Cov kws kho mob niaj hnub no tsis siv tshuaj tua kab mob rau cov kab mob otolaryngological hauv cov neeg laus tshwj tsis yog tias tsim nyog. Yog li, yog tias ib tug neeg tsis txhawj xeeb txog qhov mob hnyav, hyperthermia thiab o, thiab tus mob ntawm tus neeg mob tsis ua rau muaj kev txhawj xeeb, tus kws kho mob yuav siv sij hawm tos-thiab-saib tus cwj pwm thiab tshuaj tua kab mob tsis raug tshuaj vim:
- muaj feem ntau ntawm cov kab mob tshuaj tiv thaiv kab mob tshwm sim;
- kev tshwm sim ntawm kev phiv.
Cov tshuaj tua kab mob zoo tshaj plaws rau cov kab mob ENT hauv cov neeg laus yog dab tsi?
Kev qhia
Thaum tus neeg mob muaj cov kab mob hauv qab no, kev noj tshuaj tiv thaiv kab mob raws sij hawm dhau los ua qhov tseem ceeb:
- Purulent otitis media yog ib hom kab mob otorhinolaryngological, purulent o ntawm pob ntseg nruab nrab uas muaj tag nrho nws cov anatomical seem hauv cov txheej txheem pathological.
- Angina yog ib qho kab mob sib kis nrog cov tsos mob hauv zosdaim ntawv ntawm mob o ntawm cov khoom ntawm lymphatic pharyngeal nplhaib, feem ntau cov palatine tonsils, tshwm sim los ntawm streptococci los yog staphylococci, tsawg zaus los ntawm lwm yam kab mob, kab mob thiab fungi.
- mob tonsillitis.
- Sinusitis yog ib qho mob ntawm cov mucous ntawm ib los yog ntau dua paranasal sinuses. Nws tuaj yeem tshwm sim raws li qhov teeb meem ntawm tus mob rhinitis, mob khaub thuas, lwm yam kab mob sib kis, nrog rau tom qab raug mob ntawm lub ntsej muag.
Yuav tshuaj tua kab mob dab tsi rau tus kab mob ENT?
Qhov sib txawv ntawm cov tshuaj tua kab mob
Tshuaj tua kab mob tau muab faib ua ob peb pawg kho mob:
- Aminoglycosides yog cov tshuaj nephrotoxic thiab ototoxic uas muaj txiaj ntsig tiv thaiv kab mob gram-tsis zoo uas ua rau muaj kab mob sib deev, nrog rau mob meningitis thiab digestive disorders. Cov tshuaj tiv thaiv kab mob no tsis siv rau cov kab mob otolaryngological hauv cov menyuam yaus thiab cov neeg laus cov neeg laus vim muaj kev ua haujlwm tsawg thiab cov npe loj ntawm cov tshuaj tiv thaiv tsis zoo.
- Sulfanilamides yog dav-spectrum systemic antibacterial agents. Adversely cuam tshuam clostridia, listeria, protozoa thiab chlamydia. Sulfonamides tsis tshua pom zoo rau kev kho mob ENT kab mob. Raws li txoj cai, nrog ib tus neeg intolerance rau fluoroquinolones thiab tshuaj ntawm cov tshuaj penicillin.
- Penicillins muaj zog tiv thaiv cov kab mob gram-positive thiab gram-negative, yog li lawv tau siv dav hauv ENT xyaum rau kev kho mob ntawm cov neeg laus thiab menyuam yaus. Muaj me mecontraindications, tab sis tuaj yeem ua rau muaj kev tsis haum loj.
- Cephalosporins muaj cov kab mob bactericidal. Siv los tshem tawm streptococci thiab staphylococci, uas feem ntau ua rau tonsillitis, sinusitis thiab otitis media.
- Macrolides yog cov tshuaj tua kab mob zoo tshaj plaws. Zoo tshem tawm mycoplasmas, chlamydia. Lawv muaj cov nyhuv bacteriostatic.
- Fluoroquinolones yog qhov nrov tshaj plaws broad-spectrum uas muaj txiaj ntsig zoo tshuaj tiv thaiv kab mob. Pab nrog swb ntawm meningococcus, staphylococcus aureus. Txwv tsis pub thaum cev xeeb tub, pub niam mis, tshuaj muaj ntau daim ntawv teev cov tshuaj tsis zoo.
Tus kws kho mob tshwj xeeb txiav txim siab rau kev teem sijhawm ntawm cov tshuaj ntawm ib lossis lwm pab pawg rau cov kab mob otolaryngological, raws li cov lus pom zoo, nrog rau cov yam ntxwv ntawm anamnesis, cov ntaub ntawv hais txog kev ua tau zoo ntawm cov tshuaj siv yav dhau los thiab cov tshuaj tiv thaiv rau kws tshuaj. Cov tshuaj tua kab mob dab tsi yog siv rau cov kab mob ENT hauv cov neeg laus?
Tshuaj tua kab mob rau sinusitis hauv cov neeg laus
Sinusitis yog ib qho txheej txheem inflammatory ntawm daim nyias nyias uas cuam tshuam rau paranasal sinuses. Cov kab mob hauv qab no yog qhov txawv ntawm qhov chaw tshwm sim:
- Sinusitis - swb ntawm maxillary sinuses.
- Ethmoiditis - o ntawm cov mucous daim nyias nyias ntawm cov hlwb ntawm cov pob txha ethmoid.
- Frontitis yog ib yam kab mob uas cov txheej txheem inflammatory tshwm sim nyob rau hauv lub mucous daim nyias nyias ntawm lub frontal sinusNos.
- Sphenoiditis yog ib qho mob hnyav lossis mob ntev ntawm cov mucous hauv paus ntawm sphenoid paranasal sinus.
Sinusitis hauv cov neeg laus thiab menyuam yaus tuaj yeem mob hnyav lossis mob ntev, cov tsos mob tseem ceeb ntawm tus kabmob nyob rau theem mob:
- Purulent Nasal tawm suab;
- hyperthermia - overheating, tsub zuj zuj ntawm cov cua sov ntau dhau hauv tib neeg lub cev nrog kev nce hauv lub cev kub, tshwm sim los ntawm lwm yam uas cuam tshuam cov cua sov hloov mus rau ib puag ncig sab nraud;
- mob plab hauv thaj tsam pem hauv ntej, saum lub puab tsaig sab sauv, uas nce ntxiv thaum lub taub hau tig. Kev mob tuaj yeem ua rau mob hnyav txawm tias cua txias ntawm lub ntsej muag.
Tus kab mob tuaj yeem muaj daim duab tsis pom kev nrog cov tsos mob tsawg dua. Kev kho tsis raug thiab tsis raws sijhawm ntawm tus kab mob tuaj yeem ua rau mob meningitis thiab sepsis. Qee zaum cov teeb meem no xaus rau tus neeg mob tuag.
Penicillins
Kev kho mob ntawm sinusitis yog ua tiav tom qab tau txais cov txiaj ntsig ntawm qhov kev sim, tab sis yog tias tsis muaj sijhawm tos, ENT xaiv cov tshuaj tua kab mob dav dav ntawm pawg penicillin, piv txwv li:
- Y "Amoxicillin".
- Y"Amoxiclav".
- "Flemoxin Solutab"
Amoxicillin yog ib hom tshuaj dav dav, tab sis, yog tias nws cov txiaj ntsig hauv ib qho xwm txheej tsawg, kev kho yog kho nrog kev pab los ntawm Amoxiclav, tus neeg sawv cev tiv thaiv kab mob uas cov kab mob tseem ceeb tau ntxiv nrog clavulanic acid.
Thiab"Amoxicillin" thiab "Amoxiclav" yog absorbed zoo nyob rau hauv lub plab thiab cov hnyuv, faib thoob plaws tag nrho cov ntaub so ntswg ntawm lub cev. Cov tshuaj raug tso tawm nrog cov zis, yog li lub ntsiab contraindication rau lawv siv yog kev puas tsuaj rau lub excretory system thiab tag nrho intolerance rau lub active tshuaj.
Yuav tsum tau siv tshuaj rau cov kab mob otolaryngological ntawm qhov ncauj lossis txhaj tshuaj.
"Flemoxin Solutab" yog tib yam "Amoxicillin", tsuas yog cov tshuaj tsim tawm raws li lub npe txawv. Tso tawm los ntawm cov khw muag tshuaj hauv daim ntawv ntsiav tshuaj.
Rau cov kab mob, ENT dav sau tshuaj tua kab mob rau menyuam yaus:
- "Erythromycin".
- "Azithromycin".
- "Sumamed".
Cov tshuaj tua kab mob no muaj tshuaj lom me me, tsis txhob ua rau pom kev ua xua, xws li tshuaj penicillin.
Rau kev kho mob ntawm cov neeg mob, cov tshuaj no yog siv rau hauv daim ntawv ntawm cov ntsiav tshuaj, tshuaj ntsiav thiab hmoov rau kev tsim cov tshuaj ncua.
YCephalosporins
Cov tshuaj nrov tshaj plaws yog tiam thib peb, piv txwv li, "Ceftriaxone". Cov tshuaj pab tiv nrog purulent sinusitis, yog tsim nyob rau hauv daim ntawv ntawm cov hmoov, los ntawm kev txhaj tshuaj yog npaj nrog kev pab los ntawm cov kuab tshuaj. Kev taw qhia yog qhov mob, qhov tshwm sim ntawm qhov tshwm sim hauv zos yog qhov zoo li.
Rau kev kho mob hauv zos ntawm cov txheej txheem inflammatory hauv daim nyias nyias ntawm qhov ntswg qhov ntswg hauv cov neeg laus, cov tshuaj tua kab mob thiab tshuaj tsuag yog siv:
- "Isofra" yog cov tshuaj Fabkis txoj, cov qauv uas suav nrog framycetin, uas tawm tsam cov kab mob coccal.
- "Polydex" kho tau zoo nrog sinusitis thiab otitis media. Muaj nyob rau hauv daim ntawv ntawm cov tshuaj tsuag thiab tee. Cov tshuaj muaj txiaj ntsig zoo hauv kev tso tawm purulent.
- "Bioparox" muaj cov khoom xyaw nquag - fusafungin. Ua nyob rau hauv daim ntawv ntawm aerosol, nws tshem tawm o ntawm cov mucous daim nyias nyias ntawm lub qhov ntswg sinuses.
Rau kev kho mob zoo ntawm sinusitis nrog cov tshuaj tua kab mob hauv zos, nws yog thawj zaug uas yuav tsum tau siv vasoconstrictor tee uas yuav tshem tawm qhov o thiab muab qhov tsim nyog patency rau cov tshuaj tua kab mob.
Otitis media
Pathological mob ntawm lub pob ntseg ntawm lub hauv paus chiv keeb. Muaj ntau hom kab mob otitis media:
- outer;
- medium;
- internal.
Qhov nrov tshaj plaws yog otitis media. Nws npog cov kab noj hniav los ntawm tympanic membrane mus rau thaj chaw uas cov pob txha auditory nyob. Feem ntau yog cov menyuam yaus hnub nyoog qis dua tsib xyoos, tab sis cov neeg laus kuj raug tus kab mob no.
qhov chaw tseem ceeb ntawm tus kab mob:
- Pseudomonas aeruginosa thiab Haemophilus influenzae.
- Staphylococcus.
- Pneumococcus.
- nceb ntawm genus Candida.
Tshuaj kho mob otitis media hauv cov neeg laus
Cov kab mob tua kab mob yog siv los kho:
- Y"Amosil".
- "Ospamox".
- "Flemoxin".
- Y"Amoxiclav".
- "Zinnat".
- "Axotin".
- "Zinacef".
- "Cephurus".
- "Ceftriaxone".
Hauv qhov xwm txheej tshwj xeeb, kws kho mob otolaryngologist pom zoo rau cov neeg mob laus nrog tshuaj los ntawm pawg fluoroquinolone, xws li Norfloxacin hauv cov ntsiav tshuaj.
Kev kho tau zoo thiab hauv zos, uas tau ua nrog tee ntawm ob hom, uas suav nrog tsuas yog tshuaj tua kab mob: Ciprofarm, Normax, Otofa.
Yog tias cov mucous ntawm lub pob ntseg kis tau cov kab mob, cov kws kho mob pom zoo kom siv cov tshuaj pleev ib ce: Clotrimazole, Pimafucin, Pimafucort.
Thaum xaiv cov pob ntseg uas haum tshaj plaws rau cov neeg laus thiab menyuam yaus, nws yog qhov tseem ceeb los txiav txim siab seb puas muaj pob pob ntseg perforation, uas feem ntau tshwm sim nrog otitis media. Yog tias kuaj pom cov kua paug tawm, tus neeg mob tsuas tuaj yeem siv cov tshuaj tua kab mob ib leeg xwb yam tsis muaj tshuaj loog lossis tshuaj tiv thaiv kab mob.
Ntxiv rau, cov tshuaj tua kab mob aminoglycoside kuj tsis pom zoo:
- "Gentamicin".
- "Framicetin".
- "Neomycin".
- "Polymyxin".
Cov kab mob nquag no muaj cov nyhuv ototoxic rau ntawm lub suab ossicles thiab cov mucous ntawm lub pob ntseg sab hauv, uas tuaj yeem ua rau tsis hnov lus, lag ntseg lossis mob ntawm lub hlwb.
Yog li ntawd, khootitis media tsis tuaj yeem ua yam tsis tau kuaj thiab saib xyuas los ntawm kws kho mob tshwj xeeb.
Angina
Tus kab mob kis mob hnyav, cov kab mob ua rau ua rau cov palatine tonsils tawg. Cov cim:
- Rise hauv lub cev kub kom siab.
- mob caj pas.
- Kev loj hlob ntawm palatine tonsils.
- Txoj kab mob los yog cov plaque ntawm cov tonsils.
- Migraine yog ib yam kab mob neurological, feem ntau cov tsos mob thiab cov yam ntxwv ntawm uas yog episodic los yog tsis tu ncua mob hnyav thiab mob taub hau ntawm ib sab ntawm lub taub hau.
- Kev tsim txom.
- Apathy yog ib yam tsos mob uas qhia nyob rau hauv indifference, indifference, nyob rau hauv ib tug detached cwj pwm rau tej yam tshwm sim nyob ib ncig ntawm, nyob rau hauv tsis muaj lub siab xav rau tej yam.
- Ntsuag.
- tawv nqaij.
- Tachycardia yog ib yam mob tshwj xeeb ntawm lub cev uas lub plawv dhia siab tshaj 90 neeg ntaus ib feeb.
Kev kuaj mob yog tsim los ntawm kev tshawb fawb ntawm cov ntsiab lus purulent ntawm lub pharynx, nrog rau kev ntsuam xyuas ntawm tus neeg mob. Cov kab mob hauv qab no yuav tshwm sim:
- Myocarditis.
- Rheumatism.
- Meningitis.
- YPyelonephritis.
Cov kab mob Otolaryngological raug tshem tawm hauv cov neeg laus uas muaj tshuaj tua kab mob (ENT yuav sau qhov tsim nyog tom qab kuaj pom). Cov kab mob ua pa ua pa ua rau:
- Ystreptococcus;
- staph;
- staphylococcus thiab streptococcus.
Tshuaj tua kab mob txhawm rau tshem tawm mob caj pas hauv cov neeg lauscov neeg mob
Tsis tshua muaj kab mob nrog Staphylococcus aureus, pneumococcus, mixed flora. Tus neeg kis tus kab mob no ib txwm yog tus neeg muaj tus kab mob, txoj hauv kev kis tau los ntawm huab cua. Kev kho mob rau cov neeg laus yog ua nrog cov tshuaj hauv qab no:
- Y"Amoxicillin"
- Y"Amoxiclav".
- "Erythromycin".
- "Sumamed".
- Y"Zitrolide".
- "Hemomycin".
- "Zinnat".
- "Ceftriaxone".
Y "Ciprofloxacin".
Kev kho mob hauv zos hauv cov neeg laus yog ua los ntawm kev tso dej ntawm lub pharynx nrog cov tshuaj tua kab mob "Bioparox", "Gexoral", nrog rau nquag gargling nrog cov kev daws teeb meem ntawm "Gexoral", "Oracept". Tag nrho cov no yog cov tshuaj uas muaj tshuaj tua kab mob rau kev kho mob ntxiv ntawm angina.
Cov peev txheej ntawm cov mob tonsillitis tsis tuaj yeem cuam tshuam nrog kev siv cov tshuaj hauv zos. Tus kws kho mob otolaryngologist, tau ua qhov kev kuaj mob rau tus neeg mob, nws xav kom muaj cov kab mob tua kab mob.
Raws li txoj cai, tonsillitis hu ua tonsillitis, uas tuaj yeem ua rau mob thiab mob ntev. Raws li cov kws tshaj lij, tus kab mob ENT no tuaj yeem tsis tshua muaj los ntawm ib puag ncig, feem ntau qhov kev kis tus kheej tshwm sim vim qhov txo qis hauv kev tiv thaiv. Kev poob ntawm kev tiv thaiv ua rau kev loj hlob ntawm cov kab mob pathogenic microflora ntawm lub qhov ncauj thiab pharynx. Tonsillitis tas li tshwm sim nyob rau hauv lub xub ntiag ntawm caries, nrog rau sinusitis, stomatitis.
Cov tshuaj tua kab mob dab tsi rau kev kho mob ENT tuaj yeem siv los ntawm cov poj niam cev xeeb tub
Kab mob ntawm cov kab mob ENT systematically tshwm sim hauv cov poj niam hauv "txoj hauj lwm txaus nyiam". Rau cuaj lub hlis, nws nyuaj rau tsis txhob ntes cov kab mob lossis kab mob uas tuaj yeem ua rau mob sinusitis lossis otitis media.
Nyob rau hauv qhov xwm txheej hnyav, kev kho tshuaj tua kab mob yog qhov tseem ceeb, vim tias muaj qhov tshwm sim ntau ntawm cov kab mob hauv plab ntawm tus menyuam hauv plab thiab kev loj hlob ntawm cov kab mob nyuaj.
Raws li txoj cai, kws kho mob otolaryngologists sau rau cov poj niam cev xeeb tub:
- penicillins;
- Ymacrolides;
- Ycephalosporins.
Cov tshuaj ntawm cov pab pawg no hla lub placental barrier, tab sis tsis muaj kev cuam tshuam rau tus me nyuam hauv plab. Nws tsis pom zoo kom siv aminoglycosides thiab fluoroquinolones, lawv muaj kev puas tsuaj rau kev loj hlob thiab kev loj hlob ntawm tus menyuam.
Lwm pab pawg tshuaj raug tso cai ib feem, nyob ntawm lub sijhawm cev xeeb tub.
Txhua yam tshuaj tua kab mob rau cov kab mob ENT ntawm cov kab mob ua pa yuav tsum tau muab rau tus poj niam hauv "txoj hauj lwm" nkaus xwb los ntawm kws kho mob tshwj xeeb. Tus kws kho mob otolaryngologist yuav tsis paub txog tus neeg mob lub cev xeeb tub. Yog li ntawd, thaum mus ntsib tus kws kho mob tshwj xeeb, yuav tsum tau qhia txog tus mob no.
