Kev mob caj pas feem ntau tshwm sim tom qab muaj kab mob xws li tonsillitis. Nws xav tau kev kho mob tam sim ntawd thiab, qee zaum, kev phais mob, vim cov txheej txheem purulent uas nyob hauv lub taub hau yog fraught nrog rau qhov tshwm sim loj. Lub caj pas abscess zoo li cas hauv daim duab, nrog rau nws cov tsos mob, pab kom nkag siab qhov txawv ntawm cov txheej txheem purulent.
Stages
Kev mob caj pas pib los ntawm cov theem hauv qab no:
- Thawj theem yog qhov tshwm sim ntawm qhov muaj cov tsos mob ntawm qhov mob, uas pom cov pob txha purulent nrog lub caj pas abscess (daim duab).
- theem thib ob muaj tus qauv nthuav tawm ntau dua. Nyob rau theem no, cov kab noj hniav uas muaj cov kua qaub ncav cuag nws qhov siab tshaj plaws thiab pib tawg nyob rau hauv siab.
- 3 theem yog theem kawg, nyob rau hauv uas muaj rupture ntawm kab noj hniav nrog cov kua ntswg.
Qhov chaw
Nyob ntawm qhov chaw ntawm cov kab noj hniav uas cov paug nyob, abscesses muab faib ua:
- pem hauv ntej - ib qho chaw ua haujlwm, txij li cov kab mob microbes tau yooj yim nkag mus rau ntawm cov tshuab, ua rau mob;
- posterior - qhov tshwm sim ntawm ib qho abscess hauv kab noj hniav ze ntawm pharyngeal tonsil;
- qis -Cov kua paug tawm hauv qab ntawm palatine tonsil;
- lateral - qhov chaw nyuaj tshaj plaws rau qhov tshwm sim abscess, ua rau muaj teeb meem.
Topographic nta
Peb pawg yog qhov txawv ntawm qhov chaw nyob:
- peritonsillar abscess yog qhov mob ntawm thaj chaw uas nyob ib puag ncig cov tonsils;
- peritonsillar abscess yog ib qho mob hauv cov ntaub so ntswg ntawm lub pharynx;
- retrapharyngeal abscess - tshwm sim hauv qhov chaw pharyngeal.
Kev tshwm sim
Feem ntau, ib qho abscess hauv caj pas tshwm sim thaum cov kab mob xws li streptococcus, staphylococcus, thiab qee zaum Escherichia coli nkag. Tus mob no feem ntau yog qhov tshwm sim thib ob, uas yog, nws yog ib qho teeb meem ntawm lwm tus kab mob.
Kev ua paug tuaj yeem ua rau muaj teeb meem ntawm cov kab mob xws li tonsillitis. Tus kab mob hauv lub caj pas kis tau los ntawm cov qog nqaij hlav, yog li lawv nyob hauv lub xeev o.
Qhov tseem ceeb ua rau muaj pob khaus hauv caj pas:
- Kev puas tsuaj los ntawm cov khoom siv thaum noj mov. Nws tuaj yeem yog pob txha lossis khoom txawv teb chaws.
- Kev raug mob ntawm cov mucosa tom qab kuaj mob plab los ntawm gastroscopy.
- Kev raug mob rau mucosa thaum noj cov kua qaub lossis kua qaub ntau ntau.
- mob caj pas thaum noj dej kub lossis khoom noj kub.
- Kev mob caj pas tsis kho.
- Qhov tshwm sim ntawm qhov muaj qee yam kab mob sib deev, xws li syphilis thiab ua pa, tuberculosis.
- Kev muaj tus kab mob sib kis hauvmloog.
Kab mob cuam tshuam rau abscess
Cov kab mob hauv qab no kuj tseem tuaj yeem ua rau kev txhim kho ntawm cov kab mob angina:
- kab mob HIV;
- mob ntshav qab zib mellitus;
- muaj qog nqaij hlav malignant;
- ib yam kab mob uas txo qis kev tiv thaiv kab mob.
Symptoms
Cov tsos mob ntawm tus kab mob hauv lub caj pas pib tshwm sim tam sim tom qab qhov pib ntawm kev loj hlob, hauv thawj theem. Tus kab mob abscess muaj cov tsos mob hauv qab no:
- muaj qhov mob kis raws cov ceg ntawm cov hlab ntsha plexus mus rau pob ntseg thiab thaj tsam ntawm cov txheej txheem alveolar;
- kev sib cog lus ntawm cov nqaij masticatory, uas ua rau nyuaj rau qhib qhov ncauj;
- xav tias muaj lub cev txawv teb chaws hauv caj pas;
- squeezing hauv caj pas, uas tsis tso cai rau nqos tag nrho cov zaub mov, thiab qee zaum yog qhov tshwm sim ntawm salivation ntau;
- o thiab mob thaum kov cov qog nqaij hlav;
- khoom noj kub ua rau tsis xis nyob, thaum zaub mov txias txo cov tsos mob;
- hyperthermia;
- muaj pa phem;
- xav zuj zus, qaug zog, qaug zog thiab pw tsis tsaug zog tshwm;
- mob hnyav, muaj qhov ua tsis taus pa, uas yog qhov tshwm sim ntawm kev sib tshooj ntawm lub larynx rau kev tso cua, nrog rau qhov mob hnyav thaum tig lossis tig taub hau;
- muaj qhov o ntawm thaj chaw paratonsillar;
- nrog tonsils.
Tom qab lub qhov txhab qhib, qhov mob thiab qhov mob ploj mus ib ntus.
Kev nyuaj siab
Ib qho teeb meem ntawm lub caj pas abscess tshwm sim thaum tus kab mob tsis muab pov tseg raws sijhawm. Qhov no yog vim lub fact tias ib tug abscess tsim ib kab noj hniav uas muaj kua paug. Feem ntau, hauv kab noj hniav no muaj tag nrho cov kab mob pathogenic thiab microbes uas ua rau mob, lawv tsis kis mus rau thaj tsam no. Tab sis qee zaum lub caj pas abscess tuaj yeem cuam tshuam los ntawm qhov tseeb tias kev ywj pheej ntawm cov kab noj hniav tshwm sim, qhov chaw ntawm tus kab mob nyob. Cov kab mob no tau tso tawm, thiab, ib zaug ntawm cov mucous membrane, nws tau nqus los ntawm cov phab ntsa ntawm caj pas, nkag mus rau hauv cov hlab ntsha dav dav, thiab kis thoob plaws lub cev los ntawm cov ntshav los yog lymph.
Qhov kev kis kab mob no tuaj yeem ua rau muaj kev loj hlob ntawm tus kab mob septic, ua rau lub cev tsis zoo. Nws yog ib qho tsim nyog yuav tau kho tam sim ntawd tom qab pom cov tsos mob ntawm rupture thiab intoxication ntawm lub cev nrog cov kab mob. Yog tias koj tsis ua, ces lawv kis tau tuaj yeem ua rau tuag taus. Tus mob no tsis kho tus kheej. Thaum cov kab noj hniav nrog cov kua paug tawm, cov teeb meem ntawm qhov no yuav tshwm sim hauv ib teev. Yog li ntawd, yog tias tus txheej txheem no raug kuaj pom, koj yuav tsum sab laj nrog kws kho mob tam sim ntawd thiab mus pw hauv tsev kho mob.
Diagnosis
Tus kws kho mob tuaj yeem kuaj pom qhov tseeb ntawm lub caj pas tsuas yog tom qab kawm cov duab kho mob ntawm kev loj hlob ntawm tus kab mob. Thaum lub sijhawm kuaj xyuas, tus kws kho mob ib txwm saib xyuas qhov mob ntawm cov qog nqaij hlav thiab qhov muaj qhov o. nyob rau hauv lub caj pas. Ua li no, nws palpates saum caj pas. Nws kuj tseem ua qhov kev kuaj pom ntawm lub larynx rau qhov mob uas siv lub laryngoscope. Kom paub meej, tus kws kho mob yuav sau cov kev kuaj hauv qab no:
- kuaj ntshav. Nrog rau abscess, kuaj pom cov leukocytes ntau ntxiv hauv cov ntshav.
- Kev kuaj lub caj pas kom pom muaj cov kab mob uas pom tseeb los ntawm lub tshuab ntsuas. Feem ntau, lawv nrhiav pom muaj tus kab mob streptococcus, staphylococcus, E. coli.
- Study of the reaction of bacteria in the smear to antibiotics.
- Kev kuaj kab mob turbeculosis thiab syphilis.
- Kev kuaj zis kom pom muaj cov kua ntswg.
- Sputum tsom rau cov kab mob txaus ntshai.
Tshawb Fawb Ntxiv
Tsis tas li, tus kws kho mob, nrog rau kev kuaj sim, tuaj yeem sau cov kev tshawb fawb hauv qab no:
- Ultrasound ntawm paranasal sinuses;
- otoscopy;
- rhinoscopy;
- X-ray ntawm maxillary sinuses;
- X-ray ntawm lub ncauj tsev menyuam qaum.
Tom qab ua qhov kev tshawb fawb tsim nyog, tsim cov tsos mob thiab kho tus mob caj pas hauv cov neeg laus, mus ncaj qha rau kev kho.
kev kho mob phais
Kev ua haujlwm abscess hauv caj pas feem ntau yog ua los ntawm kev tshem tawm ntawm abscess thiab suturing. Kev xaiv ntawm txoj kev phais phais yuav nyob ntawm qhov chaw ntawm cov txheej txheem inflammatory. Qhov kev ua haujlwm no yog ua nyob rau hauv qhov chaw khov. Rau qhov anterior abscess, ib qho incision yog uanyob rau hauv ob txoj kev: los ntawm lub palatoglossal koov los yog nyob rau hauv qhov chaw ntawm ntau tsub zuj zuj ntawm cov kua paug.
Cov kab mob tom qab raug pom zoo kom txiav thaum siv cov kua dej los ntawm lub hauv paus palatine koov ntawm qhov deb ntawm ib nrab ib centimeter ntawm nws ntug. Thaum txiav qhov qis abscess, cov ntaub so ntswg txiav los ntawm kab noj hniav nyob rau hauv qis ntawm lub palatoglossal arch.
Cov txheej txheem phais yuav tsum ua kom cov ntaub so ntswg nyob ib puag ncig cov abscess tau txais cov ntshav ntau. Nws yog ib qho tseem ceeb tshwj xeeb tshaj yog tsis ua kom puas cov hlab ntsha loj, rau qhov no nws raug nquahu kom muab cov ntaub so ntswg ntawm cov hlab ntsha thiab mus rau qhov tob tob, thiab tom qab ntawd, thawb lawv sib nrug nrog clamps, qhib cov abscesses. Kev siv cov clamps yog qhov tsim nyog kom tsis txhob ua rau cov ntaub so ntswg puas tsuaj nrog cov cuab yeej ua haujlwm.
Tom qab qhib nrog kev pab ntawm cov tshuaj tua kab mob ("Furacilin", "Rivanol", "Chlorhexidine", thiab lwm yam), gargle yog ua tiav. Qhov no yog ua los tiv thaiv kev nqus cov kua paug los ntawm cov phab ntsa ntawm lub pharynx. Nws raug nquahu kom nqa tawm qhov qhib thib ob ntawm ob sab ntawm qhov kev phais vim qhov tseeb tias thawj hnub tom qab qhib, cov kua paug tuaj yeem rov ua dua nyob rau hauv cov kab noj hniav abscess, thiab cov npoo ntawm qhov txiav mucous membrane tam sim ntawd pib rov zoo. Tom qab tshem tawm cov kab mob abscess, qhov mob hauv lub pharynx txo qis, qhov kub thiab txias normalizes, qhov mob ploj thaum nqos, thiab cov xwm txheej zoo tuaj.
Tshuaj kho caj pas abscess
Nyob rau theem pib ntawm kev txhim kho abscess lossis tom qab nws tshem tawm, cov tshuaj tua kab mob sib txawv tau muab. PibKev kho tshuaj, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas cov kua paug rau qhov muaj cov kab mob, thiab twb yog los ntawm hom kab mob, ib hom tshuaj tua kab mob raug xaiv uas yuav cuam tshuam rau lawv. Muaj ntau ntau txoj hauv kev los noj tshuaj tua kab mob yog tias koj muaj qhov txhab:
- tshuaj tua kab mob hauv qhov ncauj (cov ntsiav tshuaj, tshuaj ntsiav);
- tshuaj pleev ib ce (tshuaj pleev), siv los kho thiab tiv thaiv abscesses xws li mob caj pas;
- txhaj tshuaj ncaj qha rau hauv qhov chaw abscess, feem ntau yog siv rau qhov mob hnyav.
Feem ntau, kev kho mob rau qhov mob ntawm txhua theem yog ua nrog tshuaj tua kab mob penicillin:
- "Amoxicillin";
- "Cephalexin";
- Y "Carbenicillin";
- "Oxacillin";
- Y"Piperacillin".
Tau tshuaj tua kab mob saum toj no tau kaum hnub. Yog tias tus neeg mob ua xua rau cov tshuaj tua kab mob no, ces cov tshuaj tua kab mob macrolides tau muab:
- "Erythromycin";
- "Clarithromycin";
- "Oleandomycin";
- "Azithromycin";
- "Josamycin";
- "Midecamycin".
Muab cov macrolides saum toj no rau kaum hnub. Cov tshuaj pleev rau kev siv sab nraud kuj tau sau tseg. Nrog lawv siv, cov txiaj ntsig ntawm kev kho mob tshwm sim hauv ib lub lis piam. Qhov zoo ntawm cov tshuaj pleev ib ce yog cov tshuaj tua kab mob, xyaum tsis tau nkag mus rau hauv cov hlab ntsha dav dav, ua rau thaj tsam cuam tshuam. Piv txwv li, siv tshuaj xws li:
- "Levomekol";
- "Vishnevsky's ointment".
Yog tias ib tus neeg, ntxiv rau qhov ua paug, muaj ntshav qab zib mellitus, ces cov tshuaj uas ua kom cov metabolism hauv lub cev tsis muaj zog ntxiv, piv txwv li:
- qab zib-txo;
- tshuaj txo cov ntshav qab zib.
Yuav insulin
kev kho neeg zoo
Kev kho tus caj pas abscess hauv tsev muaj kev kho mob nrog cov qauv sib txawv, uas tau piav qhia hauv qab no:
