1、定義：定義： 扁桃體作為咽淋巴環(huán)的重要結(jié)構(gòu)，位于呼吸道和消化道的上端，最先接觸自口鼻進(jìn)入的病原，在機(jī)體抵抗力下降時(shí)容易受到病原體侵犯而發(fā)炎。主要包括急慢性扁桃體炎。 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 pat

2、hogen, then takes place inflammation, including acute / chronic tonsillitis.定義：定義：腭扁桃體的急性非特異性炎癥，常伴有急性咽炎，是一種咽部常見病，多發(fā)于兒童青年，在季節(jié)更替，氣溫變化時(shí)容易發(fā)病?？煞譃榭ㄋ曰撔詢尚?。 The acute non-special inflammation of Palatine tonsil, being linked to pharyngitis. That is the common disease and more takes place in children/youth,

3、 including catarrh/ suppurating type.感染感染主要致病菌為乙型容血性鏈球菌葡萄球菌肺炎雙球菌腺病毒厭氧菌機(jī)體防御能力下降機(jī)體防御能力下降常見誘因常見誘因受涼勞累潮濕煙酒傳染性傳染性飛沫或直接接觸傳染，通常呈散發(fā)性，偶有爆發(fā)流行nThe main germs was B streptococccusnStaphylococcinPneumonia-diplococcusnAdenoviruses/Anaerobesncold/tired/wetness/smoking/drinkingndroplet/directly contacting急性卡他性扁桃體炎：

4、急性卡他性扁桃體炎：咽痛低熱輕度全身癥狀： 乏力酸痛精神差粘膜急性充血腫脹，扁桃體表面無滲出物血象：白細(xì)胞總數(shù)及 中性白細(xì)胞升高n Pharyngeal pain/Low fevern Lightly total symptom: aching pain/inertian Acute congestion of mucosa, having little exudates on tonsil surfacen Blood: The amount of WBC/ neutrophil was high.急性化膿性扁桃體炎急性化膿性扁桃體炎起病急，局部和全身癥狀較重咽痛劇烈，反射痛，吞咽困難畏寒高

5、熱：幼兒可高熱抽搐，嘔吐昏睡扁桃體腫大，周圍充血，表面有膿點(diǎn)或假膜，假膜不超出扁桃體范圍，易擦拭去，不出血下頜角淋巴結(jié)腫大壓痛血象：白細(xì)胞總數(shù)及中性白細(xì)胞升高n Rapidly illness, having more symptoms of total/local body.n Pharyngeal pain intensity / flecting pain / disphagian Feeling cool /high fever: tic/vomiting / lethargyn Swelling of tonsil / peri-tonsil hyperemia,having pus

6、 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.典型病史典型病史+咽部咽部檢查檢查鑒別診斷：鑒別診斷：咽炎猩紅熱潰瘍性咽炎n Pharyngitisn Scarlet fevern Ulcerative pharyngitis. 局部并發(fā)癥：局部并發(fā)癥：扁桃體周圍膿腫急性中耳炎：兒童常見急性淋巴結(jié)炎咽旁膿腫：較少見 全身并發(fā)癥全身并

7、發(fā)癥:(機(jī)體對(duì)鏈球菌所產(chǎn)生的型變態(tài)反應(yīng))風(fēng)濕熱急性關(guān)節(jié)炎心肌炎急性腎炎n peritonsillar abscessn Acute otitis median Acute lymphadenitisn Parapharyngeal abscess( the type of allergic reaction induced by streptococcus)n Rheumatic fevern Acute arthritisn Acute nephritis抗菌消炎是本病的治療原則，青霉素是首選藥物。對(duì)癥治療是解熱鎮(zhèn)痛局部治療是含漱液+含片n The therapetic principle

8、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 treatment.n Local treatment were using gargle鍛煉身體，增強(qiáng)體質(zhì)，提高機(jī)體抵抗力。注意病人隔離，防止傳染。n Body building and reinforcement health, then rising resistance of body.

9、n Attention to insulation of patients, that prevents from infection由急性扁桃體炎反復(fù)發(fā)作或隱窩口內(nèi)細(xì)菌病毒孳生感染而演變成的腭扁桃體慢性炎癥。n The inflammation of palatin tonsil induced by the repetition attacking of acute tonsillitis or infection of bacteria/ virus from crypt .感染：感染： 乙型溶血性鏈球菌腺病毒反復(fù)急性發(fā)作慢性炎癥免疫因素：免疫因素： 微生物扁桃體自身變態(tài)反應(yīng)慢性炎癥 s

10、treptococcus B /adenovirus repetition of acute attacking chronic inflammation microorganism tonsil self- allergic reaction infammation早期：早期： 隱窩口粘膜受損上皮增生潰瘍炎性滲出物后期：后期： 扁桃體疤痕形成開口受阻小膿腫the mucosa of crypts damaged epithelial proliferation,ulcering, inflammatory exudates the formation of scar in tonsil ap

11、erture hindering the little abscess反復(fù)急性發(fā)作病史反復(fù)急性發(fā)作病史咽部不適癥狀咽部不適癥狀扁桃體肥大引起的癥狀扁桃體肥大引起的癥狀全身慢性中毒癥狀全身慢性中毒癥狀體癥：體癥：l扁桃體慢性充血，疤痕粘連；l隱窩口封閉，有時(shí)可見黃白色干珞樣或點(diǎn)狀分泌物；l頜下淋巴結(jié)腫大。n actue attaccking again and againn The upset symptoms in pharynxn The symptoms induced by tonsil hypertrophyn Chronic toxicosis of total bodyn Sing

12、s:l Chronic congestion/scarl Crypts were closed, having some white dischargesl Swelling of submandbular lymph nodeslPhysiologic hypertrophy of tonsillKeratosis 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.并發(fā)癥：并發(fā)癥： 隱窩口內(nèi)的細(xì)菌和毒素變態(tài)反應(yīng)并發(fā)癥風(fēng)濕性關(guān)節(jié)炎風(fēng)濕熱腎病心臟病bacteria and its toxins allergic reaction complication nRheumatic arthritisnRheumatic fevernNephrosisnCardiac disease保守治療：保守治療：免疫療法