Nyob rau hauv tsab xov xwm peb yuav txiav txim siab mob thiab mob ntsws sinusitis.
Nov yog tus kab mob inflammatory lossis tsis haum ntawm paranasal sinuses.
Raws li ICD-10 system, mob sinusitis muaj code J01, ntev - J32.
Feem ntau, cov kab mob no tshwm sim hauv maxillary sinuses (tom qab ntawd lawv tham txog sinusitis), kuj tseem muaj cov txheej txheem pathological ntawm cov hlwb ntawm ethmoid labyrinths (nrog ethmoiditis), lub frontal thiab sphenoid lobes yuav raug kev txom nyem nrog sphenoiditis thiab frontal sinusitis. Txawm li cas los xij, ntau zaus tus kab mob kis mus rau ntau qhov sinuses ib zaug, thiab tom qab ntawd tus neeg mob polysinusitis. Thaum tag nrho cov cheeb tsam paranasal koom nrog, ces pansinuitis tshwm sim. Wb tham ntxiv txog tus mob sinusitis thiab sib piv cov kab mob no.
Acute form: ua rau
Yog li, cia peb saib seb qhov sinusitis yog dab tsi. Cov tsos mob thiab kev kho mob yuav piav qhia hauv qab no.
Ua rau daim ntawv mob hnyavFeem ntau muaj cov kab mob ua pa nyuaj nrog rau cov kab mob (xws li mob khaub thuas), hypothermia, mob khaub thuas, kab mob sib kis thiab raug mob. Cov chav kawm ntawm tus kab mob tuaj yeem ua rau hnyav dua los ntawm qhov sib txawv ntawm lub cev sib xyaw ua ke nrog hypertrophy ntawm qis lossis nruab nrab ntawm lub plhaub, kev tiv thaiv tsis zoo, kev tsis haum tshuaj, thiab nce hauv nasopharyngeal tonsils (cov nroj tsuag adenoid hauv cov menyuam yaus).
Tsis yog txhua tus paub tias yam kab mob - sinusitis.
Cov tsos mob hnyav
Sib npaug rau qhov no:
- ua kua ntswg ntau tshaj xya mus rau kaum hnub yam tsis pom kev txhim kho.
- Kev pom qhov ntswg congestion, purulent los yog mucous tawm.
- Txoj kab mob hnoos qeev hauv qab caj pas nrog rau cov hnoos qeev ntau tshaj plaws thaum sawv ntxov.
- Qhov tshwm sim ntawm mob taub hau, hnyav thiab tsis xis nyob hauv thaj tsam ntawm qhov txhab ntawm qhov txhab. Qee lub sij hawm tsis xis nyob mus rau thaj tsam ntawm cov hniav, qhov muag, pob txha, lub puab tsaig.
- Kev muaj kev nkag siab ntawm lub ntsej muag ntawm daim tawv nqaij hauv qhov projection ntawm qhov cuam tshuam sinuses.
- nce qhov kub kom txog peb caug yim degrees thiab siab dua. Raws li txoj cai, xws li cov tsos mob tau pom nyob rau hauv ib qho mob hnyav. Hauv cov txheej txheem ntev, qhov kub tsis tshua muaj siab lossis tuaj yeem nyob ntawm qhov ntsuas qis, uas yog, ntawm peb caug-tsib degrees.
- Pom kev qaug zog, qaug zog, chim siab. Qhov tshwm sim ntawm photophobia, tearing, tsis qab los noj mov, pw tsaug zog.
- Txhob hnov tsw ntxhiab lossis nws qhov tsis tuaj yeem ua tiav.
- Zoopuffiness ntawm ob sab plhu thiab daim tawv muag.
Txhawm rau sib piv cov mob hnyav thiab mob ntev, koj yuav tsum nkag siab qhov ua rau ntawm cov kab mob no.
Ua rau tus kab mob ntev
Lub ntsiab tseem ceeb hauv kev txhim kho ntawm daim ntawv no ntawm pathology, sib piv rau hom mob, suav nrog:
- Presence of deviated septum.
- Kev txhim kho mob rhinitis.
- Qhov tshwm sim ntawm qhov tsis sib xws ntawm anastomosis ntawm lub qhov ntswg kab noj hniav thiab qhov sinus.
- Qhov tshwm sim ntawm kev tsis haum tshuaj.
- Txuag kev tiv thaiv tib neeg.
- Kev tsom mus rau kev kis kab mob ntev (tshwm sim mob tonsillitis, kho hniav pathology).
- Txoj kev cuam tshuam rau lub cev ntawm ib puag ncig muaj kuab paug.
- Kev muaj kab mob fungal.
Ib yam uas provokes ib qho exacerbation ntawm sinusitis tuaj yeem yog kis kab mob nrog rau hypothermia. Hauv cov txheej txheem odontogenic, kev kho hniav kho hniav tuaj yeem yog lub zog pib. Nrog rhinogenic deviations, o ntawm cov mucous daim nyias nyias ntawm qhov ntswg kab noj hniav thiab sinuses tshwm sim nrog rau kev ua txhaum ntawm ntuj cleansing thiab stagnation ntawm pathogenic secretions (uas yog, mucus). Xws li stagnation, ua ke nrog kev ua pa tsis zoo, yog qhov ua rau ua rau cov txheej txheem inflammatory.
Cov tsos mob ntawm tus mob sinusitis
Qhov tshwm sim ntawm mob sinusitis nyob ntawm seb tus kab mob. Sab nraud ntawm qhov exacerbation, cov tsos mob tuaj yeem tsis tshua muaj lossis tsis tuaj yeem ua ke. Qhov tseeb, qhov no yog qhov sib txawv tseem ceeb ntawm hom kab mob sinusitis thiab nws daim ntawv mob. Feem ntau yog ib tug neegkev txhawj xeeb:
- Kev muaj qhov ntswg congestion nrog rau qhov nyuaj hauv qhov ntswg ua pa.
- Pom cov mucous tsis txaus lossis purulent tawm ntawm qhov ntswg. Qhov no tuaj yeem tshwm sim nyob rau hauv daim ntawv ntawm ziab crusts, thaum tsis tu ncua los ntawm lub qhov ntswg yog pom, uas provokes tawg thiab abrasions ntawm lub cev.
- Tshuaj hnoos qeev los ntawm lub caj pas rov qab.
- Kev ua kom qhuav hauv caj pas.
- Zoo mob taub hau.
- Kev ua pa phem.
Thaum tus kab mob hnyav zuj zus, cov tsos mob uas yog tus yam ntxwv ntawm daim ntawv mob hnyav ntawm sinusitis yuav tshwm sim.
Diagnosis
Raws li ib feem ntawm kev kuaj mob, cov kev kuaj mob hauv qab no tau ua tiav:
- Kev kuaj mob otorhinolaryngological.
- X-ray (los yog xam tomography) ntawm paranasal sinuses.
- Sinus ultrasound. Nws yog ib qho tsim nyog sau cia tias cov txheej txheem no muaj kev nyab xeeb, tsis muaj contraindications, yog siv los kuaj mob sinusitis thiab ua ib feem ntawm kev tswj cov txheej txheem kho.
- Kev kuaj mob hauv chaw kuaj mob (peb tab tom tham txog kev kuaj ntshav dav dav, tseb tawm tawm ntawm cov sinuses lossis dej ntws tawm ntawm cov nroj tsuag, thiab lwm yam).
- Ua qhov kev tshuaj ntsuam xyuas qhov ntswg ntawm qhov ntswg thiab nasopharynx los tsim kom muaj cov yam ntxwv ntawm cov qauv anatomical.
Txuas ntxiv kom paub seb qhov mob sinusitis yog dab tsi. Nws cov tsos mob thiab kev kho mob sib cuam tshuam.
Kev kho mob
Nws tsim nyog hais tias nyob rau hauv daim ntawv mob ntawm sinusitis, kev kho mob yog nqa tawm nyob rau hauv ob peb cov lus qhia. Ua ntejNyob rau hauv tag nrho, nws yog tsim nyog los tshem tawm cov kua paug los ntawm lub sinuses. Feem ntau ntawm cov xwm txheej, kev saib xyuas kev kho mob rau mob sinusitis yog ua yam tsis muaj kev sib tsoo.
Kev tshem tawm tuaj yeem ua tiav siv cov txheej txheem YAMIK. Cov txheej txheem no yog ua los ntawm cov cuab yeej hu ua YAMIK catheter. Cov kab hauv qab yog tias los ntawm cov catheter hauv qhov ntswg, tswj lub siab yog tsim thiab cov kua paug tawm los ntawm lub fistula ntuj (qhov), thiab tom qab ntawd txhaj tshuaj (nws tuaj yeem yog tshuaj tua kab mob lossis mucolytics).
Sinusitis ntsiav tshuaj yuav tham tom qab.
Ntxiv rau, cov khoom nruab nrog cev thiab cov kab mob paranasal raug ntxuav siv cov txheej txheem hloov chaw. Nws yog nqa tawm nrog kev pab los ntawm ib tug tshwj xeeb suction, uas yog los ntawm ib tug aspirator, thaum lub sij hawm tus txheej txheem, cov txheej txheem pathological raug tshem tawm thiab cov tshuaj raug txhaj rau hauv lub sinuses.
Tab sis txawm hais tias muaj txoj hauv kev zoo ntawm kev kho mob ntawm cov kab mob sinusitis, qee zaum, punctures ntawm maxillary sinuses tseem xav tau. Cov txheej txheem no yog ua nruj me ntsis raws li cov lus qhia thiab yuav tsum tau siv tshuaj loog. Tom qab tshuaj loog, ib rab koob uas tsis tshua muaj tshwm sim yog muab tso rau ntawm lub qhov ntswg mus rau hauv qhov sinus. Tag nrho cov ntsiab lus purulent raug tshem tawm los ntawm rab koob thiab cov tshuaj raug txhaj. Raws li txoj cai, lub puncture yog nqa tawm tag nrho painlessly, tab sis nyob rau tib lub sij hawm nws muaj kev ruaj ntseg. Nyob rau hauv lub neej yav tom ntej, punctures nrog sinusitis tsis cuam tshuam rau qhov mob ntawm lub qhov ntswg thiab nws cov sinuses, thiab lub qhov me me sab laug los ntawm rab koob kho tsis muaj ib tug kab.
Kev kho mob ntxivmob sinusitis thiab mob ntev, o nyob rau hauv lub qhov ntswg kab noj hniav yuav raug tshem tawm, kom ntseeg tau ib tug ib txwm outflow ntawm cov ntsiab lus ntawm lub sinuses. Nyob rau hauv ib qho kev mob hnyav, cov tshuaj vasoconstrictor npaj rau kev siv ywj pheej yuav tsum tau sau tseg, thiab anemization ntawm qhov ntswg qhov nruab nrab kuj tau ua nyob rau hauv cov xwm txheej ntawm chaw ua haujlwm otolaryngological. Mucolytic cov neeg ua haujlwm (uas ua rau cov hnoos qeev nyias) tau muab nrog rau cov tshuaj tua kab mob thiab tshuaj tua kab mob hauv daim ntawv ntawm cov tshuaj tsuag thiab qhov ntswg te. Cov txiaj ntsig zoo heev tau ua tiav thaum siv cov tshuaj ntsev rau ntxuav lub qhov ntswg. Cov tshuaj homeopathic kuj tau siv dav.
Tsis muaj qhov tseem ceeb tsawg yog kev teem caij kho tshuaj tua kab mob. Antibacterial kev kho mob rau sinusitis feem ntau yog sau rau purulent o tiv thaiv keeb kwm ntawm kub taub hau thiab intoxication. Nws yog ib qho tseem ceeb heev uas yuav tau xaiv txoj cai ntawm cov tshuaj tua kab mob, soj ntsuam qhov ntau npaum thiab lub sij hawm ntawm cov tshuaj. Txawm li cas los xij, kev kho tshuaj tua kab mob yuav tsum tau muab los ntawm tus kws kho mob nkaus xwb. Nrog rau kev siv cov kev kho mob sib xyaw ua ke, kev rov zoo tag nrho yog tias muaj mob sinusitis tau tiav nyob rau hauv xya mus rau kaum hnub.
Kev nyuaj siab
Thaum tsis muaj kev kho mob txaus, tus neeg tuaj yeem tsim cov teeb meem hauv qab no thiab kev hem thawj hauv zos:
- Qhov tshwm sim ntawm qhov abscess lossis phlegmon ntawm lub orbit.
- Kev txhim kho ntawm intracranial abscess.
- Zoo kab mob meningitis.
- pib ntawm sepsis.
Yog tias muaj teeb meem tshwm sim, yuav tsum muaj kev phais sai sai.
Kev sib pivmob thiab mob ntev sinusitis peb muaj. Tam sim no xav txog cov lus qhia dav dav.
Cov lus qhia dav dav rau sinusitis
Sinusitis yog ib yam kab mob uas tshwm sim heev, thiab tus kab mob no kho tau. Kev kho mob tuaj yeem ua tau raws li tus neeg mob sab nraud, nrog rau hauv tsev, raws li kev siv nruj ntawm txhua tus kws kho mob cov tshuaj. Kev kho mob nrog pej xeem txoj kev tsuas yog siv tau rau lub hom phiaj ntxiv dag zog. Cov tshuaj niaj hnub yuav tsis hloov lub ntsiab kev kho mob.
Txhua txoj kev ua kom sov rau sinusitis yog contraindicated, raws li nws tuaj yeem ua rau mob hnyav zuj zus, thiab tib lub sijhawm rau kev sib kis ntawm qhov mob nrog kev txhim kho tom qab ntawm cov teeb meem.
Tsis txhob ntshai tus kws kho mob otorhinolaryngologist uas yuav ua qhov ntswj tam sim. Nws yog ib qho tsim nyog yuav tsum paub tias punctures ntawm maxillary sinuses yeej ib txwm ua nruj me ntsis raws li cov lus qhia, tsuas yog tom qab kev ntsuam xyuas ntxiv tau ua tiav, thiab tsuas yog thaum nws tsis tuaj yeem ua yam tsis muaj nws. Thiab lwm qhov, lawv siv lwm txoj hauv kev, tsis yog txoj hauv kev txaus ntshai.
Sinusitis tshuaj
Nyob rau hauv lub xub ntiag ntawm tus kab mob nruab nrab, cov tshuaj xaiv yog Amoxicillin thiab Ampicillin. Txoj kev kho zaum kawg yog sau tseg, raws li txoj cai, yog tias vim li cas thawj zaug tsis haum. Lwm cov tshuaj yog cephalosporins nyob rau hauv daim ntawv ntawm "Cefuroxime axetil" thiab "Cefaclor". Tsis tas li ntawd, tus neeg mob uas muaj kab mob sinusitis tuaj yeem muab tshuaj macrolides hauv daim ntawv ntawm "Azithromycin", "Clarithromycin" lossis tetracyclines (piv txwv li, "Doxycycline"), fluoroquinolones hauv daim ntawv ntawm "Grepafloxacin" thiab lwm yam.tom ntej no.
Nws yog ib qho tseem ceeb uas yuav tsum paub ua ntej uas cov tshuaj tua kab mob yuav noj rau sinusitis.
Thaum mob hnyav, cov tshuaj hauv qab no tsim nyog:
- Kev siv cov tshuaj tiv thaiv ntawm cov tshuaj tiv thaiv penicillins hauv daim ntawv "Amoxicillin", "Ampicillin" parenterally.
- thib ob thiab thib peb tiam cephalosporins xws li Cefuroxime nrog rau Ceftriaxone, Cefotaxime lossis Cefoperazone parenterally.
- Thaum muaj kev fab tshuaj rau lactams, cov kws kho mob tau sau ntawv "Ciprofloxacin" lossis "Chloramphenicol" parenterally.
Amoxicillin
Xav txog cov lus qhia siv rau kev ncua Amoxicillin.
Qhov no yog ib daim ntawv me me ntawm cov tshuaj. Nws tuaj yeem npaj tau los ntawm diluting cov tshuaj granular nrog dej. Daim ntawv no ntau npaum ntawm "Amoxicillin" rau sinusitis muaj ntau yam zoo hauv kev sib piv nrog cov ntsiav tshuaj:
- Cov tshuaj nyob rau hauv daim ntawv ntawm kev ncua yog npaj rau kev kho cov menyuam yaus. Yog li ntawd, nws muaj ib tug qab ntxiag saj thiab raspberry tsw.
- Daim diav muaj 250 milligrams ntawm cov tshuaj, uas ua rau nws muaj peev xwm txiav txim siab npaum li cas ntawm cov tshuaj, thaum tsom rau qhov hnyav ntawm tus menyuam (tsis yog nws lub hnub nyoog nkaus xwb).
- Cov tshuaj muaj pes tsawg leeg suav nrog simethicone, uas tiv thaiv kev loj hlob ntawm colic thiab tsam plab hauv cov menyuam yaus.
Raws li cov lus qhia rau kev siv rau kev tshem tawm Amoxicillin qhia, txhawm rau npaj cov tshuaj no, koj yuav tsum tau ntxiv cov dej boiled rau qhov yuav tsum tau ua. Tom ntej no, tus neeg sawv cev zoo shaken kom txog thaum ib homogeneous loj tau txais. Tom qab ntawd, qhov kev ncua yog npaj rau kev siv. "Amoxicillin" rau cov menyuam yaus nyob rau hauv daim ntawv ntawm kev npaj tau raug ncua tuaj yeem khaws cia tsis pub dhau ob lub lis piam, tom qab ntawd cov tshuaj no ua rau tsis zoo rau kev noj. Co zoo ua ntej siv txhua. Tom ntej no, peb yuav pom tias tus kab mob no tshwm sim nws tus kheej hauv cov menyuam yaus li cas.
Cov tsos mob ntawm tus mob sinusitis hauv menyuam yaus
Daim duab kho mob ntawm cov kab mob xws li sinusitis txawv me ntsis ntawm cov tsos mob ntawm tus mob ua pa nyuaj. Hauv cov menyuam yaus, qhov txo qis hauv qab los noj mov thiab kev ua si tau pom nrog rau qhov kub thiab txias. Tab sis lwm cov cim qhia tseem tab tom txhim kho:
- Qhov tshwm sim ntawm ob sab lossis ib sab qhov ntswg congestion nrog rau kev hloov pauv ntawm lub suab ntawm lub suab vim qhov xwm txheej no.
- Kev muaj mucous los yog purulent tawm ntawm lub qhov ntswg, uas tej zaum yuav pom cov kab mob ntawm cov ntshav.
- hnoos qhuav yam tsis muaj kev pab (nrog rau cov menyuam yaus thaum hmo ntuj).
- Qhov tshwm sim ntawm tus menyuam qhov kev tsis txaus siab ntawm qhov mob taub hau (nws txoj haujlwm ncaj qha nyob ntawm seb qhov sinus yog qhov twg).
- Mob taub hau tuaj yeem ua rau hnyav dua los ntawm kev khoov rau pem hauv ntej thiab nqes (piv txwv li, thaum khi hlua khi).
- daim tawv nqaij ntawm lub ntsej muag tshaj qhov mob qhov txhab tuaj yeem ua reddened.
- Smell acuity nyob rau hauv cov me nyuam mos yog heev txo, los yog rhiab heev rau ntau yam tsw ploj tag nrho.
- Dryness ntawm nasopharyngeal mucosa tshwm.
- Qhov kub nce siab tshaj peb caug-tsib degrees.
- Facetus me nyuam yuav zoo li o.
- Tshuaj tshwm sim ntawm kev chim siab nrog rau nquag awakenings thaum pw tsaug zog thiab nce rhiab heev rau lub teeb.
Kawm yuav kho mob sinusitis kom zoo.
Yuav ua li cas kho sinusitis mus tas li?
Ob hom kab mob no kho tau, tab sis rau qhov no tus neeg yuav tsum tau siv zog ntau, ua raws li tag nrho cov lus pom zoo ntawm cov kws tshaj lij. Txoj cai tseem ceeb yog: kev kho yuav tsum tau pib tam sim tom qab tau txais kev kuaj mob. Tsis muaj sijhawm los nkim sijhawm, vim tias cov txheej txheem inflammatory yuav txuas ntxiv mus txog thaum lawv nres, thiab qhov no tsuas yog ua tau nrog kev pab ntawm cov tshuaj tshwj xeeb.
Qhov txiaj ntsig zoo ntawm sinusitis yog muab los ntawm cov tshuaj tua kab mob, xws li Azithromycin thiab cephalosporins, uas tso cai rau koj tshem tawm cov kab mob tseem ceeb, uas yog, kab mob thiab kab mob. Hauv qee qhov xwm txheej, cov tshuaj tua kab mob hauv zos tau muab tshuaj rau hauv daim ntawv ntawm "Bioparox" lossis "Isofra", lawv lub luag haujlwm tseem ceeb yog tshem tawm cov kab mob, thiab tib lub sijhawm kom tsis txhob muaj cov txheej txheem inflammatory.
Rau lub hom phiaj ntawm cov hnoos qeev tawm, qhov ntswg te nrog tshuaj tsuag yog siv, piv txwv li, "Otlin" nrog rau "Naphthyzinum", "Naftozolin", "Pinosol" thiab lwm yam. Cov tshuaj mucolytic yog siv los tshem tawm cov mucous secretions los ntawm lub qhov ntswg kab noj hniav, xws li Guaifenesin. Cov tshuaj homeopathic kuj tau sau rau sinusitis, lawv yog raws li cov khoom ntawm lub hauv paus chiv keeb, uastxo qhov kev pheej hmoo ntawm kev phiv tshuaj. Txawm li cas los xij, kev kho tshuaj tsis txaus rau cov laj thawj uas nws cuam tshuam txoj kev loj hlob ntawm cov kab mob txaus ntshai, tab sis tsis tshem tawm cov kua paug tawm ntawm cov sinuses. Nrog rau cov kev kho mob zoo li no rau mob sinusitis, nws yog ib qho tseem ceeb uas yuav tau siv lwm txoj hauv kev los ntawm kws kho mob.
