Ntawm cov kab mob uas twb muaj lawm ntawm tib neeg lub hnov lus, cov kws kho mob paub qhov txawv ntawm qhov mob suppurative otitis media. Cov kab mob kis tau sai sai los ntawm lub pob ntseg los ntawm lub raj auditory, cuam tshuam rau cov txheej txheem mastoid.
Kho tsis tau mob khaub thuas, kua ntswg, SARS, rhinitis, nkag mus rau hauv pob ntseg ntawm tus kab mob tshwm sim los ntawm cov kab mob pathogenic thiab fungi tuaj yeem ua rau muaj kev ua txhaum cai. Nws yog ib qho tseem ceeb heev uas yuav tsum paub txog tus kab mob raws sij hawm thiab ua tiav kev kho mob, vim tias tus kab mob tuaj yeem ua rau muaj teeb meem ntau yam.
Ntxhais kab mob
Mob suppurative otitis media muaj ICD-10 code H66.0. Cov neeg ua haujlwm kho mob xa mus rau cov kab mob nyuaj thiab txaus ntshai. Pathology tuaj yeem ua mus rau ntau txoj kev sib txawv, thiab kev kho mob raug xaiv nruj me ntsis raws li cov txiaj ntsig ntawm kev kawm.
Qee zaum cov neeg mob tseem tswj tau kom tshem tawm cov kab mob zoo thaum pib ntawm kev loj hlob, qhov tseem ceeb tshaj plaws yogxyuam xim rau qhov teeb meem raws sij hawm. Feem ntau, otitis media yog qhov nyuaj los ntawm qhov tshwm sim ntawm adhesions, uas ua rau tsis hnov lus thiab maj mam tig mus rau hauv daim ntawv mob ntev.
Yeej, cov tsos mob ntawm tus mob suppurative otitis media tau pom hauv cov menyuam yaus hnub nyoog qis dua 3 xyoos. Qee zaum relapses raug kaw, thiab tus kab mob no nyuaj heev. Ib tug feature ntawm daim ntawv purulent ntawm pathology yog ib qho mob tshwm sim thiab ib tug sluggish chav kawm.
theem kab mob
Cov kws kho mob paub qhov txawv peb theem ntawm tus mob suppurative otitis media, uas muaj qee yam tsos mob. Tshwj xeeb, cov theem no yog:
- preperforative;
- perforated;
- reparative.
Thawj ntawm cov no yog suav tias yog thawj daim ntawv ntawm cov kab mob. Nws yog tus cwj pwm los ntawm qhov tsis muaj cov tsos mob, los yog cov cim qhia tsis dhau. Cov tsos mob tseem ceeb yog qhov muaj mob ntawm lub pob ntseg. Tsis tas li ntawd, kev mob kuj tuaj yeem tshwm sim hauv lub tuam tsev, hauv pliaj, uas ua rau muaj kev tsis xis nyob heev.
Lub sijhawm dhau mus, qhov mob hnyav ntawm cov tsos mob nce ntxiv, vim qhov ua kom pom tseeb ntawm qhov mob nthuav dav, thiab nws tsuas yog tsis tuaj yeem tiv taus lawv. Txawm tias cov tshuaj tua kab mob tsis muab cov txiaj ntsig xav tau. Nrog rau qhov mob hnyav heev, lub suab nrov thiab lub suab nrov hauv pob ntseg, tsis tu ncua congestion, uas ntxiv aggravates tus neeg txoj kev noj qab haus huv, ntxiv rau. Tus neeg mob maj mam pib hnov mob zuj zus, thiab qhov no tshwm sim tshwj xeeb tshaj yog tias otitis media nce mus rau keeb kwm ntawm tus mob khaub thuas.
Ntxiv rau tag nrho cov cim no, nws tau sau tsegdeterioration nyob rau hauv kev noj qab nyob zoo, kub nce, lub cev mob. Muaj cov tsos mob ntawm kev qaug cawv, uas yuav tsum tau kho tam sim ntawd, txwv tsis pub muaj teeb meem loj heev tuaj yeem tshwm sim.
Cov theem tom ntej ntawm mob purulent otitis media yog qhov nyuaj dua - perforative. Nws pib tam sim ntawd tom qab rupture ntawm lub pob ntseg, los ntawm cov kua paug pib ntws. Hauv qhov no, qhov mob maj mam txo qis. Ib tug neeg pib hnov zoo dua, qhov kub thiab txias txo qis los yog ploj tag nrho. Hauv thawj hnub tom qab kev tawg ntawm daim nyias nyias, cov kua paug tawm yuav muaj zog heev, thiab cov ntshav me me tuaj yeem tshwm sim. Cov neeg mob nco ntsoov lub xub ntiag ntawm lub pulsation tas li. Maj mam, tus nqi ntawm purulent paug pib txo, thiab lawv ua thicker thiab ntau viscous. Mob perforated purulent otitis xov xwm yuav tsum tau kev kho mob ceev, vim daim ntawv no yog heev txaus ntshai thiab provokes ntau yam teeb meem.
Txoj kev kho tus kab mob no yog tus cwj pwm los ntawm kev tso tawm cov kua paug tawm, nrog rau kev kho sai ntawm qhov txhab. Tom qab ntawd, tus neeg pib hnov zoo li qub, qhov kub thiab txias rov qab mus rau qhov qub, thiab lub xeev kev noj qab haus huv zoo dua. Qee qhov xwm txheej, tus kab mob tuaj yeem ua rau qeeb, tsis muaj qhov tawg ntawm lub pob ntseg thiab tawm ntawm cov ntsiab lus purulent. Qhov kub thiab txias tsis tu ncua, lub rooj sib hais tsis rov qab los, thiab qhov mob tsis ploj mus. Thaum pib ntawm tus kab mob, ntuav, mob taub hau, thiab kiv taub hau kuj koom nrog lwm cov tsos mob.
Qhov notshwm sim nrog ntev maturation ntawm cov kua paug thiab tsim ntawm perforation. Yog tias qhov no tshwm sim, ces tus kab mob tuaj yeem nkag mus tob rau hauv pob txha taub hau, ua rau muaj qhov tshwm sim tsis tau.
Kev tshwm sim
Raws li kev txheeb cais, feem ntau mob suppurative otitis media tsim vim kev nkag mus ntawm staphylococci. Qee zaum provocateurs ntawm tus kab mob yog pneumococci. Proteus, diphtheria bacillus thiab otomycosis fungi provoke o ntau dua.
Ntau zaus, cov kab mob thiab kab mob nkag mus rau hauv lub pob ntseg los ntawm txoj hlab auditory. Thaum lub sij hawm ib txwm ua hauj lwm, nws tshem tawm cov kab mob, tiv thaiv lub pob ntseg kwj dej los ntawm txoj kev loj hlob ntawm pathological dab. Thaum lub caij txias thiab lwm cov txheej txheem sib kis, kev ua haujlwm ntawm Eustachian raj tsis muaj zog thiab cov kab mob tau qhib. Yog li ntawd, mob purulent otitis media pib tsim nyob rau hauv ib tug me nyuam thiab ib tug neeg laus.
Otolaryngologists txheeb xyuas ntau yam ua rau muaj kev cuam tshuam, tshwj xeeb xws li:
- pharyngitis;
- rhinitis;
- tonsillitis;
- laryngitis;
- laryngotracheitis.
Ntxiv rau, benign neoplasms ntawm lub larynx, qhov ntswg kab noj hniav, kev ua haujlwm, cov txheej txheem kho mob tuaj yeem ua rau muaj teeb meem. Tus kab mob tuaj yeem tshwm sim thaum kab mob tympanic kis tau, uas tshwm sim nrog kev raug mob thiab kev nkag mus ntawm lub cev txawv teb chaws mus rau hauv pob ntseg kwj dej.
Ib qho ntawm feem ntau ua rau muaj kab mob purulentyog lub cev tsis muaj zog. Yog li ntawd, cov txheej txheem inflammatory tshwm sim nrog cov teeb meem txaus ntshai.
Nws tau raug pov thawj tias purulent otitis media tuaj yeem tshwm sim tawm tsam keeb kwm yav dhau los ntawm pob ntseg pob ntseg. Nws yog suav hais tias yog lub ntsiab tshwm sim ntawm hom rhinitis, dermatitis, hawb pob, diathesis, bronchitis. Qhov tsis zoo ib puag ncig cuam tshuam rau etiology ntawm qhov mob ntawm lub pob ntseg.
Cov tsos mob tseem ceeb
Cov tsos mob ntawm tus mob purulent otitis media yog tus yam ntxwv zoo heev, yog li nws nyuaj heev kom tsis meej pem nrog lwm tus kab mob. Cov cim tseem ceeb ntawm tus kab mob yuav tsum muaj xws li:
- mob rhiab hauv pob ntseg;
- hnov tsis hnov;
- kub nce;
Thaum kis tus kab mob, ua ntej ntawm tag nrho cov, ib tug neeg pib hnov mob hnyav heev, uas tej zaum yuav yooj yim heev bearable. Mob hnyav zuj zus thaum tus neeg mob sim kov pob ntseg xwb. Tib lub sijhawm, ntau tus hais tias cov tsos mob yog qhov ntse heev thiab tshwm sim nws tus kheej thaum lub sijhawm tig lub taub hau.
hnov tsis hnov tsw yog pom tawm tsam keeb kwm ntawm kev mob hnyav. Lub mucous daim nyias nyias yog qhov tsis yooj yim thiab nyias, yog li txhua yam kab mob cuam tshuam tsis zoo rau kev hnov lus. Qee zaum, tib neeg tshaj tawm tias lawv yuav luag tsis muaj dab tsi thiab txhua lub suab tsis zoo.
Kab mob hauv pob ntseg ib txwm nrog kev nce ntxiv hauv lub cev kub, mus txog 39 degrees. Thawj 2 hnub khob nws yuav luagua tsis tau, raws li cov txheej txheem festering txuas ntxiv.
Kev tso kua paug tawm ntawm pob ntseg tsis tshwm sim tam sim ntawd, txij li thawj hnub ntawm cov txheej txheem inflammatory nws tsuas yog khaws cia. Tom qab cov mucosa tsis tuaj yeem tiv taus, nws tawg, thiab cov ntsiab lus ntws tawm.
Lub tsev kho mob yuav tsum tau hu rau thawj qhov tsis txaus ntseeg ntawm otitis media. Daim ntawv mob hnyav thiab purulent yuav tsum tau kuaj xyuas thiab kho raws sijhawm. Qhov no yuav pab tiv thaiv qhov teeb meem.
Diagnostics
Thaum lub sijhawm mob purulent otitis media, kev kuaj mob yog qhov tseem ceeb. Thaum hu rau tus kws kho mob, nws pib sau anamnesis. Tus kws kho mob otolaryngologist ua qhov kev kuaj mob ua ntej raws li cov tsos mob.
Cia li suav ntshav kom tiav. Nws qhia tau hais tias muaj kab mob o. Tib lub sijhawm, leukocytosis tau pom, nrog rau kev nce hauv ESR.
Ntxiv rau, rau txoj kev tshawb fawb, exudate yog coj ncaj qha los ntawm kev tsom mus rau qhov mob. Nws tau raug tshawb fawb txog qhov muaj cov kab mob thiab qhov tsis haum rau cov tshuaj tua kab mob. Rau qhov kev ntsuam xyuas, txoj hauv kev xws li:
- otoscopy;
- kev kuaj kab mob;
- radioography;
- paracentesis.
Txhua hom kev tshawb fawb no pab txiav txim siab txog etiology ntawm tus mob suppurative otitis media. Qhov no, nyob rau hauv lem, tso cai rau koj xaiv txoj kev kho.
Kev kho mob
Thaum khomob purulent otitis xov xwm, tshwj xeeb yog them rau theem ntawm cov kab mob, vim hais tias kev siv cov tshuaj yuav loj nyob ntawm qhov no. Nyob rau hauv thawj hnub, thaum kev noj qab nyob zoo ntawm ib tug neeg pib deterioration sharply, kev siv tshuaj antipyretic yog qhia.
Cov kws kho mob pom zoo kom nruj pw tsaug zog rau txhua tus neeg mob otitis media, vim tias lub cev muaj qhov hnyav heev. Tsis tas li ntawd, kev noj qab nyob zoo tsis tuaj yeem ua rau lub neej ib txwm muaj. Yog tias muaj cov tsos mob ntawm mastoiditis, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob.
Kom normalize lub ntuj qhov cua ntawm pob ntseg, ib tug neeg yuav tsum tau muab tshuaj vasoconstrictor tee rau hauv lub qhov ntswg. Txhawm rau txo qhov mob, koj yuav tsum siv cov tshuaj tshwj xeeb uas tau txhaj ncaj qha rau hauv pob ntseg kwj dej. Lawv kuj muaj nyob rau hauv daim ntawv ntawm tee. Cov kws kho mob kuj pom zoo kom siv cov tshuaj boric acid. Nws yog tsim nyog sau cia tias tag nrho cov nyiaj yuav tsum sov.
Mob suppurative otitis media yog kho nrog tshuaj tua kab mob qhov ncauj. Kev kho mob yuav siv sij hawm 7-10 hnub, thiab nws yuav tsum tsis txhob nres txawm tias tom qab zoo dua, vim qhov no tuaj yeem ua rau rov mob dua.
Thaum lub sijhawm tshem tawm cov kua paug, tus kws kho mob tuaj yeem sau tshuaj tiv thaiv kab mob, nrog rau microlytics, uas yuav pab ua kom lub cev tawm ntawm cov kua dej tawm.
Drug therapy
Kev kuaj tus kab mob no tsis ua rau muaj teeb meem txhua, thiab tom qab ntawd, cov neeg mob tau muab cov txheej txheem kho mob. Kho mobKev kho mob ntawm tus mob purulent otitis media suav nrog kev siv xws li:
- poob;
- tshuaj tua kab mob;
- tshuaj uas tshem tawm cov tsos mob sib xws.
Feem ntau ntawm cov tee nyob rau hauv cov ntaub ntawv ntawm rupture ntawm lub pob ntseg thiab purulent otitis xov xwm yog nruj me ntsis txwv tsis pub siv, vim hais tias lawv tsuas muaj peev xwm ua rau cov kab mob hnyav dua. Txawm hais tias kev tshuaj xyuas zoo, nws tsis tuaj yeem siv cov tshuaj "Otipax". Rau kev kho mob ntawm purulent paug, Otofa tee yog tsuas yog sau. Nws yog ib qho tshuaj tua kab mob zoo heev.
Anauran yog lwm qhov mob zoo thiab tshuaj tiv thaiv kab mob. Cov tshuaj no raug pom zoo siv rau hauv cov mob hnyav thiab mob ntev. Ua ntej instillation ntawm cov kua, nws yog ib qhov tsim nyog yuav tau kho lub pob ntseg kwj dej kom huv si nrog hydrogen peroxide los yog lwm yam tshuaj tua kab mob.
Nrog rau sab laug lossis sab xis sab xis mob purulent otitis media, tus kws kho mob feem ntau sau tshuaj tua kab mob. Cov tshuaj nrov tshaj plaws yog Amoxicillin, vim nws muaj cov tshuaj tua kab mob thiab tshuaj tua kab mob. Rau kev siv tshuaj pleev ib ce, aminoglycosides kuj pom zoo. Cov nyiaj no raug tso cai siv tsis pub dhau 14 hnub. Tag nrho cov tshuaj tau sau rau hauv daim ntawv tshuaj ntsiav lossis ntsiav tshuaj, thiab kev txhaj tshuaj yog siv rau qhov mob hnyav. Yog tias purulent otitis media tshwm sim tom qab SARS, tom qab ntawd kom rov zoo sai dua, tus kws kho mob tau sau tshuaj immunostimulating thiab tshuaj tiv thaiv kab mob.
Nkauj Hmoobcov txheej txheem
Purulent otitis media tsis pom zoo kom kho nrog cov tshuaj pej xeem, vim nws tsis tuaj yeem kwv yees seb txhua txoj kev tshwj xeeb yuav ua haujlwm li cas. Nws yog nruj me ntsis txwv tsis pub siv cua sov, vim qhov no tsuas yog ua rau muaj kev cuam tshuam ntawm cov txheej txheem pathological.
Raws li kev kho pej xeem, koj tsuas tuaj yeem siv tshuaj yej los ntawm chamomile thiab lwm yam tshuaj tiv thaiv kab mob. Cov cuab yeej no raug pom zoo kom siv ua ke nrog lwm txoj hauv kev kom tau txais txiaj ntsig sai dua.
Physiotherapy
Kev kho mob ntawm sab laug-sab mob purulent otitis media, nrog rau sab xis, yog ua los ntawm kev siv lub cev kho lub cev. Ib qho txiaj ntsig zoo sib xws tau raug sau tseg los txo cov tsos mob ntawm tus kab mob thiab kho qhov hnov lus. Ntawm cov txheej txheem tseem ceeb siv yog:
- laser kho;
- kho mob ultrasonic;
- UHF txoj kev kho.
Yog tias koj xav tau xa cov tshuaj tua kab mob mus rau thaj tsam cuam tshuam, ces electrophoresis raug tshuaj.
Surgery
Yog tias kev kho kev saib xyuas tsis tuaj yeem ua tiav qhov kev xav tau, ces kev phais yog qhia. Thaum lub sij hawm o, lub outflow ntawm purulent ntsiab lus tseem ceeb heev. Rau qhov no, kev tshem tawm ntawm polyps thiab granulations yog sau.
Ntxiv rau, tympanic bypass tuaj yeem raug qhia. Ua li no, ib lub qhov me me yog ua nyob rau hauv daim nyias nyias, uas yog muab tso rau hauv ib lub raj me me. Cov tshuaj yog muab los ntawm nws. Kev phais pob ntseg nruab nrab thiab labyrinth kuj ua tau.
Yuav ua li cas thiaj yuav tshwm sim
Txhua yam kab mob uas tsis ncaj ncees lawm provokes qhov tshwm sim ntawm tus naj npawb ntawm cov teeb meem txaus ntshai, uas nyuaj rau tshem tawm ntau dua li tus kab mob qub. Raws li qhov tshwm sim, kev ua haujlwm ntawm tympanic daim nyias nyias yuav ua tsis taus, ua rau tsis hnov lus ib nrab lossis ua tiav. Cov teeb meem txaus ntshai tshaj plaws yog:
- mob pob txha ntawm lub cev;
- pob ntseg lesion;
- pob txha caries;
- meningitis.
Nrog kev nyeem ntawv tsis paub lossis kho tsis tau sijhawm, daim ntawv mob hnyav ntawm tus kab mob maj mam hloov mus ua mob otitis media, uas nyuaj rau kho. Txhawm rau tshem tawm qhov tshwm sim ntawm cov kab mob txaus ntshai, nws yog qhov yuav tsum tau mus ntsib kws kho mob tam sim ntawd ntawm thawj cov cim qhia ntawm kev tsis zoo hauv kev noj qab haus huv. Otolaryngologists pom zoo tias kev tiv thaiv kev kuaj mob ntawm lub pob ntseg yuav tsum tau ua tsawg kawg ob zaug hauv ib xyoos.
Huab cua
Nrog rau txoj hauv kev muaj peev xwm, qhov kev cia siab ntawm tus mob suppurative otitis media yog qhov zoo heev. Tus kab mob no xaus nrog kev rov zoo tag nrho thiab kho qhov hnov lus. Yog tias tus kab mob tau pib, ces nws tuaj yeem ua rau mob ntev nrog kev tsim cov perforation ruaj khov ntawm lub pob ntseg. Yog li ntawd nws yog ib qho tseem ceeb heev rau kev kuaj mob thiab kho cov kab mob uas twb muaj lawm nyob rau lub sijhawm.
Kev tiv thaiv kev tiv thaiv
Txhua tus neeg laus paub tias kev tshem tawm tus kabmob thiab tiv thaiv nws txoj kev loj hlob hauv lub cev yog qhov yooj yim dua li kev kho cov kab mob otitis media uas twb dhau los lawm. Tiv thaivcov kev ntsuas yog tsom rau kev saib xyuas cov kab mob hnov lus zoo. Nws yog txwv tsis pub ntxuav lub pob ntseg nrog pob ntseg sticks, nrog rau cov tee dej tsis muaj kws kho mob cov tshuaj.
Nyob rau lub caij txias, nco ntsoov hnav cov kaus mom tiv thaiv koj lub pob ntseg kom tsis txhob tshuab. Nws yog ib qho tseem ceeb kom txo qis nyob rau hauv cov chav damp, hauv cov cua ntsawj ntshab. Kev kho mob khaub thuas thiab kab mob sib kis yuav tsum ua kom tiav thiab ua rau kom rov ua tiav. Txhawm rau sib sau cov txiaj ntsig tom qab chav kho mob, koj yuav tsum ua raws li cov cai no rau ib xyoos.
Kev noj qab haus huv ntxiv yuav pab ua kis las, ua kom lub cev tawv, tswj kev ua neej nyob. Lub cev tiv thaiv kab mob tiv thaiv kab mob nkag mus rau hauv pob ntseg. Nws yog ib qho tseem ceeb uas yuav tsum tau them sai sai rau cov khoom noj kom zoo, sib npaug. Kev noj haus yuav tsum muaj cov zaub mov thiab cov vitamins.
Thaum lub sijhawm ua kom cov kab mob kis tau zoo, nws raug nquahu kom noj cov tshuaj tsim nyog, nrog rau cov vitamin complexes, txhawm rau tiv thaiv. Nco ntsoov tias kev noj tshuaj rau tus kheej tuaj yeem ua rau muaj kev phom sij rau kev noj qab haus huv.
