1、解放軍第89醫(yī)院 唐少松,咽 炎Pharyngitis,定義： 咽粘膜粘膜下組織和淋巴組織的炎癥，常為上呼吸道感染的一部分，包括急慢性咽炎。,Definition: The inflammation of mucosa , submucosa and lymphatic tissue , which is the part of respiratory tract infection, including acute / chronic pharyngitis.,解放軍第89醫(yī)院 唐少松,急性咽炎Acute pharyngitis,定義： 咽粘膜粘膜下組織淋巴組織的急性炎癥，常為上呼吸道感染的

2、一部分，多由急性鼻炎向下蔓延所致，常見(jiàn)于冬春及秋冬之交。,Definition: The inflammation of mucosa , submucosa and lymphatic tissue , which is the part of respiratory tract infection, resulting from acute rhinitis,解放軍第89醫(yī)院 唐少松,病 因Etiology,1.病毒感染 柯薩奇病毒, 腺病毒 副流感病毒, 流感病毒, 鼻病毒 2.細(xì)菌感染 鏈球菌, A組乙型 葡萄球菌 肺炎雙球菌 3.理化因素 高溫 粉塵煙霧 4.誘發(fā)因素 全身或局部抵抗

3、力下降 環(huán)境條件差,Virus infection Coxsackie virus/adenovirus Bacterial infection Streptococcus Staphylococcus Pneumonia diplococcus Agent Hyperthermia Dust/smog Evoking factor The poor environmental condition The resistance of total body/local is descent,解放軍第89醫(yī)院 唐少松,臨床表現(xiàn)Clinical situation,癥狀： 起病急，咽干咽痛 吞咽疼痛

4、 全身癥狀：較輕，頭痛食欲下降干咳 體癥： 咽部粘膜急性充血 懸雍垂水腫 淋巴濾泡和側(cè)索紅腫 下頜下淋巴結(jié)腫大壓痛,Symptom Pharyngeal pain/dryness Swallowing pain Total body symptom: headache/anorexia/cough Sign Acute congestion of pharyngeal mucosa Staphyle edema The red swelling of lymphatic follicle and cord Swelling and pain of submandibular lymph nod

5、es,解放軍第89醫(yī)院 唐少松,診 斷Diagnosis,診斷 病史+體癥+癥狀+咽培養(yǎng) 鑒別診斷 猩紅熱 百日咳 流感 麻疹,Diagnosis History Sign Symptom Pharyngeal culture Differentia diagnosis Scarlatina Whooping cough Influenza measles,解放軍第89醫(yī)院 唐少松,治 療Treatment,抗病毒治療： 嗎啉雙胍病毒唑板藍(lán)根銀黃沖劑 抗細(xì)菌治療： 磺胺頭孢拉啶羅紅霉素 局部用藥： Dobells液西瓜霜潤(rùn)喉片銀黃含片 中醫(yī)中藥： 銀翹散加減,Anti-virus: Morox

6、ydine, virazole,Isatis Tiactoria Antibacterial treatment: SMZ, Roxithromycin Local drug: Dobells solution Traditional Chinese medicine fludeton,解放軍第89醫(yī)院 唐少松,慢性咽炎Chronic pharyngitis,定義： 咽部粘膜粘膜下及淋巴組織的彌漫性炎癥，為上呼吸道慢性炎癥的一部分，是臨床上的常見(jiàn)病和多發(fā)病。,Definition : The diffuse inflammation of mucosa, submucosa and lymph

7、atic tissue , which is the part of respiratory tract chronic infection and the clinical common disease , multi-disease.,解放軍第89醫(yī)院 唐少松,病 因Etiology,急性咽炎反復(fù)發(fā)作 局部刺激因素： 長(zhǎng)期經(jīng)口呼吸 煙酒粉塵有害氣體刺激 鼻炎鼻竇炎引起涕倒流至咽部 全身因素： 貧血 心血管病等慢性病繼發(fā)引起本病,Acute pharyngitis attacked over and over Local stimulation factor Mouth breathing

8、for the long-term smoking/drinking/dust/harmful gases Rhinitis/sinusitis Factor of total body: anemia cardio-disease,解放軍第89醫(yī)院 唐少松,病理分型pathological typing,慢性單純性咽炎 以粘膜慢性充血為主，輕度增生。 慢性肥厚性咽炎 以粘膜下結(jié)締組織及淋巴組織增生為主，咽喉壁淋巴濾泡咽側(cè)索呈條索狀增厚。,Chronic simple pharyngitis chronic congestion of mucosa is main, having a litt

9、le hyperplasia. Chronic hypertrophic pharyngitis hyperplasia of connective tissues under mucosa and lymphatic tissues, such as lymphatic follicle and pharyngeal lateral cord.,解放軍第89醫(yī)院 唐少松,臨床表現(xiàn)Clinical situation,多樣性癥狀： 異物感干燥發(fā)癢微痛惡心感刺激性干咳 全身癥狀： 不明顯 體癥： 咽反射敏感 粘膜慢性充血，小血管擴(kuò)張，暗紅色，有分泌物 粘膜肥厚，彌漫充血， 淋巴濾泡增生，側(cè)索肥厚

10、 分泌亢進(jìn)，痰多,The diversity of symptom Foreign body sensation, dryness, itchy, nausea, dry cough Total body symptom Unclear Signs Pharyngeal reflex sensitive Chronic congestion of mucosa, expansion of small vessels/scoto-red/having discharge Thickness of mucosa/ Width spread congestion Hyperplasia of lym

11、phatic follicle/thickness of pharyngeal lateral cord. High excretion, more sputum,解放軍第89醫(yī)院 唐少松,診 斷Diagnosis,Attention inquiring history Careful examination Making typing,注意詢(xún)問(wèn)病史 仔細(xì)全面檢查，特別是鼻咽部喉部，排除惡性腫瘤 做好分型,解放軍第89醫(yī)院 唐少松,治 療Treatment,Etiological treatment Clearing off etiological factor, such as smoking /drinking /dust/harmful gases, rhinitis/sinusitis Reinforcement health Local treatment Chronic simple pharyngitis: Dobells