Флегмона глазницы — описание заболевания, симптомы

Флегмона глазницы — описание заболевания, симптомы

  • Kedu ihe bụ Phlegmon nke oghere anya
  • Kedu ihe na-akpalite / ihe kpatara Phlegmon nke orbit
  • Mgbaàmà nke Phlegmon nke orbit
  • Nchọpụta phlegmon nke orbit
  • Mgbochi nke phlegmon nke orbit
  • Kedu ndị dọkịta kwesịrị ịkpọtụrụ ma ọ bụrụ na ị nwere Phlegmon nke oghere anya

Phlegmon nke orbit

Kedu ihe na-akpali / akpata Phlegmon nke orbit:

Ngwọta n'oge na nke ziri ezi nke usoro mkpali dị iche iche na ihu, usoro na-adịghị ala ala na orbit, nwere ọnyá na-ebute ọrịa - ọgwụgwọ siri ike na ọgwụ nje na sulfonamides.

  • mmerụ ahụ orbital na ọrịa anụ ahụ na ụmụ nje pyogenic;

Mgbe usoro a kpaara ókè, ọnya na-etolite na orbit, nke nwere ike imeghe n'onwe ya site na akpụkpọ ahụ ma ọ bụ conjunctiva. Usoro mkpasu iwe nwere ike ịkwaga na meninges na venous sinuses (sinus cavernous) ma ọ bụ sepsis nwere ike ịmalite. N'ọnọdụ ndị dị otú ahụ, ọnwụ ga-ekwe omume.

  • iwebata n'ime orbit nke ndị mba ọzọ bu ọrịa;
  • purulent dacryocystitis, phlegmon nke nkuchianaya, purulent sinusitis;

Kedu ndị dọkịta kwesịrị ịkpọtụrụ ma ọ bụrụ na ị nwere oghere anya Phlegmon:

A na-eme nchọpụta ahụ na-adabere na foto ụlọ ọgwụ mara mma. Mmalite ngwa ngwa, ọganihu ngwa ngwa, na usoro siri ike na-amata phlegmon orbital na tenonitis. Ihe x-ray nke paranasal sinuses na orbit dị mkpa, nke dị mkpa maka nchọpụta dị iche iche nke phlegmon nke orbit site na periostitis nke mgbidi orbital, nakwa iji wepụ ihe ndị ọzọ nke orbit na-emerụ ahụ.

Usoro a na-abụkarị otu akụkụ. Mmalite dị egwu: usoro mkpali na-etolite na mberede na ngwa ngwa (n'ime awa ole na ole ma ọ bụ 1-2 ụbọchị). Mgbu na nku anya na anya anya, isi ọwụwa. Ihe mgbu na-akawanye njọ site na palpation na mmegharị anya. Nkuchi anya bụ hyperemic, edematous na ahụ siri ike, ọ fọrọ nke nta ka ọ ghara imeghe ha. Ọnọdụ izugbe siri ike: oke ọkụ, adịghị ike. Mgbochi nke mmegharị anya bọọlụ na exophthalmos na-etolite ngwa ngwa. N'ọnọdụ ebe mmepe nke phlegmon na-ebute periostitis ma ọ bụ osteitis nke mgbidi nke orbit, a ga-enwe ike ịkwaga anya nke anya; ntụziaka nke ntụgharị anya nwere ike inye aka chọpụta pathogenesis nke usoro ahụ. Site na mmepe nke mbufụt, chemosis nke conjunctiva nke eyeball na-apụta, akpụkpọ anụ mucous na-adaba, n'azụ nku anya, exophthalmos na-abawanye, anya anya na-aghọ ihe fọrọ nke nta ka ọ bụrụ ihe na-adịghị mma, ọhụụ na-ebelata nke ọma.

Usoro a na-egosipụtakarị usoro mepere emepe na-aga n'ihu site na mpaghara v. angularis thrombophlebitis nke obere arịa orbital, na-eduga na e guzobere ọtụtụ obere abscesses, nke mesịrị jiri nwayọọ nwayọọ jikọta n'ime otu ma ọ bụ karịa nnukwu abscesses. gbawara agbawa subperiosteal abscesses).

  • usoro purulent na ihu - etuto, erysipelas, ọka bali;

Phlegmon nke orbit bụ nnukwu purulent na-ekesa mbufụt nke anụ ahụ orbital yana purulent fusion na necrosis.

Mgbe akwara optic na-etinye aka na usoro mkpali ahụ, neuritis ya na-etolite na nnukwu nchikota na thrombosis retinal vein. N'ihi ọrịa trophic kpatara nrụgide akwara, keratitis na ọnya purulent corneal na-etolite mgbe ụfọdụ. Mbufụt nwere ike ịkwaga na choroid na retina ma mee ka purulent choroiditis na panophthalmitis pụta na atrophy nke anya.

  • ọrịa na-efe efe (flu, ahụ ọkụ na-acha uhie uhie, typhoid).

Kedu ihe bụ Phlegmon nke oghere anya -

Hemianopia

Mgbaàmà nke Phlegmon nke orbit:

Mgbochi nke Phlegmon nke orbit:

Ị nwere ihe na-echegbu gị? Ịchọrọ ịmatakwu ozi gbasara Phlegmon nke orbit, ihe kpatara ya, mgbaàmà ya, usoro ọgwụgwọ na mgbochi, usoro ọrịa na nri mgbe ọ gasịrị? Ka ị chọrọ nyocha? Ị nwere ike ịme oge ịhụ dọkịta.

Ihe kpatara:

Nchọpụta phlegmon orbit:

N'ime ha, akpan akpan, meningitis (na ihe fọrọ nke nta ka ọ bụrụ pasent iri abụọ n'ihe ize ndụ nke ọnwụ) na cerebral thrombosis. Enweghị usoro edozi na mmepe nke ọrịa ahụ n'oge ụfọdụ, ma ọtụtụ mgbe phlegmon na-apụta na ụmụaka na-erubeghị afọ ise.
Usoro ọgwụgwọ ọzọ nwere ike ịbụ nhọpụta nke instillations nke antimicrobial na vitamin preparations, ngwa nke ude (ma ọ bụrụ na nkuchianaya nwere ike imeghe) ihe niile na-esonyere site throbbing mgbu na orbit, okpukpu abụọ ọhụụ, ọzịza na hyperemia. nkuchianaya, conjunctiva, ibelata anya anya, mbelata ngagharị nke bọọlụ anya. N'agbanyeghị na nke a bụ ọrịa na-adịghị ahụkebe, ọ na-enye ọtụtụ ihe isi ike maka dọkịta na-awa ophthalmological. Ọrịa a dị ize ndụ ọ bụghị naanị n'ihi na ọ na-eyi egwu na-efunahụ ọhụụ, kamakwa n'ihi egwu ndụ nke onye ọrịa.
Ọ bụrụ na usoro mkpali na-aga na akwara optic, ọ na-akpalite mmepe nke neuritis, yana thrombotic occlusion, neuroparalytic keratitis.
Ọgwụgwọ phlegmon nke orbit gụnyere ụlọ ọgwụ ozugbo. Mgbe nke ahụ gasịrị, a na-enye ọgwụ nje na ọgwụgwọ symptomatic. A na-ejikwa injections: subconjunctival na retrobulbar.

Nchọpụta na ọgwụgwọ

Ọ bụrụ na e were usoro ọgwụgwọ na-arụsi ọrụ ike site na mmalite, prognosis dị nnọọ mma. Agbanyeghị, enwere obere ihe ize ndụ nke ịmalite mmachi bọọlụ anya ma emechaa. Ọ bụrụ na akwụsịghị mmepe nke ọrịa purulent n'oge, nsogbu ga-ekwe omume ruo sepsis n'ozuzu ya nwere nsonaazụ na-egbu egbu. 

ọkọlọtọ-glazza.jpgPhlegmon nke orbit bụ usoro purulent na-akpasu iwe na anụ ahụ nke orbital. Ihe e ji mara ọrịa a bụ ọnọdụ ahụike onye ọrịa siri ike, yana ọgbụgbọ, isi ọwụwa, isi ọwụwa, na ahụ ọkụ.
Dị ka a na-achị, purulent inflammations e ji mara phlegmon nke orbit nwere otu akụkụ. Ha na-etolite ngwa ngwa: mbufụt nwere ike itolite ma n'ime ụbọchị ole na ole ma n'ime awa ole na ole. Ihe mgbaàmà mbụ nke enwere ike ịhụ bụ mpụta ihe mgbu dị nkọ na nkuchianaya na orbit. N'oge palpation ma ọ bụ mgbe ị na-agbalị imegharị anya, ihe mgbu na-abawanye nke ukwuu.
Ọnọdụ izugbe na-akawanye njọ: ahụ ọkụ, ọgbụgbọ na isi ọwụwa na-agbakwunye na ahụ ọkụ.
Ọ bụrụ na usoro purulent nke e ji mara ọrịa a na-agbasa site na akwa venous n'ime oghere cranial, nke a na-eyi egwu ịmepụta nsogbu ndị dị ize ndụ.
Ọtụtụ mgbe, phlegmon na-etolite n'ihi nsogbu mgbe ọ nwesịrị sinusitis. E nwekwara ikpe nke ịbanye n'ime ọrịa sitere na foci dị nso: usoro mkpali na ezé, abscesses periodontal, osteomyelitis. N'ọnọdụ ndị na-adịghị ahụkebe, ihe kpatara phlegmon bụ mgbagwoju anya na metastases purulent mgbe sepsis na-ejikọta ya na usoro mgbagwoju anya nke ọrịa "ndabere" - dịka ọmụmaatụ, influenza. 
Ọrịa ahụ nwere ike inwe ọtụtụ nsogbu siri ike, n'ime nke ụbụrụ ụbụrụ, sepsis na meningitis dị oke egwu. 

Mgbaàmà nke phlegmon nke orbit

Ọdịdị nke phlegmon nke orbit na-abụkarị n'ihi ọnya purulent na mkpali nke anya, yana ọrịa nke sinuses, ezé, agba, skeletal trauma ma ọ bụ ọrịa.
Ekwesịrị ịme nchọpụta nke phlegmon nke orbit n'egbughị oge. Enwere ike ime nke a site n'aka onye na-ahụ maka anya, yana dọkịta ezé na onye na-ahụ maka otolaryngologist (ENT). Iji mee nchoputa, ọ dị mkpa ịnakọta anamnesis, yana iduzi nyocha ngwaọrụ - ultrasound na redio nke orbit, ultrasound na X-ray nke sinus paranasal, yana usoro dịka CT, biomicroscopy, ophthalmoscopy, wdg. .
The nkuchianaya anya zaa aza na-enweta àgwà-acha odo odo-acha anụnụ anụnụ tint, ike, na ọ na-aghọ fọrọ nke nta ka-agaghị ekwe omume imeghe ha. Ka mbufụt na-etolite, otú ahụ ka mmebi nke conjunctiva na-esiwanye ike na palpebral fissure na-etolite, ọkpụkpụ anya na-agbanwe ma jiri nwayọọ nwayọọ na-emegharị.

 

Orbital cellulitis bụ ọrịa nke anụ ahụ dị n'ime oghere anya, gburugburu na n'azụ anya.

  • Ọrịa ahụ nwere ike gbasaa na oghere anya site na isi mmalite dị ka paranasal sinuses.
  • Mgbaàmà na-agụnye mgbu, ọzịza, ọbara ọbara nke anya, ahụ ọkụ, mpụta nke bọọlụ anya, na adịghị ike ịhụ ụzọ na mmegharị anya.
  • A na-arụkarị ihe onyonyo orbital computed tomography ma ọ bụ onyonyo resonance magnetik.
  • A na-agbanye ọgwụ nje n'ime akwara, a na-anara onye ọrịa ahụ n'ụlọ ọgwụ.

Orbital phlegmon na-abụkarị n'ihi ọrịa na-agbasa na orbit site na paranasal (paranasal) sinuses, mana enwere ike ibute ya site na mgbasa nke ọrịa site na ezé ma ọ bụ site na ọbara. Orbital cellulitis nwekwara ike bute ya site na ọrịa sitere na anụmanụ ma ọ bụ ahụhụ ahụhụ, ma ọ bụ site na mmerụ ahụ ọzọ na nku anya.

Mgbaàmà nke phlegmon nke orbit gụnyere:

  • Mgbu
  • Anya uhie;
  • nsogbu mmegharị anya
  • ọhụụ abụọ.
  • mgbu mgbe ị na-emegharị anya;
  • nku anya fụrụ akpụ
  • ahụ ọkụ;

N'ikpeazụ, ọhụụ na-emebi emebi.

  • Nyocha nke dọkịta
  • Tomography gbakọọ ma ọ bụ onyonyo resonance magnetik
  • Omenala ọbara na sinus

A na-achọpụtakarị Orbital phlegmon na-enweghị ule. Otú ọ dị, a na-emekarị nyocha CT iji gosi na nchoputa ahụ bụ Computed tomography (CT) na magnetik resonance imaging (MRI) enwere ike iji ọtụtụ nyocha na nyocha dị iche iche iji kwado nsogbu anya ma ọ bụ chọpụta oke ma ọ bụ oke ọrịa anya. A na-enyocha anya ọ bụla… Gụkwuo (CT) ma ọ bụ Magnetic Resonance Imaging Computed Tomography (CT) na Magnetic Resonance Imaging (MRI) Ọtụtụ ule na ule dị iche iche enwere ike iji gosi nsogbu anya ma ọ bụ chọpụta oke ma ọ bụ ogo ọrịa anya. A na-enyocha anya ọ bụla… GỤKWUO(MRI). Na mgbakwunye, nyocha ọzọ nke ezé na oghere ọnụ, CT ma ọ bụ MRI nke sinuses paranasal nwere ike ịdị mkpa iji chọpụta ihe kpatara ya. Ọtụtụ mgbe, a na-ewere nlele anụ ahụ sinus na nlele ọbara ma zigara ya n'ụlọ nyocha maka nyocha. A na-eme Omenala Nchọpụta ọrịa na-efe efe na-ebute ọrịa na-efe efe site na ụmụ nje dị ka nje bacteria, nje, fungi na nje nje. Dọkịta ahụ na-enyo enyo na ọ bụ ọrịa na-adabere na mgbaàmà onye ọrịa, nsonaazụ nke nyocha anụ ahụ ... Gụọ nkọwa ndị ọzọ nke ụdị (maka uto nke microorganisms) iji chọpụta ụdị nje bacteria na-ebute ọrịa ahụ, ebe a na-ebute ọrịa, na ọgwụ nje. ịgwọ. Onye ọrịa nwere cellulitis nke oghere anya kwesịrị ịhụ onye na-ahụ maka anya (ọkachamara anya).

  • N'ụlọ ọgwụ
  • Ọgwụ nje
  • Ntinye aka

A na-anabatakarị ndị ọrịa nwere cellulitis nke orbit n'ụlọ ọgwụ. A na-enye usoro ọgwụ nje ozugbo enwere ike ka a na-eme nyocha ụlọ nyocha. A na-enye ọgwụ nje na intravenous. Enwere ike ịgbanwe ọgwụ nje ndị e were na mbụ ma ọ bụrụ na a na-enye ọgwụ nje ndị ọzọ dị irè karị dabere na nsonaazụ omenala. N'ọnọdụ ụfọdụ, mmerụ ahụ anya na-achọ ịwa ahụ iji wepụ pus (abscess) ma ọ bụ sinus nwere ọrịa, wepụ ahụ ọzọ, ma ọ bụ ịgwọ ọrịa ma ọ bụrụ na ọgwụ nje naanị adịghị arụ ọrụ.

 

Phlegmon nke orbit bụ ọrịa na-ebute site na mbufụt nke anụ ahụ orbital na ọnụnọ purulent fusion na necrosis nke anụ ahụ ya.

Phlegmon nke orbit bụ ọrịa na-adịghị ahụkebe, mana n'ihe banyere nsonaazụ ya, ọ na-enwe otu n'ime ebe izizi n'ihe egwu dị na ndụ na ahụike mmadụ. Mgbagwoju anya nke phlegmon nke orbit nwere ike ịbụ meningitis ma ọ bụ thrombosis nke arịa ụbụrụ, na-eduga na ọnwụ. Ọrịa a na-eme n'agbanyeghị afọ na okike, mana ọ na-adịkarị na ụmụaka.

Ihe na-akpata mmepe nke phlegmon nke orbit

Ihe na-akpata phlegmon nke orbit nwere ike ịbụ staphylococcal ma ọ bụ streptococcal ọrịa, diplococcus ma ọ bụ E. coli. Nje bacteria na-esi na ihu na veins nke na-efe efe na-abanye na isi mkpali na-elekwasị anya n'ime anụ ahụ periorbital ma na-etolite obere ọkpụkpụ pustular. Ka usoro ahụ na-etolite, ha na-ejikọta ibe ha, na-eme otu nnukwu oghere.

Phlegmon nke orbit na-etolitekarị megide ndabere nke ọrịa ụfọdụ nke anya, ezé, agba, sinuses paranasal, mmerụ ahụ nke akpụkpọ ihu ma ọ bụ ọkpụkpụ ihu.

Ọrịa dị iche iche na-enwekarị mmetụta dị ukwuu na mmebi anya. Sinusitis, na karịsịa ethmoiditis, bụ isi ihe na-akpata phlegmon. Mpaghara dị nso nke usoro mkpali dị iche iche na-emetụta nwere ike ịkpalite purulent fusion nke anụ ahụ paraorbital. Ọtụtụ mgbe, ihe na-akpata phlegmon nke orbit na-adabere na ọzịza nke periodontal abscess, furunculosis, erysipelas, barley na phlegmon nke nkuchianaya. Mmerụ anya na anya, n'ihi ntinye nke ndị mba ọzọ n'ime ha, na-enyekwa aka na mmepe nke phlegmon nke orbit. Mgbe ụfọdụ, ọrịa ahụ na-amalite dị ka mgbagwoju anya nke influenza, typhoid ma ọ bụ ahụ ọkụ na-acha uhie uhie.

Mgbaàmà nke phlegmon nke orbit

Mmepe nke phlegmon nke orbit na-apụta na mberede ma na-aga n'ihu ngwa ngwa. Ngwakọta purulent nwere ike ime n'ime otu ụbọchị, ebe ndị ọrịa na-enwe oké mgbu na orbit na nkuchianaya, nke nwere àgwà na-akpali akpali. Ntugharị ọ bụla nke bọọlụ anya na-ewusi ya ike. Edematous, acha ọbara ọbara-violet nku anya na-enwe nnukwu esemokwu, ọ na-esiri ike imeghe ha. Ka usoro ahụ na-etolite, enwere mgbanwe na enweghị ike imegharị anya nke anya, ọzịza nke conjunctiva na mbelata ọhụụ.

Ọnọdụ izugbe nke onye ọrịa na-akawanye njọ. Enwere ahụ ọkụ, ọgbụgbọ, mgbu na-akawanye njọ. Ọ bụrụ na akwara optic na-adọta n'ime usoro pathological, mgbe ahụ, neuritis ya na-etolite. Mbufụt na-edugakwa na mgbachi nke arịa ọbara retina na mmebi nke cornea (keratitis). Mgbe ahụ, akụkụ niile nke anya na-etinye aka na usoro mkpali, nke a na-egosipụta site na choroiditis na panophthalmitis, na-eduga na nkwụsị zuru ezu nke ọrụ anya.

Nchọpụta nke phlegmon nke orbit

Ọrịa ahụ chọrọ nchọpụta dị iche iche na tenonitis, periostitis nke mgbidi orbital, ọnụnọ nke onye mba ọzọ na anya, Quincke edema, sarcoma, glioma na hemorrhages. Ihe dị iche iche nke phlegmon nke orbit bụ ọganihu ngwa ngwa nke ọrịa ahụ.

Nyocha nke onye ọrịa ahụ nke ọma site n'aka onye na-ahụ maka anya na nsonye nke dọkịta ezé na onye na-ahụ maka otolaryngologist bụ iwu.

A na-eji ultrasound na X-ray nyocha nke orbit. Na mgbakwunye, a na-enyocha sinuses paranasal, ọnọdụ nke akwara optic. Ọ bụrụ na a na-enyo enyo sepsis, a na-eme omenala ọbara maka ịmụ nwa.

Ọgwụgwọ phlegmon nke orbit

Ozugbo achọpụtara phlegmon nke orbit, ọ dị mkpa ịga ụlọ ọgwụ ngwa ngwa nke onye ọrịa. A na-enye ya ọgwụ nje na ọgwụ symptomatic, a na-eme ọgwụgwọ iji belata ịṅụbiga mmanya ókè. A na-enye ọgwụ nje na oke doses, maka enyemaka dị nkọ nke usoro purulent-inflammatory.

Ọ bụrụ na ọ dị mkpa, a na-emepe oghere maxillary na trepanation nke mgbidi orbital, a na-asacha paranasal sinuses ma wepụ ya na ntinye nke antiseptik na antimicrobials. A na-enye ọgwụ mgbochi nje na mmanu iji meziwanye ọnọdụ conjunctiva na cornea.

N'ime oge mgbake, a na-egosi usoro ọgwụgwọ physiotherapeutic. A na-egbochi lensị kọntaktị ruo mgbe mgbake zuru oke. Ya mere, ọ bụrụ na ndozi ọhụụ dị mkpa, ọ bụ naanị enyo nkịtị nwere enyo anya ka a ga-eji.

Usoro mgbochi

Na mgbochi nke mmepe nke phlegmon, ọgwụgwọ n'oge nke ọrịa ọ bụla na-egbuke egbuke dị na mpaghara ihu dị mkpa. Tụkwasị na nke ahụ, ọ dị ezigbo mkpa idebe iwu nke ịdị ọcha, iji ihe nchebe anya. Ihe a niile na-enyere aka igbochi phlegmon nke orbit.

Usoro purulent na phlegmon nke orbit, dị ka a na-achị, bụ otu akụkụ ma na-esonyere ya na mmepe ngwa ngwa (site na ọtụtụ awa ruo ọtụtụ ụbọchị). A na-eji ya na-egbu mgbu na nku anya na orbit, nke na-eme ka palpation na mmegharị anya nke anya. Nkuchi anya na-adị nkọ nke ọma, na-acha uhie uhie-violet tint, na-adịghị ahụkebe, na-emeghe na mgbalị. Ka mbufụt na-abawanye, chemosis na-apụta - pinching nke conjunctiva nke palpebral fissure, diplopia, exophthalmos, ntugharị nke anya bọọlụ, enweghị ike ime ya na-etolite, ọhụụ na-ebelata nke ukwuu. Ọnọdụ izugbe nke onye ọrịa na-akawanye njọ: ahụ erughị ala na-eto eto, isi ọwụwa, ahụ ọkụ na ọgbụgbọ na-akpaghasị.

Ihe na-akpata phlegmon nke orbit

N'otu oge ahụ, ethmoidectomy, maxillary sinusectomy na trepanation nke orbital mgbidi, puncture na drainage nke paranasal sinus, ịsacha ya na nchịkwa nke ọgwụ. Nchọpụta mpaghara mgbanwe na-eme ka ọ dị mkpa iji ọgwụ nje mee ihe orbitotomy na drainage nke ọwa ọnya. N'ịga n'ihu na ọgwụgwọ, a na-eji ihe ndị na-egbu egbu na-asa oghere oghere ahụ, na-eburu n'uche mmetụta nke osisi nje.

Mmepe nke usoro purulent na anụ ahụ orbital na-eme na nkebi, na-agafe na preseptal ogbo, ogbo nke orbital cellulitis, ogbo nke subperiosteal abscess, ogbo nke abscess na phlegmon. N'otu oge ahụ, ọgwụgwọ zuru oke n'oge nwere ike ịkwụsị mmepe nke mbufụt purulent n'oge ọ bụla.

Mgbasa nke ọrịa purulent na-edugakarị na panophthalmitis, ụbụrụ ụbụrụ, maningitis ma ọ bụ cavernous sinus thrombosis, yana sepsis n'ozuzu ya na-akpata ọnwụ.

Ọgwụgwọ na-arụsi ọrụ ike nke a na-eme na mmalite nke ọrịa ahụ na-enye aka na nsonaazụ ya dị mma. N'ezie, n'ime ogologo oge mgbe ebufefefe phlegmon nke orbit, ọtụtụ nsogbu nwere ike ime: mmachi nke anya ngagharị, secondary strabismus, corneal leukoma, amblyopia, atrophy nke optic akwara. 

Ọrịa a bụ ihe ngosi maka ụlọ ọgwụ ngwa ngwa nke onye ọrịa na mmalite ọgwụgwọ ozugbo. N'otu oge ahụ, a na-enye ọgwụ na-atụ ụjọ nke ọgwụ nje antibacterial sara mbara, gbakwunyere ihe mgbaàmà na ọgwụ ndị na-ewepụ ihe. Site na nchịkwa parenteral nke antimicrobials, a na-enye ọgwụ retrobulbar na subconjunctival injections.

 

The preseptal ogbo nke ọrịa e ji mkpali edema nke anụ ahụ nke orbit na eyelids, unexpressed exophthalmos, na ichekwa nke anya ngagharị, na-enweghị mgbanwe na visual acuity. Ọganihu ọzọ nke usoro mkpali na mgbasa ya na akụkụ azụ nke orbit na-akpalite mmepe nke cellulitis orbital. Ụdị ọrịa a na-egosipụta site na edema nke nku anya, chemosis, exophthalmos, njedebe nke mmegharị anya, na ibelata ịhụ ụzọ. N'ọnọdụ ahụ mgbe nchịkọta nke pus na-eme n'etiti mgbidi periorbital na mgbidi ọkpụkpụ nke orbit, mbibi nke ikpeazụ na-eme, na nhazi nke subperiosteal abscess. A na-akọwa ọkwa a site na edema na hyperemia nke nkuchianaya elu, nchụpụ nke anya nke anya n'akụkụ nke ọzọ site na ọnọdụ nke oghere na njedebe nke njem ya. Na mgbakwunye, exophthalmos na-etolite, nrụrụ dị ukwuu nke ịhụ anya na-eme. Site na oghere nke orbit, a na-enwe mkpokọta pus n'ime anụ ahụ nke orbit, n'ihi nke a na-emepụta oghere, na-ejedebe site na akpụkpọ ahụ pyogenic. Na mgbakwunye na ihe ịrịba ama ndị a kọwara n'elu, na ọnyà nke orbit, ophthalmoplegia, mkpakọ nke akwara anya, na ìsì na-etolitekarị.

Phlegmon nke oghere anya ọgwụgwọ

Prognosis na mgbochi nke ọrịa

N'ime nsogbu ndị dị oke egwu nke phlegmon: ụbụrụ ụbụrụ, thrombosis nke sinuses venous, meningitis, sepsis. Enwere ike iwepụta nsonaazụ dị mma nke ọrịa ahụ dị ka ntọhapụ nke pus na mberede site na conjunctiva ma ọ bụ akpụkpọ nkuchianaya.

Phlegmon nke orbit bụ nnukwu nsogbu. N'agbanyeghị ọnụ ọgụgụ dị nta nke nta (ihe dị ka 1% nke ndị mmadụ), ọrịa a na-etinye ihe ize ndụ ma ọrụ anya onye ọrịa na ndụ ya. Mgbe usoro nke purulent mbufụt na-agbasa n'akụkụ ihe ndina venous n'ime oghere cranial, nsogbu ndị dị ize ndụ nwere ike ime - cerebral vascular thrombosis na meningitis, nke n'ihe dị ka 20% nke ikpe na-ejedebe na ọnwụ nke ndị ọrịa. Phlegmon nke orbit na-apụta na ndị nọ n'afọ ndụ niile, mana ọ na-adịkarị na ụmụaka na-erubeghị afọ ise.

N'ụlọ ọgwụ anyị, a na-eme nhọpụta ahụ site n'aka ndị ọkachamara na-ahụ maka anya kachasị mma nwere ahụmahụ ọkachamara dị ukwuu, iru eru kachasị elu, na nnukwu ụlọ ahịa ihe ọmụma. Ụlọ ọgwụ ahụ na-enye nyocha na ọgwụgwọ nke ndị okenye na ụmụaka karịrị afọ 4. Ndị ọkachamara anyị emepụtala ma na-arụsi ọrụ ike na-eji mmemme dị irè maka mgbochi na ọgwụgwọ nke pathologies anya.

Onye ọrịa a na-enyo enyo na ọ bụ phlegmon nke orbit kwesịrị ịnata ndụmọdụ ozugbo site n'aka onye na-ahụ maka anya, otolaryngologist na dọkịta ezé.
A na-eme ka nchoputa ahụ dị mfe site na nchịkọta data anamnestic (ọnụnọ nke usoro purulent na mpaghara maxillofacial), akara njirimara nke ọrịa ahụ, nyocha nke mpụga site na iji ihe nkuchianaya anya, palpation nke anya.

Orbital phlegmon, dị ka phlegmon ndị ọzọ, na-emekarị site na Staphylococcus aureus na ọcha, hemolytic na green streptococcus, obere mgbe pneumobacillus, diplococcus, E. coli. Ọrịa na-efe efe na-abanye na anụ ahụ periorbital site na veins ihu ma ọ bụ veins nke orbit, nke na-enweghị valves. N'okwu a, a na-ebu ụzọ mepụta obere pustules, nke na-ejikọta n'ime abscesses.

Mgbaàmà nke phlegmon nke orbit

Nhazi nke ogbo nke ọrịa

Nchọpụta ngwaọrụ kwesịrị ịgụnye ultrasound, yana redio nke orbit, x-ray na ultrasound nke sinuses paranasal, yana orthopantomogram. Iji dokwuo anya nkọwa, diaphanoscopy, ophthalmoscopy, iji nyochaa ọnọdụ nke akwara optic, biomicroscopy, exophthalmometry, wdg na-ejikarị eme ihe site na nchọpụta ụlọ nyocha, nyocha ọbara ọbara n'ozuzu, yana nyocha nke ịmụ nwa nke ọbara. Omenala, nwere uru nyocha izizi maka orbital phlegmon.
Phlegmon nke orbit na-adịkarị iche na phlegmon nke nkuchianaya, nnukwu dacryocystitis, tenonitis, periostitis nke orbital mgbidi, ahụ mba ọzọ nke orbit, retrobulbar hemorrhage, glioma, sarcoma, neurofibromatosis, Quincke edema.

Nchọpụta na ọgwụgwọ anya na Moscow Eye Clinical Reviews

Na mgbakwunye, na phlegmon, a na-enye iwu ntinye nke mmiri ọgwụ nje, yana ntinye nke ngwọta siri ike na njikọ. Ọ bụrụ na oghere nke nku anya ga-ekwe omume, a na-atụ aro itinye mmanụ n'ime. A na-agbakwunye ọgwụgwọ ọgwụ ọgwụ site na physiotherapy - UHF, UVI, nke a na-edepụta obere oge.

Mgbasa mbufụt nke anụ ahụ orbital na-egosi phlegmon nke orbit.

Ọgwụgwọ phlegmon nke orbit

Ihe fọrọ nke nta ka ọ bụrụ 70% nke ọrịa phlegmon bụ mgbagwoju anya nke sinusitis, karịsịa ethmoiditis. Purulent mbufụt nke orbital anụ ahụ, na mgbakwunye, nwere ike ịkpalite site ọrịa si kacha nso foci nke mbufụt: ọrịa ezé na agba (oke agba osteomyelitis, periodontal abscess), ihu akpụkpọ (furunculosis, erysipelas), anya (bali, dacryocystitis, phlegmon). nke nkuchianaya, oria unan orbits gbagwojuru anya site mba ọzọ ahụ nke anya). Ọ na-adịkarịghị, ihe na-akpata ọrịa a bụ purulent metastasis na sepsis, nke na-agbagwoju anya site na usoro ọrịa na-efe efe (ọkụ na-acha uhie uhie, influenza, typhoid).

Phlegmon nke orbit Orbital phlegmon ma ọ bụ orbital cellulitis bụ mbufụt na-ekesa purulent nke anụ ahụ orbital. Ọrịa ahụ bụ ọnọdụ siri ike n'ozuzu (ya na isi ọwụwa, ọgbụgbọ na ọkụ ọkụ), na-esonyere ya na mgbu mgbu na orbit, exophthalmos, diplopia, hyperemia na ọzịza nke nku anya, conjunctival chemosis, njedebe anya na-agagharị, mbelata anya anya. 

Mmepe nke orbital phlegmon, dị ka a na-achị, na-akpata ọrịa purulent nke anya, paranasal sinuses, akpụkpọ anụ, dento-jaw usoro, mmerụ nke ọkpụkpụ ihu, yana ọrịa n'ozuzu.

Site na mgbanwe nke usoro mbufụt na akwara optic, neuritis na thrombotic blockage nke veins retinal na-etolite, keratitis neuroparalytic na-amalite, na-esonyere nguzobe nke ọnya purulent na cornea. Mgbe choroid na akpụkpọ anya ndị ọzọ na-etinye aka na usoro ahụ, choroiditis ma ọ bụ panophthalmitis na-eme, ihe si na ya pụta bụ atrophy nke anya.

Mgbochi nke phlegmon nke orbit mejupụtara n'oge ịdị ọcha nke foci nke purulent ọrịa nke akpụkpọ ihu, eze, akụkụ ENT, anya. Site na mmebi n'ibu na anya ma ọ bụ iri ihe ndị si mba ọzọ, ọgwụgwọ ọgwụ mgbochi mpaghara nke amanyere iwu dị mkpa iji gbochie nsogbu ndị na-efe efe. 

Iji dokwuo anya ụgwọ nke otu usoro, mee oge atọrọ na Moscow Eye Clinic, ị nwere ike ịkpọ na Moscow 8 (800) 777-38-81 8 (499) 322-36-36 (kwa ụbọchị site na 9:00 ka 21: 00 ) ma ọ bụ site na iji akwụkwọ ndebanye aha n'ịntanetị.

 

Phlegmon nke orbit bụ ọrịa na-efe efe nke na-agụnye anụ ahụ nwere abụba ma bụrụ nke a na-eji na-apụta na mpụta purulent. N'ozuzu, pathology a nwere ike ime ọ bụghị naanị na mpaghara a nke anya, kamakwa n'akụkụ ndị ọzọ nke ya - nkuchianaya, akpa lacrimal. Ya mere a na-ewere echiche nke phlegmon dị ka aha mkpokọta nke ọtụtụ omume ọjọọ dị iche iche. A na-achọpụta ọrịa a obere oge, mana ọ bụ nnukwu ihe egwu maka ọnọdụ ahụike na ọbụna ndụ mmadụ.

Ihe kpatara ya

Isi ihe dị mkpa maka mmepe nke purulent mbufụt na akụkụ ọ bụla a na-ahụ anya bụ ntinye nke microorganisms pathogenic n'ime ya. Ọtụtụ mgbe, ndị na-akpata ọrịa dị otú ahụ bụ streptococci, E. coli na staphylococci, bụ ndị nwere ike ịbanye n'ime eriri anya yana mmiri mmiri ma ọ bụ site na kọntaktị. Enwere ọtụtụ ihe kpatara ọdịdị phlegmon nke orbit:

  • ụdị ọ bụla nke na-efe efe ma ọ bụ mkpali anụ ahụ, dịka ọmụmaatụ, erysipelas, furunculosis na-adịghị ala ala;
  • abanye n'ime ahụ mmerụ ahụ;
  • nsi ọbara n'ozuzu;
  • ntụpọ anya - conjunctivitis, mmebi nke akpa lacrimal, ọka bali;
  • ihe mba ọzọ kụrụ;
  • ọrịa mkpali nke imi imi;
  • ọnụnọ nke elekwasị anya na-efe efe na oghere ọnụ - ọrịa periodontal ma ọ bụ caries.

Ihe na-akpata phlegmon nke orbit

N'ezie, ọ dịghị mkpa ọ bụla na n'ihu nsogbu ndị a mbufụt nke orbit ga-eme. Ma mgbochi adịghị ike, ụkọ vitamin, nri na-adịghị mma na-aghọ ihe na-akpalite mmalite nke ọrịa dị ize ndụ.

Mgbaàmà

N'ozuzu, a na-ewere phlegmon nke orbit dị ka ụdị ọrịa a na-ahụkarị. Ọrịa a na-aga n'ihu n'ọnọdụ niile ngwa ngwa na naanị otu ụbọchị ihe ịrịba ama ya na-adakarị na-apụta n'ụzọ doro anya. Na foto nke phlegmon nke orbit, a na-egosipụta njirimara nke ntụpọ a na-adịghị ahụkebe ngwa ngwa.

N'ozuzu, ihe ịrịba ama niile nke pathology a nwere ike kewaa na mpaghara na n'ozuzu. Ụdị nke mbụ gụnyere:

  • ọbara ọbara na ntakịrị bluing nke akpụkpọ ahụ na mpaghara anya mebiri emebi;
  • nnukwu edema na mpaghara mmepe nke ihe na-egbu egbu;
  • elu okpomọkụ nke epithelium ziri ezi na-elekwasị anya nke ọrịa;
  • ntakịrị protrusion nke anya na ike ịkwaga ya;
  • eyelids na-anọgide na-emechi oge niile, ọ fọrọ nke nta ka ọ ghara ikwe omume imeghe anya.

Mgbaàmà mpaghara nke phlegmon nke orbit

Ihe ịrịba ama ndị ọzọ

Tụkwasị na nke ahụ, onye ahụ na-enwe mmetụta dị egwu, nke na-abawanye na palpation na ọbụna obere aka na akụkụ ahụ. Ọbụlagodi n'ihe gbasara ntakịrị ọzịza nke nku anya, ọhụụ na-ada nke ukwuu.

Ihe ịrịba ama a na-ahụkarị nke phlegmon nke oghere anya gụnyere:

  • mmụba na okpomọkụ nke ahụ;
  • ahụ ọkụ na oyi;
  • adịghị ike siri ike na mbelata arụmọrụ;
  • isi ọwụwa.

Ọ bụ ihe kwesịrị ịrịba ama na n'ime onye ọrịa toro eto, ọrịa ahụ na-eji akara ngosi mpaghara pụta ìhè karị, ma ọrịa nwata na-eji akara ngosi zuru oke nke mmepe nke usoro pathological.

Ihe ịrịba ama a na-ahụkarị nke phlegmon nke orbit

Ogo nke ọganihu

Phlegmon nke eriri nke orbit na-etolite na nkebi, na-agafe ọkwa dị iche iche.

  • A na-akpọ ọkwa nke mbụ preseptal cellulitis - enwere ọzịza na mbufụt nke anụ ahụ dị nso na orbit. Anya na-agbapụta ntakịrị, mana mmegharị ya ka dị, ebe nsogbu ọhụụ ka na-anọghị kpamkpam.
  • Nkeji nke abụọ bụ orbital cellulitis, nke a na-eji ọdịdị edema na mpaghara nkuchianya mara. Exophthalmos na-apụtawanye nke ọma, conjunctiva na-azakwa, bọọlụ anya nke nta nke nta na-efunahụ mmegharị ahụ, nhụsianya anya na-agbadata nke ukwuu.
  • Ogbo nke ọzịza nke subperiosteal na-amalite mgbe ọtụ na-agbakọta n'etiti ọkpụkpụ na mgbidi periorbital. Ihe ịrịba ama nke ogbo a: anya na-atụgharị ntakịrị gaa n'akụkụ na-abụghị nke ọnyà, ọbara ọbara na ọzịza na-apụta na nku anya, ọhụụ na-adaba ọbụna karịa.
  • A na-ewere oghere nke orbit dị ka ọkwa ikpeazụ na mmepe nke pathology. N'oge a, pus na-agbakọta n'ime anụ ahụ orbital, a na-emepụta oghere, nke na-enweta oke dị ka akpụkpọ anụ pyogenic. Na mgbakwunye, ahụ mkpọnwụ nke akwara oculomotor, mkpakọ nke akwara optic, na ọbụna nhụsianya zuru oke nwere ike ime.

Ọ bara uru ịsị na site na nyocha na ọgwụgwọ n'oge, ọ ga-ekwe omume igbochi mmepe nke nsonaazụ dị njọ na mgbanwe nke ọrịa ahụ na ọkwa ọzọ.

Foto ụlọ ọgwụ

Ọtụtụ mgbe, na phlegmon nke orbit, purulent mbufụt nwere ụdị nwere otu akụkụ ma na-aga n'ihu ngwa ngwa - site na ọtụtụ awa ruo ụbọchị abụọ. Ọ bụrụ na usoro pathological na-ekpuchi akwara optic, mgbe ahụ nke a nwere ike ịkpalite neuritis, thrombotic occlusion nke arịa dị na anụ ahụ merụrụ ahụ.

N'ihe banyere mgbanwe nke purulent phlegmon na choroid nke akụkụ ahụ, a na-amụ panophthalmitis, nke na-agụnyekarị atrophy nke anya. Na ọkwa dị elu, ụbụrụ ụbụrụ, maningitis, na sepsis nwere ike ime.

N'ọnọdụ ụfọdụ, a na-ewere mwepụ nke pus site na ahụ dị ka ihe dị mma nke ọrịa ahụ. Ihe ahụ na-agbaji akpụkpọ anụ nke conjunctiva ma ọ bụ nkuchianaya gaa n'èzí.

Ọtụtụ mgbe, ọzịza na phlegmon nke orbit na-aga aka. A sị ka e kwuwe, usoro pathological na-agbatị n'anụ ahụ na akụkụ ndị dị nso. Ọkpụkpụ, dị ka e kwurula, bụ ọkwa ikpeazụ nke ọrịa ahụ. N'okwu a, onye ọrịa ahụ na-etolite ọzịza nke nkuchianaya, na anya anya na-emechi kpamkpam. Ndo nke akpụkpọ ahụ dị n'akụkụ anya na-aghọ nke mbụ na-acha uhie uhie, na mgbe ahụ cyanotic. Conjunctiva na-aza, na-enweta atụmatụ vitreous. O nwere ike ịbụ exophthalmos. Enwere oke mgbu mgbe ị na-agbanye anya. N'okwu a, mmebi nke akwara optic na retina ga-ekwe omume.

Nchọpụta nchọpụta

Iji gbochie mmebi nke ọnọdụ izugbe nke onye ọrịa, ị kwesịrị ịkpọtụrụ ọkachamara mgbe ihe ịrịba ama mbụ na-adịghị mma mere. Ọ dị ezigbo mkpa ịme nchọpụta dị mkpa n'oge, kwado nchoputa a na-enyo enyo ma tinye aka na ọgwụgwọ kwesịrị ekwesị. Iji mee nke a, ịkwesịrị ịkpọtụrụ ọ bụghị naanị onye na-ahụ maka anya, kamakwa onye na-ahụ maka otolaryngologist, yana dọkịta ezé.

Iji kwado nchoputa nke orbital phlegmon, ọ dị mkpa ịnakọta na nyochaa ozi sitere na anamnesis, mụta banyere mbufụt mbụ na mwepu purulent, palpate na n'èzí na-enyocha anya mebiri emebi site na iji nkuchianaya.

Nchọpụta nke phlegmon nke orbit

Iji kwado nchoputa ahụ, na mgbakwunye na usoro nchọpụta ngwá ọrụ, dịka ọmụmaatụ, redio, ultrasound, orthopantomograms, diaphanoscopy na ophthalmoscopy nwere ike ime - usoro ndị a na-enye gị ohere ikpebi ọnọdụ nke akwara optic. Nke mbụ, ọ bụrụ na a na-enyo enyo na mmepe nke phlegmon, a na-eme nyocha n'ozuzu na omenala ọbara maka ịmụ nwa dị ka ụzọ nchọpụta ụlọ nyocha.

Ọgwụgwọ phlegmon nke orbit

Site na ọrịa a, onye ọrịa ahụ chọrọ ụlọ ọgwụ ngwa ngwa na nhọpụta ọgwụgwọ ọgwụ. Ọtụtụ mgbe, maka ọgwụgwọ phlegmon, a na-eji ọgwụ nje na-ebu ibu nke ndị na-ahụ maka nje bacteria nwere ụdị ọrụ dị iche iche, yana ọgwụ mgbaàmà maka detoxification. Na ọgwụgwọ, a na-eji tetracycline, penicillins, sulfonamides.

Ọ bụrụ na onye ọrịa nwere ụdị ọrịa siri ike, yana foto ụlọ ọgwụ akpọpụtara nke ịṅụbiga mmanya ókè, mgbe ahụ, a ga-atụ aro ọgwụgwọ symptomatic na ọgwụ mgbu na antipyretics.

Ọgwụgwọ ọgwụgwọ nke phlegmon nke orbit

Na mgbakwunye na eziokwu na a na-eme nchịkwa parenteral nke ọgwụ nje, a na-achọ injections subconjunctival na retrobulbar. N'otu aka ahụ, a na-atụ aro ka ịme otomy sinus na mgbanwe na mgbidi orbital, nkwụsị nke sinus na ethmoidotomy, sochiri iwebata ọgwụ.

Mkpa ịwa ahụ

Ọtụtụ mgbe, ọgwụgwọ anaghị ezu ezu na-enweghị enyemaka ịwa ahụ - imeghe phlegmon nke orbit. Mgbe emechara oghere nke mmiri purulent, a na-etinye onye ọrịa n'ime turund - mmiri mmiri pụrụ iche nke etinyere na ọgwụ nje. A na-ewepụ usoro ahụ n'ime naanị ụbọchị 2, mgbe ahụ, a na-etinye bandeeji aseptic na ọnya ahụ.

Ndị dọkịta na-ahụ maka anya na-akwadokarị ndị ọrịa na-ekpo ọkụ UHF, agbanyeghị, usoro a iji kpochapụ orbital phlegmon nwere ike ịdị irè naanị na mmalite nke mmepe ya. Usoro ọgwụgwọ physiotherapeutic dị otú ahụ na-eme ka o kwe omume ịmepụta usoro ahụ na-adịghị mma ma gbochie mgbasa nke purulent n'ime akụkụ miri emi nke anụ ahụ mebiri emebi.

Mmepe nke phlegmon nke orbit

Mmetụta

N'ọnọdụ ndị a na-adịghị ahụkebe, phlegmon nke orbit nwere ike ịkpalite mmepe nke nnukwu nsogbu:

  • ọzịza na ụbụrụ ụbụrụ;
  • sepsis;
  • nhazi nke mkpụkọ ọbara n'ime arịa nke sinus;
  • maningitis.

Nsonaazụ nke phlegmon nke orbit

A na-ewere ọrịa a dị oke ụkọ, mana dị oke egwu. N'ọnọdụ ọ bụla, ọ na-aga n'ihu ngwa ngwa, yabụ mgbe mgbaàmà mbụ pụtara, ị ga-akpọtụrụ onye dọkịta anya ruru eru ozugbo.

Site na phlegmon nke orbit nke anya, ụlọ ọgwụ ngwa ngwa na mmalite ọgwụgwọ ngwa ngwa na nhọpụta nke ujo dose nke ọgwụ nje na ihe mgbaàmà na-egosi, a na-eme ọgwụgwọ detoxification. Site na nchịkwa parenteral nke antimicrobial, a na-eme retrobulbar na subconjunctival injections.

N'otu oge ahụ, ọgwụgwọ n'oge nwere ike ịkwụsị ọganihu nke mbufụt n'oge ọ bụla.

Site na ntughari nke usoro mbufụt na mpaghara akwara optic, neuritis na-etolite, oghere nke veins retinal site na thrombus, neuroparalytic keratitis, na-esonyere nguzobe nke ọnya purulent na cornea. Mgbe vaskụla na akụkụ ndị ọzọ nke anya na-etinye aka na usoro mbufụt nke purulent, choroiditis na panophthalmitis na-etolite, na-eduga na atrophy anya.

Na mgbakwunye, site na phlegmon nke orbit, a na-enye ntinye nke ọgwụ nje antibacterial na ngwọta siri ike n'ime akpa conjunctival; oghere nkuchianaya - ngwa nke manu na conjunctiva na cornea. Mgbe nke ahụ gasịrị, a na-agbakwunye ọgwụgwọ ọgwụ na physiotherapy - UHF, UVI.

Ọgwụgwọ na-arụsi ọrụ ike, nke a na-eme na mmalite nke phlegmon nke orbit, na-enye aka na nsonaazụ dị mma nke ọrịa ahụ. Otú ọ dị, n'ime ogologo oge, enwere ike ịnwe njedebe nke mmegharị anya nke anya, strabismus nke abụọ na amblyopia, corneal cataracts, na atrophy nke akwara optic. Ọganihu na mgbasa nke ọrịa purulent nwere ike iduga panophthalmitis, ụbụrụ ụbụrụ, maningitis, septic thrombosis nke cavernous sinus, sepsis n'ozuzu ya nwere ihe na-egbu egbu.

Mmepe nke orbital phlegmon nwere ike ịbụ n'ihi ọrịa purulent nke anya, sinuses paranasal, akpụkpọ anụ, ezé ezé, mmerụ ihu, na ọrịa n'ozuzu.

Mgbochi nke phlegmon nke orbit chọrọ idebe ọcha n'oge nke purulent foci nke akpụkpọ ihu, akụkụ ENT, eze, na anya. Site na ihe ndị si mba ọzọ na n'ibu mebie anya, ọgwụ mgbochi ọgwụ mgbochi nke nsogbu na-efe efe dị mkpa.

Purulent mbufụt na-eso phlegmon nke orbit, dị ka a na-achị, bụ unilateral, nwere ngwa ngwa mmepe (mgbe ụfọdụ ọtụtụ awa, ma ọtụtụ mgbe 1 ma ọ bụ 2 ụbọchị). N'okwu a, enwere mgbu na-egbu mgbu na orbit na nku anya, nke na-abawanye site na palpation nke anyaball na mmegharị ya. Anya nku anya na-adị nkọ nke ukwuu, nwere agba na-acha ọbara ọbara-violet, na-esighi ike ma ghara imeghe. Ka usoro nke mbufụt na-aga n'ihu, mmebi conjunctival (chemosis), diplopia, exophthalmos na-eme na palpebral fissure, anya anya na-agbanwe ma na-efunahụ njem, ọhụụ na-ebelata nke ọma. Ọnọdụ izugbe nke onye ọrịa na-akawanye njọ ngwa ngwa: adịghị ike na-etolite, isi ọwụwa na ọgbụgbọ na-eme, ahụ ọkụ na-amalite.

Phlegmon nke orbit ga-adị iche na phlegmon nke nkuchianaya, nnukwu dacryocystitis, tenonitis, periostitis nke orbital mgbidi, mba ọzọ nke orbit, retrobulbar hemorrhage, glioma, sarcoma, neurofibromatosis, Quincke edema.

Phlegmon nke orbit, ma ọ bụ cellulitis orbital, bụ mbufụt na-agbasa purulent mbufụt nke eriri nke orbit. Phlegmon nke orbit na-esonyere ọnọdụ siri ike n'ozuzu ya na isi ọwụwa, ọgbụgbọ, ahụ ọkụ, mgbu na-egbu mgbu na orbit, exophthalmos, ọzịza na ọbara ọbara nke nku anya, diplopia, chemosis conjunctival, obere mmegharị anya, mbelata ọhụụ.

Nsogbu siri ike nke na-eme na phlegmon nke orbit nwere ike ịbụ: ụbụrụ ụbụrụ, thrombosis nke sinuses venous, meningitis, sepsis. Site na nsonaazụ dị mma nke phlegmon nke orbit, pus na-agbaji ozugbo site na akpụkpọ nkuchianaya ma ọ bụ conjunctiva wee pụta.

Amụma na mgbochi nke phlegmon nke orbit

Mgbasa mbufụt nke anụ ahụ orbital ka a na-akpọ phlegmon nke orbit.

Nchọpụta nke phlegmon nke orbit na-amalite site na nchịkọta data anamnestic na ọnọdụ purulent gara aga na mpaghara maxillofacial. Mgbe ahụ, a na-eme nyocha anya nke anya site na iji ihe nkuchi anya, a na-eme palpation.

 

  • Ogbo nke phlegmon (abscess).

Phlegmon nke orbit bụ nnukwu nsogbu ịwa ahụ anya. N'agbanyeghị eziokwu ahụ bụ na ọ dị ntakịrị (ihe dị ka 1% nke ikpe na ọnụ ọgụgụ mmadụ), ọrịa dị otú ahụ nwere ike ịdị ize ndụ ma maka ọrụ anya onye ọrịa na ndụ ya. Mgbe usoro purulent na-esi na orbit dị n'akụkụ akwa venous banye n'ime oghere cranial, nsogbu ndị dị ize ndụ nwere ike ịmalite, dị ka thrombosis nke arịa ụbụrụ ma ọ bụ meningitis, nke na-edugakarị na ọnwụ nke onye ọrịa. Phlegmon nke orbit na-emetụta ndị mmadụ n'afọ ọ bụla, mana ọtụtụ mgbe, ọ na-eme na ụmụaka na-erubeghị afọ 5.

Ihe dị ka 70% nke ikpe nke orbital phlegmon na-aghọ mgbagwoju anya nke sinusitis (ethmoiditis, karịsịa). Ọkpụkpụ purulent nke anụ ahụ nke orbital nwekwara ike ịkpalite site na ọrịa sitere na foci kacha nso nke mbufụt: ezé ma ọ bụ agba (agba agba osteomyelitis, periodontal abscess), akpụkpọ ihu (furunculosis, erysipelas), anya (bali, dacryocystitis, phlegmon nke nkuchianaya, oria orbital mmerụ ahụ, mgbagwoju anya ndị mba ọzọ na anya), wdg Na-adịkarịghị, ihe na-akpata phlegmon bụ purulent septic metastasis, mgbagwoju anya site na-efe efe (flu, red fever, typhoid).

N'otu oge ahụ, a na-eme ethmoidotomy na maxillary sinusotomy na trepanation nke mgbidi orbital, nsị na drainage nke imi imi na lavage na nchịkwa mpaghara nke ọgwụ ọjọọ. A na-awụpụ ọwa ọnya ahụ na tururunda tinye ya na ngwọta ọgwụ nje. Mgbe nke ahụ gasịrị, a na-asacha oghere mgbawa ahụ na nkwadebe nke ahịhịa nje na-enwe mmetụta.

  • ogbo nke orbital cellulitis.

Nkeji nke mmepe nke phlegmon nke orbit

Ọgwụgwọ phlegmon nke orbit

  • Ọkwa nke subperiosteal abscess.

Nchọpụta ngwá ọrụ dị mkpa nke ọrịa ahụ gụnyere ultrasound nke anya, redio nke orbit, yana nyocha X-ray na ultrasound nke paranasal sinuses, orthopantomogram. Iji dokwuo anya nkọwa, enwere ike ịnye diaphanoscopy, iji chọpụta ọnọdụ nke akwara optic - ophthalmoscopy, yana exophthalmometry, biomicroscopy, wdg Site na nyocha ụlọ nyocha, nyocha ọbara ọbara n'ozuzu, yana omenala ọbara maka nyocha nke ịmụ nwa, bụ. Nke bụ isi diagnostic mkpa maka orbital phlegmon.

Usoro nke suppuration na orbital anụ ahụ nwere usoro mmepe, na-agafe ọtụtụ usoro:

N'ụlọ ọgwụ na Moscow Eye Clinic, onye ọ bụla nwere ike nyochaa site na iji ngwá ọrụ nyocha nke oge a, na, dabere na nsonaazụ ya, nweta ndụmọdụ sitere n'aka ọkachamara ruru eru. Anyị na-emeghe ụbọchị asaa n'izu ma na-arụ ọrụ kwa ụbọchị site n'elekere 9 nke ụtụtụ ruo elekere 9. Ndị ọkachamara anyị ga-enyere aka chọpụta ihe kpatara ọnwụ ọhụụ ma na-agwọ ọrịa ndị a chọpụtara. Ahụmahụ ndị dọkịta na-awa refractive, nyocha zuru ezu na nyocha, yana ahụmịhe ọkachamara dị ukwuu nke ndị ọkachamara anyị na-ahụ maka nsonaazụ dị mma maka onye ọrịa.

Phlegmon nke orbit

Phlegmon nke orbit n'ọtụtụ ọnọdụ na-akpata Staphylococcus aureus ma ọ bụ ọcha, hemolytic na greenish streptococcus, obere mgbe pneumobacillus, diplococcus na E. coli. Ọrịa nwere ike ịbanye n'ime anụ ahụ nke orbital site na veins nke ihu ma ọ bụ orbit, nke na-enweghị valves. N'okwu a, a na-ebu ụzọ mepụta obere pustules, nke na-ejikọta na nnukwu abscesses.

Ị nwere ike chọpụta ego nke otu usoro, mee oge ọhụhụ na Moscow Eye Clinic site na ịkpọ multi-channel phone 8 (800) 777-38-81 (kwa ụbọchị site na 9:00 ruo 21:00, n'efu maka. mobile na mpaghara nke Russian Federation) ma ọ bụ site na dejupụta online ndebanye aha.

 

  • Ọkwa nke preseptal cellulitis.

Ogbo nke cellulitis nke preseptal na-esonyere ya na ọzịza na-egbu egbu nke anụ ahụ orbital na nku anya, exophthalmos na-apụtaghị ìhè, na ichekwa mmegharị anya na anya anya. Mmepe ọzọ nke usoro na-efe efe na mgbasa ya na mpaghara azụ, na-eme ka ihe omume nke orbital cellulitis. A na-egosipụta ụdị ọgwụgwọ ọrịa a site na edema nke nku anya, chemosis, exophthalmos, njedebe nke mmegharị anya na mbelata ọhụụ. Site na nchịkọta nke pus n'etiti mgbidi ọkpụkpụ nke orbit na periorbital, mgbidi nke orbit na-ebibi ma mepụta abscess subperiosteal. Ọ na-esonyere ya na edema na hyperemia nke nkuchianya elu, nkwụsịtụ na-agagharị agagharị na nkwụsị nke anya anya n'akụkụ nke ọzọ site na abscess, exophthalmos, na nnukwu mmebi nke anya anya. Site na oghere nke orbit, pus na-agbakọta n'ime anụ ahụ nke orbital wee mepụta oghere. ejedebere site na akpụkpọ ahụ pyogenic. Na mgbakwunye, na oghere nke orbit, ophthalmoplegia na-etolitekarị, mkpakọ nke irighiri akwara na-apụta, na kpuru ìsì.

Phlegmon nke orbit bụ ọrịa na-efe efe nke na-agụnye anụ ahụ nwere abụba ma bụrụ nke a na-eji na-apụta na mpụta purulent. N'ozuzu, pathology a nwere ike ime ọ bụghị naanị na mpaghara a nke anya, kamakwa n'akụkụ ndị ọzọ nke ya - nkuchianaya, akpa lacrimal. Ya mere a na-ewere echiche nke phlegmon dị ka aha mkpokọta nke ọtụtụ omume ọjọọ dị iche iche. A na-achọpụta ọrịa a obere oge, mana ọ bụ nnukwu ihe egwu maka ọnọdụ ahụike na ọbụna ndụ mmadụ.

Ihe kpatara ya

Isi ihe dị mkpa maka mmepe nke purulent mbufụt na akụkụ ọ bụla a na-ahụ anya bụ ntinye nke microorganisms pathogenic n'ime ya. Ọtụtụ mgbe, ndị na-akpata ọrịa dị otú ahụ bụ streptococci, E. coli na staphylococci, bụ ndị nwere ike ịbanye n'ime eriri anya yana mmiri mmiri ma ọ bụ site na kọntaktị. Enwere ọtụtụ ihe kpatara ọdịdị phlegmon nke orbit:

  • ụdị ọ bụla nke na-efe efe ma ọ bụ mkpali anụ ahụ, dịka ọmụmaatụ, erysipelas, furunculosis na-adịghị ala ala;
  • abanye n'ime ahụ mmerụ ahụ;
  • nsi ọbara n'ozuzu;
  • ntụpọ anya - conjunctivitis, mmebi nke akpa lacrimal, ọka bali;
  • ihe mba ọzọ kụrụ;
  • ọrịa mkpali nke imi imi;
  • ọnụnọ nke elekwasị anya na-efe efe na oghere ọnụ - ọrịa periodontal ma ọ bụ caries.

Ihe na-akpata phlegmon nke orbit

N'ezie, ọ dịghị mkpa ọ bụla na n'ihu nsogbu ndị a mbufụt nke orbit ga-eme. Ma mgbochi adịghị ike, ụkọ vitamin, nri na-adịghị mma na-aghọ ihe na-akpalite mmalite nke ọrịa dị ize ndụ.

Mgbaàmà

N'ozuzu, a na-ewere phlegmon nke orbit dị ka ụdị ọrịa a na-ahụkarị. Ọrịa a na-aga n'ihu n'ọnọdụ niile ngwa ngwa na naanị otu ụbọchị ihe ịrịba ama ya na-adakarị na-apụta n'ụzọ doro anya. Na foto nke phlegmon nke orbit, a na-egosipụta njirimara nke ntụpọ a na-adịghị ahụkebe ngwa ngwa.

N'ozuzu, ihe ịrịba ama niile nke pathology a nwere ike kewaa na mpaghara na n'ozuzu. Ụdị nke mbụ gụnyere:

  • ọbara ọbara na ntakịrị bluing nke akpụkpọ ahụ na mpaghara anya mebiri emebi;
  • nnukwu edema na mpaghara mmepe nke ihe na-egbu egbu;
  • elu okpomọkụ nke epithelium ziri ezi na-elekwasị anya nke ọrịa;
  • ntakịrị protrusion nke anya na ike ịkwaga ya;
  • eyelids na-anọgide na-emechi oge niile, ọ fọrọ nke nta ka ọ ghara ikwe omume imeghe anya.

Mgbaàmà mpaghara nke phlegmon nke orbit

Ihe ịrịba ama ndị ọzọ

Tụkwasị na nke ahụ, onye ahụ na-enwe mmetụta dị egwu, nke na-abawanye na palpation na ọbụna obere aka na akụkụ ahụ. Ọbụlagodi n'ihe gbasara ntakịrị ọzịza nke nku anya, ọhụụ na-ada nke ukwuu.

Ihe ịrịba ama a na-ahụkarị nke phlegmon nke oghere anya gụnyere:

  • mmụba na okpomọkụ nke ahụ;
  • ahụ ọkụ na oyi;
  • adịghị ike siri ike na mbelata arụmọrụ;
  • isi ọwụwa.

Ọ bụ ihe kwesịrị ịrịba ama na n'ime onye ọrịa toro eto, ọrịa ahụ na-eji akara ngosi mpaghara pụta ìhè karị, ma ọrịa nwata na-eji akara ngosi zuru oke nke mmepe nke usoro pathological.

Ihe ịrịba ama a na-ahụkarị nke phlegmon nke orbit

Ogo nke ọganihu

Phlegmon nke eriri nke orbit na-etolite na nkebi, na-agafe ọkwa dị iche iche.

  • A na-akpọ ọkwa nke mbụ preseptal cellulitis - enwere ọzịza na mbufụt nke anụ ahụ dị nso na orbit. Anya na-agbapụta ntakịrị, mana mmegharị ya ka dị, ebe nsogbu ọhụụ ka na-anọghị kpamkpam.
  • Nkeji nke abụọ bụ orbital cellulitis, nke a na-eji ọdịdị edema na mpaghara nkuchianya mara. Exophthalmos na-apụtawanye nke ọma, conjunctiva na-azakwa, bọọlụ anya nke nta nke nta na-efunahụ mmegharị ahụ, nhụsianya anya na-agbadata nke ukwuu.
  • Ogbo nke ọzịza nke subperiosteal na-amalite mgbe ọtụ na-agbakọta n'etiti ọkpụkpụ na mgbidi periorbital. Ihe ịrịba ama nke ogbo a: anya na-atụgharị ntakịrị gaa n'akụkụ na-abụghị nke ọnyà, ọbara ọbara na ọzịza na-apụta na nku anya, ọhụụ na-adaba ọbụna karịa.
  • A na-ewere oghere nke orbit dị ka ọkwa ikpeazụ na mmepe nke pathology. N'oge a, pus na-agbakọta n'ime anụ ahụ orbital, a na-emepụta oghere, nke na-enweta oke dị ka akpụkpọ anụ pyogenic. Na mgbakwunye, ahụ mkpọnwụ nke akwara oculomotor, mkpakọ nke akwara optic, na ọbụna nhụsianya zuru oke nwere ike ime.

Ọ bara uru ịsị na site na nyocha na ọgwụgwọ n'oge, ọ ga-ekwe omume igbochi mmepe nke nsonaazụ dị njọ na mgbanwe nke ọrịa ahụ na ọkwa ọzọ.

Foto ụlọ ọgwụ

Ọtụtụ mgbe, na phlegmon nke orbit, purulent mbufụt nwere ụdị nwere otu akụkụ ma na-aga n'ihu ngwa ngwa - site na ọtụtụ awa ruo ụbọchị abụọ. Ọ bụrụ na usoro pathological na-ekpuchi akwara optic, mgbe ahụ nke a nwere ike ịkpalite neuritis, thrombotic occlusion nke arịa dị na anụ ahụ merụrụ ahụ.

N'ihe banyere mgbanwe nke purulent phlegmon na choroid nke akụkụ ahụ, a na-amụ panophthalmitis, nke na-agụnyekarị atrophy nke anya. Na ọkwa dị elu, ụbụrụ ụbụrụ, maningitis, na sepsis nwere ike ime.

N'ọnọdụ ụfọdụ, a na-ewere mwepụ nke pus site na ahụ dị ka ihe dị mma nke ọrịa ahụ. Ihe ahụ na-agbaji akpụkpọ anụ nke conjunctiva ma ọ bụ nkuchianaya gaa n'èzí.

Ọtụtụ mgbe, ọzịza na phlegmon nke orbit na-aga aka. A sị ka e kwuwe, usoro pathological na-agbatị n'anụ ahụ na akụkụ ndị dị nso. Ọkpụkpụ, dị ka e kwurula, bụ ọkwa ikpeazụ nke ọrịa ahụ. N'okwu a, onye ọrịa ahụ na-etolite ọzịza nke nkuchianaya, na anya anya na-emechi kpamkpam. Ndo nke akpụkpọ ahụ dị n'akụkụ anya na-aghọ nke mbụ na-acha uhie uhie, na mgbe ahụ cyanotic. Conjunctiva na-aza, na-enweta atụmatụ vitreous. O nwere ike ịbụ exophthalmos. Enwere oke mgbu mgbe ị na-agbanye anya. N'okwu a, mmebi nke akwara optic na retina ga-ekwe omume.

Nchọpụta nchọpụta

Iji gbochie mmebi nke ọnọdụ izugbe nke onye ọrịa, ị kwesịrị ịkpọtụrụ ọkachamara mgbe ihe ịrịba ama mbụ na-adịghị mma mere. Ọ dị ezigbo mkpa ịme nchọpụta dị mkpa n'oge, kwado nchoputa a na-enyo enyo ma tinye aka na ọgwụgwọ kwesịrị ekwesị. Iji mee nke a, ịkwesịrị ịkpọtụrụ ọ bụghị naanị onye na-ahụ maka anya, kamakwa onye na-ahụ maka otolaryngologist, yana dọkịta ezé.

Iji kwado nchoputa nke orbital phlegmon, ọ dị mkpa ịnakọta na nyochaa ozi sitere na anamnesis, mụta banyere mbufụt mbụ na mwepu purulent, palpate na n'èzí na-enyocha anya mebiri emebi site na iji nkuchianaya.

Nchọpụta nke phlegmon nke orbit

Iji kwado nchoputa ahụ, na mgbakwunye na usoro nchọpụta ngwá ọrụ, dịka ọmụmaatụ, redio, ultrasound, orthopantomograms, diaphanoscopy na ophthalmoscopy nwere ike ime - usoro ndị a na-enye gị ohere ikpebi ọnọdụ nke akwara optic. Nke mbụ, ọ bụrụ na a na-enyo enyo na mmepe nke phlegmon, a na-eme nyocha n'ozuzu na omenala ọbara maka ịmụ nwa dị ka ụzọ nchọpụta ụlọ nyocha.

Ọgwụgwọ phlegmon nke orbit

Site na ọrịa a, onye ọrịa ahụ chọrọ ụlọ ọgwụ ngwa ngwa na nhọpụta ọgwụgwọ ọgwụ. Ọtụtụ mgbe, maka ọgwụgwọ phlegmon, a na-eji ọgwụ nje na-ebu ibu nke ndị na-ahụ maka nje bacteria nwere ụdị ọrụ dị iche iche, yana ọgwụ mgbaàmà maka detoxification. Na ọgwụgwọ, a na-eji tetracycline, penicillins, sulfonamides.

Ọ bụrụ na onye ọrịa nwere ụdị ọrịa siri ike, yana foto ụlọ ọgwụ akpọpụtara nke ịṅụbiga mmanya ókè, mgbe ahụ, a ga-atụ aro ọgwụgwọ symptomatic na ọgwụ mgbu na antipyretics.

Ọgwụgwọ ọgwụgwọ nke phlegmon nke orbit

Na mgbakwunye na eziokwu na a na-eme nchịkwa parenteral nke ọgwụ nje, a na-achọ injections subconjunctival na retrobulbar. N'otu aka ahụ, a na-atụ aro ka ịme otomy sinus na mgbanwe na mgbidi orbital, nkwụsị nke sinus na ethmoidotomy, sochiri iwebata ọgwụ.

Mkpa ịwa ahụ

Ọtụtụ mgbe, ọgwụgwọ anaghị ezu ezu na-enweghị enyemaka ịwa ahụ - imeghe phlegmon nke orbit. Mgbe emechara oghere nke mmiri purulent, a na-etinye onye ọrịa n'ime turund - mmiri mmiri pụrụ iche nke etinyere na ọgwụ nje. A na-ewepụ usoro ahụ n'ime naanị ụbọchị 2, mgbe ahụ, a na-etinye bandeeji aseptic na ọnya ahụ.

Ndị dọkịta na-ahụ maka anya na-akwadokarị ndị ọrịa na-ekpo ọkụ UHF, agbanyeghị, usoro a iji kpochapụ orbital phlegmon nwere ike ịdị irè naanị na mmalite nke mmepe ya. Usoro ọgwụgwọ physiotherapeutic dị otú ahụ na-eme ka o kwe omume ịmepụta usoro ahụ na-adịghị mma ma gbochie mgbasa nke purulent n'ime akụkụ miri emi nke anụ ahụ mebiri emebi.

Mmepe nke phlegmon nke orbit

Mmetụta

N'ọnọdụ ndị a na-adịghị ahụkebe, phlegmon nke orbit nwere ike ịkpalite mmepe nke nnukwu nsogbu:

  • ọzịza na ụbụrụ ụbụrụ;
  • sepsis;
  • nhazi nke mkpụkọ ọbara n'ime arịa nke sinus;
  • maningitis.

Nsonaazụ nke phlegmon nke orbit

A na-ewere ọrịa a dị oke ụkọ, mana dị oke egwu. N'ọnọdụ ọ bụla, ọ na-aga n'ihu ngwa ngwa, yabụ mgbe mgbaàmà mbụ pụtara, ị ga-akpọtụrụ onye dọkịta anya ruru eru ozugbo.


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