评论
打印
Acute Epiglottitis: Causes, Symptoms, Treatment.
急性会厌炎：病因、症状、治疗。
It is an acute inflammatory condition confined to supraglottic structures which include epiglottis, aryepiglottic folds and arytenoids.
急性会厌炎是一种急症状态，主要累及喉部声门上区的会厌及其周围组织（包括会厌谷、杓状会厌襞和杓状软骨等。
There is marked oedema of these structures which may obstruct the airway.
这些结构有明显的水肿，可能阻塞气道。
What Causes Epiglottitis?
会厌炎的原因是什么？
It is a serious condition and affects children of 2-7 years of age but can also affect adults.
急性会厌炎是喉科的急重症之一，2-7岁儿童及成人皆可出现。
H.Influenzae B is the most common organism responsible for this condition in children.
对于儿童来说，最常见的致病病原体是乙型流感嗜血杆菌。
Clinical Features One: Onset of symptoms is abrupt with rapid progression.
临床特点一：起病急骤，病程进展非常迅速。
Two: Sore throat and dysphagia are the common presenting symptoms in adults.
二：喉咙痛和吞咽困难是成年患者的常见症状。
Three: Dyspnoea and stridor are the common presenting symptoms in children.
三：呼吸困难和喘鸣是儿童常见的症状。
They are rapidly progressive and may prove fatal unless relieved.
它们进展迅速，如果不及时治疗，可能会致命。
Four: Fever may go up to 40°C.
四：发烧可能高达40°C。
It is due to septicaemia.
由于败血症引发的。
Patient's condition may rapidly deteriorate.
病人的病情可能会迅速恶化。
Examination One: Depressing the tongue with a tongue depressor may show red and swollen epiglottis.
检查一：用压舌器压舌可能会出现会厌红肿。
Indirect laryngoscopy may show oedema and congestion of supraglottic structure.
间接喉镜检查可见声门上结构肿胀和充血。
This examination is avoided for fear of precipitating complete obstruction.
尽量避免喉镜检查，以免造成完全阻塞。
It is better done in operation theatre where facilities for intubation are available.
最好在有插管设备的手术室进行。
Two: Lateral soft tissue X-ray of neck may show swollen epiglottis (thumb sign).
检查二：颈部外侧软组织X光片可见会厌肿胀（拇指征）。
Treatment One: Hospitalisation Essential because of the danger of respiratory obstruction.
治疗一：由于有呼吸道阻塞的危险，必须住院治疗。
Two: Antibiotics.
治疗二：抗生素。
Ampicillin or third generation cephalosporin are effective against H.Influenzae and are given by parenteral route (i.M.Or i.V.) without waiting for results of throat swab and blood culture.
氨苄西林或第三代头孢菌素对流感嗜血杆菌有效，无需等待咽拭子和血液培养结果即可给药（肌肉注射或静脉注射）。
Three: Steroids: given in appropriate doses relieve oedema and may obviate need for tracheostomy.
治疗三：类固醇：给予适量剂量可以减轻水肿，并且可以避免气管切开术。
Four: Adequate hydration.
治疗四：充足的补水。
Patient may require parenteral fluids.
病人可能需要静脉输液。
Five: Humidification and oxygen.
治疗五：雾化吸入治疗。
Six: Intubation or tracheostomy may be required for respiratory obstruction.
治疗六：因呼吸道堵塞可能需要经口或经鼻气管插管、气管切开术等。
