Phlegmon ntawm lub qhov muag qhov muag yog cov kab mob inflammatory uas cuam tshuam nrog cov ntaub so ntswg rog thiab yog tus cwj pwm los ntawm cov tsos mob ntawm purulent paug. Feem ntau, qhov no pathology tuaj yeem tshwm sim tsis tau tsuas yog nyob rau hauv qhov chaw ntawm lub qhov muag, tab sis kuj nyob rau hauv nws lwm yam departments - daim tawv muag, lub lacrimal sac. Tias yog vim li cas lub tswv yim ntawm phlegmon yog suav hais tias yog lub npe sib sau ua ke ntawm ntau qhov sib txawv. Tus kab mob no tau kuaj pom tsis tshua muaj, tab sis nws ua rau muaj kev phom sij loj rau lub xeev kev noj qab haus huv thiab txawm tias tib neeg lub neej.
Kev tshwm sim
Qhov tseem ceeb ua ntej rau kev txhim kho purulent o nyob rau hauv ib qho kev pom ntawm lub cev yog ingress ntawm pathogenic microorganisms rau hauv nws. Feem ntau, cov kab mob tshwm sim ntawm cov kab mob no yog streptococci, E. coli thiab staphylococci, uas tuaj yeem nkag mus rau hauv cov fiber ntau ntawm lub qhov muag nrog rau cov kua dej lom lossis sib cuag. Muaj ntau qhov laj thawj tshwj xeeb rau qhov pom ntawm phlegmon ntawm lub orbit:
- txhua yam kab mob kis los yog kab mob ntawm daim tawv nqaij, piv txwv li, erysipelas, mob furunculosis;
- kev raug mob ntawm lub cev;
- xam ntshav lom;
- qhov muag tsis xws luag - conjunctivitis, puas rau lacrimal sac,barley;
- ntaus los ntawm lwm yam khoom;
- kab mob ntawm cov sinuses;
- kev muaj kab mob hauv lub qhov ncauj - kab mob los yog kab mob caries.
Tau kawg, nws tsis yog qhov tsim nyog uas thaum muaj cov teeb meem no o ntawm lub qhov muag yuav tshwm sim. Tab sis tsis muaj zog tiv thaiv kab mob, tsis muaj vitamin deficiency, khoom noj khoom haus tsis zoo yuav ua rau muaj kev tshwm sim ntawm tus kab mob txaus ntshai.
Symptoms
Feem ntau, phlegmon ntawm lub orbit yog suav tias yog hom kab mob feem ntau ntawm cov kab mob no. Tus kab mob no kis tau sai heev nyob rau hauv txhua rooj plaub thiab nyob rau hauv ib hnub xwb tag nrho nws cov tsos mob tshwm sim, thiab heev kom meej meej. Nyob rau hauv daim duab ntawm phlegmon ntawm lub qhov muag qhov (socket), cov tsos mob ntawm tus yam ntxwv ntawm qhov tsis tshua muaj tsis xws luag yog yooj yim piav qhia.
Feem ntau, tag nrho cov cim qhia ntawm cov kab mob no tuaj yeem muab faib ua hauv zos thiab dav. Thawj qeb suav nrog:
- liab thiab me ntsis ntawm daim tawv nqaij ntawm thaj chaw ntawm qhov muag puas;
- o loj hauv qhov chaw mob;
- siab kub ntawm lub epithelium txoj cai nyob rau hauv lub hom phiaj ntawm tus kab mob;
- me ntsis ntawm qhov muag thiab nyuaj txav nws;
- daim tawv muag kaw txhua lub sijhawm, nws yuav luag qhib qhov muag tsis tau.
Lwm cov paib
Tsis tas li ntawd, tus neeg raug tsim txom hnov mob hnyav, uas nce nrog palpation thiab txawm tias lub teeb kov ntawm lub cev. Txawm tias me ntsis o ntawm daim tawv muagkev pom kev poob qis heev.
Cov cim qhia ntawm qhov muag qhov muag phlegmon suav nrog:
- nce lub cev kub;
- kub thiab txias;
- qaug zog hnyav thiab tsis ua haujlwm;
- mob taub hau.
Nws yog ib qho tseem ceeb uas tus neeg laus tus neeg mob tus kab mob no yog tus cwj pwm los ntawm cov tsos mob ntawm lub zos, tab sis ib tug me nyuam mob yog yus muaj los ntawm cov cim qhia ntawm kev loj hlob ntawm pathological txheej txheem.
Kev nce qib
Phlegmon ntawm cellular cov ntaub so ntswg ntawm lub orbit tsim nyob rau hauv theem, dhau los ntawm ntau theem.
- Thawj theem hu ua preseptal cellulitis - muaj o thiab o ntawm cov ntaub so ntswg ze ntawm lub orbit. Lub qhov muag bulges me ntsis, tab sis nws txoj kev txav mus los tseem nyob, thiab cov teeb meem ntawm qhov muag tseem tsis pom.
- theem thib ob yog orbital cellulitis, uas yog tus cwj pwm los ntawm qhov tsos ntawm edema hauv thaj tsam ntawm daim tawv muag. Exophthalmos ua kom pom tseeb dua, lub conjunctiva kuj swells, lub qhov muag maj mam poob mus, qhov muag pom kev poob qis.
- Lub subperiosteal abscess theem pib thaum cov kua paug nkag ntawm cov pob txha thiab phab ntsa periorbital. Cov cim qhia ntawm theem no: ob lub qhov muag txav me ntsis mus rau sab nraud ntawm qhov txhab, liab thiab o tshwm rau ntawm daim tawv muag, qhov muag poob ntau dua.
- Abscess ntawm lub orbit yog suav tias yog theem kawg hauv kev txhim kho pathology. Nyob rau theem no, cov kua paug accumulates nyob rau hauv cov ntaub so ntswg orbital, ib tug kab noj hniav yog tsim, uas tau txais ciam teb raws li ib tug pyogenic.plhaub. Tsis tas li ntawd, tuag tes tuag taw ntawm cov leeg oculomotor, compression ntawm lub paj hlwb, thiab txawm tias tsis pom kev ua tiav yuav tshwm sim.
Nws tsim nyog hais tias nrog kev kuaj mob raws sijhawm thiab kev kho mob, nws muaj peev xwm tiv thaiv kev loj hlob ntawm qhov tshwm sim loj thiab kev hloov pauv ntawm tus kab mob mus rau theem tom ntej.
daim duab kho mob
Feem ntau, nrog phlegmon ntawm lub orbit, purulent o muaj ib daim ntawv ntawm ib sab thiab loj hlob sai heev - los ntawm ob peb teev mus rau ob hnub. Yog tias cov txheej txheem pathological npog lub paj hlwb, qhov no tuaj yeem ua rau muaj qhov tshwm sim ntawm neuritis, thrombotic occlusion ntawm cov hlab ntsha nyob rau ntawm cov ntaub so ntswg raug mob.
Nyob rau hauv rooj plaub ntawm kev hloov pauv ntawm purulent phlegmon mus rau choroid ntawm lub cev, panophthalmitis yog yug, uas feem ntau entails ua tiav atrophy ntawm lub qhov muag. Nyob rau theem siab, lub hlwb abscess, meningitis thiab sepsis yuav tshwm sim.
Qee zaum, kev tshem tawm cov kua paug tawm ntawm lub cev yog suav tias yog qhov txiaj ntsig zoo ntawm tus kab mob. Cov khoom tawg los ntawm daim tawv nqaij ntawm daim tawv nqaij los yog daim tawv muag mus rau sab nraud.
Feem ntau ib qho abscess thiab phlegmon ntawm lub orbit mus tuav tes. Tom qab tag nrho, cov txheej txheem pathological txuas mus rau cov ntaub so ntswg thiab cov kabmob uas nyob ze. Ib qho abscess, raws li twb tau hais lawm, yog theem kawg ntawm tus kab mob. Hauv qhov no, tus neeg mob tsim o ntawm daim tawv muag, thiab lub hom phiaj ntawm lub qhov muag raug kaw tag nrho. Cov tawv nqaij ntawm lub qhov muag ua ntej liab, thiab tom qab ntawd cyanotic. Lub conjunctiva swells, tau txais vitreous nta. Tej zaum exophthalmos. Muaj mob hnyav thaum nias ntawm qhov muag. Tib lub sijhawm, nws yog qhov ua tau heevKev puas tsuaj rau lub paj hlwb thiab retina.
Diagnosis
Txhawm rau tiv thaiv kev tsis zoo ntawm tus neeg mob, koj yuav tsum hu rau tus kws kho mob tshwj xeeb thaum thawj cov tsos mob tshwm sim. Nws yog ib qho tseem ceeb heev kom ua tiav qhov kev kuaj mob tsim nyog nyob rau lub sijhawm, lees paub qhov kev kuaj mob uas raug liam thiab koom nrog kev kho kom tsim nyog. Txhawm rau ua qhov no, koj yuav tsum sab laj tsis yog tus kws kho qhov muag, tab sis kuj yog tus kws kho mob otolaryngologist, nrog rau kws kho hniav.
txhawm rau txheeb xyuas qhov kev kuaj mob ntawm "phlegmon ntawm lub voj voog", nws yog qhov yuav tsum tau sau thiab txheeb xyuas cov ntaub ntawv los ntawm anamnesis, kawm txog kev mob yav dhau los nrog cov paug tawm, palpate thiab sab nraud tshuaj xyuas lub qhov muag puas siv daim tawv muag lifter.
Txhawm rau kom paub meej qhov kev kuaj mob, ntxiv rau cov txheej txheem kuaj mob, xws li radiography, ultrasound, orthopantomograms, diaphanoscopy thiab ophthalmoscopy tuaj yeem ua tau - cov txheej txheem no tso cai rau koj los txiav txim qhov xwm txheej ntawm lub paj hlwb. Ua ntej tshaj plaws, yog tias xav tias kev txhim kho phlegmon, kev tshuaj xyuas dav dav thiab ntshav kab lis kev cai rau kev tsis muaj menyuam yog ua raws li kev kuaj mob hauv chaw kuaj mob.
Kev kho phlegmon ntawm lub orbit
Nrog tus kab mob no, tus neeg raug tsim txom xav tau kev mus pw hauv tsev kho mob sai thiab muab tshuaj kho mob. Feem ntau, kev thauj khoom ntawm cov tshuaj tua kab mob uas muaj ntau qhov kev ua haujlwm, nrog rau cov tsos mob ntawm cov tshuaj detoxification, yog siv los kho phlegmon. Tetracyclines, penicillins, sulfonamides yog siv los kho.
Yog tus neeg mob muajKev kuaj pom tus kab mob hnyav, nrog rau cov duab qhia pom ntawm kev qaug cawv, tom qab ntawd kev kho mob nrog cov tshuaj tua kab mob thiab tshuaj tua kab mob yuav raug pom zoo.
Ntxiv nrog rau kev tswj hwm parenteral ntawm cov tshuaj tua kab mob, yuav tsum tau txhaj tshuaj subconjunctival thiab retrobulbar. Nyob rau tib lub sijhawm, nws raug nquahu kom ua maxillary sinusectomy nrog kev hloov pauv ntawm phab ntsa orbital, sinus puncture thiab ethmoidectomy, ua raws li kev qhia tshuaj.
Yuav tsum tau phais
Ntau zaus, kev kho tsis tiav yam tsis muaj kev phais - qhib phlegmon ntawm lub orbit. Tom qab ntxuav cov kab noj hniav los ntawm cov kua purulent, tus neeg mob tau muab tso rau hauv lub turunda - ib qho dej tshwj xeeb soaked hauv tshuaj tua kab mob. Cov txheej txheem raug tshem tawm tom qab tsuas yog 2 hnub, thiab tom qab ntawd hnav khaub ncaws aseptic rau qhov txhab.
Ntau zaus, ophthalmologists pom zoo kom UHF cua sov rau cov neeg mob, tab sis hom kev tshem tawm ntawm orbital phlegmon tuaj yeem ua tau zoo tsuas yog thaum ntxov ntawm nws txoj kev loj hlob. Xws li cov txheej txheem physiotherapeutic ua rau nws muaj peev xwm los txheeb xyuas cov txheej txheem txawv txav thiab tiv thaiv kev sib kis ntawm cov ntsiab lus purulent mus rau hauv cov txheej sib sib zog nqus ntawm cov ntaub so ntswg puas.
Txhais tau
Nyob tsis tshua muaj, phlegmon ntawm lub orbit tuaj yeem ua rau muaj kev cuam tshuam loj heev:
- abscess hauv hlwb;
- sepsis;
- clot formation in sinus hlab ntsha;
- meningitis.
Tus kab mob no suav hais tias tsawg kawg, tab sis txaus ntshai heev. Nyob rau hauv txhua rooj plaub, nws muaj kev loj hlob sai heev, yog li thaum thawj cov tsos mob tshwm sim, koj yuav tsum tau hu rau ib tug kws kho mob uas tsim nyog tam sim ntawd.
