Як лікувати гнійну ангіну

Як лікувати гнійну ангіну

Як лікувати гнійну ангіну

Ангіною, або гострим тонзилітом. називають гостре інфекційне захворювання, що вражає тканини піднебінних мигдалин. Згідно патоморфологічної класифікації ця хвороба може протікати в декількох формах: катаральної, фолікулярної. лакунарной і некротической. Останні 3 форми відрізняються від першої наявністю гнійних виділень на мигдалинах, завдяки чому в народі вони об’єднані загальною назвою – гнійна ангіна.

Зміст

Етіологія гострого тонзиліту

Причиною захворювання є бактеріальна інфекція. Збудник потрапляє в мигдалини ззовні або з вогнищ хронічної інфекції в організмі. Переважна кількість випадків гострого тонзиліту викликається бактерією, яка має назву?-гемолітичний стрептокок групи А, і лише 20% хвороби викликається стафілококами і їх поєднанням зі стрептококами.

Факторами ризику розвитку гнійної ангіни є:

    переохолодження організму загальне або локальне (в області горла); знижений імунний статус; різкі перепади температур; запиленість і загазованість, надмірна сухість повітря; шкідливі звички (куріння).

Епідеміологія

Гострий тонзиліт – одне з найбільш часто зустрічаються захворювань верхніх дихальних шляхів. Він вражає в основному дітей починаючи від 5 років і дорослих працездатного віку. Хвороба має яскраво виражену сезонність – пік захворюваності припадає на осінньо-весняний період.

Джерелом інфекції є хвора на ангіну людина, а також безсимптомний носій стрептокока. Основний шлях передачі – повітряно-крапельний, але не виключена роль і контактно-побутового (тобто через предмети побуту), і аліментарного (з їжею) механізмів. Це висококонтагіозна інфекція, особливо висока сприйнятливість до неї відзначається у дітей та осіб з вогнищами хронічної інфекції в ротовій порожнині.

Симптоми гострого тонзиліту

Дане захворювання зазвичай починається гостро і протікає досить важко. Інкубаційний період (від моменту зараження до появи перших ознак хвороби) становить 1-2 діб. На перший план виступають ознаки загальної інтоксикації організму:

    виражена слабкість; млявість; погіршення апетиту; підвищення температури до фебрильних цифр (38-40 C); пітливість; болі в м’язах і суглобах.

На тлі інтоксикаційного синдрому у пацієнта з’являються болі в горлі, спочатку неінтенсивні, але з часом вони стають все сильнішими, досягаючи максимуму на 3-4 добу від початку захворювання. На цьому етапі болю виражені, турбують хворого і вдень і вночі, заважаючи спати і роблячи неможливим акт ковтання – хворий не може їсти.

Нерідко відзначається запалення лімфатичних вузлів – вони збільшуються в розмірах, болять при ковтанні, болючі при дотиках до них.

Діагностика

Діагноз гострого тонзиліту ставиться на підставі скарг пацієнта (характерна клінічна картина), даних анамнезу (гострий початок) і даних огляду ротоглотки – фарінгоскопіі. При даному дослідженні лікар визначить, яка форма гнійної ангіни у його пацієнта:

    фолликулярная (мигдалини збільшені в розмірах, гіперемійовані, різко набряклі; на їх поверхні візуалізуються біло-жовті утворення 2-3 мм в діаметрі – нагноившиеся фолікули; ці утворення мимовільно розкриваються, утворюючи на поверхні мигдалин гнійний наліт); лакунарная (мигдалини яскраво гіперемійовані, набряклі, лакуни їх розширені, в них є вміст гнійного характеру, яке, виступаючи за межі лакун, утворює дрібні вогнища або плівки на поверхні мигдалин; плівки ці без праці і безслідно видаляються шпателем); некротическая (мигдалини гіперемійовані і різко набряклі, покриті нальотами брудно-зеленого або сірого кольору, при видаленні яких залишається глибокий кровоточить дефект; некроз може виходити за межі мигдаликів, поширюючись на задню стінку глотки, піднебінний язичок).

Загальний аналіз крові покаже збільшення числа лейкоцитів – лейкоцитоз, зсув лейкоцитарної формули вліво, підвищення ШОЕ іноді до 40-50 мм / год.

Важливо знати, що поразка мигдалин не обов’язково може бути первинним – в окремих випадках воно виникає на тлі таких серйозних інфекційних захворювань, як дифтерія та інфекційний мононуклеоз. У сумнівних випадках пацієнту можуть бути призначені специфічні дослідження крові на визначення збудника або бактеріологічне дослідження нальоту, взятого з поверхні мигдалин. З метою попередження поширення інфекції хворий може бути госпіталізований в інфекційний стаціонар.

Лікування гнійної ангіни у дорослих

Лікування ангіни має проводитися виключно під контролем лікаря! Неадекватне і несвоєчасно розпочате лікування може призвести до серйозних ускладнень, які можуть спричинити за собою навіть летальний результат. Лікування гострого тонзиліту засобами виключно народної медицини неприпустимо !

Оскільки гострий тонзиліт зазвичай протікає з вираженими явищами інтоксикації організму, в гострому періоді захворювання хворому показаний постільний режим з обмеженням контактів з оточуючими і дотриманням голосового спокою.

Щоб уникнути травмування запаленої слизової, їжа, що вживається хворим в період хвороби, повинна бути м’якою і теплою, а для підвищення імунного статусу організму пацієнта – вітамінізованої. З метою більш швидкого виведення токсинів хворому показано рясне пиття, звичайно ж, в теплому вигляді: фруктові та овочеві морси, зелений чай з лимоном, молоко з медом, лужна мінеральна вода без газу – ці напої повинні стати практично основою раціону хворого ангіною.

Медикаментозне лікування включає в себе такі лікувальні заходи, як полоскання і зрошення ротової порожнини розчинами антисептиків, інгаляції лікарських засобів, прийом препаратів перорально (тобто через рот – таблетовані форми) та / або парентерально (шляхом ін’єкцій та інфузій).

Найголовнішим компонентом лікування гострого тонзиліту була, є і завжди буде антибіотикотерапія. Нехтувати даними моментом ніяк не можна, оскільки бактеріальна інфекція може з мигдалин поширитися на життєво важливі органи – серце і нирки. Переважно застосовують амоксицилін-клавуланат (Амоксиклав, Аугментин), феноксиметилпенициллин, цефалоспорини ІІ-ІІІ поколінь (Цефуроксим, Зіннат, Цефтриаксон, Цефікс) і макроліди (Азитроміцин, Еритроміцин). Антибіотик необхідно приймати протягом ще 3 днів після нормалізації температури тіла і лише після закінчення цього періоду препарат можна скасувати.

Призначення місцевого антибіотика Биопарокса при гнійної ангіні не менш важливо, ніж проведення системної антибіотикотерапії. Даний препарат впливає безпосередньо на вогнище запалення, вбиваючи бактерії відразу, по місцю.

Крім Биопарокса можуть бути призначені місцеводіючі спреї і льодяники, які мають протизапальну і знеболюючу дію: Декатилен, Трахісан, Нео-ангін, Ингалипт, Фарингосепт, Септолете, Тантум Верде, Каметон – подібних препаратів безліч, і в кожного доктора мається на прикметі кілька особливо улюблених засобів для лікування ангіни.

Полоскання горла при гнійної ангіні також мають сенс. З цією метою використовують розчини всіляких антисептиків (фурацилін, Стоматидин, хлорофіліпт спиртової), відвари трав (ромашки, череди). Чим частіше полоскати горло при цьому захворюванні, тим більший ефект буде помітний. 3-4 полоскання на добу безглузді, важливо полоскати горло хоча б кожну годину, а краще і кожні 30 хвилин. Використовувані розчини можна чергувати.

Розчин Люголя, або по-народному Люголь, при гнійної ангіні теж застосовується нерідко. В якості розчину для полоскання його не використовують, а наносять ватною паличкою безпосередньо на область мигдалин, одночасно знімаючи з них гнійні плівочки. Крім Люголя з цією метою може бути використаний масляний розчин хлорофіліпту.

Інгаляції при гнійної ангіні менш актуальні, проте проведення даної процедури з використанням лужних мінеральних вод, розчинів антисептичних трав або просто фізіологічного розчину пом’якшить запалену слизову оболонку і поліпшить відходження мокроти.

З метою зменшення набряку мигдаликів хворому можуть бути призначені антигістамінні засоби (Алерон, Еріус, зодак).

У разі регіонарного лімфаденіту на область уражених лімфовузлів призначають зігріваючі компреси (наприклад, полуспиртовой) і компреси з лікарськими засобами (можуть включати в себе антибіотик, протиалергічний, протизапальний препарати, антисептичні розчини, а також Димексид).

На етапі одужання хворому показані фізіотерапевтичні процедури – УВЧ на область мигдалин, електрофорез.

Ускладнення гострого тонзиліту

При неадекватному або несвоєчасному лікуванні гнійна ангіна може викликати ряд ускладнень, які умовно поділяються на ранні та пізні.

Ранні обумовлені поширенням інфекції на сусідні з миндалинами органи і тканини. Це паратонзіллярний абсцес, отити. синусити. гнійний лімфаденіт регіонарних лімфовузлів. Ці стани вимагають невідкладного лікування і зазвичай проходять безслідно.

Пізні ускладнення виникають зазвичай через 3-4 тижні після перенесеного гострого тонзиліту. До них відносять ревматическую хвороба серця (формування пороку), постстрептококовий гломерулонефрит, артрити. Ці хвороби вимагають тривалого, іноді довічного лікування і можуть призвести до інвалідизації хворого.

Профілактика гнійної ангіни

Специфічною профілактики гострого тонзиліту не існує.

Щоб попередити захворювання, слід приділяти максимум уваги власному здоров’ю: раціонально харчуватися, повноцінно відпочивати, вести активний спосіб життя. Важлива своєчасна діагностика і санація вогнищ хронічної інфекції в організмі, а також загартовування.

Щоб уникнути розповсюдження інфекції, слід максимально ізолювати хворого, запропонувати йому індивідуальний посуд та засоби особистої гігієни. Крім того, слід регулярно провітрювати і проводити вологе прибирання приміщення, в якому перебуває хворий.

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