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| 急、慢性咽炎 |
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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。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。病因Etiology1.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﹑压痛诊断D
iagnosis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：Dobell’s液﹑西瓜霜润喉片﹑银黄含
片中医中药：银翘散加减慢性咽炎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。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病理分型pathol
ogicaltyping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。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，痰多诊断DiagnosisAttentioninquiringhistoryCaref
ulexaminationMakingtyping治疗TreatmentEtiologicaltreatm
entClearingoffetiologicalfactor,suchassmoking/drinking/d
ust/harmfulgases,rhinitis/sinusitisReinforcementhealthLocal
treatmentChronicsimplepharyngitis:Dobell’ssolutionsThickeni
ngpharyngitis:Burning/laser/freezingtreatmentmedicinetreatm
ent解放军第89医院唐少松Definition:Theinflammationofmucosa,
submucosaandlymphatictissue,whichisthepartofrespirator
ytractinfection,includingacute/chronicpharyngitis.Definit
ion:Theinflammationofmucosa,submucosaandlymphatictiss
ue,whichisthepartofrespiratorytractinfection,resulting
fromacuterhinitisVirusinfectionCoxsackievirus/adenovirusB
acterialinfectionStreptococcusStaphylococcusPneumoniadiploco
ccusAgentHyperthermiaDust/smogEvokingfactorThepoorenviron
mentalconditionTheresistanceoftotalbody/localisdescentS
ymptomPharyngealpain/drynessSwallowingpainTotalbodysymptom
:headache/anorexia/coughSignAcutecongestionofpharyngealmuc
osaStaphyleedemaTheredswellingoflymphaticfollicleandcor
dSwellingandpainofsubmandibularlymphnodesDiagnosisHist
orySignSymptomPharyngealcultureDifferentiadiagnosisScarlat
inaWhoopingcoughInfluenzameaslesAnti-virus:Moroxydine,vira
zole,IsatisTiactoriaAntibacterialtreatment:SMZ,Roxithromyci
nLocaldrug:Dobell’ssolutionTraditionalChinesemedicineflud
etonDefinition:Thediffuseinflammationofmucosa,submucosa
andlymphatictissue,whichisthepartofrespiratorytractchr
onicinfectionandtheclinicalcommondisease,multi-disease.A
cutepharyngitisattackedoverandoverLocalstimulationfactor
Mouthbreathingforthelong-termsmoking/drinking/dust/harmful
gasesRhinitis/sinusitisFactoroftotalbody:anemiacardio-dise
aseChronicsimplepharyngitischroniccongestionofmucosa
ismain,havingalittlehyperplasia.Chronichypertrophicpharyn
gitishyperplasiaofconnectivetissuesundermucosaandlymp
hatictissues,suchaslymphaticfollicleandpharyngeallateral
cord.ThediversityofsymptomForeignbodysensation,dryness,
itchy,nausea,drycoughTotalbodysymptomUnclearSignsPharyng
ealreflexsensitiveChroniccongestionofmucosa,expansionofs
mallvessels/scoto-red/havingdischargeThicknessofmucosa/Widt
hspreadcongestionHyperplasiaoflymphaticfollicle/thicknesso
fpharyngeallateralcord.Highexcretion,moresputum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病因治疗消除各种致病因素，如烟酒﹑辛辣刺激物﹑有毒气体增强体质局部治疗单纯性咽炎：Dobell’s液﹑含片﹑六神丸肥厚性咽炎：药物治疗:含片﹑呋喃西林液外科治疗:烧灼法﹑激光或冷冻法解放军第89医院唐少松 |
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