Acute ubovu rhinosinusitis: izimbangela, izimpawu, uphethwe, ukuphathwa

Isikhathi esining impela ENT udokotela ubeka iziguli zakhe kutholakala ukuthi uphethwe yini ezifana rhinosinusitis acute, okuyinto isifo elingenhla ipheshana zokuphefumula. Lesi sifo iphathwa ngemithi elwa namagciwane. Ngokuvamile ibangela izinkinga ngemva kokuhlinzwa, okuholela ifomu acute iba ubovu noma ezingamahlalakhona. Mhlawumbe yokuthengisa kuzodinga ukuhlinzwa. Ake sicabangele ngaphezulu ngokuningiliziwe isifo njengoba rhinosinusitis, izimpawu kanye nokwelashwa leli egunjini lokuhlolwa kwezifo.

ukuma

Kuye lapho kukhona lesi sifo ababonakali ngezikhundla:

• sinusitis (sinusitis maxillary);
• ethmoiditis (ukuvuvukala ithambo ethmoid) ;
• sphenoiditis (ukuvuvukala itheku sphenoid);
• pansinusitis futhi polisinusit (ukulahlekelwa eminye noma yonke le sinuses);
• sinusitis (itheku frontal is abavusa).

Zonke lezi zifo ababizwa esinye isikhathi - "rhinosinusitis".

izimbangela

rhinosinusitis olunamandla singenzeka ngenxa yezizathu ezilandelayo:

• ngenxa ukutheleleka;
• ngaphansi kwethonya nomzimba.

Ngokuvamile lokhu sifo sibangelwa nomkhuhlane. Amagciwane faka sinuses futhi ukukhuthaza ukuvuvukala yabo. Ngokuvamile, uma isifo lingena singene ingaphakathi acinene, umzimba ngokushesha iyaphendula kule ukuzivikela komzimba, isikhwehlela anda edema kumiswa. Lokhu kuholela yokuthi ngenxa paranasal sinuses okuqukethwe iqala ukuba ziboniswe nobunzima, futhi kudala izimo ezivuna esiphelweni okwalandela microorganism eziyingozi kanye kumiswa ubomvu.

Umzimba womuntu njalo ezinye izinhlobo zama-bacterium eziningi ongatheni, musa avuse okuvela izinqubo ukuvuvukala. Ngokunciphisa imisebenzi okuvikela umzimba, bona aqale ukwanda, ngokuvamile abangela acute ubovu rhinosinusitis.

Ngaphezu kwalokho, kukhona izimo zokucabanga okubangelwa isifo ukuthi kukhona ungalokothi uphuze izinto sokuthuthukiswa sifo:

• izakhiwo yokwakheka ekhaleni (lakhulisiwe turbinate, septum ukusonteka, njll ...);
• immunodeficiency;
• khona izifo ezifana-cystic fibrosis, rhinitis iguliswa, adenoids, nabanye;
• kwehlisa amasosha omzimba.

izimpawu

Phawula izimpawu ezilandelayo eyinhloko ukuvuvukala sinuses:

• umkhuhlane;
• ubuhlungu bekhanda;
• izinguquko egazini;
• ubuthakathaka futhi umkhuhlane;
• ukuminyana acinene.

Ngemva kwesikhathi esithile, rhinosinusitis acute kuboniswa kanje:

• umkhuhlane;
• osenyameni normal kusukela ingaphakathi acinene;
• ukuvuvukala Isivalo noma izihlathi;
• halitosis;
• ukukhwehlela, ngokuvamile sibi ebusuku;
• ingathiyeki ukuphefumula acinene;
• ukuphazamiseka lokuhogela;
• ukungezwani futhi kwengcindezi sinuses abathintekayo;
• umuzwa ukutubeka;
• amazinyo, sibi kakhulu ngesikhathi ukuhlafuna.

Acute ubovu rhinosinusitis bangase babe nezinkolelo ezihlukahlukene enkulu izimpawu jikelele kanye lendawo. Izimpawu incike imbangela ivela khona, khona ezinye izifo, kanye nobudala isiguli. Futhi izingane zithanda ukuba nzima ukubekezelela lesi sifo.

rhinosinusitis Polypoid has cishe izimpawu ezifanayo njengoba ifomu oyingozi. Njengoba lolu hlobo lesi sifo kakhulu, ukuze elashwe yayo ukuhlinzwa endoscopic isetshenziswa ngesikhathi esifanayo ne ukwelashwa anti-iguliswa.

ukuhlola

Njengoba nje izimpawu zokuqala rhinosinusitis, okuyinto hhayi kuphela kudlule ezinsukwini ezimbalwa, kodwa futhi ngcono, kufanele ngaso sonke isikhathi xhumana nodokotela. Ukuze uthole olunembile uphethwe Uchwepheshe inquma indawo kwasendaweni lesi sifo, ezakheke kanye nohlobo amagciwane noma igciwane oholele ukuthuthukiswa ukutheleleka.

Lemisebenti lelandzelako abazenzi ukuqinisekisa ukubonakaliswa basemtholampilo rhinosinusitis olunamandla ludlule:

• isimo jikelele isiguli;
• ongalungisa cwaningo;
• bafeze amasu ocwaningo wezinsimbi.

ENT luhlolo

Ukuhlola nesineke iqala ukuqoqwa umlando wakhe kwezokwelapha. Ukuze wenze lokhu, isiguli uchaza izimpawu, isikhathi sokukhishwa emakhaleni nasebusweni ubuntu babo, khona ubuhlungu ekhanda ubuso, futhi indawo yabo. Kufanele futhi utshele udokotela wakho mayelana nanoma yisiphi yokungezwani komzimba kanye imikhuhlane esanda kushintshwa.

Imiphumela yaloku kuhlola okungenhla kuyokusiza ngisho ulwazi mayelana izinqubo zamazinyo kwenziwe, imithi ukuthatha, abantu ukuhlukumezeka immunocompromised.

Ngemva kwalokho, udokotela wenza behlolwa esiguli, enza palpation we izihlathi nebunzi, ukucacisa isisa we sinuses. Ukusebenzisa ENT luhlolo kungathola yokulimala ngalo ingaphakathi acinene.

ukuhlolwa laboratory

Ukuba khona ukuvuvukala kanye nesimo Yiqiniso lokho elikushoyo kusisiza ukunquma segazi. Kulokhu ukuhlaziywa igazi kanye isilinganiso mafomu.

Ngaphezu kwalokho, ngaphandle kwesibeletho ihlolwe okuqukethwe pathogenic itheleleke sinuses. Ngosizo izifundo microbiological ukusungula uhlobo lwegciwane kanye nokuzwela yayo ezintweni ezihlukahlukene elwa namagciwane. Kodwa kufanele sikhumbule ukuthi imiphumela assays enjalo efomini acute izinsuku 3-4 kuphela lapho kuqala izimpawu zokuqala zesifo. Ngakho-ke, ngokuvamile ulahlekelwe ukuqondana abo.

cwaningo wezinsimbi

amathuluzi Special asetshenziswa ukufunda i ukusazi ngokunembile isifo esikuphethe:

• Endoscopy acinene - ukusetshenziswa yayo tube fiber-optic, ekupheleni okuyinto umthombo wokukhanya. Nge isifundo esinjalo kungathola ngisho ukuphambuka kancane kule ingaphakathi acinene, futhi ukulinganisa septal ukwephuka kuthi khona izimila, ezifana ama-polyp.
• computed tomography - kubhekwa ngendlela engcono kuhlolwe ngamehlo we sinuses acinene. It is mhlawumbe eyenziwa uma kwenzeka izinkinga.
• Radiography - eyayisetshenziswa kabanzi kuze Endoscopy futhi computed tomography. Okwamanje, yaba okungaphezu mancane amathuba okuthi baphendukela.
• Magnetic resonance tomography - kuyindlela enhle kakhulu ngoba uphethwe yezinkinga ukuvuvukala ngaphakathi Yekhanda, izimila ebulalayo. sinusitis maxillary kubonakala ngesimo ukuhwalala we sinuses maxillary.

zokwelapha

rhinosinusitis olunamandla lithathwa njengenye indlela yezokwelapha futhi kuhlinzwa. Ukuphumelela indlela ngayinye kubhekwa nodokotela nesineke ngayinye. Khetha indlela yokwelapha kuxhomeke ezicini eziningana: yobudala isiguli, uhlobo sifo kanye nesimo busebenze, kungenzeka komzimba, njll Kodwa lokho futhi lwemithi ngelashwe kukhethwe, kumele zathumela ..:

• ukuqeda izimpawu ukuvuvukala;
• ukubuyisela patency izindinyana ukuthi ukuxhuma acinene izindima itheku;
• ukususa kusukela axils okuqukethwe pathogenic;
• ukuqeda umthombo ukutheleleka.

rhinosinusitis e abadala Ukwelashwa kufanele kwenziwe ngaphansi kokuqondisa esiqinile udokotela, njengoba imithi engalawuliwe ngokuvamile kuholela ukuxakeka. Umgomo oyinhloko ukwelashwa - ukususwa agent ezithathelwanayo futhi ubuyisele ikhono sinuses paranasal wedwa bahlanza.

imithi

Acute ubovu rhinosinusitis ziphathwe imithi ezilandelayo:

• yokuvula amakhala;
• immunocorrectors;
• imithi elwa namagciwane;
• izidakamizwa ezengeziwe lingaze.

Yokuvula amakhala futhi yokuvula amakhala kuvame anqunyiwe kwasekuqaleni bese uwasebenzise kumelwe zibe yizinsuku ezingu akukho kuka 4-5, ngoba ukusetshenziswa eside kwandisa edema kanye acinene ukuminyana kuphela. Le mithi ihlanganisa "ephedrine", "Nazivin", "Sanorin", "Galazolin", "Naphthyzinum" nokunye. N. ejenti okunjalo musa ukwelapha lesi sifo, futhi uqede okwesikhashana izimpawu.

Ngo izinhlobo ezithile sifo ezifana rhinosinusitis, iphathwa kuphela kungenzeka imithi elwa namagciwane kuthathwe amasonto amabili. Asiza ukuqeda zonke izimpawu, kodwa reception yabo kufanele kwenziwe kuphela ngaphansi kokuqondisa onguchwepheshe. I-antibiotic njalo ebekiwe kakhulu ezifana "Amoxicillin". Kodwa uma emva kwezinsuku ezintathu wavuma ngcono lwenzeke, ke kumelwe ithathelwe isikhundla izidakamizwa kanye isithako esebenzayo, njengoba tetracycline noma cephalosporin. Futhi Asizisoli ethola alama-antibiotic "clarithromycin", "Azithromycin" futhi "Roxithromycin".

Naphezu anhlobonhlobo imithi ehlukene zisetshenziselwa ukwelapha rhinosinusitis acute, awayona njalo ngempumelelo. Lokhu kungenxa yokuthi iningi izilokazane ezincane ezibangela ukuvuvukala engenhla ipheshana zokuphefumula, ngempumelelo amelane nemithi elwa nawo. Yingakho ngo rhinosinusitis acute, ikakhulukazi uma abavusa itheku ngokuqondile, ukusebenzisa ukukhuthazwa ukuzivikela womuntu mzimba.

Ngenxa yale njongo, sebenzisa immunomodulators futhi immunomodulators. Ziqukethe izinto ezifana ukuthi ubuyisele umsebenzi ukuzivikela mzimba. Inkambo yokwelashwa ngokuvamile amasonto 1.5-2.

Uma lolu hlobo sifo ezitholakala rhinosinusitis njengoba polypoid futhi kufanele kuthathwe usebenzisa izidakamizwa mucolytic ( "myrtol," "Sinupret", "Acetylcysteine"). Isiza thinning lokuqukethwe aminyene futhi viscous we sinuses, kuphumele i outflow kobovu iqala. Futhi, lo muthi ungase ube iqembu kwemithi futhi isenzo elwa namagciwane.

Uma izinga lokushisa komzimba anda, isiguli kumele athobele embhedeni ukuphumula. Ukuze wenze lokhu wagunyaza antipyretics ezifana "Amidopyrine" futhi "aspirin". Njengoba imithi analgesic kuvame okunqunyiwe "paracetamol", "ibuprofen". ejenti Stronger kuyaqabukela esetshenziswa, futhi besamukela ezingaphezu kuka izinsuku ezingu-7.

rhinosinusitis Allergic ziphathwe amathonsi antihistamine kanye amaphilisi. Ungasebenzisa futhi amafutha okhilimu, kodwa izidakamizwa hormone kuyabekwa kaningi impela.

Mina kufanele engeza ukuthi, ngaphezu ukwelashwa izidakamizwa, ukwelashwa ezilandelayo:

• wageza acinene itheku izixazululo isinqandakuvunda zokususa i okuqukethwe okungavamile;
• kutuswa phuza ketshezi efudumele: izithelo iziphuzo, izithelo iyisitshulu, fresh izithelo ayo, itiye ababuthakathaka, umhluzi okhalweni;
• izindlela physiotherapeutic esetshenziswa: yokwelapha microwave, imisindo ephansi, UHF.

Uma lezi zindlela Ungasingenisi umphumela ofanele, they resort ukuhlinzwa.

kokungenela kuhlinzwa

Uma ungenalo asize ukwelashwa kwezifo ezifana rhinosinusitis, ukwelashwa kulesi simo-ke Kwenziwa surgically. Ngokuvamile, lapho ngimiswa njengombonisi wokubhoboza, esiza:

• Ngokushesha ngafunda kusukela paranasal sinuses ubomvu;
• letsintsa ngco mucosa we sinuses paranasal izidakamizwa isinqandakuvunda, anti-inflammatory futhi elwa namagciwane.

Kodwa kukhona uswidi ezinjalo kanye nobubi obuthile. sengcupheni ngenxa yegazi elinobuthi, ukulahlekelwa umbono, nokunye. N. Ngakho-ke, iningi it is hhayi Kunconywa.

Izimpawu zesifo ezinganeni

Rhinosinusitis ezinganeni sifo evelele, njengoba ebangela ingxenye eyodwa kwezintathu zonke izifo ezihlobene engenhla ipheshana zokuphefumula. Futhi njengoba abadala, isigamu sezingane siyahlupheka kubo.

Ngo isifo balezo zinto, cishe ukuthuthukisa eziyingozi. I esiyingozi kakhulu kuyinto pyoseptic inkinga esemkhathini eholela umbono kahle, futhi 2% amacala zenzeka izinguquko intracranial. Uma isikhathi akusho ukuhlola isifo futhi aphathe ke, ukuthuthukisa i-pneumonia.

rhinosinusitis olunamandla ezinganeni kuzibonakalisa kanje:

• ukukhwehlela obuyisimanga isikhathi eside;
• ecinene ngokusebenzisa ikhala;
• ukukhathala;
• ukucobeka jikelele;
• izwi acinene;
• ukwandisa izinga lokushisa komzimba.

Le nqubo yokwelapha main ubhekwa yokwelapha elwa namagciwane ngokumelene isizinda amasosha omzimba likhula.

Izici lesi sifo ngesikhathi sokukhulelwa

Kaningi kukhona acute ubovu rhinosinusitis ngesikhathi sokukhulelwa, ngaphezu kwalokho, kungase kuhambisane zinkinga, njengoba kule nkathi kukhawulwe iyiphi indlela yokwelapha.

Kuphela udokotela angaba antibiotic, engalimaza owesifazane nengane uma wamukelwe ezimathonsi. Uma i-penicillin okubi iqembu idluliswe kanye cephalosporins, macrolides isetshenziswa. Kungenzeka "moxifloxacin", "levofloxacin" futhi "sparfloxacin". Bayamthonya ukubhujiswa amaprotheni zamagama kumaseli microorganism pathogenic. Le mithi abhekwa ngempumelelo kakhulu futhi ephephile ekwelapheni kwabesifazane abakhulelwe.

zokuvimbela

Ukuze ugweme izifo ezifana rhinosinusitis acute, kufanele sithathe izinyathelo ezilandelayo zokuvimbela:

• Gwema okuvezwayo hypothermia;
• eziningi ukuhamba ngaphandle, kube umzimba;
• iqeda;
• sihlanganyele emidlalweni;
• isikhathi aphathe SARS kanye amakhala yisisu;
• ikheli isikhathi wamazinyo ukwelapha amazinyo e-ongenhla;
• efiselekayo ukubhukuda olwandle amanzi olwandle emoyeni donsa ukuphulukiswa.

isiphetho

Ngakho, ubovu acute rhinosinusitis ngempela aphathwe ngaphansi kweso lwezokwelapha, ngakho lingakwazi ukuthobisa nanoma yiziphi izinkinga kuhle kuyingozi ukuthi kungaba ngisho okuyisimo esisongela ukuphila. Kuyadingeka ukuba ugweme ukuyithukuthelisa izici isifo, ngaphansi bachitha isikhathi ezindaweni angavalelwa qu, ukuyeka ukubhema. Ngempatho ezanele futhi ngesikhathi esifanele rhinosinusitis esesindile ngokuphelele.