Mob otitis media: txhais

Mob otitis media (AOM) yog kab mob ntawm pob ntseg nruab nrab uas cuam tshuam nrog lub pob ntseg lossis lub pob ntseg, ib lub pob txha me me nyob nruab nrab ntawm pob ntseg thiab pob ntseg sab hauv thiab muaj cov ossicles.

Cov kab noj hniav no txuas nrog lub raj (lub raj Eustachian) mus rau lub nasopharynx nyob rau sab nraum qab ntawm lub qhov ntswg kab noj hniav (saib daim duab hauv qab). Lub raj Eustachian pab sib npaug ntawm huab cua siab ntawm qhov ntswg qhov ntswg, pob ntseg nruab nrab thiab huab cua sab nraud.

Mob otitis media (AOM) yog tus cwj pwm los ntawm qhov feem ntau purulent effusion nyob rau hauv lub pob ntseg.

AOM yog txuas nrog cov kab mob los yog kab mob, kab mob los yog kab mob feem ntau kis mus rau nruab nrab pob ntseg vim yog ib qho rhino sinusitis los yog ib tug rhino-pharyngite los ntawm kev qiv lub raj eustachian.

Kev kis kab mob los yog mob ntawm lub qhov ntswg thiab qhov ntswg (nasosinus), cov adenoids loj tuaj yeem ua rau muaj kev cuam tshuam ntawm eustachian raj, ua rau cov kua dej tso rau hauv pob ntseg (otitis media). 'thaum pib mob tab sis raug mob, los ntawm kev kis tus kab mob, hloov mus ua mob otitis media. 

Classically, AOM tau tshwm sim los ntawm kub taub hau thiab mob hauv ib lossis ob lub pob ntseg (feem ntau tsuas yog ib qho) uas feem ntau hnyav heev, tab sis tsis tas li.

Cov tsos mob ntawm otitis nyob rau hauv cov me nyuam

Cov tsos mob tuaj yeem ua rau tsis meej pem, tshwj xeeb tshaj yog rau cov menyuam yaus thiab menyuam mos. Xav txog kev mob otitis media thaum: 

• tus menyuam feem ntau kov nws pob ntseg
• tus menyuam quaj, chim siab, nyuaj pw tsaug zog
• muaj tsis muaj qab los noj mov.
• muaj cov kab mob digestive, ua rau tsis meej pem nrog raws plab thiab ntuav
• tsis hnov ​​lus (tus me nyuam tsis teb rau cov suab qis).

Cov tsos mob ntawm tus mob otitis media hauv cov laus

• throbbing mob (punctuated los ntawm kev ntaus lub plawv) nyob rau hauv pob ntseg, uas yuav tawg mus rau hauv lub taub hau.
• ib qho kev xav ntawm pob pob ntseg, tsis hnov ​​​​lus.
• tej zaum ringing nyob rau hauv pob ntseg los yog kiv taub hau

Thaum lub pob ntseg perforated, otitis tuaj yeem ua rau muaj paug tawm hauv pob ntseg ntawm qhov tso tawm ntau dua lossis tsawg dua purulent.

Kev kuaj mob ntawm tus mob otitis media

Tus kws kho mob yuav tsum tau sab laj kom paub meej qhov kev kuaj mob ntawm AOM thiab txiav txim siab txog qhov tsim nyog ntawm kev kho tshuaj tua kab mob.

Kev kuaj mob yog tsim los ntawm kev saib lub pob ntseg, qhov zoo tshaj plaws nrog lub microscope. Nws yuav ua rau nws muaj peev xwm sib txawv AOM nrog purulent effusion los ntawm congestive otitis, txwv rau qhov mob ntawm pob ntseg.

Nco ntsoov tias qhov kev ntsuam xyuas no tuaj yeem pom ib hom kab mob otitis media, myringitis (xws li mob ntawm lub pob ntseg), ntawm tus kab mob hauv lub hauv paus, mob heev uas ua rau muaj npuas feem ntau npog yuav luag tag nrho lub pob ntseg., tab sis qhov kev txhawj xeeb tsuas yog lub pob ntseg nkaus xwb, uas yog hais tias tom qab tau tho qhov npuas no, uas feem ntau ua rau qhov mob ploj mus, lub pob ntseg tseem zoo, tsis muaj pob ntseg perforation.

Cov evolution ntawm mob otitis media

Yog tias kho tau zoo, AOM kho tau hauv 8 mus rau 10 hnub, tab sis nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas qhov mob ntawm pob ntseg tom qab kev kho mob thiab xyuas kom meej, tshwj xeeb tshaj yog rau cov menyuam yaus, qhov hnov ​​​​lus tau rov qab zoo kawg nkaus.

Kev hloov pauv ntawm AOM yog li ntawd feem ntau benign tab sis muaj ntau yam teeb meem tshwm sim:

Serous los yog serum mucous otitis

Tom qab kev kho mob ntawm tus kab mob, tom qab lub pob ntseg, qhov uas tsis yog-purulent tab sis inflammatory, tsis mob effusion tseem nyob, uas ntawm ib sab txhawb kev rov tshwm sim ntawm AOM.

Qhov effusion no tuaj yeem ua rau tsis hnov ​​​​lus tsis zoo hauv cov menyuam yaus vim tias nws muaj feem cuam tshuam rau kev hais lus qeeb; yog li qhov yuav tsum tau saib xyuas thaum kawg ntawm kev kho mob. Ib audiogram (hnov lub rooj sib hais) tej zaum yuav tsim nyog yog tias muaj kev tsis ntseeg. Thaum tsis muaj kev kho mob, ib tus yuav raug coj los qhia txog kev teeb tsa ntawm transtympanic aerator.

Tympanic perforation

Lub purulent effusion tuaj yeem ua rau muaj zog ntawm lub pob ntseg tsis muaj zog (qhov no qhov mob tshwj xeeb yog khaus) thiab ua rau lub pob ntseg perforation., nrog qee zaum ntshav tawm ntawm cov kua qaub uas feem ntau suppresses qhov mob.

Tom qab kho, lub pob ntseg feem ntau kaw tsis tu ncua, tab sis nyob rau hauv lub sij hawm sib txawv heev, uas tej zaum yuav kav li ob peb lub hlis.

Kev tsim kho tshwj xeeb

• la meningitis
• labyrinthite
• mastoiditis, tsis tshua muaj hnub no
• Cov kab mob otitis ntev - suav nrog cholesteatoma, ib hom mob hnyav otitis - kuj dhau los ua tsis tshua muaj. 

Cov menyuam yaus, cuam tshuam ntau dua li cov neeg laus

Thaum muaj hnub nyoog 3 xyoos, kwv yees li ntawm 85% ntawm cov menyuam yaus yuav muaj tsawg kawg yog ib qho AOM, thiab ib nrab yuav muaj tsawg kawg yog ob. AOM feem ntau cuam tshuam rau cov menyuam yaus, vim yog cov duab thiab txoj haujlwm ntawm lawv lub raj eustachian (nqaim thiab nyob hauv kab rov tav) nrog rau qhov tsis paub meej ntawm lawv lub cev tiv thaiv kab mob. Cov tub hluas muaj kev pheej hmoo me ntsis dua cov ntxhais, vim peb tsis paub.

Kev tswj hwm loj ntawm qee cov tshuaj tiv thaiv, tshwj xeeb yog cov tshuaj tiv thaiv kab mob pneumococcus thiab tiv thaiv Haemophilus influenza, tau ua kom txo tau qhov zaus ntawm cov kab mob otitis media thiab tshwj xeeb tshaj yog cov zaus ntawm AOMs tshwm sim los ntawm cov kab mob tshuaj tua kab mob. 

AOM feem ntau tshwm sim nyob rau hauv cov xwm txheej ntawm eustachian tube tsis ua haujlwm, cov kua dej hauv lub ntsws otitis (cov kua dej tsis tu ncua tom qab lub pob ntseg yog yooj yim dua superinfected), rov kis kab mob ntawm lub qhov ntswg los yog sinuses ntawm kev tsis haum lossis tsis ua xua. .

Nws kuj tseem muaj ntau dua thaum muaj kev tiv thaiv kab mob (cov me nyuam yug ntxov ntxov, tsis muaj zaub mov noj, thiab lwm yam) los yog anatomical abnormalities ntawm lub ntsej muag, trisomy 21, cleft palate (los yog harelip) piv txwv.

Ua li cas koj thiaj kis tau pob ntseg?

•     Nkag mus rau hauv chaw zov me nyuam lossis crèche.
•     Muaj pa luam yeeb los yog muaj kuab paug ntau heev.
•     Pub lub raj mis ntau dua li pub mis niam (saib ntu Kev Tiv Thaiv).
•     Lub raj mis pub thaum pw.
•     Nquag siv lub pacifier
•     Yog tsis muaj lub tshuab kom raug