;
- electrocoagulation - cauterization ntawm tonsils nrog hluav taws xob tam sim no;
- radiofrequency ablation (coblation);
- excision nrog hlau voj thiab txiab -cov txheej txheem ntau tshaj.
Lwm txoj hauv kev yog ablation. Qhov no yog qhov tsis lees txais cov ntaub so ntswg los ntawm hluav taws xob (cov tonsils tsis raug tshem tawm tag nrho). Ablation yog laser thiab xov tooj cua yoj. Manipulation siv sijhawm ib nrab teev xwb.
Tshuaj loog rau tonsillectomy yog hauv zos, tsis tshua muaj dav. Lub sijhawm ua haujlwm yog 1.5 teev. Tom qab phais txaj so - 3 hnub.
Tus neeg mob yuav tsum pw ntawm lawv sab, nrog lub hauv ncoo qis kom tsis txhob muaj cov hnoos qeev thiab cov ntshav los ntawm qhov txhab los ntawm qhov txhab nkag mus rau hauv lub ntsws. Haus dej yog tso cai tom qab 6-8 teev. Noj - tsuas yog tom qab ib hnub, zaub mov yuav tsum sov thiab mos.
kev kho neeg zoo
Kev kho mob purulent tonsillitis hauv tsev yog qhov ua tau zoo raws li txhua tus kws kho mob cov lus pom zoo.
Yuav kom mos caj pas, cov mis nyuj sov nrog dej qab zib thiab butter tuaj yeem pom zoo.
Lwm cov zaub mov:
- Sawv ntxov yaug - ntxiv 1 tbsp rau 200 ml dej. l. txiv apple cider vinegar.
- Nws kuj yog qhov zoo rau gargle nrog cov kua txiv hmab txiv ntoo tshiab, dej qab zib tov nrog ntsev thiab iodine. Haus dej tsawg kawg yog 3-4 zaug hauv ib hnub.
- Tshuaj tua kab mob - dos thiab qej. Lawv yuav tsum tau crushed, squeezed kua txiv tov nrog zib mu. Koj tuaj yeem sib tov birch buds thiab kua cider vinegar nrog zib mu.
- YHerbal teas - linden nrog zib mu, thyme, cranberries. Nrog rau qhov mob hnyav heev, nws yog qhov zoo dua los haus dej sov txog li 2 litres ib hnub.
- Tonsils tuaj yeem lubricated nrog fir roj, nws muaj cov kab mob bactericidal. Tsis tas li ntawd, fir roj tuaj yeem muab ntxiv rau kev daws rau gargling. Nyob rau hauv rooj plaub ntawm kev tso cai ntawm tus kws kho mob tuaj koom, fir yog thawj zaug npajdej - 200 ml ntawm dej sov 1 tsp. zib mu + 2 tee roj. Cov tshuaj yog siv rau yaug - 3-4 zaug ib hnub twg.
ntsuas kev tiv thaiv
Qhov tseem ceeb tshaj plaws hauv kev tawm tsam mob caj pas yog ua kom lub cev tawv thiab ntxiv dag zog rau lub cev. Qhov no yuav tau yooj yim los ntawm kev noj zaub mov zoo, kev noj cov vitamins, pw tsaug zog zoo thiab so. Tsis tas li ntawd, nws yog ib qho tsim nyog los kho cov kab mob foci ntev ntawm cov kab mob hauv daim ntawv ntawm caries, sinusitis thiab sinusitis, o ntawm lub ntsws sab sauv. Tsis txhob haus dej khov los ntawm lub tub yees thaum kub dhau, yuav tsum zam kom tsis txhob muaj kev kub ntxhov.
