Thaum peb mob qa, tab sis ib txwm muaj teeb meem tshwm sim. Txawm hais tias nws yog banal tonsillitis uas txhawj xeeb rau peb tom qab hypothermia los yog noj ntau dhau ntawm cov dej khov. Ib qho ntawm feem ntau comorbidities yog paratonsillar abscess. Cov tsos mob ntawm tus kab mob paratonsillar abscess yog o ntawm caj dab, kub taub hau, thiab txawv teb chaws lub cev. Tag nrho cov ntawm lawv kuj pom nyob rau hauv angina zoo tib yam, yog li nws yog ib qho nyuaj rau tam sim ntawd paub txog ib tug ntxiv kab mob. Cov neeg mob sim zaum kawg mus kho tom tsev, tab sis tom qab qhov kub nce mus txog 40 degrees, lawv tseem nrhiav kev pab los ntawm kws kho mob.
YTus essence ntawm pathology
Cov kab mob hauv cov tshuaj hu ua mob ntawm cov nqaij mos, nrog rau kev tsim cov kua paug. Qhov tseeb, qhov no yog ib qho purulent detritus nyob rau hauv daim tawv nqaij, mucous daim nyias nyias los yog nyob rau hauv lub fascial mob. Yog tias cov txheej txheem kis mus rau thaj chaw loj, ces nws twb tau muab cais ua phlegmon. Qhov no pathology provokes kev loj hlob ntawm cov kab mob los yog fungi.
Txawm hais tias cov tsos mob ntawm tus kab mob paratonsillar abscess tau yooj yim zam los ntawm ib tus neeg, qhov no yog kab mob uas tuaj yeem ua rau tuag taus. Cov kua dej uas muaj kab mob no ua rau cov ntaub so ntswg uas nws tuaj yeem sib cuag nrog thiab tuaj yeem nkag mus rau lub hlwb, caj dab, thiab txawm tias lub hauv siab kab noj hniav. Qhov no yuav ua rau tus kab mob kis thoob plaws lub cev, poob siab thiab tuag sai.
Historical sketch
Yuav kom nkag siab qhov hnyav ntawm cov kab mob no, koj tuaj yeem siv cov piv txwv los ntawm keeb kwm. Nws yog qhov zoo dua los pib txij thaum ub. Nyob rau hauv lub xyoo pua kaum ob BC, Shah ntawm Khorezm, Ala ad-Din Tekesh, tuag los ntawm no pathology. Nws yog ib qho nyuaj rau liam tus neeg no rau qhov tsis paub thiab tsis saib xyuas cov tsos mob, txij li thaum lub sijhawm nws kav lub xeev tau mus txog nws txoj kev coj noj coj ua thiab kev nom kev tswv loj tshaj plaws.
Muaj ib qho version uas nws yog los ntawm paratonsillar abscess uas tus thawj coj nto moo ntawm Seminole Indians, Osceola, tuag. Nws tshwm sim xyoo 1838 thaum cov neeg Mev tau kov yeej South America. Ib zaug ntxiv, cov tshuaj ntawm cov neeg no nyob rau theem siab, cov neeg European tsis tau hnov txog ntau yam tshuaj. Yog li ntawd, tsis tas yuav tham txog kev tsis saib xyuas.
Tus kws sau ntawv Fab Kis thiab tus kws tshaj lij Michel Montaigne, Pope Adrian thib plaub thiab Scottish xibfwb ntawm kev tshawb fawb txog kev ntseeg Ian MacLaren thiab qee tus neeg muaj koob npe tau tuag los ntawm kev mob yooj yim.
Views
Txij li cov tsos mob ntawm paratonsillar abscess yog ib txwm raug, nws raug cais ntawm cov kws kho mob otorhinolaryngologist nkaus xwb los ntawm qhov chaw. Muaj plaub hom kab mob.
- Top. Nws yog qhov feem ntau ntawm cov txheej txheem purulent. Qhov no yog vim lub anatomical nta ntawm cov tonsils. Qhov saum npoo ntawm lub cev tau ntsib cov kab mob muaj zog, vim tias nws yog thawj zaug uas tau siv lub tshuab thaum kis kab mob. Tus kab mob pib nrog cov tsos ntawm cov xim daj daj ntawm lub palatine arches.
- Daim ntawv posterior, thaum lub tsom xam nyob nruab nrab ntawm lub palatine koov thiab tonsil. Qhov no yog qhov kev xaiv yooj yim tshaj plaws rau kev kuaj mob, txij li qhov chaw ntawm qhov mob tau pom meej meej. Tus kab mob no ua rau tus neeg mob tsis xis nyob, cuam tshuam nrog kev hais lus, nqos thiab qhib qhov ncauj. Thaum nyuaj, tej zaum yuav muaj teeb meem ua pa.
- Daim ntawv qis dua. Abscess tsuas yog nyob rau sab qis ntawm lub tonsil. Qhov teeb meem no feem ntau tshwm sim los ntawm cov kab mob ntawm cov hniav thiab cov pos hniav.
- Outer form. Nws yog qhov tshwm sim tsis tshua muaj tshwm sim. Hauv qee cov ntaub ntawv, koj tuaj yeem pom lub npe lateral paratonsillar abscess. Nws yog nrog qhov chaw nyob no uas muaj feem ntau tshaj plaws ntawm kev kis tus kabmob mus rau thaj chaw nyob sib ze.
Tus kab mob pib mob hnyav, mob ntev yog kis tau thiab tshwm sim tsuas yog hauv cov pej xeem txom nyem uas tsis nrhiav kev pab kho mob tam sim ntawd.
Etiology
Cov tsos mob ntawm paratonsillar abscess tshwm sim thaum muaj kab mob purulent tshwm sim ntawm cov tonsil hauv cov ntaub so ntswg nyob sib ze, tshwm sim los ntawm kev loj hlob thiab kev ua haujlwm tseem ceeb ntawm cov kab mob. Feem ntau, staphylococci thiab streptococci ua raws li tus kab mob sib kis, tab sisNws tuaj yeem yog cov kab mob fungi, cov kab mob kis tau zoo, thiab qee zaum txawm tias muaj kab mob.
Paratonsillar abscess tsis yog kab mob ywj pheej. Raws li txoj cai, qhov no yog qhov tshwm sim ntawm kev kho tsis raug lossis kev kho mob ntawm angina. Cov neeg mob ntseeg tias qhov mob hauv lub caj pas yog qhov yooj yim heev thiab kev kuaj mob tsis txaus ntseeg kom thab tus kws kho mob nrog cov tsis zoo li no. Tab sis qhov tseeb, koj yuav tsum tsis txhob saib xyuas koj tus kheej txoj kev noj qab haus huv, thiab nws yog qhov zoo dua los nrhiav kev pab thaum pib dua li kho qhov tshwm sim ntawm koj qhov kev ua tsis zoo tom qab.
Qhov thib ob yog vim li cas rau abscesses ntawm qhov chaw no yog mob tonsillitis. Cov txheej txheem kis tus kab mob qeeb zuj zus nyob rau hauv lub cev, uas ua rau ib tus neeg lom, ua rau nws txoj kev tiv thaiv tsis muaj zog. Tag nrho cov no ua rau muaj teeb meem ntawm qhov mob khaub thuas tshaj plaws.
Qee zaus paratonsillitis tshwm sim tom qab tshem tawm cov ntaub so ntswg lymphoid los ntawm palatine arches. Qhov no tej zaum yuav yog qhov tshwm sim ntawm kev ua haujlwm tsis zoo, thaum ib feem ntawm cov tonsils tseem nyob thiab lawv rov qab los rau lawv qhov loj me. Los yog thaum tus kws kho mob puas ntsoog mucous daim nyias nyias ntawm lub larynx nrog instruments.
Plaub qhov chaw nyob rau hauv qeb ntawm ua rau abscess yog caries. Qhov no tseem yog qhov tseem ceeb ntawm kev kis kab mob, uas yuav tsum tau ua kom huv si kom tsis txhob ua rau lub cev tsis muaj zog tiv thaiv thiab tsis ua rau cov kab mob "ntawm qhov kev tawm tsam".
Symptoms
Tus kab mob paratonsillar tshwm sim li cas? Cov tsos mob tsis tshwm sim tam sim ntawd, tab sis tsuas yog peb mus rau plaub hnub tom qab kev cuam tshuam ntawm cov kab mob mus rau hauv cov tonsils. Qhov tseeb tshaj plaws, lub tsev kho mob pib pom nws tus kheej txij hnub thib tsib ntawm kev mob.
thawj qhov tsos mob yog mob. Thaum xub thawj, nws ua rau me ntsis tsis xis nyob, tab sis nyob rau hauv tus txheej txheem ntawm o thiab tsub zuj zuj ntawm cov kua paug, nws yuav ua tau ntau thiab ntau nyuaj rau nws. Mob yog nyob rau tib sab ntawm abscess, tab sis tuaj yeem kis mus rau pob ntseg, lub puab tsaig sab sauv, caj dab, maxillary sinuses.
Ib qho tsos mob ntawm tus kab mob paratonsillar abscess yog o ntawm lub caj pas thiab muaj qhov o ntawm cov mucosa ntawm sab ntawm qhov txhab. Cov ntaub so ntswg nyob rau hauv qhov chaw no yog liab, muaj zog stretched, kub. Vim yog qhov "pob", nqos, ua pa cuam tshuam, thiab lub sijhawm dhau mus, qhov mob ntawm cov nqaij ntshiv loj tuaj - lockjaw. Nws nyuaj rau tus neeg mob qhib nws lub qhov ncauj.
Vim vim kev kis kab mob hauv tib neeg lub cev, cov kab mob submandibular, occipital thiab cervical lymph nodes nce. Qee lub sij hawm nws tseem ceeb heev rau qhov muag liab qab. Tus neeg mob tsis tshua tig nws lub taub hau, khoov nws caj dab, pw tsis zoo. Cov txheej txheem purulent ua rau ua pa tsis zoo, thiab kev sib kis ntawm qhov mob mus rau cov ntaub so ntswg ntawm caj dab tuaj yeem ua rau hoarseness. Ntawm cov tsos mob, qhov kub thiab txias, tsis muaj zog, thiab pw tsaug zog sawv tawm.
Paratonsillar abscess hauv menyuam yaus
Tsis yog hauv cov neeg laus xwb, paratonsillar abscess tuaj yeem pom tias muaj teeb meem. Cov tsos mob ntawm cov menyuam yaus feem ntau tsis cuam tshuam rau qhov mob hnyav, vim tias lawv lub cev tiv thaiv kab mob tsis zoo thiab tsis zoo ib txwm teb rau tus kab mob.
Tus mob caj pas tsis tuaj yeem daws tau los ntawm kev yaug thiab nqus, tus menyuam tsis tuaj yeem nqos qaub ncaug, cia nyob ib leeg noj tshuaj lossis noj. Hauv menyuam yausthaum me nyuam mos, o ntawm caj pas ua rau muaj teeb meem ua pa kom txog thaum nws nres. Lub cim ceeb toom thib ob rau cov niam txiv yuav tsum yog lub suab hloov. Nws ua ntxhib thiab gurgling, zoo li yog lawv tus menyuam tuav lub qos yaj ywm hauv nws lub qhov ncauj.
Qee tus me nyuam muaj spasms ntawm cov leeg ntawm lub ntsej muag thiab caj dab, trismus, mob kis mus rau pob ntseg lossis nraub qaum. Ntawm qhov kev tshuaj xyuas lub hom phiaj, kev pom liab tsis yog nyob rau ntawm qhov txhab, tab sis thoob plaws hauv lub pharynx.
Diagnosis
Yuav kuaj xyuas "peritonsillar abscess" li cas? Nws cov tsos mob yog ci txaus kom qhov no tuaj yeem ua tiav ntawm ib daim duab kho mob. Tus kws kho mob sau ib qho anamnesis, tom qab ntawd hais kom tus neeg mob qhib nws lub qhov ncauj dav thiab tshuaj xyuas cov mucous ntawm lub oropharynx thiab lub larynx. Nrog lub spatula, nco ntsoov kov qhov chaw o, tshem tawm cov yeeb yaj kiab los ntawm cov tonsils.
Cia li xa tus neeg mob mus kuaj mob:
- kuaj ntshav;
- tshuaj urinalysis;
- kuaj kab mob paug tawm ntawm pharynx;- hnoos qeev rau kab mob diphtheria bacillus.
Yog tias tsim nyog, tus neeg mob yuav tsum tau x-ray lossis tomography ntawm lub caj dab kom pom qhov chaw ntawm cov txheej txheem pathological.
Kev kho mob
Yog tias koj tau kuaj pom tus kab mob paratonsillar abscess, kev kho mob hauv tsev yog nruj me ntsis txwv. Yog tias tus neeg mob tsis xav mus rau hauv tsev kho mob tiag tiag, ces nws yuav tsum nyob hauv tsev kho mob ib hnubnyob rau hauv kev saib xyuas ntawm cov neeg ua haujlwm. Kev kho tus kab mob abscess tuaj yeem yog kev saib xyuas, phais lossis nyuaj.
Cov tshuaj tau tshem tawm ntawm paratonsillar abscess. Kev kho tshuaj tua kab mob tsuas yog siv tau thaum pib ntawm tus kab mob, thaum cov kab mob tseem tsis tau mus txog qhov tseem ceeb thiab kis thoob plaws lub cev. Tab sis txawm tias nyob rau hauv cov mob hnyav heev, cov kws kho mob yuav tsum tau sau cov tshuaj tua kab mob los tiv thaiv sepsis thiab txo qhov cuam tshuam ntawm intoxication.
Hauv zos sau tshuaj yaug nrog tshuaj tua kab mob ("Chlorophyllipt", "Furacilin", cov tshuaj sov hypertonic) thiab cov tshuaj pleev uas txo qhov mob thiab mob.
kev kho neeg zoo
Puas tuaj yeem kho paratonsillar abscess yam tsis tau phais? Cov tshuaj ib txwm teb nrog categorical tsis kam. Kev kho mob hauv tsev, tshwj xeeb yog los ntawm cov txuj ci txuj ci, tuaj yeem ua rau muaj kev phom sij rau lub neej thiab kev noj qab haus huv. Tab sis ntawm qhov tod tes, pog cov zaub mov yuav los ua ke los pab tiv thaiv o thiab mob caj pas.
Yuav ua li cas thiaj txo tau tus kab mob paratonsillar abscess? Kev kho mob nrog pej xeem tshuaj yog siv cov khoom siv zib ntab thiab muv. Ua ntej ntawm tag nrho cov, qhov no siv rau propolis, uas combines cov khoom ntawm ib tug antiseptic thiab ib tug tiv thaiv stimulant. Rau rinsing, ib tug tincture ntawm lawv spruce cones nrog ntxiv ntawm coniferous tseem ceeb roj yog zoo suited.
Qhib qhov abscess
Koj tsis tuaj yeem kuaj pom tus kab mob paratonsillar abscess los ntawm daim duab. Cov tsos mob, tau kawg, muaj yeeb yuj heev, tab sis cov kws kho mob nyiam"Saib nrog koj txhais tes", yog li ntawd, nrog cov tsos mob ntawm tus kab mob no, nws raug nquahu kom khiav mus rau kev sab laj nrog kws phais.
Tus kws kho mob tshuaj xyuas tus neeg mob, hais lus txiav txim thiab hais kom qhib qhov abscess. Tag nrho cov txheej txheem yuav siv sij hawm qhov chaw nyob rau hauv lub tsev kho mob thiab yuav siv sij hawm txog 20 feeb. Tom qab tshuaj loog rau qhov chaw mob, tus kws phais ua rau ntau qhov kev phais thiab sau cov kua paug uas tau tshwm sim hauv lub tais. Tom qab ntawd nws ntxig cov kua dej (lub raj lossis roj hmab strip) txhawm rau txhim kho cov dej ntws tawm. Qee zaum cov tonsils kuj raug tshem tawm nrog rau qhov qhib ntawm abscess.
Kev nyuaj siab
Yuav ua li cas thiaj ua tau tus kab mob paratonsillar abscess? Nws cov tsos mob thiab kev kho mob tsis ua rau muaj lus nug ntxiv ntawm cov neeg nyob hauv, vim txhua yam yog qhov laj thawj thiab nkag siab. Tab sis yog tias koj khiav tawm txoj kev kho, ces cov txheej txheem pathological tuaj yeem nthuav dav thiab ua rau muaj qhov tshwm sim loj:
- Phlegmon ntawm caj dab. Pus melts fatty cov ntaub so ntswg thiab ntws nyob rau hauv daim tawv nqaij ntawm lub caj dab, o tuaj, ib tug rwj thiab necrosis txawm tshwm sim.
- Mediastinitis. Yog hais tias, nrog lub caj dab phlegmon, tus neeg mob tsis mus rau hauv tsev kho mob thiab tos, tom qab ntawd cov kua paug txav mus ntxiv thiab nkag mus rau hauv siab, nrog rau cov kab mob hauv nruab nrog cev, pleura, lub ntsws thiab lub plawv hauv cov txheej txheem inflammatory.
- Sepsis. Kev kis kab mob tag nrho lub cev vim kis kab mob los ntawm cov hlab ntsha.
Nws yog ib qho tseem ceeb kom nco ntsoov cov kev piam sij no thiab kho cov txheej txheem purulent inflammatory hauv lub sijhawm, txawm tias lawv nyob qhov twg.
Kev Tiv Thaiv
Kev tiv thaiv zoo dua li kho. Qhov tseeb yeej ib txwm muaj tseeb. Yog li ntawd, cov kws kho mob qhia lawv cov neeg mobtswj kev tiv thaiv ntawm qib siab, ua kom tawv thiab nrhiav kev pab hauv lub sijhawm.
Lub luag haujlwm tseem ceeb kuj tau ua los ntawm kev tshem tawm cov kab mob foci ntev, xws li mob tonsils lossis adenoids thiab cov hniav carious. Nws yog ib qho tsim nyog yuav tau mus ntsib kws kho hniav thiab tus kws kho hniav tsis tu ncua los tswj cov txheej txheem no.
