Cov kev kho mob ntawm cov kab mob sinusitis yog txiav txim los ntawm tus kws kho mob tom qab qhia meej txog daim ntawv ntawm tus kab mob thiab tus neeg mob tus mob. Ib qho laj thawj ntawm cov txheej txheem mob hnyav nyob rau hauv paranasal sinuses yog tus kab mob kis los yog kab mob ntawm txoj hlab pa. Kev xaiv cov kev kho mob thiab cov tshuaj kho kom raug, kev kho mob tsis tu ncua yuav pab kho tus kab mob kom tiav.
YDab tsi yog sinusitis?
Cov maxillary sinuses nyob ze ntawm lub qhov ntswg thiab txuas nrog lawv los ntawm qhov hluav taws xob qhib (ostia) nrog txoj kab uas hla ntawm 1-3 hli. Thaum muaj kab mob tshwm sim thiab pib mob, qhov ntswg kab noj hniav swells, thaiv qhov qhib ua rau cov sinuses. Nyob rau hauv no blocked ib feem ntawm lub maxillary kab noj hniav, leukocytes sib sau ua ke, uas pib mus tua tus kab mob, uas ua rau ib tug mob daim ntawv ntawm catarrhal sinusitis. Nyob rau theem no, kev kho mob thaum ntxov muab txoj hauv kev kom tsis txhob muaj teeb meem ntxiv.
Yog tias tus neeg mob tsis nco txog qhov pib ntawm tus kab mob thiab tsis tig mus rau tus kws kho mob hauv lub sijhawm, tom qab ntawd cov leukocytes tuag nyob hauv cov sinuses, "fermentation" pib, uas yog hu ua purulent o. Hauv qhov xwm txheej zoo li no, kev kho mob yuav tsum tau pib sai sai, coj mus rau hauv tus account paub txog cov tshuaj twg siv rau sinusitis. Tom qab tag nrho, lub paj hlwb nyob ze, uas yog txaus ntshai rau tus neeg mob uas muaj teeb meem loj, thiab txawm rau nws lub neej.
Kev kho mob ntawm sinusitis: cov cai dav dav
Tom qab kuaj xyuas thiab tsim qhov ua rau tus kab mob no, tus kws kho mob tau sau cov kev kho mob uas yuav pab kov yeej cov kab mob uas tau nkag mus rau hauv lub cev, txo tus neeg mob tus mob thiab zam kev rov qab los ntxiv. Cov tshuaj muaj txiaj ntsig zoo rau sinusitis pab txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm Lawv kuj tuaj yeem txo qhov o ntawm qhov ntswg mucosa, txo qhov mob taub hau, txhim kho tus neeg mob tus mob, txo qhov kub thiab txias.
Kev kho mob nyuaj ntawm sinusitis hauv cov neeg laus muaj cov txheej txheem ntawm ntau hom tshuaj, xws li:
- tshuaj tua kab mob;
- tshuaj tiv thaiv kab mob;
- tshuaj tiv thaiv kab mob;
- vasoconstrictor tshuaj tsuag thiab tso qhov ntswg;
- antipyretic;
- immunostimulating agents.
Tag nrho cov npe ntawm cov tshuaj rau sinusitis, ua nyob rau hauv ib tug complex, yuav txo tau qhov mob thiab kho tus kab mob yam tsis tau siv ib tug puncture ntawm lub maxillary sinus ("xov"), uas yog siv nyob rau hauv cov ntaub ntawv loj ntawm purulent sinusitis..
Yau cov sinuses
Thawj kauj ruam hauv kev kho mob sinusitis yog cov txheej txheem rau tshem tawm cov kua qaub thiab cov khoom o ntawm cov sinuses thiab qhov ntswg kab noj hniav. Hauv tsev kho mob, qhov no feem ntau ua tiav siv cuckoo lossis Proetsu txoj kev. Nws qhov kev txiav txim nyob rau hauv qhov tseeb hais tias ib tug tshuaj tov yog nchuav rau hauv ib lub qhov ntswg, thiab cov ntsiab lus yog nqus tawm ntawm lwm yam los ntawm lub tshuab nqus tsev vacuum.
Thaum tus txheej txheem, tus neeg mob yuav tsum rov hais lo lus "cuckoo" kom tsis suav nrog cov kua nkag mus rau hauv caj pas, yog li lub npe "neeg". Yuav kom ua tiav cov txheej txheem hauv tsev, koj tuaj yeem siv cov cuab yeej pabcuam, siv cov kua qaub rau cov dej. Tsis tas li ntawd nyob rau hauv lub tsev muag tshuaj koj muaj peev xwm yuav ib tug tshwj xeeb set "Dolphin", uas muaj xws li ib lub raj mis nrog ib tug raj, lub nozzle thiab ib tug dispenser ntawm lub hau. Cov khoom siv kuj tseem muag cov pob khoom pov tseg nrog cov tshuaj ntxhia-zaj zaub uas npaj rau ntxuav cov sinuses.
"Dolphin" nrog rau qhov sinus pab tsis tau tsuas yog ntxuav cov hnoos qeev, tab sis kuj tshem tawm cov kab mob, plua plav thiab lwm yam khoom tsis zoo, tom qab ntawd tus neeg mob ua pa rov qab zoo. Cov dej muaj pes tsawg leeg ntawm cov kua ntxhua khaub ncaws muaj xws li ib tug complex ntawm minerals, raws li zoo raws li cov nroj tsuag extracts ntawm qus sawv thiab licorice, uas muaj ib tug antiseptic, anti-inflammatory thiab tiv thaiv kev tiv thaiv nyhuv.
Ua ntej noj cov ntsiab lus ntawm lub hnab yuav tsum tau yaj hauv cov dej npau, cov txheej txheem nws tus kheej muaj kev nyab xeeb rau lub qhov ntswg thiab tsis ua rau tsis xis nyob.
txhais tau tias "Ntses taub ntswg ntev" muaj nyob rau hauv 3 hom:
- rau cov neeg laus - cov khoom siv tshwj xeeb (ntim 240 ml) thiab 10 lossis 30 hlwv ntawm cov kua ntxhua khaub ncaws;
- rau cov menyuam yaus hnub nyoog 4 xyoos - ib lub raj mis 120 ml thiab 30 pcs 1 g;
- cov khoom lag luam ntxhia raug muag cais hauv cov hnab rau menyuam yaus, 1 g txhua thiab rau cov neeg laus, 2 g txhua.
Kev siv tshuaj tua kab mob
Nyob rau hauv cov ntaub ntawv ntawm o nyob rau hauv lub maxillary sinuses, nws yog ib qhov tsim nyog yuav tsum tau txwv tsis pub cov me nyuam ntawm cov kab mob pathogenic sai li sai tau thiab tiv thaiv tus kab mob los ntawm kev nkag mus rau hauv lub sinuses. Txhawm rau ua qhov no, ENT cov kws kho mob tshwj xeeb siv cov txheej txheem los yog tshuaj tua kab mob hauv zos.
Txhawm rau txiav txim siab tus neeg sawv cev ntawm tus kab mob kom raug, lub qhov ntswg tau muab los ntawm lub qhov ntswg kab noj hniav, ua tiav Gram stain, thiab tom qab ntawd cov noob bacteriological thiab tshuaj xyuas kom nkag siab rau ntau hom tshuaj. Feem ntau, kev cog qoob loo yog ua tiav hauv daim ntawv mob ntev ntawm tus kab mob, uas tsis tuaj yeem ua raws li tus qauv kev kho mob ntawm sinusitis - broad-spectrum tshuaj tua kab mob.
Nrog rau cov tshuaj xaiv kom raug, cov txiaj ntsig zoo ntawm kev kho mob tshwm sim hauv 2-3 hnub, qhov no yog qhov txo qis hauv qhov kub thiab txias, txo qhov mob taub hau thiab lub siab ntawm lub hauv pliaj thiab qhov ntswg, thiab kev txhim kho kev noj qab haus huv.
Cov tshuaj tua kab mob niaj hnub zoo rau sinusitis yog cov tshuaj ntawm ntau pawg:
- aminopenicillins ("Ampisid", "Libakcil", "Sulbacin", thiab lwm yam);
- amoxicillin clavulonates ("Augmentin","Amoxiclav", "Rapiclav");
- macrolides ("Sumamed", "Azitrox", "Elrox", "Kystrotsin");
- cephalosporins ("Zaftera", "Maxipim", thiab lwm yam);
- fluoroquinolones ("Levostar", "Zanocin", "Sparbakt", thiab lwm yam).
Nyob rau tib lub sijhawm, nws yog ib qho tsim nyog yuav tsum noj cov tshuaj probiotic kom normalize plab hnyuv ("Linex", "Bion-3", "Normoflorin", thiab lwm yam).
Lub luag haujlwm ntawm vasoconstrictor tee lossis tshuaj tsuag (decongestants) yog tshem tawm qhov o ntawm lub qhov ntswg mucosa thiab cov sinuses uas nyob ib sab, txo qhov congestion, thiab ua pa yooj yim. Lawv raug pom zoo kom siv tsuas yog thawj hnub ntawm kev mob txhawm rau txhawm rau txo tus mob, kom muaj peev xwm "dawb" ua pa rau ob peb hnub. Yog xav paub ntau tshaj txoj kev kho mob, koj yuav tsum sab laj nrog kws kho mob kom paub meej txog daim ntawv ntawm sinusitis thiab siv cov kev kho mob zoo dua.
Cov txiaj ntsig kho qhov ntswg decongestants yog raws li hauv qab no:
- tawm tsam kab mob thiab kis kab mob;
- txhim kho qhov tawm ntawm kev faib zais cia;
- kho dua tshiab ntawm cov haujlwm ntawm ciliated epithelium;
- kua mucus thiab nws tshem tawm mus rau sab nraud;
- moisturizing lub mucosa thiab alleviating tus mob;
- vasoconstriction thiab edema tshem tawm.
Cov hom tseem ceeb ntawm pheej yig tee hauv qhov ntswg los ntawm sinusitis yog qhov txawv los ntawm cov tshuaj nquag:
- xylometazoline (tshuaj "Otrivin","Galazolin", thiab lwm yam) - tus nqi yog 40-100 rubles;
- phenylephrine ("Vibrocil") - cov tee ntau uas muaj cov tshuaj tiv thaiv kab mob thiab vasoconstrictor, kuj tseem siv tau rau cov menyuam yaus, tus nqi yog kwv yees li 300 rubles;
- nafazolin ("Sanorin") - pom zoo siv los ntawm cov menyuam yaus hnub nyoog 2 xyoos, tus nqi 40-80 rubles;
- oxymetazoline ("Nazol" thiab "Nazol-Baby") - tso cai rau menyuam yaus, nqe 180-240 rubles
- "Rinofluimucil" - tshuaj tsuag uas muaj mucolytic, anti-inflammatory thiab vasoconstrictive nyhuv, 280 rubles
Qhov tsis zoo ntawm cov tshuaj decongestants yog cov nyhuv luv luv, uas feem ntau kav li 2-3 teev (Sanorin, Naphthyzin) txog 12 teev (Nazol, Nazivin, thiab lwm yam).
Rau kev kho mob ntawm tus kab mob, hormonal los yog qhov ntswg tee nrog tshuaj tua kab mob. Nrog sinusitis, lawv txo qhov mob zoo thiab rhuav tshem qhov ua rau tus kab mob. Lawv raug tshuaj los ntawm kws kho mob tsuas yog tom qab tshawb pom thiab kuaj xyuas tus kab mob ntawm tus kab mob. Cov tshuaj no muaj xws li "Nasonex", "Flixonase" (muaj cov tshuaj hormones); "Isofra", "Polydex", "Sofradex", "Garazon", "Protargol", "Fluimucil" (cov tshuaj tua kab mob), thiab lwm yam.
Cov lus qhia rau kev siv cov tee rau sinusitis
Kev xaiv cov tshuaj rau sinusitis nyob rau hauv daim ntawv ntawm cov tshuaj tsuag thiab qhov ntswg te yog nyob ntawm cov tsos mob ntawm tus kab mob thiab cov tsos mob tsis zoo:
- nrog qhov ntswg qhuav thiab tawm hnyavCov khoom uas muaj cov ntsev ntsev, piv txwv li, "Aquamaris", "Salin", uas pab moisturize lub mucosa thiab tshem tawm cov hnoos qeev;
- nyob rau hauv cov kua paug tawm, yuav tsum tau siv cov tshuaj tua kab mob, lawv yuav tsum tau muab los ntawm kws kho mob tom qab kuaj;
- thaum qhuav secretion accumulates nyob rau hauv sinuses, mucolytics yog muab rau nyias;
- yog tus neeg mob ua pa nyuaj, cov tshuaj vasoconstrictor zoo tib yam yog tsim rau "kev cawm";
- rau cov menyuam yaus thiab cov poj niam cev xeeb tub nws yog qhov zoo dua los siv cov kev npaj tshwj xeeb tau pom zoo rau lub hnub nyoog thiab tus mob lossis tshuaj kho pej xeem;
- thaum tsis muaj tee pab ntxiv lawm, ces qhov ntswj ntawm maxillary sinus yog siv los ua "kawg" kev kho, kev phais yog ua tau.
"Nasonex" thiab lwm yam tshuaj hormonal
Cov tshuaj yog nyob rau hauv pab pawg ntawm cov tshuaj hormonal hauv zos raws li corticosteroids thiab yog npaj rau kev kho mob ntawm cov txheej txheem inflammatory hauv qhov ntswg thiab qhov ntswg. "Nasonex" rau sinusitis nyob rau hauv cov neeg laus tsuas yog siv tom qab sab laj nrog kws kho mob, vim hais tias nws muaj cov tshuaj hormone mometasone. Qhov no yog ib qho tshuaj hormonal muaj zog uas muaj cov nyhuv inhibitory ntawm cov txheej txheem inflammatory ntawm cov mucous daim nyias nyias ntawm lub qhov ntswg thaum siv topically.
Cov tshuaj tuaj hauv daim ntawv ntawm kev ncua uas yuav tsum tau shaken ua ntej siv. Kev txhaj tshuaj yog ua los ntawm kev siv lub tshuab dispenser tshwj xeeb.
Qhov kev txiav txim ntawm "Nasonex" yog raws li hauv qab no:
- txo qismucosal o los ntawm thaiv cov neeg nruab nrab;
- tshem tawm ntawm edema (vasoconstrictor nkaus), uas tso cai rau lub qhov ntswg ua pa dawb;
- anti-allergic effect, uas cuam tshuam nrog kev thaiv cov receptors ntawm cov mucous membrane uas hnov mob rau qhov ua xua ntawm qhov ua xua.
Cov tshuaj tau pom zoo siv rau hauv sinusitis, nyuaj los ntawm kev cuam tshuam ntawm cov kab mob pathogenic, ua ke nrog cov tshuaj tua kab mob. Thaum cov kua paug tawm ntawm qhov ntswg, nws raug nquahu kom yaug lawv kom huv si ua ntej.
Cov koob tshuaj "Nasonex" rau cov neeg laus yog 2 txhaj ob zaug hauv ib hnub, rau cov menyuam yaus hnub nyoog 2.5 xyoos - 1 txhaj tshuaj 1 zaug hauv ib hnub. Cov tshuaj muaj contraindications (ib tug neeg intolerance rau lub Cheebtsam) thiab cov kev phiv tsis zoo nyob rau hauv daim ntawv ntawm lub qhov ntswg los ntshav, tsis xis nyob, mob taub hau, nce qhov muag siab, yog li ntawd nws tsuas yog siv tom qab sab laj nrog kws kho mob.
Zoo ib yam tee thiab tshuaj tsuag rau kev kho mob ntawm sinusitis nrog glucocorticosteroids raug pom zoo rau kev kho mob nrog exacerbation ntawm cov kab mob ntev:
- "Flixonase" (muaj fluticasone) - siv rau cov neeg laus thiab menyuam yaus hnub nyoog 5 xyoos;
- "Avamys" - siv ib hnub ib zaug (thaum sawv ntxov) rau cov neeg laus thiab menyuam yaus hnub nyoog 4 xyoos.
Sinuforte
Qhov kev txiav txim ntawm tee hauv qhov ntswg "Sinuforte" yog raws li lub peev xwm ntawm cov tshuaj nquag - cyclamen los ntawm pab pawg ntawm saponins - txhawm rau txhawm rau tso tawm cov kua qaub uas ua rau cov mucous membranes.daim nyias nyias ntawm lub qhov ntswg kab noj hniav, uas pab tso tawm viscous tuab mucus mus rau sab nraud.
"Sinuforte" nrog sinusitis pab ntxuav lub qhov ntswg kab noj hniav thiab cov sinuses los ntawm cov kua paug, restores kua thiab qhov cua. Lub ntim ntawm cov tshuaj muaj lub raj mis nrog cov hmoov thiab kua extract ntawm European cyclamen, tom qab txuas lawv, koj yuav tsum co lawv, ntsia hlau dispenser cap rau lub raj mis, uas cov tshuaj yog sprayed mus rau hauv lub qhov ntswg.
Cov lus qhia rau kev siv yog raws li hauv qab no:
- tom qab npaj cov tshuaj, tshem lub hau thiab ua tshuaj tsuag rau saum huab cua;
- thaum lub sijhawm ua haujlwm, ua kom koj lub taub hau ncaj, ntxig rau sab saud ntawm lub tshuab xa mus rau hauv qhov ntswg thiab tshuaj tsuag rau hauv txhua qhov sinus;
- tom qab 2-3 feeb, cov tshuaj pib ua haujlwm: muaj qhov tso tawm ntawm cov hnoos qeev thiab kav ntev txog 2 teev;
- pus tawm ua ntej, maj mam tso tawm ua pob tshab;
- tom qab ntxuav cov sinuses, ua pa ib txwm rov qab los;
- txhaj tshuaj txhua 1-2 hnub, 1 koob;
- Lub sijhawm kho - 8 hnub nrog cov txheej txheem txhua hnub thiab 16 - thaum thov txhua hnub;
- tom qab 6-8 kev kho mob kom rov zoo tag nrho.
Contraindications rau kev siv "Sinuforte":
- siab rhiab heev rau cov tshuaj nquag (cyclamen);
- ua xua rhinitis;
- ntshav siab (hypertension);
- Cov menyuam yaus hnub nyoog qis dua 12;
Sinuforte yuav tsum tsis txhob noj tib lub sijhawm raws li tshuaj loog hauv zos. Kuj tshuajkuj tseem muaj nyob rau hauv daim ntawv ntawm cov tee uas tau txhaj rau hauv qhov ntswg qhov ntswg uas siv lub tshuab tshwj xeeb ntawm lub raj mis.
Txiv thiab qhov ntswg dauv "Polydex": cov lus qhia rau kev siv
Cov txiaj ntsig zoo ntawm cov tee uas muaj tshuaj tua kab mob hauv kev kho mob sinusitis:
- txo qhov ntim ntawm purulent paug;
- txo qhov concentration thiab kev puas tsuaj ntawm cov kab mob pathogenic;
- inhibition ntawm o ntawm qhov ntswg mucosa.
Ib qho ntawm cov tshuaj siv dav hauv daim ntawv tshuaj tsuag lossis tee - "Polydex". Cov lus qhia rau kev siv cov tee hauv qhov ntswg pom zoo kom siv cov tshuaj 5 zaug hauv ib hnub, txhaj tshuaj 1 zaug (rau cov neeg laus), lossis peb zaug hauv ib hnub (cov menyuam yaus hnub nyoog 2-16 xyoo).
Nws muaj:
- phenylephrine, uas ua rau cov hlab ntsha thiab ua rau nws yooj yim ua pa los ntawm qhov ntswg;
- dexamethasone - cov tshuaj hormones uas pab rhuav tshem cov kab mob pathogenic thiab nres cov txheej txheem inflammatory;
- neomycin thiab polymyxin yog cov tshuaj tua kab mob.
Contraindications rau kev siv "Polydex" yog kub siab, tsis haum tshuaj, glaucoma nyob rau hauv tus neeg mob, ib tug nyiam mus convulsions.
"Isofra": cov lus qhia rau kev siv rau cov menyuam yaus thiab cov neeg laus
Cov tshuaj no yog qhov nrov tshaj plaws, vim nws qhov kev ua tau zoo thiab muaj peev xwm siv tau rau cov menyuam yaus. Nws hais txog cov tshuaj pleev ib ce rau cov tsos mob ntawm cov kab mob ENT. Muaj sulfateframycetin, uas muaj zog tiv thaiv kab mob thiab muaj peev xwm ua kom puas cov kab mob hlwb nrog kev ua txhaum ntawm lawv cov metabolism. Nws qhov kev ua tau zoo tiv thaiv kab mob gram-positive thiab gram-negative pathogenic cov kab mob uas ua rau cov kab mob ua pa sab saud.
Recommended use:
- neeg laus - 1 txhaj tshuaj txhua 4-6 teev;
- raws li cov lus qhia rau kev siv "Isofra", rau cov menyuam yaus hnub nyoog qis dua 1 xyoos, lawv tau txhaj peb zaug ib hnub, 1 koob;
- kev kho mob yog 7-10 hnub nyob ntawm qhov mob hnyav;
- thaum txhaj, lub raj mis yuav tsum tuav ntsug.
Nyob rau hauv cov xwm txheej hnyav, nrog rau kev hem thawj ntawm cov teeb meem los yog nrog purulent sinusitis, kev siv tshuaj tsuag yuav tsum tau ua ke nrog kev siv tshuaj tua kab mob hauv qhov ncauj lossis txhaj tshuaj. Thaum cev xeeb tub thiab pub menyuam yaus, kev siv "Isofra" raug txwv vim muaj kev cuam tshuam tsis zoo rau kev tsim ntawm tus menyuam lub cev hnov lus.
Kev kho mob sinusitis hauv me nyuam
Rau cov kev kho mob ntawm sinusitis nyob rau hauv cov me nyuam mos, nws yog qhov zoo tshaj plaws los siv cov tshuaj tsuag qhov ntswg, vim hais tias kev siv cov tshuaj tsuag los yog aerosol yuav provoke laryngospasm nyob rau hauv tus me nyuam uas muaj tsis haum thiab lwm yam teeb meem kev noj qab haus huv.
Feem ntau ntawm cov tshuaj no yog contraindicated nyob rau hauv cov me nyuam hnub nyoog qis dua 2-3 xyoo, vim hais tias cov tsim ntawm maxillary sinuses nyob rau hauv ib tug me nyuam tseem nyob rau hauv thawj 3-4 xyoo. Yog li ntawd, kev kho mob yuav tsum pib nrog ntxuav lub sinuses nrog saline los yog Aquamaris rau cov me nyuam, lawv raug tso caitxawm yog me nyuam yuav luag yug los.
Tom qab hnub nyoog 3 xyoos, cov menyuam yaus tshwj xeeb cov tshuaj tee raug tso cai siv, piv txwv li, "Nazol-Baby" thiab lwm tus. Kev saib xyuas yuav tsum tau ua thaum muab tshuaj ntsuab npaj ("Pinosol", "Sinuforte"), uas, nrog rau tus neeg intolerance, tuaj yeem ua rau muaj kev tsis haum tshuaj.
Daim ntawv teev cov tshuaj rau kev kho mob ntawm sinusitis yog loj heev, yog li ntawd, rau ib tug ua tau zoo rov qab zoo, nws yog ib qhov zoo tshaj plaws mus cuag ib tug kws kho mob laryngologist uas xaiv tau cov tshuaj uas yuav pab tau alleviate tus mob, txo qhov mob. Cov tsos mob tsis zoo ntawm tus kab mob thiab pab kho nws.
