The method of treatment of chronic tonsillitis

 

(57) Abstract:

The invention relates to medicine, namely to otorhinolaryngology. The method consists in the fact that antibiotics are injected intradermally on the border of the upper and middle thirds of the Sterno sternocleidomastoid muscle at its front edge on both sides by 1/2 of a single therapeutic dose every other day for 10-15 days and additionally at the injection site exposed to ultrasound for 5 minutes daily. The method improves the efficiency of the treatment.

The invention relates to medicine, namely to otolaryngology, and can be used for the treatment of chronic tonsillitis.

The Palatine tonsils are part of the immune system. Because of their anatomic location, they are a kind of immune receptor, with which to begin the implementation of the reactions of cellular and humoral immunity, forming local and systemic protection of the body from bacteria and viruses. The formation of chronic tonsillitis and the development of its complications is the result of long interaction microbial agent in the gaps with the tissues of the tonsils and causes the reaction of the regional lymphatic system [1]. Chronic tonsillitis JV is additional tissue, endocrine organs.

Despite the challenging infectious-allergic pathogenesis of chronic tonsillitis, the primary factor in its development is infection. Therefore, for the treatment of chronic tonsillitis antibiotic therapy is etiotropic therapy.

A known method of washing lacunae of tonsils solutions of antibiotics and antiseptics. When this antibiotic is in contact with the amygdala for a short time and does not penetrate into regional lymph nodes. It is almost impossible to sanitize all gaps because of their convoluted structure. Pronounced pharyngeal reflex in many patients causes a negative attitude towards this procedure. Common antibacterial therapy, intramuscular and oral administration of drugs, chronic tonsillitis practically ineffective, as the antibiotics are in the lymphoid tissue associated with the protein condition, that is weakened. When you do this directly in the amygdala gets the minimum number of antibiotic from the total injected dose. Surgery - tonsillectomy is undesirable because of the important role of the tonsils in the reactions of local and General immunity.

Closest to the proposed metainterface antibiotics, when the antibiotic is also rapidly excreted by the efferent system of blood capillaries, giving the overall effect on the body. Injection into the tissue of the tonsil and peritonsillar tissue sharply painful and dangerous because of the possibility of introducing infection with the passage of the needle through infected mucous membrane of the mouth and pharynx. For effective impact of the pathogen in chronic tonsillitis is necessary to create a high concentration of antibiotic in the lymphoid tissue of the tonsils and the ways of regional lymph flow.

The invention consists in the treatment of chronic tonsillitis by lymphotropic the introduction of antibiotics in the region of digastric-jugular node of the first order for the tonsils with the subsequent effect of ultrasound on the area.

The method is as follows. Conducted to determine the sensitivity of microflora tonsils on the impact of antibiotics in the traditional way. Then prepare a solution of the antibiotic, is detrimental to the microflora of the tonsils, which contains a single therapeutic dose in 2-3 ml of 0.5% solution of novocaine. This solution is injected intradermally on the border of the upper and middle thirds of the Sterno-clavicle-sostava individual, is determined by reference). This region corresponds to the location of the digastric-jugular node, which is the lymph node of the first order for Palatine tonsils [3]. The introduction is carried out through the day, the course of 5-7 injections, creating a depot of antibiotic in regional lymph nodes. In parallel, a daily injection of the drug to stimulate regional lymph circulation produce ultrasonic effect on labile technique in pulsed mode 10 min, power of 0.4 watts/sq. cm for 5 min on each side for 10-15 days, depending on age and severity of clinical manifestations [4].

The treatment by the proposed method was performed in 38 patients with chronic tonsillitis in age from 16 to 36 years, all patients received a positive clinical effect due to the maximum concentration of antibiotic in inflammation: improved pharyngoscopy picture, decreased the size of the tonsils and regional lymph nodes, purified lacunas of tonsils from pathological content. When remote inspections for 0.5 year ended recurrence of angina in 19 patients out of 22, had frequent sore throats in history; normalized body temperature in 10 patients out of 14, who suffered from bacteriological studies of pathological microflora was not sown. Positive reconsiderations and cytomorphological dynamics. Any side effects and recurrence were noted.

Example 1. Patient E., 24 years old, complained of bad breath, persistent purulent gaps, weakness. In the last two years suffered 8 Angin. Upon examination of ENT-organs revealed the presence of purulent-necrotic plugs in the lacunae of tonsils, tonsil 2 degree increase, friable consistence, fused with nebnymi fit last hypermonogenic. Palpable submandibular and salustia lymph nodes on both sides. The mucous membrane of the nasal cavity with congestive phenomena. In the study of peripheral blood ESR - 22 mm in 1 h, the number of eosinophils - 7, but otherwise unremarkable. Bacteriological study of the microflora of the lacunae of tonsils found hemolytic Streptococcus sensitive to lincomycin. The treatment by the proposed method within 10 days after the day was intradermally injected with 0.5 ml of 30% aqueous solution of lincomycin in the projection of digastric-jugular node on both sides (5 injections on each side), at the same time performed 10 daily sessions of ultrasonic treatment according to the standard technique in the area of the market tonsils decreased to 1 degree increase. The mucous membrane of the Palatine arches, posterior pharyngeal wall returning to a normal color, decreased the size of regional lymph nodes. The mucous membrane of the nose was pink, ESR - 10 mm in 1 h, eosinophils - 3. When you smear of lacunas of tonsils - seeding sterile. Reconsiderate dynamics showed the transition labile stage of hemodynamic disturbances in the function. Over the next 10 months Angin was not.

Example 2.

Patient K. , 20 years old, suffered from long-term current subfebrile temperature, vegetative-vascular dystonia on cardial type. Complained of bad breath, recurrent pain in the heart dull, whining character, a constant body temperature 37,2 - 37,4oC in the last two years. Angina 1-2 times per year. Repeatedly examined by a physician, any pathological changes of internal organs was found. Periodic treatment with antibiotics orally and intramuscularly in the last 6 months had a temporary effect: when it stops the fever was returning. If pharyngoscopy noted the hardening of the tonsils, when the rotation stood out purulent-caseous plugs. Lostanlen diagnosis: chronic tonsillitis, decompensated form, vegetative-vascular dystonia on cardial type, subfebrility. Bacteriological examination of selected hemolytic Streptococcus, sensitive to ampicillin. Treated by the proposed method over 15 days: a day was administered intradermally 250 thousand UNITS ampicillin dissolved in 2 ml of 0.5% solution of novocaine in the projection of digastric-jugular node on both sides of (7 injections on each side), simultaneously conducted 15 daily sessions of ultrasonic treatment according to the standard technique in the field of administration of ampicillin. The patient's condition has improved: on the 12th day from the start of treatment was normalized body temperature, mucous membrane of the pharynx was pink, regional lymph nodes was reduced to normal size, marked by the disappearance of pathological discharge from the lacunae of tonsils. When you smear test hemolytic Streptococcus was not sown. When monitoring patients within 6 months of angina was not, the body temperature within normal limits, stopped the pain in the heart.

Thus, when treating of the proposed method is the localization of the medicinal product in inflammation and ways regionalnego lymphotropism antibiotic with intradermal administration.

The method is technically simple, can be performed in any clinic. therapeutic effect is achieved by introducing a much smaller doses of the antibiotic. Being causal, the method eliminates unwanted overall effect of the antibiotic on the body, which is important for immunological weakened people.

Sources of information

1. Soldatov, I. B. Manual of otorhinolaryngology. - M.: Medicine. - 1997. - S. 348.

2. Transfiguration B. S., Popova, N. Tonsillitis, chronic tonsillitis and associated common diseases. M: Medicine. - 1970. - 383 S.

3. Zhdanov D. A. General anatomy and physiology of the lymphatic system. - L.: Medgiz. - 1952. - 336 S.

4. The Panchenkov R. T., Mirenkov Y. E., Yarema, I. C., E. Shcherbakov, Endolymphatic antibiotic therapy. - M.: Medicine, 1984. - 239 S.

The method of treatment of chronic tonsillitis, including the introduction of antibiotics, characterized in that the antibiotic is injected intradermally on the border of the upper and middle thirds of the Sterno sternocleidomastoid muscle at its front edge on both sides by 1/2 of a single therapeutic dose every other day for 10 to 15 days, and additionally at the injection site exposed to ultrasound for 5 minutes daily.

 

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