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1、扁 桃 体 炎 Tonsillitis定义： 扁桃体作为咽淋巴 环的重要结构，位于 呼吸道和消化道的上 端，最先接触自口鼻 进入的病原，在机体 抵抗力下降时容易受 到病原体侵犯而发炎 。主要包括急慢性 扁桃体炎。Definition:Definition: Tonsil is the important structure of the pharyngeal lymphatic circle, located at the upper of respiratory tract and digestive tract, which is first contact with pathogen f
2、rom mouth/nose. That is easily invading by pathogen, then takes place inflammation, including acute / chronic tonsillitis.89医院 唐少松急性扁桃体炎 Acute tonsillitis定义：腭扁桃体的急性非特异 性炎症，常伴有急性咽 炎，是一种咽部常见病 ，多发于儿童青年， 在季节更替，气温变化 时容易发病。可分为卡 他性化脓性两型。 DefinitionDefinition: : The acute non-special inflammation of Palatin
3、e tonsil, being linked to pharyngitis. That is the common disease and more takes place in children/youth, including catarrh/ suppurating type.89医院 唐少松病 因 Etiology感染n主要致病菌为乙型容血性 链球菌n葡萄球菌n肺炎双球菌n腺病毒n厌氧菌 机体防御能力下降 常见诱因n受凉劳累潮湿烟酒 传染性n飞沫或直接接触传染，通常呈 散发性，偶有爆发流行InfectionInfectionnThe main germs was B streptoco
4、cccusnStaphylococcinPneumonia-diplococcusnAdenoviruses/Anaerobes The ability of body The ability of body defencedefence was descentwas descent Common factorCommon factorncold/tired/wetness/smoking/drinking InfectivityInfectivityndroplet/directly contacting89医院 唐少松临床特征 Clinical feature急性卡他性扁桃体炎：n咽痛n低
5、热n轻度全身症状：乏力酸痛精神差n粘膜急性充血肿胀，扁 桃体表面无渗出物n血象：白细胞总数及中性白细胞升高Acute catarrhal tonsillitisAcute catarrhal tonsillitisn Pharyngeal pain/Low fevern Lightly total symptom: aching pain/inertian Acute congestion of mucosa,having little exudates ontonsil surfacen Blood: The amount of WBC/neutrophil was high.89医院 唐少
6、松临床特征 Clinical feature急性化脓性扁桃体炎 n起病急，局部和全身症状 较重 n咽痛剧烈，反射痛，吞咽 困难 n畏寒高热：幼儿可高热 抽搐，呕吐昏睡 n扁桃体肿大，周围充血， 表面有脓点或假膜，假膜 不超出扁桃体范围，易擦 拭去，不出血 n下颌角淋巴结肿大压痛 n血象：白细胞总数及中性 白细胞升高ActueActue suppurativesuppurative tonsllitistonsllitisn Rapidly illness, having more symptoms of total/local body. n Pharyngeal pain intensity
7、 / flecting pain / disphagia n Feeling cool /high fever: tic/vomiting / lethargy n Swelling of tonsil / peri-tonsil hyperemia,having pus and false membrane on tonsil surface. n swelling of lymphatic nodes ia angle of mandible,having pressing pain. n Blood: The amount of WBC/neutrophil was high.89医院
8、唐少松急性化脓性扁桃体炎89医院 唐少松急性化脓性扁桃体炎89医院 唐少松诊 断 Diagnosis典型病史+咽部 检查鉴别诊断：n咽炎n猩红热n溃疡性咽炎Typical history/ Typical history/ pharyngeal pharyngeal examinationexaminationDifferential diagnosisDifferential diagnosisn Pharyngitisn Scarlet fevern Ulcerative pharyngitis.89医院 唐少松并发症 Complication 局部并发症：n扁桃体周围脓肿n急性中耳炎：儿
9、童常 见n急性淋巴结炎n咽旁脓肿：较少见 全身并发症:(机体对链球 菌所产生的型变态反应)n风湿热n急性关节炎心肌炎n急性肾炎Local complications:Local complications:n peritonsillar abscessn Acute otitis median Acute lymphadenitisn Parapharyngeal abscess Complications of total Complications of total body:body:( the type of allergic reaction induced by streptoco
10、ccus)n Rheumatic fevern Acute arthritisn Acute nephritis89医院 唐少松治 疗 Treatmentn抗菌消炎是本病的治疗原则，青霉素是首选药物。n对症治疗是解热镇痛n局部治疗是含漱液+含片n The therapetic principle of this disease is anti-bacteria and eliminating inflammation, penicillin is the first-line of clinical drug.n Relief of fever and pain were the second
11、 treatment.n Local treatment were using gargle89医院 唐少松预 防 preventionn锻炼身体，增 强体质，提高 机体抵抗力。n注意病人隔离 ，防止传染。n Body building and reinforcement health, then rising resistance of body.n Attention to insulation of patients, that prevents from infection89医院 唐少松慢性扁桃体炎 Chronic tonsillitisn由急性扁桃体炎 反复发作或隐窝 口内细菌病毒
12、 孳生感染而演变 成的腭扁桃体慢 性炎症。n The inflammation of palatin tonsil induced by the repetition attacking of acute tonsillitis or infection of bacteria/ virus from crypt .89医院 唐少松病 因 Etiology感染：乙型溶血性链球菌 腺病毒反复急 性发作慢性炎症免疫因素：微生物扁桃体 自身变态反应慢 性炎症Infection :Infection :streptococcus B /adenovirus repetition of acute at
13、tacking chronic inflammation ImmuningImmuning infactorsinfactors: : microorganism tonsil self - allergic reaction infammation89医院 唐少松病 理 pathology早期：隐窝口粘膜受损 上皮增生溃疡 炎性渗出物后期：扁桃体疤痕形成 开口受阻小脓肿Earlier period:Earlier period: the mucosa of crypts damaged epithelial proliferation,ulcering, inflammatory exuda
14、tes Anaphase:Anaphase:the formation of scar in tonsil aperture hindering the little abscess89医院 唐少松临床表现 Clinical situationn反复急性发作病史n咽部不适症状n扁桃体肥大引起的症状n全身慢性中毒症状n体症：l扁桃体慢性充血，疤 痕粘连；l隐窝口封闭，有时可 见黄白色干珞样或点 状分泌物；l颌下淋巴结肿大。n actue attaccking again and againn The upset symptoms in pharynxn The symptoms induced
15、by tonsil hypertrophyn Chronic toxicosis of total bodyn Sings:l Chronic congestion/scarl Crypts were closed, having some white dischargesl Swelling of submandbular lymph nodes89医院 唐少松诊 断 Diagnosis 病史+体症+症状 鉴别诊断： l扁桃体生理性肥大 l扁桃体角化症：白色 沙砾样角化物，触之 坚硬，不能拭去。 l扁桃体肿瘤：腺体肿 大且有溃疡，需行活 检确诊。 History+signs+symptom Differential diagnosiss lPhysiologic hypertrophy of tonsil lKeratosis of tonsil: the small white sand-like masses, which are difficult to remove by swabbing. ltumor of tonsil: the swelling and ulcering of tonsil, pathologic evidence is the final diagnosis.89
