Izimpawu nokwelashwa kwe-tonsillitis, i-sinusitis nezinye izifo ze-ENT

K. m. N., Otorhinolaryngologist, inhloko yomtholampilo we-otorhinolaryngology wesikhungo sezokwelapha saseYurophu

Ukuphefumula kanzima emakhaleni kuyisibonakaliso esisobala kakhulu sokuthi sekuyisikhathi sokubona i-otorhinolaryngologist. Izimbangela zalesi sibonakaliso kungaba iziyaluyalu ezihlukahlukene, phakathi kwazo ngokuvamile ukugoba kwe-septum yamakhala, i-sinusitis ephindaphindayo (i-sinusitis), i-tonsillitis engapheli kanye ne-obstructive sleep apnea syndrome.

Izinkinga ze-ENT pathologies

Ngokuvamile, izimbangela ze-ENT pathologies ziyahlukahluka kuye ngokuthi uhlobo lwesici.

• Ukugoba kwe-septum yamakhala, isibonelo, kwenzeka kokubili izingane kanye nabantu abadala. Kodwa-ke, njengomthetho, izingane eziningi zine-septum yamakhala eyisicaba kusukela ekuzalweni. Ngesikhathi sokukhula kanye nokwakhiwa kwamathambo obuso, amaphutha avame ukwenzeka, ukulimala kwenzeka, ngenxa yokuthi i-septum ingagoba. Futhi, izinkinga zokuphefumula zingaba zimbi phakathi noma ngemva kokusebenza ngokomzimba, lapho umuntu edinga ukugcwalisa izindawo zokugcina umoya-mpilo, kodwa akakwazi ukwenza lokhu.

• Izimbangela zohlobo oluyingozi kakhulu lokuhona ziyi zokuphelelwa umoya, okungukuthi, i-obstructive sleep apnea syndrome (OSAS) ingaba kokubili i-malocclusion nokuphazamiseka endaweni yekhala, i-nasopharynx, i-laryngopharynx. Ungasiza ukukhomba umthombo wokuhona kwakho ukuhlolwa okuphelele - Ukuqapha kwenhliziyo kanye ne-polysomnography. Lezi zifundo zisivumela ukuthi sibone izinkinga umuntu ahlangabezana nazo lapho elele.

• Izimbangela zohlobo oluyingozi kakhulu lokuhona ziyi zokuphelelwa umoya, okungukuthi, i-obstructive sleep apnea syndrome (OSAS), ingaba kokubili i-malocclusion nokuphazamiseka endaweni yekhala, i-nasopharynx, i-laryngopharynx. Ungasiza ukukhomba umthombo wokuhona kwakho ukuhlolwa okuphelele - Ukuqapha kwenhliziyo kanye ne-polysomnography. Lezi zifundo zisivumela ukuthi sibone izinkinga umuntu ahlangabezana nazo lapho elele.

• Ukuvuvukala kwama-tonsils isikhathi eside (tonsillitis engapheli) nomthelela kukho kokubili izifo kanye nezakhi zofuzo. I-Allergies, amasosha omzimba angazinzile ngisho nama-caries nawo angabangela lesi sifo. Ukuthola i-tonsil egulayo, ukutheleleka kuhlala ku-lacunae, okungukuthi, ekucindezelekeni okungena ekugqilazweni kwamathoni. Imfucumfucu yokudla kanye namagciwane angena ku-lacunae ekhubazekile.

• Esinye sezifo ezingapheli zokuvuvukala kwe-mucous yezono ze-paranasal i-sinusitis... Izimbangela ukuvuvukala kungaba kokubili pathologies azalwa naso futhi aluthola of the ikhala. Izifo ezibangelwa amagciwane noma amagciwane, i-rhinitis ye-allergen nayo ivusa ukuqala kwe-sinusitis. Uma ubona ukulahlekelwa kwephunga nokunambitha, ikhanda, ubuthakathaka, futhi okubaluleke kakhulu, ukukhishwa kwe-mucus ephuzi noma eluhlaza emakhaleni, cishe inqubo yokuvuvukala ikhona.

Izindlela zokulungiswa nokwelashwa kwama-pathologies

1. Ukulungiswa kokugoba kwe-septum yamakhala kungenzeka ngosizo lokungenelela kokuhlinzwa - i-septoplasty… Lokhu kuhlinzwa kunconywa ezigulini ezineminyaka engaphezu kuka-18-20 ubudala, kusukela kule minyaka uhlaka lwamathambo obuso lubhekwa njengolwakhiwe ngokugcwele. Kodwa-ke, izingane zingaphinde zenziwe i-septoplasty uma zine-curvature enzima ye-septum yamakhala, okwenza impilo yengane ibe nzima. Ngesikhathi sokusebenza, izingcezu ezigobile ze-septum yamakhala ziyasuswa noma zihanjiswe. Konke ukukhwabanisa kwenziwa ngaphakathi kwekhala, ngakho azikho izimpawu esikhumbeni. Ngenqubo ye-septoplasty, kungenzeka ukulungisa izinkinga ezihambisana nayo, yingakho ukuhlolwa kwe-endoscopic ye-nasal cavity kanye ne-computed tomography yezono ze-paranasal kudingekile ngaphambi kokuhlinzwa. Idatha yokuhlolwa isivumela ukuthi sibone izinkinga ngaphezu kokugoba kwe-septum yamakhala futhi inikeze odokotela ithuba lokuzilungisa ngesikhathi se-septoplasty.

2. Ukwelashwa kokuhlinzwa kwe-apnea kukhonjiswe ukuhona okulula kanye ne-apnea yokuqina okumaphakathi kuya kokumaphakathi. Izinhlobo ezinzima zalezi pathologies ziyi contraindication ukungenelela ngokuhlinzwa. Kunezindawo ezi-3 zokwelashwa kokuhlinzwa kwe-apnea yokulala nokuhona.

• Okokuqala ukulungisa ulwanga oluthambile.

• Okwesibili ukuqedwa ngokushesha kwe-pathologies yamakhala. Lokhu kuhlanganisa ukulungiswa kwe-septum yamakhala, ama-turbinates, izono.

• Okwesithathu inhlanganisela yalezi zindlela.

3. I-tonsillitis itholakala ngesikhathi sokubonisana nokuhlolwa okubukwayo (uchwepheshe uthola ukunamathela kwamathoni ngama-arches), kanye nemiphumela yokuhlolwa kwaselabhorethri (udokotela ubheka izimpawu zokutheleleka kwe-streptococcal).

Lapho uthola i-tonsillitis eyingozi abelwe Ukwelashwa kwama-anti-virus.

RџS•Rё ifomu elingapheli izifo, kunconywa ukususa okuqukethwe kusuka ku-lacunae yamathoni usebenzisa:

• Ukuhlanza и inkambo yezidakamizwa.

• Kwabelwe futhi physiotherapy - i-ultraviolet irradiation kanye ne-ultrasound esifundeni se-submandibular.

• Uma izindlela ezinjalo zingenawo umphumela oyifunayo, kunconywa ukuthi usebenzise ukungenelela kokuhlinzwa - ukususwa kwamathoni.

• Enye yezindlela zokuhlinza ezingenzeka zokwelapha i-tonsillitis engapheli igagasi lomsakazo fulguration of tonsils… Kubandakanya ukusebenzisa amandla kagesi anemvamisa ephezulu ukuze ukhiphe izicubu ngaphandle kokuthintana okuqondile kwe-electrode nethishu.

• Indlela yesimanje yobuchwepheshe obuphezulu nayo ingasetshenziswa - i-robotic assisted tonsillectomy… Ukususwa kwamathoni ngale ndlela kwenziwa ngokunemba okuqondile ngenxa yesistimu yesimanje yamarobhothi kanye nemishini yevidiyo ye-endoscopic.

3. Ukwelashwa kwakudala kwe-sinusitis imithi.ebekwe udokotela. Kodwa-ke, ngeshwa, le ndlela ivame ukufakazela ukungasebenzi kwayo, ngoba izimpawu zihamba okwesikhashana, futhi lesi sifo singena esigabeni esingapheli.

Indlela entsha futhi ephumelelayo yokwelashwa kwe-sinusitis okwamanje ukusebenza kwe-endoscopic sinus operation… Lesi siqondiso sokwelashwa sihilela ibhaluni sinusoplasty. Inqubo inciphisa izingozi zokulahlekelwa igazi, ukuhlukumezeka, izinkinga zangemva kokuhlinzwa kanye nokwephulwa kwe-anatomy yemvelo yezono. Ngesikhathi se-balloon sinusoplasty, ngaphandle kokulimaza ulwelwesi lwamafinyila, ochwepheshe bavula izoni ezivuthayo, bafake i-catheter yebhaluni lapho, bese beyifutha futhi basebenzise izixazululo ezikhethekile zokugeza izono kusuka kubomvu namafinyila. Ngemuva kokugeza, ithuluzi liyasuswa emgodini.

Isikhathi sokuvuselela

1. Njengomthetho, isikhathi se-postoperative ngemuva i-septoplasty esibhedlela izinsuku 1-2… Isiguli singabe sesibuyela ekhaya. Ukuphefumula okuvamile kubuyiselwa phakathi kwezinsuku ezingu-7-10. Ngesikhathi sokuvuselela, kunconywa ukuthi uyeke ukubhema, ukuphuza utshwala, ingcindezi engokomzimba neyokushisa, ungaqhumisi ikhala lakho kakhulu, futhi futhi ungasusi ama-tampons kungakapheli amahora ayi-XNUMX ngemuva kokuhlinzwa. Lokhu kuzonciphisa ingozi yokopha.

2. Ukuhlinzwa kwe-Apnea zenziwa ngaphansi kwe-anesthesia jikelele. Isikhathi sokuvuselela si cishe amaviki e-xnumx… Ngaphezu kokungenelela kokuhlinzwa ekwelapheni ukuhona, kungenzeka ukusetshenziswa izithonjana ze-intraoral or Ukwelashwa kwe-CPAP… Lokhu kwelashwa kuqukethe ukudala ingcindezi eyakhayo, esiza ukubuyisela amandla omoya. Ngesikhathi sokulala, isiguli sigqoka imaski exhunywe emshinini odala ukucindezela okuhle.

3. Amathoni akhishwa kusetshenziswa izinzwa zesimanje. Lokhu akugcini nje ukufaka isandla ekusebenzeni okunethezeka kwesiguli, kodwa futhi kunikeza isikhathi sokululama ngokushesha.

4. Isikhathi sokuvuselela ngemuva ibhaluni sinusoplasty ngokwesilinganiso usuku olulodwangenkathi ngemva ukuhlinzwa zakudala isiguli sidinga ukululama kusukela ezinsukwini ezintathu kuya kweziyisihlanu.