Qhib lub abscess: indications, txheej txheem, piav qhia

Txoj hauv kev tseem ceeb ntawm kev kho tus kab mob paratonsillar lossis retropharyngeal abscess uas tshwm sim hauv lub pharynx yog qhib qhov tsim tawm los ntawm kev phais. Nws yog qhia rau cov neeg mob ntawm txhua lub hnub nyoog, noj mus rau hauv tus account contraindications. Kev siv thev naus laus zis ntawm kev cuam tshuam kev phais pom zoo kom ua haujlwm 4-5 hnub tom qab qhov pib ntawm abscess tsim. Tsis ua raws li cov lus pom zoo no tuaj yeem ua rau muaj qhov tseeb tias kev ua haujlwm tau ua tiav ntxov dhau, thaum cov kab mob abscess tseem tsis tau tsim. Nyob rau hauv cov ntaub ntawv no, cov kab mob pathogenic cov kab mob twb tau concentrated nyob ib ncig ntawm lub tonsil, tab sis cov theem ntawm melting ntawm cov ntaub so ntswg adenoid tseem tsis tau pib. Txhawm rau kom paub meej txog theem ntawm purulent o, kev kuaj mob puncture yog ua.

Txoj hauv kev los kuaj xyuas qhov kev npaj ntawm qhov abscess rau qhib muaj nyob rau hauv tho qhov taw tes saum toj kawg nkaus ntawm cov ntaub so ntswg o nyob ze rau cov tonsil cuam tshuam. Nws yog ntshaw kom nqa tawm ib tug puncture nyob rau hauv kev tswj ntawm ib tug roentgenoscope los yog ultrasound. Tom qab punctureing cheeb tsam abscess, tus kws kho mob kos nws cov ntsiab lus mus rau hauv ib tug sterile syringe.

Cov kev xaiv ua tau:

• Lub xub ntiag ntawm cov kua qaub nyob rau hauv lub syringe chim yog ib tug tsos mob ntawm ib tug abscess uas tau tsim, lub teeb liab rau kev ua hauj lwm.

• Lub xub ntiag ntawm kev sib xyaw ntawm cov qog ntshav thiab cov ntshav nrog cov kua paug hauv lub syringe yog ib qho tsos mob ntawm ib qho kev tsis haum xeeb, thaum siv tshuaj tua kab mob txaus tuaj yeem tiv thaiv kev phais.

Indications rau qhib lub abscess

Indications rau kev kuaj mob ntawm abscess los ntawm puncture:

• Cov tsos mob tshwm sim, ua rau mob hnyav los ntawm tig taub hau, nqos, sim tham;

• Hyperthermia tshaj 39 ° C;

• Angina kav ntev dua 5 hnub;

• Hypertrophy ntawm ib tonsil (tsis tshua muaj ob);

• Kev loj hlob ntawm ib lossis ntau cov qog ntshav;

• Cov tsos mob ntawm intoxication - mob leeg, qaug zog, tsis muaj zog, mob taub hau;

• Tachycardia, palpitations.

Yog tias kev kuaj mob puncture tau ua raws li ultrasound lossis X-ray kev taw qhia, feem ntau ntawm cov kua paug tuaj yeem raug tshem tawm thaum lub sijhawm ua haujlwm. Txawm li cas los xij, qhov no yuav tsis daws qhov teeb meem kiag li, koj tseem yuav tau tshem tawm cov abscess.

Yog vim li cas rau kev phais:

• Tom qab ntxuav cov kab noj hniav abscess, cov xwm txheej rau kev sib kis ntawm cov kua paug ploj;

• Thaum lub sij hawm phais, cov kab noj hniav yog kho nrog tshuaj tua kab mob, uas tsis tuaj yeem ua tiav thaum lub qhov txhab;

• Yog tias qhov abscess me me, nws raug tshem tawm nrog rau cov tshuaj ntsiav tsis qhib nws;

• Tom qab tshem tawm cov kua paug, cov kev mob tshwm sim zoo dua, qhov mob ploj mus, cov tsos mob ntawm intoxication ploj, qhov kub thiab txias txo;

• Txij li thaum cov kab mob uas ua rau mob purulent yuav luag tag nrho, qhov kev pheej hmoo ntawm kev rov tshwm sim yog tsawg;

• Qee zaum, nrog rau qhov qhib ntawm cov kab noj hniav, cov tonsils raug tshem tawm, uas pab tshem tawm qhov ua kom pom tseeb ntawm qhov mob thiab txo qhov kev pheej hmoo ntawm kev rov tshwm sim ntawm tus kab mob.

Kev phais kom tshem tawm ib qho abscess nyob rau hauv caj pas yog ua nyob rau hauv tus neeg mob sab nraud. Qhov no yog ib txoj kev tsim kom zoo uas tsis ua rau muaj teeb meem. Tom qab kev phais qhib ntawm abscess, tus neeg mob raug xa mus rau kev saib xyuas tom tsev hauv tsev, tuaj rau kev soj ntsuam tom qab 4-5 hnub.

Indications rau inpatient kho ntawm paratonsillar abscess:

• Cov menyuam yaus hnub nyoog (cov menyuam kawm ntawv preschool tau pw hauv tsev kho mob nrog lawv niam lawv txiv);

• Cov poj niam cev xeeb tub;

• Cov neeg mob uas muaj kab mob somatic lossis txo kev tiv thaiv;

• Cov neeg mob uas muaj kev pheej hmoo siab tom qab phais mob (sepsis, phlegmon);

• Cov neeg mob uas muaj qhov tsis zoo ntawm abscess los tswj nws qhov tsim.

Ua ntej kev npaj ua haujlwm, kom tsis muaj zog ntawm cov kab mob pathogenic thiab tiv thaiv lawv txoj kev sib kis, tus neeg mob tau muab tshuaj tua kab mob. Kev phais mob yog ua raws li kev tshuaj loog hauv zos. Yog tias qhov xwm txheej ceev, nws raug tso cai qhib lub abscess yam tsis muaj tshuaj loog.

Cov theem ntawm kev qhib lub abscess

1. Ib qho kev phais yog ua nrog qhov tob ntawm tsis pub ntau tshaj 1-1,5 cm ntawm qhov siab tshaj plaws ntawm cov kab mob purulent, vim tias nws yog nyob rau ntawm cov ntaub so ntswg thinnest, thiab cov abscess nyob ze tshaj plaws. Qhov tob ntawm qhov txiav yog txiav txim siab los ntawm kev pheej hmoo ntawm kev puas tsuaj rau cov hlab ntsha thiab cov hlab ntsha nyob ze.

2. Pus raug tso tawm ntawm kab noj hniav.

3. Tus kws phais mob, siv cov cuab yeej blunt, rhuav tshem cov partitions hauv cov kab noj hniav kom txhim kho cov kua paug tawm thiab tiv thaiv nws cov stagnation.

4. Kev kho cov kab mob abscess nrog ib qho tshuaj tua kab mob rau kev tua kab mob.

5. Qhov txhab suturing.

Txhawm rau tiv thaiv kev rov qab los, kev kho tshuaj tua kab mob tau raug sau tseg. Thaum qhib qhov abscess, nws yuav pom tias cov kua paug tsis nyob hauv cov tshuaj ntsiav, nws tau kis ntawm cov ntaub so ntswg ntawm caj dab. Yog tias qhov teeb meem no tshwm sim los ntawm cov kab mob anaerobic uas tsis tuaj yeem nkag mus rau cov pa oxygen, cov kua dej yog ua los ntawm kev phais ntxiv ntawm lub caj dab kom coj mus rau hauv huab cua thiab tshem tawm cov kua paug. Yog hais tias qhov kev pheej hmoo ntawm rov tshwm sim raug tshem tawm, cov kua dej incisions yog sutured.

Cov cai ntawm kev coj ua tom qab phais kom qhib abscesses:

• Txhawm rau kom tsis txhob o thiab ua kom qeeb qeeb, nws yog txwv tsis pub kom sov lub caj dab;

• Txhawm rau txo qhov kev pheej hmoo ntawm vasoconstriction lossis dilation, nws raug tso cai haus dej haus tsuas yog hauv chav tsev kub;

• Kev siv cov khoom noj ua kua yog pom zoo;

• Yuav tsum ua raws li qhov txwv tsis pub haus cawv thiab haus luam yeeb;

• Txhawm rau tiv thaiv kev rov qab los, nws yog ib qho tsim nyog yuav tsum tau kawm txog kev kho mob nrog tshuaj tua kab mob thiab tshuaj tua kab mob, siv cov vitamin thiab ntxhia complexes;

• 4-5 hnub tom qab kev ua haujlwm, tus kws kho mob tshuaj xyuas tus neeg mob, ntsuas qhov kev pheej hmoo ntawm cov teeb meem tshwm sim, cov txheej txheem rov tsim dua tshiab.

Feem ntau, kev rov ua dua tom qab phais yog qhov tsawg heev. Tom qab ib lub lim tiam tau faib rau lub sijhawm rov ua haujlwm, tus neeg mob tuaj yeem raug pom zoo rau cov txheej txheem ib txwm muaj.