Acute maxillary sinusitis yog cov txheej txheem inflammatory uas tshwm sim hauv cov maxillary sinuses. Nws yog ib qho yooj yim los twv seb yog vim li cas lub npe thib ob ntawm tus kab mob no yog sinusitis. Tus kab mob no sai sai kis mus rau lub submucosal txheej, periosteal thiab pob txha cov ntaub so ntswg ntawm lub Upper dentition. Raws li kev txheeb cais, cov kab mob no yog qhov laj thawj tshaj plaws rau kev mus ntsib kws kho mob ENT, vim qhov mob ntawm qhov txhab tshwm sim rau cov neeg laus thiab menyuam yaus.
Qhov hnyav ntawm cov tsos mob feem ntau nyob ntawm qhov hnyav ntawm tus kab mob. Thaum kuaj mob sinusitis, otolaryngologists ua tib zoo kawm tus neeg mob lub neej keeb kwm, ua ib qho kev kuaj mob thiab cov txheej txheem ntsuas. Feem ntau, X-rays, ultrasound yog txaus kom paub meej tias o nyob rau hauv lub sinuses, nyob rau hauv tej rooj plaub lawv mus rau puncture. Sinusitis yog kho nrog kev saib xyuas thiab kev phais.
YCaus of sinusitis
Yog tias koj paub ua ntej nws yog dab tsi - mob maxillary sinusitis (hauv daim duab qhia hauv tsab xov xwm, koj tuaj yeem pom qhov chaw ntawm paranasal sinuses), tej zaum koj yuav hnov txog cov laj thawj rau nws tsim. Ntawm cov xwm txheej uas tuaj yeem ua rau muaj kev loj hlob ntawm sinusitis, kev coj noj coj ua tsis sib haum xeeb yog nyob ntawm:
- kis kab mob;
- Nyob hauv qhov txias, khov ntawm lub cev;
- mob qhov ncauj;
- kab mob ntawm txoj hlab ntsws sab sauv;
- ua xua rhinitis;
- mob hnoos qeev;
- deviated septum;
- adenoiditis;
- kev phais kho mob ntawm cov hniav sab sauv;
- kev raug mob thiab qhov ntswg qhov ntswg;
- kev tiv thaiv kev tiv thaiv;
- kab mob HIV.
Qhov ua rau muaj kev loj hlob ntawm tus mob maxillary sinusitis thiab nws exacerbation tuaj yeem ntseeg tau tias kev ua neej tsis zoo, haus cawv thiab siv yeeb tshuaj. Raws li kev tshuaj ntsuam genetic abnormalities, intrauterine anomalies kuj muaj peev xwm cuam tshuam txoj kev loj hlob ntawm sinusitis. Thaum kawg, qhov zoo ntawm ecology thiab ib puag ncig muaj kuab paug ua lub luag haujlwm loj. Cov tsos mob ntawm tus mob maxillary sinusitis tuaj yeem tshwm sim los ntawm ib lossis ntau qhov ua rau tib lub sijhawm.
Kev faib kab mob
Ntau txhiab tus neeg tig mus rau kws kho mob txhua hnub nrog sinusitis. Txawm li cas los xij, txhua tus neeg mob yuav muaj ntau hom mob maxillary sinusitis. ICD-10 code,sib xws rau sinusitis, J32.0 - o nyob rau hauv lub Upper paranasal sinuses ntawm lub qhov ntswg kab noj hniav. Tsis tas li ntawd, cov kws tshaj lij faib cov kab mob ua ntau hom, nyob ntawm qhov etiology:
- Rhinogenic. Cov hnoos qeev ntev, cov kab mob fungal tuaj yeem ua rau tus mob sinusitis no.
- Hematogenous. Pathology tshwm sim thaum muaj kab mob uas yav tas los nyob hauv lub cev nkag mus rau hauv cov hlab ntsha.
- Taumatic. Puas yog qhov tshwm sim ntawm pob txha ntawm lub puab tsaig sab sauv lossis qhov ntswg qhov ntswg.
- Vasomotor. Nws yog tsim los ntawm cov tshuaj tiv thaiv tsis raug ntawm lub cev rau cov stimuli sab nraud (cua txias, tshuaj, thiab lwm yam).
- Odontogenic. Mob maxillary sinusitis ntawm hom no yog tshwm sim los ntawm kev cuam tshuam ntawm cov kab mob pathogenic nyob hauv cov kab noj hniav carious ntawm cov hniav.
- ua xua. Hom kab mob sinusitis no yog ib qho teeb meem ntawm kev tsis haum rhinitis.
Cov ntawv ntawm maxillary sinusitis
Muaj lwm qhov kev faib tawm ntawm tus kab mob paranasal sinus - cov tsos mob. Nyob ntawm qhov xwm txheej, tus kab mob tau muab faib ua:
- Mob catarrhal maxillary sinusitis. Raws li txoj cai, xws li sinusitis tsis txawv ntau ntawm cov mob khaub thuas hauv peb txoj kev nkag siab, vim nws tau nthuav tawm los ntawm congestion thiab mucous tawm ntawm qhov ntswg. Catarrhal sinusitis tuaj yeem kho tau thiab zam qhov teeb meem. Yog tias koj pib tus kab mob, nws tuaj yeem hloov mus rau hauv daim ntawv purulent.
- Acute purulent maxillary sinusitis. Tsis zoo li yav dhau los, nws yog tus cwj pwm los ntawm qhov muaj cov ntsiab lus exudative hauv cov sinuses. Nrog purulent sinusitisCov neeg mob yuav hnov zoo heev, mob taub hau tshwm.
Txhua yam kab mob sinusitis tuaj yeem ua ib leeg lossis ob sab.
Dab tsi yog qhov mob ntawm paranasal sinuses
Kev saib xyuas tshwj xeeb tsim nyog rau cov tsos mob ntawm sinusitis. Cov cim tseem ceeb ntawm tus mob maxillary sinusitis yog:
- nasal congestion;
- ua tsis taus pa.
Tus so ntawm cov tsos mob uas tshwm sim los ntawm ntau hom kab mob sinusitis yuav tshwm sim nyob ntawm seb qhov xwm txheej ntawm tus kab mob. Feem ntau nyob rau hauv mob sinusitis:
- subfebrile lub cev kub;
- thawj qhov tso tawm ntawm cov hnoos qeev, thiab tom qab ntawd - purulent infiltrate;
- txham;
- mob taub hau;
- kev nyuaj siab;
- tsis muaj lossis tsis hnov tsw tsw;
- tsis xis nyob thiab mob nyob rau sab sauv ntawm lub ntsej muag.
Cov tsos mob tuaj yeem ua rau lub sijhawm txav nrawm, txham, hnoos. Mob ob sab maxillary sinusitis yog nrog los ntawm kev nce lacrimation thiab conjunctivitis. Los ntawm txoj kev, nyob rau hauv daim ntawv ntev ntawm maxillary sinusitis, zoo li tshwm sim tau pom.
Yuav ua li cas yog qhov teeb meem
Kev kuaj mob sinusitis yuav tsum tau kho. Nws tsis yooj yim sua kom tsis quav ntsej tus kab mob uas zoo li tsis ua rau muaj kev hem thawj rau kev noj qab haus huv. Inaction yog fraught nrog txaus ntshai teeb meem. Feem ntau ntawm lawv yuav tsum tau ceevKev kho mob phais:
- mob ntawm cov mucous ntawm lub larynx;
- oxygen deficiency;
- apnea;
- ntshav lom;
- kev puas tsuaj rau cov pob txha cranial thiab lub hlwb.
Sinusitis thaum yau
Tsis zoo li cov neeg laus, cov pob txha ntawm cov menyuam mos tau tsim tsis zoo, yog li cov hnoos qeev tsis tshua muaj tshwm sim hauv lawv. Hauv cov hnub nyoog qis dua 3 xyoos, sinusitis feem ntau yog kab mob hauv qhov xwm txheej. Tsis tas li ntawd, mob maxillary sinusitis muaj tsawg dua hauv cov menyuam yaus dua li cov neeg laus. Nyob rau hauv cov ntaub ntawv no, qhov rov tshwm sim ntawm mob rhinitis feem ntau yog nrog los ntawm o ntawm pob ntseg nruab nrab.
Sinusitis hauv cov menyuam yaus yog qhov nyuaj rau kev kuaj mob. Qhov tsis muaj peev xwm ntawm tus menyuam kom tsis txaus siab txog qhov mob thiab piav qhia nws lub xeev kev noj qab haus huv txwv tsis pub cov niam txiv paub txog qhov teeb meem. Tab sis txawm tias qhov no, koj tuaj yeem kwv yees txog sinusitis hauv tus menyuam. Cov menyuam mos uas mob sinusitis muaj qhov ua tsis taus pa. Cov menyuam mos ua rau tsis xis nyob thiab tsis muaj zog, pw tsaug zog tsis zoo, feem ntau tsis kam noj thiab haus dej - qhov ntswg qhov ntswg tiv thaiv kom tsis txhob nqus ntawm lub mis los yog pacifier.
Cov menyuam yaus twb muaj peev xwm qhia tau dab tsi txhawj xeeb rau lawv thiab piav qhia lawv tus mob. Cov menyuam yaus thiab cov menyuam kawm ntawv preschool feem ntau raug kev txom nyem los ntawm ntau qhov sinuses tib lub sijhawm. Nrog rau qhov mob dav dav ntawm sinusitis, cov ntshav impurities yuav tshwm sim nyob rau hauv purulent-mucous tawm.
Lwm cov tsos mob ntawm tus mob sinusitis thaum yau, ntxiv rau qhov ntswg qhov ntswg, suav nrog:
- photophobia;
- desensitization rau tsw;
- qhuav caj pas;
- hnoos heev thaum hmo ntuj;
- lub cev kub;
- kev chim siab yav tsaus ntuj.
Cov menyuam yaus muaj lub sijhawm nyuaj nrog exacerbation ntawm maxillary sinusitis. Thaum muaj mob, kev mloog tsis zoo, kev nco thiab kev kawm muaj peev xwm txo qis. Tus me nyuam pw tsis tsaug zog thaum hmo ntuj, yuav snore.
Kev kuaj mob ntawm sinusitis ntawm maxillary sinuses
Txhua tus kws kho mob otolaryngologist tuaj yeem txiav txim siab sinusitis tau yooj yim, tab sis kom paub meej qhov kev kuaj mob, tus neeg mob tseem yuav tau ua ntau txoj kev tshawb fawb. Ua ntej xa tus neeg mob mus kuaj mob, tus kws kho mob yuav paub txog nws cov keeb kwm kho mob thiab sim nrhiav qhov ua rau tus kab mob. Tsis tas li ntawd, rau kev kho kom zoo ntawm tus kab mob, nws yog ib qho tseem ceeb kom paub meej qhov xwm ntawm nws cov chav kawm - mob ntev los yog mob. Txhawm rau ua qhov no, tshawb xyuas qhov ntsuas qhov hnyav ntawm cov tsos mob.
Kev kuaj mob ntawm maxillary sinusitis suav nrog kev siv cov kev tshawb fawb ntsuas:
- radioography;
- magnetic resonance imaging;
- rhinoscopy;
- nasal endoscopy;
- ultrasound;
- pawg.
Ntxiv rau kev kuaj ENT, cov neeg mob feem ntau raug qhia kom sab laj nrog kws kho hniav txog qhov mob ntawm lub puab tsaig sab sauv thiab cov hniav ntawm nws. Kev kho mob pib tsuas yog tom qab cov txiaj ntsig ntawm tag nrho cov kev tshawb fawb, xyuas kom tus neeg mob muaj mob maxillary sinusitis. Hauv keeb kwm ntawm tus kab mob, tus kws kho mob piav qhia txog kev kho kom zoo tshaj plaws uas tuaj yeem ua tauKev hloov kho nyob ntawm tus kheej tus yam ntxwv ntawm lub cev thiab tus nqi rov qab.
Cov ntsiab lus thiab cov tswv yim ntawm kev kho kab mob
Cov qauv tam sim no hauv kev kho mob sinusitis yog raws li cov txheej txheem nqus pa. Niaj hnub no, ntau tus kws tshaj lij muaj kev ntseeg siab tias kev qhia cov tshuaj los ntawm txoj kev aerosol tso cai rau koj los ua kom lub cev thiab tshuaj lom neeg ntawm cov khoom xyaw nquag. Tab sis cov kws tshaj lij tau dhau los ua qhov tsis ntseeg txog kev noj tshuaj - hauv lawv txoj kev xav, qhov ua tau zoo ntawm cov tshuaj no tsis tuaj yeem siab tshaj plaws vim cov ntshav tsis txaus rau cov kab mob paranasal.
Txoj kev thib ob nrov los kho sinusitis yog kev siv electrophoresis, uas suav nrog kev qhia txog qhov tsawg kawg nkaus ntawm cov tshuaj hauv daim ntawv ionized. Cov tshuaj tuaj rau ntawm qhov chaw ntawm qhov mob tam sim ntawd thiab muaj cov tshuaj tua kab mob muaj zog. Kev sib xyaw ua ke ntawm aerosols thiab electrophoresis muab cov txiaj ntsig zoo. Tsis zoo li cov tshuaj siv tshuaj, nws qhov kev ua yog thaiv los ntawm cov hlab ntsha, cov tshuaj pleev xim nkag mus rau hauv cov sinuses los ntawm qhov pores, ncaj qha mus rau cov ntaub so ntswg.
Thaum kho tus mob sinusitis, tus kws kho mob ntsib cov haujlwm hauv qab no:
- relieve o ntawm tus neeg mob lub mucosa;
- dawb qhov ntswg qhov ntswg rau qhov tawm ntawm infiltrate los ntawm maxillary sinuses;
- tawm tsam cov kab mob lossis kab mob kis;
- kho mob cov tsos mob thiab kho cov kab mob thib ob.
Tsis zoo li rhinitis, qhov ntws ntawm qhov tso tawm los ntawm cov kab noj hniav ntawm cov sinuses nrog sinusitis cuam tshuam, thiabTxhawm rau tiv thaiv kev kis kab mob nrog cov kab mob microflora, tus neeg mob tau muab tshuaj tua kab mob hauv zos, uas yog siv los ntawm kev nqus pa.
Txhua cov tshuaj uas tam sim no siv hauv otolaryngology hauv kev kho mob ntawm sinuses yog conditionally muab faib ua:
- mucolytic;
- dej;
- tshuaj tua kab mob;
- Yanti-inflammatory.
Hauv kev mob ob sab maxillary sinusitis, immunomodulators yuav tsum tau siv, feem ntau ntawm homeopathic keeb kwm. Qhov zoo tshaj plaws yog tinctures ntawm Eleutherococcus, ginseng, calendula. Cov tshuaj ntsuab no tsis tsuas yog ua kom lub cev tiv thaiv kab mob, tab sis kuj tiv thaiv kev loj hlob ntawm cov kab mob pathogenic hauv lub qhov txhab. Nws yog ib qho tsim nyog yuav tsum tau kho nrog immunomodulators raws li kev saib xyuas nruj thiab kev tswj hwm ntawm tus kws kho mob.
Kev siv tshuaj ntsuab los tiv thaiv sinusitis qhia tau zoo. Yog hais tias chav kawm ntawm sinusitis tsis nyuaj los ntawm cov kab mob, kev kho mob yog lined tsis muaj tshuaj tua kab mob. Cov txiaj ntsig zoo tau tshwm sim los ntawm kev siv cov inhalers nrog rau cov tshuaj tua kab mob thiab cov tshuaj vasoconstrictor, ua tsaug uas nws muaj peev xwm txo tau cov txheej txheem inflammatory hauv cov sinuses.
Txij li thaum mob purulent maxillary sinusitis yog suav tias yog daim ntawv mob hnyav tshaj plaws, rau nws txoj kev kho mob lawv siv cov tshuaj complex ntawm "shock" quab yuam. Feem ntau, nrog xws li sinusitis, ib tug raug xaiv ua ke ntawm cov tshuaj tua kab mob (qee zaum muab intravenously) thiab tshuaj tua kab mob plays lub luag hauj lwm tseem ceeb. Hauv qee qhovrooj plaub, tiv thaiv keeb kwm yav dhau los ntawm kev tiv thaiv tsis muaj zog, tus kab mob tuaj yeem ua rau lub cev qhuav dej ntawm cov ntaub so ntswg thiab, vim li ntawd, lub hlwb puas, sepsis. Cov no yog cov kab mob txaus ntshai heev, uas feem ntau ntawm cov neeg mob xaus rau kev tsis taus lossis tuag rau tus neeg mob.
Tshuaj kho mob mob sinusitis
Yog tias koj mus txog qhov teeb meem ntawm kev kho mob ntawm tus mob maxillary sinusitis objectively, koj yuav tsum xyuam xim rau cov tshuaj nrov tshaj plaws uas kws kho mob tau sau tseg. Txhawm rau kho tus kheej nrog sinusitis, raws li koj xav tau, yog tsis yooj yim sua. Tsis tas li ntawd, tib cov tshuaj tuaj yeem muaj qhov sib txawv ntawm lub cev ntawm cov neeg mob. Yog vim li ntawd tsuas yog tus kws kho mob uas tuaj koom yuav tsum xaiv cov tshuaj.
Nrog rau qhov mob me thiab nruab nrab ntawm sinusitis, sab xis thiab sab laug-sab mob maxillary sinusitis, German "Sinupret" tau ua pov thawj nws tus kheej zoo. Nws tsuas muaj cov khoom xyaw tshuaj ntsuab uas txo qhov mob uas tshwm sim nyob rau hauv lub ntsws sab sauv (sorrel, verbena, gentian, elderberry, primrose). Sinupret tsis muaj analogues nrog cov ntsiab lus zoo ib yam. Cov tshuaj no tshwj xeeb hauv nws hom vim:
- muaj ob qho tshuaj tiv thaiv kab mob thiab immunomodulatory teebmeem;
- tswj cov viscosity ntawm cov hnoos qeev;
- fights mucostasis;
- txhim kho lub ntuj tso tawm ntawm infiltrate los ntawm sinuses;
- restores ib txwm ua haujlwm ntawm lub epithelium.
Yog cov tshuaj ntsuab tsis tsim cov txiaj ntsig, tus kws kho mob yuav muab tshuaj rau tus neeg mob.sinuses. Cov txheej txheem tsis zoo no yuav tso cai rau koj kom paub txog hom kab mob thiab xaiv cov tshuaj tua kab mob zoo. Tom qab noj cov khoom siv biomaterial, nws yuav siv sijhawm ob peb hnub kom paub tias cov tshuaj tua kab mob twg cov kab mob microflora nkag siab rau. Nrog sinusitis, cov tshuaj hauv qab no tau sau tseg:
- Cefuroxime;
- "Amoxicillin clavulanate";
- "Amoxicillin";
- Y"Trimethoprim"
Yog tias kuaj pom tus mob maxillary sinusitis muaj tus kab mob kis los ntawm keeb kwm, kev kho mob yog tsim raws li txoj cai sib txawv. Hmoov tsis zoo, tsis muaj cov tshuaj muaj txiaj ntsig zoo uas tuaj yeem tshem tawm cov kab mob ntawm lub cev tag nrho. Cov tshuaj tua kab mob tsuas yog inhibit qhov kev ua ntawm cov kab mob. Lub ntsiab tseem ceeb hauv kev kho yog txhawm rau txhim kho lub cev tiv thaiv kab mob.
Puncture tsis ua rau cov neeg mob hauv cov xwm txheej tsis sib xws ntawm sinusitis. Tom qab ntawd kev kho mob ntawm sinusitis yog ua raws li "classic" tswvyim:
- Antiseptic inhalation.
- Vasoconstrictors (tsis pub dhau ib lub lis piam).
- Cov tshuaj tua kab mob dav dav tseem tos cov txiaj ntsig (Ceftriaxone, Nafcillin).
- Antihistamines (yog tias nquag ua xua).
Ntawm qhov nruab nrab, kev kho mob ntawm tus mob sinusitis kav li 2-4 lub lis piam. Yog hais tias sinusitis tau dhau los ua tus kab mob thib ob, qhov kev sib tsoo thiab bakposev yog qhov yuav tsum tau ua.
Yuav ua li cas tiv thaiv kab mob
Tiv thaiv tus mob maxillarysinusitis los rau ib tug yooj yim txoj cai - raws sij hawm kho rhinitis, nrog rau lub qhov ntswg los ntawm kev tsis haum etiology, kab mob ua pa, thiab kuj saib xyuas qhov mob ntawm lub qhov ncauj kab noj hniav. Txoj kev pheej hmoo ntawm kev tsim kab mob sinusitis tsawg tsawg yog tias tus neeg mob noj kom zoo thiab ua rau muaj kev noj qab haus huv. Nco ntsoov tias txhua yam kab mob tiv thaiv yooj yim dua li kho.
