Mob tonsillopharyngitis yog ib yam kab mob kis tau los ntawm kev mob ntawm lub pharynx thiab tonsils. Pathological microorganisms, feem ntau yog cov kab mob, koom nrog hauv kev txhim kho cov txheej txheem pathological, txawm li cas los xij, qee zaum nws tuaj yeem ua kab mob lossis fungi.
Mob tonsillopharyngitis raws li ICD-10, nyob ntawm qhov chaw ntawm cov txheej txheem pathological, muab faib ua tonsillitis thiab pharyngitis. Thaum lub sij hawm tus kab mob no, kis tau mus rau pathogens ua rau mob hnyav, rheumatism, lub raum thiab lub plawv tsis xws luag. Kev kho mob tsuas yog tom qab kuaj mob thiab txheeb xyuas tus neeg sawv cev ua rau tus kab mob.
Ntxhais kab mob
ICD-10 code rau mob tonsillopharyngitis yog dab tsi? Nws muab cov tsos mob ntawm ob yam kab mob. Tonsillitis raws li ICD-10 muaj tus lej J03, thiab pharyngitis - J02. Qhov kev kuaj mob no qhia txog qhov muaj tag nrho cov cim qhia uas muaj kev puas tsuaj rau lymphoid formations thiab tonsils. Tsis tas li ntawd, palate thiab pharyngeal mucosa koom nrog cov txheej txheem pathological.
Qhov ob nopathologies tshwm sim ib txhij nyob rau hauv cov me nyuam. Phau ntawv siv ntawm International Classification of Disease tsis sau tus mob tonsillopharyngitis. Rau kev faib tawm, cov cai ntawm nws cov khoom yog siv.
Kev tshwm sim
Tus mob tonsillopharyngitis hauv cov menyuam yaus thiab cov neeg laus txhim kho thaum cov kab mob nkag mus rau hauv lub cev. Hauv particular, kab mob, fungi, kab mob tuaj yeem ua cov kab mob. Tsis tas li ntawd, tus kab mob tsim tawm tsam keeb kwm ntawm kev ua xua thiab ntau yam kev raug mob. Ib qho laj thawj tseem ceeb ntawm tus kab mob hu ua:
- adenovirus;
- flu;
- coronavirus;
- rhinovirus;
- respiratory syncytial virus.
Nrog kev txo qis hauv kev tiv thaiv kab mob, tus kab mob tuaj yeem tiv thaiv keeb kwm ntawm kev ntws ntawm cytomegalovirus, herpes, Epstein-Barr virus, HIV. Nrog rau lub cev tsis muaj zog, lwm yam ua rau pathology tuaj yeem hu ua:
- syphilis;
- chlamydia;
- streptococci;
- hnoos;
- gonorrhea.
Feem ntau muaj mob tonsillopharyngitis hauv cov menyuam yaus hnub nyoog 5-15 xyoos. Hauv cov menyuam yaus hnub nyoog qis dua 3 xyoos, cov kab mob zoo sib xws pib tawm tsam keeb kwm ntawm tus kab mob kis, thiab tom qab 5 xyoos - kab mob.
Yuav ua li cas yog cov paib
Cov tsos mob ntawm tus mob tonsillopharyngitis tau hais tau zoo, uas yog vim li cas koj tuaj yeem paub cov kab mob yooj yim. Ib qho ntawm cov cim tseem ceeb yog qhov muaj mob thaum nqos. Tsis tas li ntawd, qhov mob thaum nqos tuaj yeem muab rau pob ntseg. Qhov no tshwm sim thaum muaj mob hnyav. Ntawm cov tsos mob tseem ceebmob tonsillopharyngitis, nws yog ib qho tsim nyog los qhia txog cov tsos mob xws li:
- mob taub hau;
- nasive voice;
- kub nce;
- qaug zog;
- ua pa tsis zoo;
- caj pas liab;
- cov quav hniav dawb thiab o ntawm cov tonsils.
Qee zaum kuj yuav muaj ntau yam cim qhia ntawm tus kab mob, uas yuav tsum raug ntaus nqi xws li:
- pob hauv qhov ncauj;
- plab hnyuv;
- fever;
- o lossis mob qog nqaij hlav.
Ntau zaus, kab mob tuaj yeem cuam tshuam ncaj qha rau cov hlab ntsha thiab lub plawv cov leeg. Tshwj xeeb tshaj yog txaus ntshai yog mob tonsillopharyngitis rau cov poj niam cev xeeb tub. Qhov tshwm sim ntawm tus kab mob no tuaj yeem yog cov teeb meem cuam tshuam nrog cov hlab ntsha, lub plawv, ob lub raum, nrog rau kev mob hnyav ntawm lub cev. Yog tias kev kho mob tau ua tsis raug, ces txawm tias qhov tshwm sim me me ntawm qhov mob tuaj yeem ua rau muaj ntau yam teeb meem kev noj qab haus huv.
Tus kab mob mob hnyav yog qhov txaus ntshai heev, vim nws tuaj yeem ua rau lub cev tsis zoo, yog li thaum thawj cov tsos mob tshwm sim, yuav tsum tau pib kho tam sim ntawd txhawm rau tswj kev noj qab haus huv ntawm tus menyuam hauv plab.
Nws yog txwv tsis pub noj tus kheej thiab siv cov tshuaj ib txwm siv, vim lawv muaj ntau yam kev phiv thiab muaj kev cuam tshuam rau tus menyuam hauv plab. Qhov phom sij tseem ceeb tshaj plaws ntawm kev muaj mob thaum cev xeeb tub yog qhov ua rau nws nchuav menyuam.
Spicytonsillopharyngitis nyob rau hauv cov neeg laus thiab cov menyuam yaus pib sai heev thiab muaj cov tsos mob tshwm sim. Nws tsim tawm tsam keeb kwm ntawm overheating, hypothermia lossis kev ntxhov siab. Thaum kuaj pom, tus kws kho mob sau qhov o thiab liab ntawm palatine tonsils. Qee zaum, petechial hemorrhages tau sau tseg.
Thaum cov kab mob kis tau tshwm sim, cov xim dawb tau sau rau ntawm thaj chaw cuam tshuam ntawm cov mucosa, uas yooj yim tshem tawm nrog spatula. Qhov no ua rau tsis muaj qhov txhab los ntshav.
Nrog cov kab mob kab mob, cov kab mob tsis muaj qhov pib mob. Cov tsos mob nce zuj zus. Tam sim ntawd muaj ib qho khaus hauv caj pas, ib qho hws me ntsis, uas maj mam hloov mus ua mob hnyav. Lub cev kub nce me ntsis, tab sis dhau sij hawm nws hloov mus ua npaws. Cov tonsils thiab lawv cov ntaub so ntswg ib puag ncig hloov maj mam.
Yog tias tsis muaj kev kho mob thaum pib, ces tus mob catarrhal tonsillopharyngitis maj mam hloov mus ua purulent. Nrog rau daim ntawv no, tus neeg mob qhov mob hnyav heev. Qhov mob muaj zog heev, thiab cov tsos mob ntawm intoxication kuj tau hais. Thaum kuaj xyuas, nws tau sau tseg tias cov tonsils yog hyperemic thiab hypertrophied. Purulent blotches raug sau tseg ntawm cov tonsils thoob plaws hauv lub mucosa.
Lymph nodes yog qhov loj thiab mob ntawm palpation. Yog tias kev kho tsis tau raws sijhawm, cov teeb meem txaus ntshai tuaj yeem tshwm sim. Tsis tas li ntawd, muaj qhov txaus ntshai ntawm kev hloov mus rau theem ntev.
Tus mob tonsillopharyngitis hauv cov menyuam yaus (daim duab ntawm cov tonsils thaum lub sijhawm muaj tus kabmob, saib saum toj no) qhia nws tus kheej hauvdaim ntawv ntawm cov tsos mob hnyav. Ntawm cov cim tseem ceeb, nws yog qhov yuav tsum tau ua kom pom xws li:
- txo kev tawm dag zog lub cev;
- ntxhis kua muag;
- poob qab los;
- tawm pob ntawm lub cev, conjunctivitis;
- fainting;
- tawg quav;
- kev sib koom tes ntawm kev txav.
Thaum thawj cov tsos mob tshwm sim, koj yuav tsum mus ntsib kws kho mob kom kuaj thiab kho.
Diagnostics
Mob tonsillopharyngitis raws li ICD-10, dua, tau faib ua tonsillitis thiab pharyngitis. Thaum ua qhov kev kuaj mob, yam xws li:
- neeg tsis txaus siab;
- survey results;
- history data;
- laboratory diagnostics.
Cov kab mob thiab kab mob kis tau los ntawm kev kuaj ntshav. Lymphocytosis qhia tias muaj tus kab mob hauv lub cev, thiab qib ESR nce ntxiv qhia txog microbial keeb kwm ntawm pathology. Txawm li cas los xij, nws tsim nyog sau cia tias nws yog qhov nyuaj heev los txiav txim siab qhov ua rau tus kab mob. Cov tsos mob ntawm tonsillopharyngitis tsis yog tshwj xeeb thiab tuaj yeem raug ntaus nqi rau txhua yam kab mob ua pa.
kuaj kab mob yuav tsum tau sau tshuaj. Hauv qhov no, tus kws kho mob siv cov khoom siv roj ntsha los ntawm qhov chaw ntawm cov tonsils thiab pharynx los txiav txim siab qhov rhiab ntawm cov kab mob mus rau cov tshuaj tua kab mob los yog tshuaj tua kab mob. Nyob rau theem siab ntawm tus kab mob, ntxivx-ray thiab cardiogram. Cov poj niam cev xeeb tub raug tshuaj xyuas ultrasound thiab kev kuaj mob ntxiv raws li kev txiav txim siab ntawm tus kws kho mob.
Txoj kev kho mob
Kev kho mob tonsillopharyngitis feem ntau ua hauv tsev kho mob nrog kev pab los ntawm cov cuab yeej tshwj xeeb. Feem ntau, cov kws kho mob tshwj xeeb ntxuav cov tonsils ntawm cov kab mob thiab kab mob, uas yuav pab txo qhov o. Rau kev kho mob zoo li no, thov:
- dub ultrasound;
- caj pas thiab qhov ncauj irrigation;
- physiotherapeutic effect.
Ultrasonic kev huv ntawm lacunae ntawm cov tonsils yog ua nrog kev tshem tawm tom qab ntawm cov kua qaub thiab ntsaws. Rau qhov no, ib tug tshwj xeeb apparatus yog siv. Ua raws li cov txheej txheem no yuav pab txo qis qhov mob hauv caj pas, uas ua rau txo qis ntawm cov tonsils o.
Kev kho lub cev los yog kev kho mob laser muaj cov tshuaj tua kab mob thiab tiv thaiv kab mob. Rau irrigation ntawm caj pas, complex ntsev compositions ntawm minerals yog siv. Lawv pab txhawb kev tiv thaiv hauv zos thiab muaj kev tiv thaiv kev ua xua.
Txhua cov txuj ci no pab kom tshem tau tus kab mob sai sai, tab sis nyob rau hauv qhov xwm txheej uas tsis muaj qhov kub thiab txias. Txhawm rau sib sau ua tiav qhov tshwm sim, cov tshuaj immunostimulating tau sau.
Ntxiv rau cov txheej txheem no, tus kws kho mob tau sau cov zaub mov, uas txhais tau hais tias kev noj cov zaub mov mos uas muaj cov vitamins ntau. Ib qho yuav tsum tau ua ua ntej rau kev kho mob ntawm tus mob tonsillopharyngitis hauv cov menyuam yaus yog kev tshem tawm cov purulent plugs thiab ntxuav.tonsils. Ua li no, gargle nrog kev siv ntau yam kev daws teeb meem. Cov kws kho mob feem ntau sau ntawv "Rivanol", "Furacilin", "Gexoral".
Nws kuj pom zoo kom siv lozenges. Txhawm rau tshem tawm qhov mob hnyav thiab ua npaws, tus kws kho mob yuav sau tshuaj tiv thaiv kab mob. Yog tias tsis muaj qhov muaj txiaj ntsig zoo nyob rau hauv cov ntaub ntawv ntawm kev ua haujlwm ntawm tus mob tonsillopharyngitis hauv tus menyuam, kev tshem tawm cov tonsils yuav raug sau tseg.
Drug therapy
Rau kev kho mob ntawm tus mob tonsillopharyngitis, tshuaj xws li:
- tshuaj tua kab mob;
- antiviral;
- immunostimulating;
- antipyretic;
- Yanti-inflammatory.
Cov tshuaj "Bioparox" tau ua pov thawj nws tus kheej zoo. Qhov no aerosol muaj cov nyhuv anti-inflammatory, zoo tua kab mob thiab fungi. Nws tuaj yeem siv los ntawm cov menyuam yaus hnub nyoog 2, 5 xyoos thiab cov neeg laus, tab sis nws yog txwv tsis pub siv thaum cev xeeb tub thiab thaum pub niam mis.
Kev npaj "Stopangin" pab tshem tawm qhov mob thiab kab mob. Tsis tas li ntawd, cov tshuaj no muaj cov nyhuv analgesic. Nws muaj nyob rau hauv daim ntawv ntawm ib tug tov rau rinsing los yog tshuaj tsuag. Nws tsis pom zoo kom siv nws hauv thawj 3 lub hlis ntawm cev xeeb tub, nrog rau kev kho cov menyuam yaus hnub nyoog qis dua 8 xyoos.
Cov tshuaj "Imudon" txhim kho kev tiv thaiv kab mob, tshem tawm thiab tiv thaiv kab mob. Txawm li cas los xij, nws tsim nyog nco ntsoov tias cov cuab yeej no muajMuaj ntau ntau contraindications, yog li koj tuaj yeem noj nws tsuas yog nrog kev tso cai los ntawm kws kho mob. Muaj nyob rau hauv daim ntawv ntawm lozenges.
Miramistin yog cov tshuaj tua kab mob hauv zos ntev. Nws raug tso cai siv los ntawm cov menyuam yaus hnub nyoog 3 xyoos, nrog rau thaum cev xeeb tub thiab pub niam mis. Tag nrho cov tshuaj no tau dav siv los kho mob tonsillopharyngitis hauv cov neeg laus. Cov tshuaj thiab ntau npaum yog muab los ntawm tus kws kho mob tsuas yog tom qab kuaj thiab kuaj mob. Nws tsim nyog nco ntsoov tias kev noj tshuaj rau tus kheej tuaj yeem txaus ntshai heev thiab yuav ua rau muaj kev phom sij ntau dua li qhov zoo.
kev kho neeg zoo
Ntxiv rau kev kho tshuaj, koj tuaj yeem siv cov tshuaj pej xeem uas pab tshem tawm qhov mob hauv caj pas thiab ua kom muaj kev noj qab haus huv zoo. Soda-ntsev rinses tau ua pov thawj lawv tus kheej zoo. Ua li no, dissolve 1 tsp nyob rau hauv 1 khob ntawm boiled dej sov. ntsev thiab dej qab zib, ntxiv ob peb tee ntawm iodine rau kev daws. Gargle 3 zaug ib hnub.
Chav nqus pa nrog decoctions ntawm tshuaj ntsuab thiab cov roj tseem ceeb kuj tseem siv tau. Rau kev kho mob, koj tuaj yeem haus cov kua txiv hmab txiv ntoo sib xyaw. Sib tov 100 ml ntawm beetroot thiab dib kua txiv thiab ntxiv 300 ml ntawm carrot kua txiv. Haus 2 zaug ib hnub.
Cov paj qhuav violet kib hauv cov roj zaub, hloov mus rau cov ntaub qhwv thiab ua kom compress. Txawm li cas los xij, nws yuav tsum nco ntsoov tias cov txheej txheem no raug txwv thaum cev xeeb tub.
txhawm rau rhuav tshem tus kab mob thiab ntxiv dag zog rau lub cev tiv thaiv kab mob, koj tuaj yeem haus cov tshuaj yej qhiav. Txiav Ginger rau hauv pieces, ntxiv 2qej cloves, txiv qaub. Muab tag nrho cov khoom xyaw npaj rau hauv saucepan thiab ncuav 0.5 liv dej. Tom qab ntawd txias cov khoom npaj thiab ntxiv me ntsis zib mu. Cov dej haus tuaj yeem noj tom qab txhua pluas noj. Cov tshuaj no muaj kev nyab xeeb kiag li thiab tsis muaj contraindications.
Rau yaug 2 tbsp. l. fenugreek noob ncuav 0.5 liv dej thiab ua noj rau 30 feeb. Lim lub decoction thiab gargle 2 zaug ib hnub twg. Nws yog ib qho tsim nyog nco ntsoov tias nws tsis tuaj yeem hloov cov tshuaj nrog cov tshuaj ib txwm siv, vim qhov no tsuas yog ua rau tus neeg mob hnyav dua. Cov txheej txheem tsis yog ib txwm siv los ua kev kho mob ntxiv.
Kev ua haujlwm
Ib txoj kev kho mob radical yog tonsillectomy. Txoj haujlwm no suav nrog kev tshem tawm cov tonsils cuam tshuam. Cov tonsils ua ib hom kev cuam tshuam hauv lub cev, thiab tseem pab tswj kev tiv thaiv kab mob. Tias yog vim li cas xws li ib tug radical txoj kev kho mob raws li kev phais yog sau los ntawm ib tug otolaryngologist nyob rau hauv feem ntau cov neeg mob, yog hais tias conservative txoj kev tsis tau coj cov xav tau.
Tom qab tshem tawm cov lymphoid tsim, kev nkag tau yooj yim dua yog qhib rau kev nkag mus ntawm cov kab mob mus rau hauv oropharynx. Qhov no ua rau kev txhim kho ntawm cov kab mob ua pa nquag, uas ua rau cov kab mob tonsillopharyngitis, laryngitis, tonsillitis, pharyngitis.
Kev phais txoj kev kho mob kuj suav nrog lacunotomy, uas yog ua los ntawm kev siv xov tooj cua yoj txoj kev. Qee zaum, laser vaporization ntawm tonsil parenchyma yog sau. Lub luag haujlwm tseem ceeb ntawm xws liKev cuam tshuam yog qhov normalization ntawm cov kua dej ua haujlwm ntawm cov tonsils los ntawm kev nthuav dav qhov khoob.
Txawm li cas los xij, thaum siv cov kev kho mob zoo li no, cov kws kho mob tshwj xeeb yuav tsum paub txog qhov muaj feem cuam tshuam. Qhov tshwm sim ntawm qhov kev cuam tshuam no yuav yog qhov ua kom cov txheej txheem cicatricial, thiab cov nyhuv yuav nruj heev.
Muaj Teeb Meem
Nyob rau hauv mob tonsillopharyngitis, cov lus pom zoo hauv chaw kho mob tau hais kom ua raws li txhua tus kws kho mob cov tshuaj, ua raws li kev pw tsaug zog, nrog rau kev noj zaub mov kom zoo, sib npaug. Nyob rau hauv rooj plaub uas tsis ua raws li tag nrho cov xwm txheej no, ntau yam teeb meem yuav tshwm sim, tshwj xeeb xws li:
- endocarditis;
- laryngitis;
- tracheitis;
- caj dab phlegmon;
- meningitis;
- fasciitis
Txhua yam teeb meem no tsis tshwm sim ntau dhau. Yeej, lawv tau nrog ntau lub cev tsis ua haujlwm, uas tuaj yeem ua rau tus neeg mob tuag. Cov teeb meem purulent yog suav tias tsis tshua muaj kev phom sij, tshwj xeeb, xws li mob glomuronephritis lossis rheumatic fever.
Yuav kom tsis txhob muaj teeb meem, koj yuav tsum sab laj nrog kws kho mob ntawm thawj cov cim qhia ntawm tus kab mob txhawm rau kuaj xyuas thiab kho.
kab mob prognosis
Qhov kev cia siab ntawm cov kab mob no feem ntau yog nyob ntawm kev mus ntsib kws kho mob raws sij hawm, kev kuaj mob, kev teem caij kho mob, nrog rau kev ua raws tag nrho cov lus pom zoo thiab cov tshuaj. Yog tias tag nrho cov xwm txheej no tau ua tiav, qhov kev kwv yees tau zoo.
Yog tias tus kab mob tsis raug tshem tawm raws sijhawm, cestus kab mob ua rau mob. Tawm tsam keeb kwm yav dhau los no, cov txheej txheem irreversible tau pib hauv lub cev, uas yuav luag tsis tuaj yeem tshem tawm.
prophylaxis
Txhawm rau tiv thaiv qhov tshwm sim ntawm tus kab mob, nws tseem ceeb heev uas yuav tsum ua raws qee yam kev tiv thaiv. Cov kws kho mob pom zoo kom zam qee yam tsis zoo hauv txhua txoj hauv kev, tshwj xeeb xws li:
- haus luam yeeb;
- cua qhuav;
- pab pa;
- dust;
- sab zog.
Nws yog ib qho tseem ceeb uas yuav tau mus ntsib kws kho mob kom raws sijhawm thiab kho cov kab mob ntawm lub qhov ntswg, hniav, cov pos hniav, tshwj xeeb tshaj yog tias lawv kis tau. Nws yog ib qho tsim nyog los saib xyuas kev ua haujlwm ntawm lub plab zom mov. Pom zoo rau qhov no:
- ua raws li kev noj zaub mov tsis zoo;
- khoom noj khoom haus;
- noj cov zaub mov muaj fiber ntau;
- txo qis ntsim, kib thiab ntsev.
Cov kws kho mob kuj pom zoo kom ua lub neej noj qab haus huv, taug kev hauv huab cua ntshiab, ua si kis las. Nyob hauv tsev, koj yuav tsum ua kom huv si thiab saib xyuas cov av noo. Nws tseem ceeb heev uas yuav tau saib xyuas koj txoj kev noj qab haus huv thiab siv sij hawm so thiab pw tsaug zog zoo.
Tonsillopharyngitis yog ib yam kab mob txaus ntshai, yog vim li cas nws thiaj li tseem ceeb rau kev kuaj mob thiab kho nws raws sijhawm kom tsis txhob muaj teeb meem tshwm sim.
