Chloramphenicol pob ntseg poob tau qhia rau kev kho mob ntawm otitis externa thiab mob hnyav thiab mob otitis media los ntawm cov kab mob nkag tau yooj yim. Cov khoom no tsis muaj xim lossis xim daj me ntsis khov ua kua; saj yog iab heev; nws tuaj yeem sib xyaw nrog dej ntawm qhov xav tau. Qee zaum cov kev tsis haum tshuaj tshwm sim.
Txawm hais tias cov khoom no yog tshuaj pleev, chloramphenicol muaj qhov cuam tshuam loj heev ntawm cov pob txha pob txha. Cov poj niam cev xeeb tub thiab pub niam mis siv nws kuj tseem yuav ua rau muaj kev phom sij loj hauv cov menyuam yug tshiab thiab menyuam mos liab. Yog li ntawd, poj niam cev xeeb tub thiab poj niam pub niam mis yuav tsum siv nws nrog ceev faj. Kev sib xyaw nrog lincomycin or erythromycin tshuaj thiab lwm yam macrolide hmoov tshuaj tua kab mob tuaj yeem ua rau muaj kev sib cav sib ceg, yog li ntawv thov ua ke tsis haum.
BALLYA muab a kuaj chloramphenicol los qhia koj yog tias muaj cov tshuaj chloramphenicol seem hauv cov khoom siv mis uas koj noj txhua hnub.
Cov khoom no yog tshuaj tua kab mob chloramphenicol. Nws muaj qhov dav-spectrum antimicrobial effect hauv vitro, suav nrog aerobic gram-negative bacteria thiab gram-positive bacteria, anaerobic bacteria, rickettsia, spirochetes thiab chlamydia.
Nws muaj cov kab mob tua cov kab mob hauv qab no: Haemophilus influenzae, Streptococcus pneumoniae thiab Neisseria meningitidis.
Nws tsuas muaj cov tshuaj tua kab mob rau cov kab mob hauv qab no: Staphylococcus aureus, Streptococcus pyogenes, Streptococcus viridans, Group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Typhoid fever, Salmonella paratyphi, Chi Anaerobic bacteria xws li Gagella thiab Bacteroides fragilis.
Cov kab mob hauv qab no feem ntau tiv taus chloramphenicol: Pseudomonas aeruginosa, Acinetobacter, Enterobacter, Serratia marcescens, Indole-positive Proteus, Methicillin-resistant Staphylococcus, thiab Enterococcus.
Cov khoom no yog tus neeg sawv cev bacteriostatic. Chloramphenicol yog roj-soluble. Nws nthuav tawm mus rau hauv cov kab mob ntawm cov kab mob thiab rov ua haujlwm khi rau 50S cov kab mob ntawm cov kab mob ribosome, cuam tshuam kev loj hlob ntawm peptide saw (tejzaum nws yog vim muaj kev cuam tshuam ntawm kev cuam tshuam ntawm transpeptidase), yog li tiv thaiv kev tsim cov peptide saw, yog li tiv thaiv cov protein synthesis .
Otitis media yog kab mob sib kis uas cuam tshuam rau tag nrho lossis ib nrab ntawm pob ntseg nruab nrab (suav nrog Eustachian tube, tympanum, tympanic sinus, thiab mastoid air chamber), thiab nws muaj ntau dua rau menyuam yaus. Nws tuaj yeem muab faib ua ob pawg: tsis suav nrog thiab txhawb nqa. Cov uas tsis txhawb nqa suav nrog cov kab mob otitis secretory, baro-raug mob otitis media, thiab lwm yam. Kev mob tshwj xeeb tsis tshua muaj, xws li tuberculous otitis media.
Mob otitis media yog ib qho mob ua paug ntawm qhov nruab nrab pob ntseg mucosa, uas kis los ntawm Eustachian tube. Tom qab kis tau tus mob khaub thuas, qhov mob ntawm lub pharynx thiab lub qhov ntswg kis mus rau Eustachian tube, thiab mucosa ntawm lub qhov ncauj pharyngeal thiab lub lumen ntawm Eustachian tube zoo li txhaws thiab o, thiab kev txav ntawm cilia raug thaiv, ua rau mob otitis media. Cov kab mob sib kis feem ntau yog pneumococcus thiab Haemophilus influenzae.
A. Suppurative otitis media
a Kab mob suppurative otitis media
Cov tsos mob ntawm pob ntseg pob ntseg o tshwm sim los ntawm cov kab mob purulent feem ntau yog pob ntseg thiab pus. Cov me nyuam cov tsos mob tshwm sim ntau dua li cov neeg laus, suav nrog ua npaws thiab ntuav. Cov teeb meem hnyav suav nrog teeb meem intracranial, xws li mob paj hlwb thiab lub paj hlwb. Lwm yam teeb meem suav nrog labyrinthitis thiab lub ntsej muag palsy palsy.
b. Ntev li mob otitis media
Nws hais txog kev mob ua paug ntev ntawm qhov nruab nrab pob ntseg mucosa, periosteum, lossis pob txha sib sib zog nqus. Tus kab mob no tshwm sim ntau dua hauv kev kho mob. Cov tsos mob tseem ceeb tshwm sim tsis tu ncua lossis tawm mus tas li ntawm lub pus, tympanic membrane perforation, thiab hnov tsis hnov lus. Hauv cov xwm txheej hnyav, nws tuaj yeem ua rau muaj teeb meem intracranial thiab extracranial.
B. Tsis-suppurative otitis media secretory otitis media
a Tsis hnov lus
Feem ntau cov kab mob otitis media tuaj yeem ua rau hnov tsis hnov lus tom qab mob khaub thuas, nqes saum lub dav hlau lossis dhia dej, thiab tej zaum yuav muaj "kev ua si rau tus kheej". Qhov hnyav ntawm kev lag ntseg hauv cov neeg mob uas muaj cov kab mob hu ua otitis media feem ntau hloov pauv. Thaum lub tragus raug kaw lossis hloov lub taub hau txoj haujlwm, kev hnov lus tuaj yeem txhim kho. Thaum lub pob ntseg pob ntseg nruab nrab yog tuab, lub rooj sib hais yuav tsis hloov pauv vim qhov hloov ntawm lub taub hau txoj haujlwm. Cov menyuam yaus feem ntau tsis muaj qhov tsis txaus siab tseem ceeb ntawm kev hnov lus tsis zoo, uas ua rau pom tias tsis quav ntsej cov niam txiv hu xov tooj, tsis muaj kev mloog lus, lossis xav tau ntim ntau dhau thaum saib TV.
b. Mob pob ntseg
Cov kab mob otitis media zais zis tuaj yeem hnov pob ntseg me ntsis, thiab cov kab mob otitis tawm mus ntev yuav muaj pob ntseg thaum kis mob thib ob.
c. Ib qho kev xav ntawm qhov puv lossis qhov txhaws ntawm pob ntseg.
d. Tinnitus
Feem ntau nws tsis hnyav, tab sis tuaj yeem sib quas ntus, thiab lub suab ua pa tuaj yeem hnov thaum lub taub hau txav, yawns lossis tshuab ntswg. Cov neeg mob tsawg nrog cov kab mob otitis media tuaj yeem muaj dej hauv pob ntseg, tab sis lub sijhawm luv luv, tsuas yog ob peb teev lossis txog ib hnub.
e. Kev kuaj mob otoscope
Hauv cov theem mob hnyav, muaj cov hlab ntshav nyob ib ncig ntawm daim tawv nqaij tympanic. Ib feem nruj ntawm daim tawv nqaij tympanic tau thim rov qab, uas tau tshwm sim raws li qhov luv, deformation lossis ploj ntawm lub khob hliav qab lub teeb; qia malleus hloov pauv rov qab thiab nce toj; cov txheej txheem luv luv malleus yog qhov pom tseeb.
Thaum tympanic effusion tshwm sim, tympanic membrane poob nws cov luster ib txwm thiab daj daj, txiv kab ntxwv-liab lossis amber; hauv cov neeg mob hnyav, daim tawv nqaij ua kua mis yog dawb los yog txho-xiav thiab tsis pom kev.
Yog tias qhov tso dej tawm sai thiab tsis ua rau lub tympanum, qib cov kua tuaj yeem pom los ntawm cov ntaub so ntswg tympanic, uas yog txoj kab nkhaus nce mus rau txoj kab nkhaus. Qee zaum cov npuas tuaj yeem pom los ntawm daim tawv nqaij tympanic. Cov npuas nce ntxiv tom qab lub raj eustachian tau tawg. Yog tias muaj cov kua dej ntau ntxiv hauv cov kab noj hniav tympanic sib sau ua ke, cov kua dej hauv lub qhov dej yuav nthuav tawm thiab cov dej ua kua dej ua kua tympanic yuav raug txwv.
Ntau tus tswv tsis paub txog otitis media hauv dev, yog li thaum tus dev qhia qee cov tsos mob ntawm otitis media, tus tswv yuav tsis paub tias muaj dab tsi tshwm sim rau tus dev. Otitis media hauv dev hais txog tag nrho lossis ib feem ntawm qhov mob txhab uas tshwm sim hauv pob ntseg pob ntseg nruab nrab ntawm cov dev. Otitis media hauv dev tuaj yeem faib ua ob hom: kab mob otitis media thiab suppurative otitis media, uas tau cais raws li qhov exudate ntawm tus dev lub pob ntseg nruab nrab. Txij li cov kab mob otitis tuaj yeem ua rau muaj kev puas tsuaj loj rau dev, kev kho lub sijhawm tseem ceeb heev.
Qee tus dev ua rau muaj mob otitis media ntau dua. Cov dev no feem ntau muaj pob ntseg ntev dua thiab plaub pob ntseg ntau dua, xws li cocker spaniels, beagles, thiab poodles. Yog tias koj khaws cov dev no, tus tswv yuav tsum ua txoj haujlwm zoo ntawm kev tiv thaiv txhua hnub, txhawm rau tiv thaiv tus dev los ntawm otitis media.
Txhua yam uas cuam tshuam qhov sib npaug ntawm qhov zais hauv tus dev lub pob ntseg tuaj yeem ua rau mob otitis media. Piv txwv li, feem ntau yog cov dej nkag rau hauv pob ntseg thaum da dej, lossis dej qias neeg nkag rau hauv pob ntseg thaum ua luam dej, lossis txawm tias cov khoom txawv teb chaws nkag rau hauv pob ntseg, lossis muaj kab mob thiab kab, uas tuaj yeem ua rau mob otitis media hauv dev. Feem ntau, auricle thiab pob ntseg kiav txhab tau mob hauv tus dev, uas yog rau otitis externa. Yog tias otitis externa tsis kho, nws yuav ua rau mob otitis media.
Cov tsos mob pom tseeb tshaj plaws ntawm otitis media yog mob pob ntseg thiab khaus. Cov dev yuav niaj hnub xav khawb pob ntseg nrog lawv cov paws thaum lawv mob. Yog tias tus dev tso cai rau khawb nws lub pob ntseg, tus dev yuav ua rau nws pob ntseg raug mob vim qhov khawb tas li, ua rau los ntshav thiab hematoma.
Yuav siv pob ntseg li cas? Tom qab thawj zaug ntxuav, nws yog qhov tsim nyog los kho tus dev qhov mob raws li nws ua. Yog tias nws tshwm sim los ntawm cov kab mob, tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob tej zaum yuav xav tau. Thiab kev kis tus kab mob fungal yuav tsum tau siv tshuaj tua kab mob tshwj xeeb. Yog tias nws yog lub cev txawv teb chaws, nws yooj yim dua nrog. Hauv kev soj qab taug qab, txhua hnub, tus tswv yuav tsum muab tshuaj rau dev thiab ntxuav pob ntseg. Feem ntau hais lus, koj yuav tsum mob siab ntev li ob lub lis piam. Feem ntau siv pob ntseg poob yog chloramphenicol pob ntseg poob thiab ofloxacin pob ntseg poob.
Feline purulent otitis media yog ib qho kab mob tshwm sim thiab nquag tshwm sim hauv cov kab mob miv pob ntseg. Qhov no yog vim yog lub cev tshwj xeeb lub cev ntawm lub pob ntseg pob ntseg nruab nrab. Ntawd yog, qhov nruab nrab pob ntseg sib txuas lus nrog nasopharynx los ntawm Eustachian tube. Yog li ntawd, thaum raug kev txom nyem los ntawm txoj hlab ua pa sab saud, tus kab mob kis tau yooj yim mus rau Eustachian tube, thiab cov kab mob nkag mus rau hauv nruab nrab pob ntseg kab noj hniav los ntawm Eustachian tube thiab ua rau mob otitis media.
Nws yuav qhia kev npau taws, tsis qab los, teb qeeb rau qhov kev txhawb sab nraud, tsis xav txav mus los, qaug zog, khaus pob ntseg, thiab taw taw kom rub pob ntseg. Cov miv feem ntau tsis muaj qhov txawv txav hauv lub cev kub, mem tes, thiab ua pa. Thaum lub sijhawm tshuaj xyuas pob ntseg, nws pom tias ib leeg los yog ob sab pob ntseg ntawm lub qhov ncauj tawm tuaj yog ua paug, hnoos qeev, thiab qee zaum ua paug thiab qias neeg ua kua tsis huv, thiab muaj ntxhiab tsw tshwj xeeb. Cov tib neeg muaj cov tsos mob ntawm txoj hnyuv, ntuav, raws plab, cem quav, thiab tsis qab los noj mov.
A. Kev kho hauv zos
Ntxuav lub pob ntseg nrog 3% hydrogen peroxide, ntxuav pob ntseg pob ntseg, thiab tshem tawm cov pus ob zaug ib hnub; khaws lub eustachian kab noj hniav tsis muaj kev cuam tshuam, instill chloramphenicol pob ntseg poob.
B. Tshuaj tua kab mob
Siv tshuaj tua kab mob kom txaus. Penicillin 800,000 units/zaug, gentamicin 80,000 units/zaug, txhaj tshuaj ob zaug ib hnub. Feline purulent otitis media raug kho nrog kev kho mob. Ntxuav lub pob ntseg pob ntseg, ua kom cov kab noj hniav eustachian tsis txhob thaiv, siv cov tshuaj tua kab mob hauv lub cev, thiab qhov pib miv yuav raug kho nyob hauv ob lub lis piam ntawm kev kho mob.
Chloramphenicol pob ntseg poob feem ntau yog siv rau pob ntseg kis kab mob. Nws tsis yog tsuas yog siv tau rau tib neeg, tab sis kuj tseem ceeb heev rau peb cov tsiaj miv thiab dev. Tab sis thaum peb siv lub pob ntseg chloramphenicol tee rau miv thiab dev, peb yuav tsum tau sab laj nrog kws tshaj lij kws kho tsiaj, thiab mloog zoo rau kev siv thiab chloramphenicol ntau npaum li cas.
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