急慢性咽炎PPT课件.ppt

咽炎Pharyngitis,定义：咽粘膜粘膜下组织和淋巴组织的炎症，常为上呼吸道感染的一部分，包括急慢性咽炎。,Definition:Theinflammationofmucosa,submucosaandlymphatictissue,whichisthepartofrespiratorytractinfection,includingacute/chronicpharyngitis.,1,急性咽炎Acutepharyngitis,定义：咽粘膜粘膜下组织淋巴组织的急性炎症，常为上呼吸道感染的一部分，多由急性鼻炎向下蔓延所致，常见于冬春及秋冬之交。,Definition:Theinflammationofmucosa,submucosaandlymphatictissue,whichisthepartofrespiratorytractinfection,resultingfromacuterhinitis,2,病因Etiology,1.病毒感染柯萨奇病毒,腺病毒副流感病毒,流感病毒,鼻病毒2.细菌感染链球菌,A组乙型葡萄球菌肺炎双球菌3.理化因素高温粉尘烟雾4.诱发因素全身或局部抵抗力下降环境条件差,VirusinfectionCoxsackievirus/adenovirusBacterialinfectionStreptococcusStaphylococcusPneumoniadiplococcusAgentHyperthermiaDust/smogEvokingfactorThepoorenvironmentalconditionTheresistanceoftotalbody/localisdescent,3,临床表现Clinicalsituation,症状：起病急，咽干咽痛吞咽疼痛全身症状：较轻，头痛食欲下降干咳体症：咽部粘膜急性充血悬雍垂水肿淋巴滤泡和侧索红肿下颌下淋巴结肿大压痛,SymptomPharyngealpain/drynessSwallowingpainTotalbodysymptom:headache/anorexia/coughSignAcutecongestionofpharyngealmucosaStaphyleedemaTheredswellingoflymphaticfollicleandcordSwellingandpainofsubmandibularlymphnodes,4,诊断Diagnosis,诊断病史+体症+症状+咽培养鉴别诊断猩红热百日咳流感麻疹,DiagnosisHistorySignSymptomPharyngealcultureDifferentiadiagnosisScarlatinaWhoopingcoughInfluenzameasles,5,治疗Treatment,抗病毒治疗：吗啉双胍病毒唑板蓝根银黄冲剂抗细菌治疗：磺胺头孢拉啶罗红霉素局部用药：Dobells液西瓜霜润喉片银黄含片中医中药：银翘散加减,Anti-virus:Moroxydine,virazole,IsatisTiactoriaAntibacterialtreatment:SMZ,RoxithromycinLocaldrug:DobellssolutionTraditionalChinesemedicinefludeton,6,慢性咽炎Chronicpharyngitis,定义：咽部粘膜粘膜下及淋巴组织的弥漫性炎症，为上呼吸道慢性炎症的一部分，是临床上的常见病和多发病。,Definition:Thediffuseinflammationofmucosa,submucosaandlymphatictissue,whichisthepartofrespiratorytractchronicinfectionandtheclinicalcommondisease,multi-disease.,7,病因Etiology,急性咽炎反复发作局部刺激因素：长期经口呼吸烟酒粉尘有害气体刺激鼻炎鼻窦炎引起涕倒流至咽部全身因素：贫血心血管病等慢性病继发引起本病,AcutepharyngitisattackedoverandoverLocalstimulationfactorMouthbreathingforthelong-termsmoking/drinking/dust/harmfulgasesRhinitis/sinusitisFactoroftotalbody:anemiacardio-disease,8,病理分型pathologicaltyping,慢性单纯性咽炎以粘膜慢性充血为主，轻度增生。慢性肥厚性咽炎以粘膜下结缔组织及淋巴组织增生为主，咽喉壁淋巴滤泡咽侧索呈条索状增厚。,Chronicsimplepharyngitischroniccongestionofmucosaismain,havingalittlehyperplasia.Chronichypertrophicpharyngitishyperplasiaofconnectivetissuesundermucosaandlymphatictissues,suchaslymphaticfollicleandpharyngeallateralcord.,9,临床表现Clinicalsituation,多样性症状：异物感干燥发痒微痛恶心感刺激性干咳全身症状：不明显体症：咽反射敏感粘膜慢性充血，小血管扩张，暗红色，有分泌物粘膜肥厚，弥漫充血，淋巴滤泡增生，侧索肥厚分泌亢进，痰多,ThediversityofsymptomForeignbodysensation,dryness,itchy,nausea,drycoughTotalbodysymptomUnclearSignsPharyngealreflexsensitiveChroniccongestionofmucosa,expansionofsmallvessels/scoto-red/havingdischargeThicknessofmucosa/WidthspreadcongestionHyperplasiaoflymphaticfollicle/thicknessofpharyngeallateralcord.Highexcretion,moresputum,10,诊断Diagnosis,AttentioninquiringhistoryCarefulexaminationMakingtyping,注意询问病史仔细全面检查，特别是鼻咽部喉部，排除恶性肿瘤做好分型,11,治疗Treatment,EtiologicaltreatmentClearingoffetiologicalfactor,suchassmoking/drinking/dust/harmfulgases,rhinitis/sinusitisReinforcementhealthLocaltreatmentChronicsimplepharyngitis:DobellssolutionsThic