课件：急、慢性扁桃体炎.ppt

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: 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 from mouth/nose. That is easily invading by pathogen, then takes place inflammation, including acute / chronic tonsillitis. 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。 Definition: The acute non-special inflammation of Palatine tonsil, being linked to pharyngitis. That is the common disease and more takes place in children/youth, including catarrh/ suppurating type. 病 因Etiology 感染 主要致病菌为乙型容血性链球菌 葡萄球菌 肺炎双球菌 腺病毒 厌氧菌 机体防御能力下降 常见诱因 受凉﹑劳累﹑潮湿﹑烟酒 传染性 飞沫或直接接触传染，通常呈散发性，偶有爆发流行 Infection The main germs was B streptococccus Staphylococci Pneumonia-diplococcus Adenoviruses/Anaerobes The ability of body defence was descent Common factor cold/tired/wetness/smoking/drinking Infectivity droplet/directly contacting 临床特征Clinical feature 急性卡他性扁桃体炎： 咽痛 低热 轻度全身症状： 乏力﹑酸痛﹑精神差 粘膜急性充血肿胀，扁桃体表面无渗出物 血象：白细胞总数及 中性白细胞升高 Acute catarrhal tonsillitis Pharyngeal pain/Low fever Lightly total symptom: aching pain/inertia Acute congestion of mucosa, having little exudates on tonsil surface Blood: The amount of WBC/ neutrophil was high. 临床特征Clinical feature 急性化脓性扁桃体炎 起病急，局部和全身症状较重 咽痛剧烈，反射痛，吞咽困难 畏寒﹑高热：幼儿可高热抽搐，呕吐﹑昏睡 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 下颌角淋巴结肿大﹑压痛 血象：白细胞总数及中性白细胞升高 Actue suppurative tonsllitis Rapidly illness, having more symptoms of total/local body. Pharyngeal pain intensity / flecting pain / disphagia Feeling cool /high fever: tic/vomiting / lethargy Swelling of tonsil / peri-tonsil hyperemia,having pus and false membrane on tonsil surface. swelling of lymphatic nodes ia angle of mandible,having pressing pain. Blood: The amount of WBC/neutrophil was high. 急性化脓性扁桃体炎 急性化脓性扁桃体炎 诊 断Diagnosis