Acute ubovu rhinosinusitis: oonobangela, iimpawu, isifo, unyango

Amaxesha amaninzi ENT ugqirha ubeka izigulane zakhe kwafunyaniswa ezifana rhinosinusitis etsolo, nto leyo sisifo iphecana eliphezulu zemiphunga. Esi sifo iphathwa kunye antibiotics. Lidla ibangela iingxaki, nto leyo uhlobo etsolo uba ubovu okanye engapheliyo. Mhlawumbi ukuthengiswa ziya kufuna uqhaqho. Makhe sihlolisise ezinye iinkcukacha isifo njengoko rhinosinusitis, iimpawu kunye nonyango yale ngezifo.

imilo

Kuxhomekeka apho kukho esi sifo ahluka:

• sinusitis (sinusitis maxillary);
• ethmoiditis (ukudumba wethambo ethmoid) ;
• sphenoiditis (ukudumba sinus sphenoid);
• pansinusitis kunye polisinusit (ilahleko lwabafundi abathile okanye lwabafundi bonke sinuses);
• sinusitis (sinus ngokungqalileyo ukuba kunokutshiseka).

Zonke ezi zifo babizwa esinye - "rhinosinusitis".

oonobangela

rhinosinusitis Acute lunokwenzeka ngenxa yezi zizathu zilandelayo:

• ngenxa yokosuleleka;
• phantsi kweempembelelo zamavumba nezidlo.

Kaninzi oku sifo sibangelwa nomkhuhlane. Virus ufake sinuses nokukhuthaza nokudumba zabo. Ngokuqhelekileyo, ukuba usuleleko lingena singene lweHo- ngeempumlo, umzimba nangoko iphendula kule omzimba, ukwanda yencindi yomlomo kunye nokudumba Ukwakheka. Oku kukhokelela ekubeni ngenxa paranasal sinuses umxholo uqalisa ziboniswe ubunzima, kwaye kudala iimeko ezithandwa zityalwe elandelayo ezincinane eziyingozi kunye nokusekwa ubofu.

Umzimba womntu sihlala ezinye iintlobo iintsholongwane hi mpimo ezincinane, musani ukubacaphukisa ukwenzeka kweenkqubo arhabaxa. Ngokunciphisa imisebenzi zokhuselo lomzimba, ukuba aqale ukwanda, esoloko ibangela etsolo ubovu rhinosinusitis.

Ukongeza, kukho iimeko zophendlo lwezifo ukuba izinto predisposing yophuhliso sifo:

• izakhiwo yokwakheka impumlo (banzi turbinate, ekudibaneni deformation, etc ...);
• immunodeficiency;
• ubukho izifo ezifana abanesigulo esinganyangekiyo, nokuthimliswa negazi, adenoids, kunye nabanye;
• base- nezifo.

iimpawu

Qaphela iimpawu ilandelayo iphambili ukudumba sinuses:

• umkhuhlane;
• yintloko ebuhlungu;
• utshintsho egazini;
• ubuthathaka kunye umkhuhlane;
• ukuxinana ngeempumlo.

Emva kwexesha elithile, rhinosinusitis etsolo kuboniswa ngolu hlobo lulandelayo:

• umkhuhlane;
• Amanzi okungaqhelekanga ukusuka lweHo- ngeempumlo;
• udumba iinkophe okanye ezidleleni;
• ungqinisiso;
• isikhohlela, okubi rhoqo ebusuku;
• nithiywe ukuphefumla ngeempumlo;
• ukuphazamiseka Isivamvo sokujoja;
• njengotsaleko xi sinuses abachaphazelekayo;
• imvakalelo fatigue rhoqo;
• bamazinyo, yondele kakhulu xa ukuhlafuna.

Acute ubovu rhinosinusitis unokuba iintlobo ngeentlobo iimpawu ngokubanzi nabeengingqi. Iimpawu kuxhomekeke unobangela livela, ubukho nezinye izifo, kunye nobudala isigulane. Kunye nabantwana nzima ukuba lingayinyamezeli sifo.

rhinosinusitis Polypoid inamalunga iimpawu ezifanayo uhlobo oyingozi. Ekubeni le ndlela esi sifo kakhulu ngakumbi, kuba unyango lwalo zotyando endoscopic isetyenziswa kunye unyango anti-komzimba.

ekuxilongweni

Kamsinya nje Iimpawu zokuqala rhinosinusitis, leyo ungadluli kwiintsuku ezimbalwa kuphela, kodwa ngcono, usoloko kufuneka udibane nogqirha. Kuba liyincutshe ukuxilongwa kugqiba indawo zalapha ekhaya kwabo sifo, imilo kunye nohlobo iintsholongwane okanye intsholongwane ebangela uphuhliso usulelo.

Le misebenzi ilandelayo zenziwa ukuqinisekisa wabonakala kwezonyango rhinosinusitis ludlule:

• imeko jikelele isigulana;
• ukwenza ihlaziya;
• ukwenza iindlela zophando instrumental.

loviwo ENT

Uviwo lwe isigulane iqala kunye nokuqokelelwa imbali yakhe yezonyango. Ukuze benze oku, isigulana ichaza iimpawu, ubude obhobhozayo ukusuka impumlo kunye nohlobo lwawo, ubukho intlungu entloko ubuso, kunye nendawo zazo. Kufuneka uxelele ugqirha wakho malunga naluphi mngundo kunye umkhuhlane kutshanje kwiCEMIS.

Uxilongo uya kukunceda nokuba ulwazi malunga nemigaqo lwamazinyo lwenziwa, amayeza okanye iipilisi ozisebenzisayo, abantu trauma immunocompromised.

Emva koko, lo gqirha wenza uviwo yesigulana, enza Ngokucofa nemihlathi kunye ebunzi, ukujonga isisa le sinuses. Ukusebenzisa iimviwo ENT bangabhaqa iziphene em- ngeempumlo.

laboratory

Ubukho inkqubo yokukrala kunye nohlobo ikhondo yayo inceda ukuqinisekisa wegazi. Kulo mzekelo uhlalutyo igazi kunye nomlinganiselo iifom zabo.

Ukongeza, in vitro va imixholo yayintsholongwane eyosulela abosulelekileyo sinuses. Ngoncedo izifundo ekuzakuqalwa ukuseka uhlobo pathogen nobuzaza kwayo arhente ezahlukeneyo antibacterial. Kodwa ke kufuneka kukhunjulwe ukuba iziphumo zePCR ezinjalo kwifomu etsolo iintsuku 3-4 kuphela emva kokuqala kwemiqondiso zokuqala zesi sifo. Ngoko ke, kaninzi baye balahlekelwa ukufaneleka kwabo.

isifundo instrumental

izixhobo ezizodwa ezisetyenziswayo ukufunda ukuxilongwa:

• endoscopy ngeempumlo - ukusetyenziswa kwayo fibre-optic ityhubhu, ekupheleni nto leyo ukukhanya. Njengoko isifundo onjalo uphawula ecaleni incinane lweHo- ngeempumlo, kwaye kananjalo ukuqikelela septal isiphako kunye nobukho yamathumba, ezifana polyp.
• Itomography ngekhompyutha - kucingwa indlela kakhulu uhlolo olubonakalayo lwe sinuses ngeempumlo. Kuya kukhethwa wenziwe xa kuthe kwakho iingxaki.
• Ray - kabanzi kusetyenziswa de endoscopy kunye Itomography ngekhompyutha. Kungoku nje, yaba kakhulu kuyanqaba ukuya luhlaza.
• Magnetic intlokoma Itomography - yindlela ebalaseleyo moshilongo yeengxaki ukudumba ngaphakathi lukakayi, nangezilonda amabi. sinusitis Maxillary esibonakaliswa ngohlobo mnyama le sinuses maxillary.

ayini

rhinosinusitis Acute iphathwa njenge ndlela zonyango kunye yotyando. Ukusebenza kwendlela nganye ithathwa ugqirha ukuba isigulane ngamnye. Khetha indlela unyango kuxhomekeke kwiimeko ezahlukeneyo: ubudala isigulane, uhlobo kwesifo kunye nohlobo ikhondo layo, ithuba negazi, njl Kodwa akukho irejimeni yonyango kunjalo, kufuneka zithunyelwe ukuba ..:

• kuphelisa iimpawu komtshiso oko;
• abuyisele patency izicatshulwa ukuba uqhagamshele ngeempumlo iindinyana sinus;
• ukususa ukusuka axils zesi siqulatho izifo;
• ukuphelisa umthombo usulelo.

rhinosinusitis e abadala Unyango kufuneka ibe phantsi kolawulo olungqongqo gqirha kwabaphilileyo, ekubeni amayeza olungalawulwayo kudla ngokukhokelela iingxaki. Eyona njongo ephambili yonyango - ukususwa yomenzeli ezosulelayo abuyisele nokubanako sinuses paranasal yedwa cleaner.

amayeza

Acute rhinosinusitis ubovu ziphathwe amayeza zilandelayo:

• ukuxinana;
• immunocorrectors;
• antibiotics;
• amachiza ezongezelelweyo nomqondiso.

Ukuxinana kunye ukuxinana ngokuqhelekileyo emiselweyo kwindawo yokuqala uze uyisebenzise kufuneka iintsuku kungekho ngaphezulu kwe 4-5, ngenxa yokuba ukusetyenziswa ixesha elide kwandisa nokudumba kunye ngeempumlo ingxinano kuphela. La machiza aquka "Ephedrine", "Nazivin", "Sanorin", "Galazolin", "Naphthyzinum" njalo njalo. N. arhente ezinjalo azisinyangi isifo, kunye nokuphelisa okwethutyana ezi mpawu.

Xa iintlobo ezithile sifo ezifana rhinosinusitis, iphathwa kuphela antibiotics angathatyathwa iiveki ezimbini. Banceda ukuphelisa zonke iimpawu, kodwa ukwamkelwa kwabo kufuneka kwenziwe kuphela phantsi kweliso yincutshe. Olwa kakhulu emiselweyo rhoqo ezifana "Amoxicillin". Kodwa ukuba iintsuku ezintathu emva kokuba uphuculo lakhe Kungenwa kwenzeke, kufuneka kufakwe ziziyobisi kunye isithako esebenzayo, njengoko tetracycline okanye cephalosporin. Kwakhona kakuhle kubalulekile abafumana le ntsholongwane "clarithromycin", "Azithromycin" yaye "Roxithromycin".

Nakuba iintlobo ngeentlobo amayeza awohlukeneyo asetyenziswa ukunyanga rhinosinusitis etsolo, azisoloko olusebenzayo. Oku kubangelwa kukuba uninzi microorganisms ezidala ukudumba iphecana eliphezulu wokuphefumla, ukuxhathisa ngempumelelo antibiotics. Kungenxa yoko rhinosinusitis etsolo, ingakumbi xa bazitshisekisayo sinus ngokungqalileyo, sebenzisa ukukhuthazwa wokhuselo kwabantu omzimba.

Ukulungiselela le njongo, sebenzisa immunomodulators kunye immunomodulators. Bona ziqulathe izinto ezinjalo ukubuyisela umsebenzi yokuzikhusela omzimba. Ikhosi ye unyango idla ngokuba ziiveki 1.5-2.

Ukuba le ndlela esi sifo bafumana rhinosinusitis njengoko polypoid kwaye kufuneka ziphathwe kusetyenziswa amachiza mucolytic ( "myrtol," "Sinupret", "Acetylcysteine"). Eziphuhlisa ngayo ukuxozwa kwiziqulatho exineneyo viscous le sinuses, okutsho ukuba nencindi bubovu iqala. Kwakhona, eli yeza ukuze abe iqela amayeza kunye nesenzo antibacterial.

Ukuba iqondo lobushushu emzimbeni anda, isigulane kufuneka athobele alale. Ukuze wenze oku azimiselweyo antipyretics ezifana "Amidopyrine" yaye "aspirin". Namachiza iintlungu zidla emiselweyo "paracetamol", "ibuprofen". arhente meleleyo asetyenziswa ngamaxesha, kwaye kufuneka bamamkele uhayi ngaphezu iintsuku ezisi-7.

rhinosinusitis uyalisa ukuphathwa ngamathontsi antihistamine kunye namacwecwe. Uyakwazi ukusebenzisa namafutha aqholiweyo nezithambiso, kodwa ke amachiza hormone ezimiselweyo rhoqo kakhulu.

Mandinazise ukuba, ukongeza emithini, unyango ilandelayo:

• wahlamba sinus izisombululo ngeempumlo kubola ngenxa yokubulala isiqulatho esingaqhelekanga;
• kucetyiswa ukuba usele amanzi ashushu: iziselo iziqhamo, iziqhamo yathamba, incindi iziqhamo ezifreshi, iti buthathaka, umhluzi iinyonga;
• iindlela physiotherapeutic kusetyenziswa: unyango microwave, ultrasound, UHF.

Ukuba ezi ndlela andithanga ndimzise isiphumo efanelekileyo, baye babhenele uqhaqho.

ukungenelela kuhlinzwa

Ukuba ngaba ukunceda unyango ngamachiza kwezifo ezifana rhinosinusitis, unyango kulo mzekelo kuliwa intsumpa. Amaninzi, xa wamisela okuhlatywa, esiza:

• ngokukhawuleza bafunda paranasal sinuses ubovu;
• echaphazela ngqo isifo le sinuses paranasal amachiza kubola, anti-ukudumba kunye antibacterial.

Kodwa kukho izimuncumuncu kunye nobubi. ingozi yityhefu igazi, ukungabi mbono, njalo-njalo. N. Ngoko ke, uninzi ayikhuthazwa.

Iimpawu zesi sifo kubantwana

Rhinosinusitis ebantwaneni isibetho elibalaseleyo, ekubeni akhawunti enye esithathwini zonke izifo ezinxulumene ne phecana eliphezulu zemiphunga. Yaye abadala, isiqingatha abantwana bayaqhubeka ukubayeka.

Xa sifo ukuba ukuphuhlisa iingxaki ezinzulu. Eyona eyingozi ingxaki Orbital pyoseptic ekhokelela angaboni kahle, yaye ngowe-2% yamatyala zenzeka utshintsho intracranial. Ukuba ixesha akanayo ukufumanisa isifo kwaye ngayo, ukuphuhlisa inyumoniya.

rhinosinusitis Acute kubantwana esizibonakalisa ngolu hlobo lulandelayo:

• ukukhohlela elide obukhulu;
• kunzima nokuphefumla ngokusebenzisa empumlweni;
• nokudinwa;
• umkhuhlane jikelele;
• izwi ngeempumlo;
• ukwanda lobushushu emzimbeni.

Olona nyango ephambili ithathwa unyango elwa ngokuchasene nentsukaphi sifo okwandayo.

Iimpawu zesi sifo ngexesha lokukhulelwa

Lidla kukho rhinosinusitis ubovu etsolo ngexesha lokukhulelwa, kaloku ke, oko ikhatshwe iingxaki, njengoko kweli thuba kuphela naluphi na unyango.

ugqirha kuphela angakunika nemithi, leyo banokubenzakalisa inkazana nomntwana xa athathwa angalawuleki. Ukuba iqela penicillin embi idluliswa kunye cephalosporins, macrolides iyasetyenziswa. Kusenokuba "moxifloxacin", "levofloxacin" yaye "sparfloxacin". Phantsi impembelelo yabo ekutshatyalalisweni protein amagama phakathi kwiiseli ezincinane izifo. La machiza zithathwa ukuba ngempumelelo kakhulu yaye sikhuselekile unyango abafazi abakhulelweyo.

ukuvimbela

Ukwenzela ukuthintela izifo ezifana rhinosinusitis etsolo, kufuneka uthabathe amanyathelo othintelo ilandelayo:

• Ziphephe uyilo kunye emzimbeni;
• kakhulu ehamba phandle, abakhuthele ngokomzimba;
• ungacimi;
• inxaxheba kwezemidlalo;
• ixesha ukunyanga SARS kunye nempumlo ezihambisayo;
• idilesi ixesha wamazinyo ukuze aphathe kwamazinyo emhlathini eliphezulu;
• kunqweneleka ukudada emanzini olwandle kunye ulwandle air Tsalani impiliso.

isiphelo

Ngenxa yoko, ubovu etsolo rhinosinusitis ukuba ziphathwe phantsi kweliso elibukhali likagqirha, ukuze abe naziphi na iingxaki amahle linobungozi le nto kuba ezisongela ubomi. Kuyimfuneko ukuba bamqumbise imiba sifo, ngaphantsi ixesha abalichitha kwiindawo evalelwe yaye ezinothuli, ukuba uyeke ukutshaya. Nokuphathwa olwaneleyo ngexesha rhinosinusitis eso sinyangekile ngokupheleleyo.