咽咽 炎炎Pharyngitis定义：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: The inflammation of mucosa , submucosa and lymphatic tissue , which is the part of respiratory tract infection, including acute / chronic pharyngitis.1PPT学习交流急性咽炎急性咽炎Acute pharyngitis定义：定义：定义：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: The inflammation of mucosa , submucosa and lymphatic tissue , which is the part of respiratory tract infection, resulting from acute rhinitis2PPT学习交流病病 因因Etiology1. 1.病毒感染病毒感染病毒感染病毒感染n柯萨奇病毒, 腺病毒n副流感病毒, 流感病毒, 鼻病毒2. 2.细菌感染细菌感染细菌感染细菌感染n链球菌, A组乙型n葡萄球菌n肺炎双球菌3. 3.理化因素理化因素理化因素理化因素n高温n粉尘烟雾4. 4.诱发因素诱发因素诱发因素诱发因素n全身或局部抵抗力下降n环境条件差 Virus infectionVirus infectionCoxsackie virus/adenovirus Bacterial infectionBacterial infectionStreptococcusStaphylococcusPneumonia diplococcus AgentAgentHyperthermiaDust/smog Evoking factorEvoking factorThe poor environmental conditionThe resistance of total body/local is descent3PPT学习交流临床表现临床表现Clinical situation症状：症状：症状：症状：n起病急，咽干咽痛n吞咽疼痛全身症状：较轻，头痛食欲下降干咳体症：体症：体症：体症：n咽部粘膜急性充血n悬雍垂水肿n淋巴滤泡和侧索红肿n下颌下淋巴结肿大压痛 SymptomSymptomPharyngeal pain/drynessSwallowing painTotal body symptom: headache/anorexia/cough SignSignAcute congestion of pharyngeal mucosaStaphyle edemaThe red swelling of lymphatic follicle and cordSwelling and pain of submandibular lymph nodes4PPT学习交流诊诊 断断Diagnosis诊断诊断诊断诊断n病史+体症+症状+咽培养鉴别诊断鉴别诊断鉴别诊断鉴别诊断n猩红热n百日咳n流感n麻疹DiagnosisHistorySignSymptomPharyngeal cultureDifferentia diagnosisScarlatinaWhooping coughInfluenzameasles5PPT学习交流治治 疗疗Treatment抗病毒治疗：抗病毒治疗：抗病毒治疗：抗病毒治疗：吗啉双胍病毒唑板蓝根银黄冲剂抗细菌治疗：抗细菌治疗：抗细菌治疗：抗细菌治疗：磺胺头孢拉啶罗红霉素局部用药：局部用药：局部用药：局部用药：Dobells液西瓜霜润喉片银黄含片中医中药：中医中药：中医中药：中医中药：银翘散加减 Anti-virus:Anti-virus:Moroxydine, virazole,Isatis Tiactoria Antibacterial treatment:Antibacterial treatment:SMZ, Roxithromycin Local drug:Local drug:Dobells solution Traditional Chinese Traditional Chinese medicinemedicine fludeton6PPT学习交流慢性咽炎慢性咽炎Chronic pharyngitis定义：定义：定义：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 : The diffuse inflammation of mucosa, submucosa and lymphatic tissue , which is the part of respiratory tract chronic infection and the clinical common disease , multi-disease.7PPT学习交流病病 因因Etiology急性咽炎反复发作急性咽炎反复发作急性咽炎反复发作急性咽炎反复发作局部刺激因素：局部刺激因素：局部刺激因素：局部刺激因素：n长期经口呼吸n烟酒粉尘有害气体刺激n鼻炎鼻窦炎引起涕倒流至咽部全身因素：全身因素：全身因素：全身因素：n贫血n心血管病等慢性病继发引起本病 Acute pharyngitis Acute pharyngitis attacked over and attacked over and overover Local stimulation Local stimulation factorfactorMouth breathing for the long-termsmoking/drinking/dust/harmful gasesRhinitis/sinusitis Factor of total body:Factor of total body:anemiacardio-disease8PPT学习交流病理分型病理分型pathological typing慢性单纯性咽炎慢性单纯性咽炎慢性单纯性咽炎慢性单纯性咽炎n以粘膜慢性充血为主，轻度增生。慢性肥厚性咽炎慢性肥厚性咽炎慢性肥厚性咽炎慢性肥厚性咽炎n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。Chronic simple Chronic simple pharyngitispharyngitis chronic congestion of mucosa is main, having a little hyperplasia.Chronic hypertrophic Chronic hypertrophic pharyngitispharyngitis hyperplasia of connective tissues under mucosa and lymphatic tissues, such as lymphatic follicle and pharyngeal lateral cord.9PPT学习交流临床表现临床表现Clinical situation多样性症状：多样性症状：多样性症状：多样性症状：n异物感干燥发痒微痛恶心感刺激性干咳全身症状：全身症状：全身症状：全身症状：n不明显体症：体症：体症：体症：n咽反射敏感n粘膜慢性充血，小血管扩张，暗红色，有分泌物n粘膜肥厚，弥漫充血，n淋巴滤泡增生，侧索肥厚n分泌亢进，痰多 The diversity of symptomThe diversity of symptomForeign body sensation, dryness, itchy, nausea, dry cough Total body symptomTotal body symptomUnclear SignsSignsPharyngeal reflex sensitiveChronic congestion of mucosa, expansion of small vessels/scoto-red/having dischargeThickness of mucosa/ Width spread congestionHyperplasia of lymphatic follicle/thickness of pharyngeal lateral cord.High excretion, more sputum10PPT学习交流诊诊 断断DiagnosisAttention inquiring historyCareful examinationMaking typing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11PPT学习交流治治 疗疗TreatmentEtiological treatmentEtiological treatmentClearing off etiological factor, such as smoking /drinking /dust/harmful gases, rhinitis/sinusitisReinforcement healthLocal treatmentLocal treatment Chronic simple pharyngitis:Chronic simple pharyngitis:lDobells solutions Thickening pharyngitis:Thickening pharyngitis:Burning/laser /freezing treatmentmedicine treatment 病因治疗病因治疗病因治疗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 局部治疗局部治疗局部治疗局部治疗 单纯性咽炎：单纯性咽炎：单纯性咽炎：单纯性咽炎： Dobells液含片六神丸 肥厚性咽炎：肥厚性咽炎：肥厚性咽炎：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12PPT学习交流