Orbital Cellulitis, Indwara z'amaso zabyimbye, na Sinus Thrombose ya Cavernous¶

Kubyimba vuba, umutuku, igitsure cyijimye kumwana cyangwa mukuru, cyangwa ibibyimba, ibishishwa, cyangwa sinus / amenyo yanduye Hagati yikiraro cyizuru nu mfuruka yumunwa (** "Triangle Triang of the Face" ), irashobora kwiyongera mumasaha make uhereye kwandura uruhu rudasanzwe ( preseptal cyangwa periorbital selulitis **). orbital selulitis ) cyangwa amaraso yanduye munsi yubwonko ( septic cavernous sinus thrombose [CST] ). Kuberako ijisho ryumuntu ( igufwa ryamagufa **) ni agasanduku gakomeye, gafunze gahujwe neza na sinus yo mu bwonko bwo mu bwonko ikoresheje imitsi idafite imbaraga, pus cyangwa kubyimba inyuma ya fibrous ** orbital septum ** ihonyora vuba imitsi ya optique, igahagarika imitsi yijisho, ikanakwirakwiza bagiteri mu gihanga. Kumenya ako kanya ** "6 Ibendera ritukura rya Orbital" ** (ububabare hamwe no kugenda kwijisho, guhumuka amaso, kutabona kabiri, kugabanuka kwamaso, kubura amaso, cyangwa reflex idasanzwe yabanyeshuri) hamwe nibitaro byihutirwa bya antibiyotike zinjira mumitsi bikiza icyerekezo nubuzima.

Kora ubu¶

1. ** Gabanya witonze ijisho ryabyimbye (udakanze ku jisho ubwaryo) hanyuma ukore intambwe 4 yintambwe yo kuryama kuri Orbital Triage Check: **
2. ** Intambwe ya 1 (Kugenzura Ijisho & Kugenzura Ububabare): ** Fata urutoki rwawe $ 30 inyandiko {santimetero} $ ($ 12 inyandiko {inches} $) imbere yumurwayi wumurwayi hanyuma ujyane buhoro buhoro muburyo bwa "H" (ibumoso, iburyo, hejuru, hepfo). Kwimura ijisho bitera ** ububabare bukabije inyuma yijisho **, cyangwa ijisho ryabyimbye ** risubira inyuma cyangwa rinanirwa kugenda byuzuye ** bitera ** iyerekwa kabiri **?
3. ** Intambwe ya 2 (Proptose / Bulging Check): ** Hagarara neza inyuma yumurwayi wicaye, uhengamye umutwe inyuma gato, hanyuma urebe neza hejuru yuruhanga rwabo mumaso yombi. Ese cornea yijisho ryanduye ** iratera imbere ** kuruta ijisho ryiza (cyangwa ijisho ryasunitswe hepfo no hanze)?
4. ** Intambwe ya 3 (Visual Acuity & Red Color Saturation Check): ** Gupfuka ijisho ryiza hanyuma urebe niba umurwayi ashobora gusoma icapiro rito neza. Fata ikintu gitukura cyane (nk'icupa ry'icupa ritukura) imbere y'ijisho ryiza hanyuma ijisho ryabyimbye: niba ibara ry'umutuku risa ** ryazimye, orange, cyangwa umukara / imvi ("desaturation itukura") ** mu jisho ryabyimbye, imitsi ya ** optique irimo gukanda **.
5. ** Intambwe ya 4 (Ikwirakwizwa ryikwirakwizwa rya Sinus Thrombose ya Cavernous): ** Reba ** IZINDI (ihabanye) ijisho **. Niba kubyimba, gutukura, guhumbya ijisho, cyangwa ubumuga bw'imitsi y'amaso bitangiye gukwirakwira ku jisho rya kabiri mu masaha 24 kugeza 48, **, biherekejwe no kubabara umutwe cyangwa umuriro ukabije, ukekwaho ** Cavernous Sinus Thrombose ** ako kanya.
6. ** Genda uhite ujya mubitaro byihutirwa byibitaro niba BURI MUNYAMABANGA 6 atukura ya Orbital ahari, cyangwa niba umurwayi ari umwana uri munsi yumwaka 1, udafite ubudahangarwa, cyangwa udashobora guhumura ijisho bihagije kugirango ubisuzume. nimero yihutirwa.
7. ** Ntuzigere unyunyuza, pop, lance, cyangwa inshinge-gutobora ibishishwa byose, guteka (furuncle), carbuncle, cyangwa umusatsi wizuru winjiye imbere muri "Triangle Danger of the Face." Kunyunyuza ibibyimba byo mu maso bisunika * Staphylococcus aureus * bagiteri na mikorobe ya septike isubira inyuma yerekeza mu bwonko.
8. ** Komeza umurwayi yicaye neza umutwe we uzamurwa hejuru ya $ 30 inyandiko {kugeza} 45 inyandiko {dogere} $ hanyuma ubigumane Ntakintu na kimwe cyumunwa (NPO). Hagarika ibiryo n'ibinyobwa kuko ibibyimba bya orbital subperiosteal akenshi bisaba amashusho yihutirwa ya CT hamwe no kubaga endoscopic sinus / imiyoboro y'amazi ya anbeste muri rusange.
9. ** Ntugashyire compresses zishyushye ukekwaho kuba ari selile yimbitse ya orbital cyangwa ibibyimba byo mumaso byihuta cyane hamwe numuriro mwinshi, kandi ntugashyire imiti yo murugo idafite sterile mumaso.
10. ** Reba ku ngaruka ziterwa na fungal (Mucormycose): ** Niba umurwayi urwaye diyabete ya ketoacidose (DKA) **, diyabete itagenzuwe neza, neutropenia, chimiotherapie, cyangwa ikoreshwa rya corticosteroid iherutse gukura itera uburibwe bwo mumaso / sinus, ijisho ryabyimbye, hamwe na ** igikonjo cyumukara imbere yizuru cyangwa umunwa hejuru yizuru (umunwa). ** Rhino-Orbital-Cerebral Mucormycose ** byihutirwa mubitaro byibitaro.

Ijisho ryabyimbye hamwe na danger-triangle infection triage icyemezo cyigiti¶

Koresha iyi clinique clinique kugirango utandukanye uburibwe bwamaso yumubiri na selile yimbitse ya orbital selulitis, sinus trombose ya cavernous, na mucormycose yibihumyo.

flowchart TD
    Start["Umubyimba ukabije, Umutuku, cyangwa Ububabare bw'amaso <br/> cyangwa Indwara yo Hagati Hagati muri Triangle Danger"] --> OpenCheck{"Witonze witonze Amaso: <br/> Reba Ijisho Ryimuka, Icyerekezo, & Umwanya"}

    OpenCheck -->|"ICYITONDERWA CYOSE CY'UMUKARA W'UMURYANGO:"| OrbitTrue["POSTSEPTAL (ORBITAL) CELLULITIS <br/> cyangwa SUBPERIOSTEAL ABSCESS: <br/> 1. Jya mu ishami ryihutirwa ryibitaro AKANYA <br/> 2. Komeza wicare neza kuri dogere 30 kugeza 45 <br/> 3. Ntukagire ikintu na kimwe ukoresheje umunwa (NPO) kuri CT scan & kubaga <br/> 4. Ukeneye antibiotike ya IV ako kanya + ENT / Ophthalmology"]

    OrbitTrue --> CSTCheck{"Amaso Yombi Yabigizemo uruhare, <br/> cyangwa Kubabara Umutwe / Indwara Yumutima Yumutima <br/> (CN III, IV, V1 / V2, VI) / Umuriro mwinshi cyane?"}

    CSTCheck -->|"YEGO: Gukwirakwiza ijisho ritandukanye muri 24-48h,"| CST["SEPTIC CAVERNOUS SINUS THROMBOSIS (CST): <br/> 1. Hamagara 911/112/999 Ako kanya <br/> 2. Ubuzima bwangiza ubuzima bwihutirwa <br/> 3. Ukeneye statut IV Vancomycin + Ceftriaxone + Metronidazole, <br/> MRV / CTV venogram yo mu bwonko, na anticoagulation ya IV"]

    CSTCheck -->|"Diyabete Ketoacidose (DKA), Neutropenia, <br/> cyangwa Immunosuppression + Eschar Yirabura mu mazuru / Palate <br/> cyangwa kunanirwa mu maso"| Mucor["RHINO-ORBITAL-CEREBRAL MUCORMYCOSIS: <br/> Akanya ko kubaga ako kanya + IV Liposomal Amphotericine B"]

    OpenCheck -->|"NTA BURUNDI BUKURIKIRA: sclera yera isa nibisanzwe <br/> - Kubyimba bigarukira gusa kuruhu rwimbere"| PreseptalCheck{"Niki Cyateye Hanze <br/> Kubyimba kw'amaso?"}

    PreseptalCheck -->|"Umuriro, ususurutsa amaso yumutuku, <br/> kurumwa vuba, gushushanya, cyangwa sinusite"| Preseptal["PRESEPTAL (PERIORBITAL) CELLULITIS: <br/> Umunsi umwe byihutirwa kwisuzumisha byihutirwa kwa antibiotique yo mu kanwa <br/> (cyangwa antibiotike ya IV niba umwana <1 yr cyangwa bikomeye)"]

    PreseptalCheck -->|"Utuntu duto duto duto duto tumeze nk'ibibyimba neza kuri <br/> ijisho ryijisho (Stye) cyangwa amashaza adafite ububabare <br/> imbere yumupfundikizo (Chalazion), nta muriro"| Stye["HORDEOLUM (STYE) CYANGWA CHALAZION: <br/> Koresha compress isukuye isukuye 10-15 min 4x kumunsi;"]

Imipaka ya Anatomique: Impamvu Orbital Septum ari firewall yijisho¶

Kugira ngo wumve impamvu amaso abiri yabyimbye asa nkaho avuye mucyumba ashobora kugira ibisubizo bitandukanye rwose, ugomba gusobanukirwa urupapuro ruto, rukomeye rwimitsi ihuza fibrous ihuza ** orbital septum **:

1. ** Orbital Septum: ** Septum ya orbital ifatanye nu ruziga ruzengurutse amagufwa yijisho ryijisho (** orbital rim ) kandi igera mu isahani yo hejuru no hepfo ya tarsal yijisho ryijisho. Ikora nka bariyeri ya anatomiki yumubiri (firewall) ** itandukanya uruhu rwimbere hamwe nuduce duto two munsi yijisho ryijisho ( umwanya wa preseptal ) nu mwobo wimbitse, ufunze amagufwa inyuma yijisho ryijisho ( umwanya wa posteptal cyangwa orbital **).
2. ** Preseptal (Periorbital) Cellulitis (Imbere ya Firewall): ** Iyo udukoko turumye ku gitsike, igikonjo hafi yijisho, cyangwa glande yijimye (stye) yanduza uruhu * imbere ya * septum ya orbital, uruhu rudakabije rwijisho ryijisho, ariko rwuzuye ijisho, ijisho ryijimye, ijisho ryijisho ryijisho ryijisho ryijisho ryijisho ryijisho ryijisho ryijisho ryijisho ryijisho ryijisho ryijisho ryijisho, zidakorwaho rwose kandi zidacanwa **.
3. ** Postseptal (Orbital) Cellulitis (Inyuma ya Firewall): ** Nigute bagiteri zinjira * inyuma ya septum ya orbital niba zidakunze gukubitirwa mu ruhu? ** Ibice birenga 85 gushika kuri 90 kw'ijana by'indwara ya selile ya orbital ikwirakwizwa biturutse ku ndwara ya paranasal sinus yegeranye, cyane cyane sinus ya Ethmoid. **
4. Urukuta rw'imbere rw'amaso atandukanya orbit na selile ya ** etmoid yo mu kirere ** ni isahani yoroheje yamagufwa yitwa ** lamina papyracea ** (bisobanurwa ngo "papyrus-thin layer"), iri munsi ya ** $ 0.5 inyandiko {milimetero} $ ($ 0.02 inyandiko {inches} $) ** umubyimba muto (foramina).
5. Iyo bacteri ikaze ya etmoide cyangwa sinusite yimbere yubaka umuvuduko, pus na bagiteri (** Streptococcus pneumoniae **, ** Staphylococcus aureus ** ibibyimba bya orbital ** cyangwa gukwirakwiza ** orbital selulitis **.
6. ** Odontogenic (Amenyo) Orbital Cellulitis: ** Umuyoboro wo hejuru utavuwe cyangwa uruti rwinyo rwinyo rwinyo rushobora kwangirika hejuru muri sinus ya maxillary kandi unyuze hasi ya orbit ukinjira mumaso.

Kugereranya byimazeyo ibintu 5 byabyimbye-amaso¶

Koresha iyi mbonerahamwe yubuvuzi kugirango utandukanye ibibyimba by'amaso, selile preseptal selulitis, orbital selulitis, sinus trombose ya caveous, na angioedema ya allergique:

"Inyabutatu ya Danger of the Face" na Septic Cavernous Sinus Thrombose (CST)¶

Kuki inyabutatu kuva ikiraro cyizuru kugera kumpera yumunwa idafite indiba zamaraso¶

Niba ushushanya inyabutatu mumaso yawe hamwe na ** hejuru hejuru yikiraro cyizuru cyawe ** (hagati yijisho ryawe) hamwe na ** impande ebyiri zo hepfo kuruhande rwibumoso nu buryo bwiburyo bwumunwa wawe ** (ushizemo izuru ryawe ryose, vestibule yizuru, iminwa yo hejuru, hamwe namenyo yo hejuru), washushanyije ** "Inyabutatu Yimpanuka yo mumaso" ** (nanone izwi nka ** Triangle yurupfu **).

Mu mitsi hafi ya yose yumubiri wumuntu, flap imwe-imwe ya flap ** valve ** irinda amaraso gutembera inyuma. Nyamara, imitsi yo mumaso yo hagati na orbit (** imitsi yo mumaso, imitsi yinguni, hamwe nimiyoboro y'amaso isumba iyindi kandi yo hasi **) ** ntabwo ifite indangagaciro zikora inzira imwe ** (cyangwa yemerera gutembera kwamaraso byerekanwa bitewe numuvuduko): 1. Mubisanzwe, amaraso ava mukiraro cyizuru niminwa yo hejuru atemba hepfo binyuze mumitsi yo mumaso mumitsi yimbere imbere mumajosi. 2. Nyamara, imitsi ya ** inguni ** ku mfuruka yimbere yijisho ihuza neza na ** isumba iy'amaso ** isumba iyindi, igenda igaruka inyuma yinyuma yijisho ryijisho ikanyura muri ** isumba ya orbital isumba ** ikinjira muri sinus ** yubuvumo ** imbere yigitereko cya gihanga. 3. Niba umuntu arwaye indwara ya bagiteri yanduye muri iyi mpandeshatu (cyane cyane ** izuru ryizuru [guteka imbere yizuru kuva gukuramo imisatsi yizuru cyangwa gutoragura izuru] **, ** acne pustule cyangwa guteka kumazuru cyangwa umunwa wo hejuru **, ** sphenoid acute cyangwa etmoid sinusitis **, cyangwa ** umuvuduko wamaraso ** wanduye wihuta cyangwa pop. .

Imbere muri Sinus ya Cavernous: Imihanda myinshi cyane mubwonko bwabantu¶

Sinus ya ** yubuvumo ** ni ibyumba bibiri byuzuye, byuzuyemo amaraso ibyumba byamaraso byicaye ibumoso niburyo bwa glande ya pituito (sella turcica) hagati yigitereko cya gihanga, gihuza hagati yacyo hagati na sinus hagati ya **.

Kwiruka * unyuze hagati * yamaraso yimitsi imbere muri sinus yubuvumo, cyangwa byinjijwe murukuta rwinyuma, ni ibintu bikomeye nta handi mumubiri unyura mumitsi: - ** Imbere ya lumen ya sinus yubuvumo: ** - ** Imiyoboro ya Carotide Yimbere ** (imiyoboro nyamukuru igaburira ubwonko) hamwe na plexus yimpuhwe ziyikikije. - ** Ubwonko bwa Cranial VI (Abducens Nerv): ** Imitsi igenzura imitsi ya ** ya rectus imitsi ** (yimura ijisho ** hanze ** yerekeza kumatwi). Kuberako Cranial Nerv VI ireremba mubwisanzure hagati ya sinus yubuvumo aho kurindwa kurukuta rwinyuma, ** kutabasha guhindura ijisho hanze (kuruhande rwa pale palsy) hafi ya buri gihe nikimenyetso CYANE CYANE CYANE CY'IMVUGO ZA Cavernous Sinus Thrombose **. - ** Yashyizwe mu rukuta rw'uruhande rwa sinus yo mu buvumo (kuva hejuru kugeza hasi): ** - ** Ubwonko bwa Cranial III (Oculomotor Nerv): ** Azamura ijisho ryo hejuru (levator palpebrae), agabanya umunyeshuri, kandi akerekeza ijisho imbere, hejuru, no hepfo. - ** Ubwonko bwa Cranial IV (Trochlear Nerv): ** Yimura ijisho hepfo no imbere. - ** Cranial Nerv V1 (Ophthalmic division of Trigeminal Nerv): ** Ibyiyumvo byunvikana kuruhanga, ijisho ryo hejuru, izuru, na cornea. - ** Cranial Nerv V2 (Igabana rya Maxillary ya Trigeminal Nerv): ** Ibyiyumvo byunvikana kumusaya, iminwa yo hejuru, namenyo yo hejuru.

Ingengabihe ya kera ya Septic Cavernous Sinus Thrombose¶

1. ** Prodrome (Umunsi wa 1 kugeza 5): ** Umurwayi afite ibibyimba bibabaza imbere yizuru cyangwa kumunwa wo hejuru (akenshi uherutse gukanda), spenoide / Ethmoid sinusitis, cyangwa selileite ya orbital, iherekejwe no kurwara umutwe ** ukabije inyuma yijisho rimwe cyangwa mu gahanga ** idasubiza imiti igabanya ububabare.
2. ** Igice kimwe cya Orbital Congestion & Cranial Nerv Palsies (Amasaha): ** Nka septique trombus ikingira sinus ya mbere yubuvumo, amaraso yimitsi ava mumaso ntashobora gutemba. Ijisho ryijimye rirafunga, umweru wumupira wijisho hanze (** chemose ), ijisho ryijisho ryerekeza imbere ( proptose **), na ** Cranial Nerv VI irananirwa mbere ** (ijisho rihinduka imbere imbere kandi ntirishobora kureba hanze), rihita rikurikirwa na ** Cranial Nervies III na IV ** (gutemba hejuru yijisho ryuzuye [ptose]) pin-ninshinge hejuru yu ruhanga no mumatama ** (Imitsi ya Cranial V1 / V2).
3. ** Ikwirakwizwa ryibice bibiri muri Sinus hagati (Mu masaha 24 kugeza 48): ** Kubera ko sinus yibumoso n iburyo yibyuma byahujwe hagati yumurongo uhuza imiyoboro ihuza imiyoboro, imiyoboro ya septique ikwirakwira kuri ** ihanganye na sinus yubuvumo mumasaha 24 kugeza 48. ** Iyo ijisho rimwe ryabyimbye hamwe nubumuga bwimitsi yijisho rigaragara gitunguranye mumaso ya KABIRI, nibiranga ibimenyetso bya Cavernous Sinus Thrombose ** (ubitandukanya na selile yoroheje ya orbital, iguma mumaso imwe).
4. ** Intracranial Sepsis & Meningitis: ** Umuvuduko mwinshi wa "piketi-uruzitiro" ($ 39.5 ^ umuzenguruko inyandiko {C} inyandiko {kugeza} 41 ^ umuzenguruko inyandiko {C} $ [$ 103 ^ umuzenguruko inyandiko {F}

Gutegura Indwara Zanduye: Sisitemu yo gutondekanya Chandler¶

Mu ishami ryihutirwa, abaganga b’amaso n’abaganga ba otolaryngologiste (ENT kubaga) bakoresha ** Chandler Classification ** kuri CT yongerewe imbaraga na CT scan ya orbits na sinus kugirango bamenye niba umurwayi akeneye antibiyotike yubuvuzi wenyine cyangwa kubagwa mubyumba byihutirwa:

Ibihe bidasanzwe byihutirwa: Sinusite yibihumyo (Rhino-Orbital-Cerebral Mucormycose)¶

Mugihe 98 ku ijana bya selileite ya orbital mubana bazima ndetse nabakuze ari bagiteri, byihutirwa, byangiza byihuse byitwa fungal bita ** Rhino-Orbital-Cerebral Mucormycose ** (biterwa nuburyo bwateganijwe * Mucorales *, nka * Rhizopus * cyangwa * Mucor *, cyangwa abarwayi * Aspergillus *) byibasiye cyane-abarwayi ba Aspergillus *) - ** Ninde ufite ibyago: ** Abarwayi muri diyabete ketoacidose (DKA). - ** Ukuntu Mucormycose yangiza tissue (Angioinvasion): ** Bitandukanye na bagiteri zitera ibishishwa bitukura bishyushye, * Mucorales * hyphae hyphae yinjira mu rukuta rwa ** arteri **, ikayifunga igahagarika amaraso yose. Ibi bitera urupfu rwihuta ** ischemic tissue (infarction) ** hanyuma igahindura tissue yanduye ** yapfuye yera hanyuma amakara-umukara (eschar necrotic) **. - ** Nigute ushobora gusuzuma Mucormycose kuruhande rwigitanda: ** Niba umurwayi wa diyabete cyangwa udafite ubudahangarwa afite ububabare bwa sinus, kunanirwa mumaso, cyangwa ijisho ryabyimbye / ryijimye, ucane itara imbere mumazuru yombi ** (urebye septum yizuru na turbinates) no kuruhu rwa ** rwumunwa (byoroshye kandi byoroshye) e **y, ** Igikonjo icyo aricyo cyose cyirabura, igikara cyijimye cyijimye / igikomere cyirabura, cyangwa igikonjo cyijimye kuri palate cyangwa imbere yizuru ni ibintu byihutirwa byo kubaga bisaba guhita byangirika mucyumba cyo kubaga hamwe na liposomal Amphotericin B mu masaha. **

Kwitaho neza kubitsike by'amaso (Styes & Chalazia) na Danger Triangle amategeko yumutekano¶

Kugira ngo wirinde utuntu duto two mu maso kutigera duhinduka orbital cyangwa ibintu byihutirwa, kurikiza aya masuku akomeye hamwe nubutabazi bwambere:

1. Nigute ushobora gufata neza umutekano wa Eyelid Stye (Hordeolum) murugo¶

Niba ufite akantu gato, gafite ibara ritukura neza neza munsi yumutwe (** hordeolum / stye ) cyangwa imbere yimbere yijisho ( imbere ya hordeolum **) hamwe na ** zeru Ibendera ritukura rya ** zeru ** (kugenda kwijisho risanzwe ridafite ububabare, iyerekwa risanzwe, nta muriro, nta gukwirakwira kumupfundikizo wose): - ** Koresha compresses zisukuye, zishyushye (ntabwo zishye) ** kuri ** iminota 10 kugeza kuri 15, inshuro 4 kumunsi **. Ubushyuhe bworoheje bushonga amavuta yibishashara (meibum) acomeka gland kuburyo bigenda byonyine. - ** Karaba intoki neza ** ukoresheje isabune namazi mbere na nyuma yo gukoraho hafi yijisho, hanyuma ureke kwambara maquillage yijisho cyangwa lens ya contact kugeza stye irangiye burundu (guta imigozi ya mascara ishaje yanduye hanyuma ukanduza cyangwa usimbuze insimburangingo). - ** NTUKIGERE ukanda, gukubita, cyangwa gutiza stye hamwe nurushinge: ** Kunyunyuza imitsi capsule ntoya ya glande isubira inyuma mumitsi ya preseptal na orbital.

2. Nigute ushobora gufata ibishishwa, guteka (furuncle), cyangwa umusatsi wameze muri Triangle Danger¶

• ** Ntuzigere ukuramo cyangwa kunanura vibrissae yizuru (umusatsi wizuru) hamwe na tewers: ** Gukuramo imisatsi yizuru ufungura umusatsi wimbitse imbere muri bagiteri ikungahaye ku mazuru (aho 30% byabantu basanzwe bitwaza * Staphylococcus aureus *), bigatera # 1 imbarutso yizuru na Cavernous Sinus Thrombose. Burigihe ** trim ** umusatsi wizuru neza hamwe numuzingi uzengurutse-imikasi cyangwa imashini izenguruka amashanyarazi.
• ** Niba ibibyimba bibabaza cyangwa ibibyimba biboneka kumazuru, imbere yizuru, cyangwa kumunwa wo hejuru: ** Ntukigere unyunyuza cyangwa ngo ubitere. Koresha compress isukuye. Niba igisebe kibabaza imbere mu mazuru cyangwa ku kiraro cyizuru gikura gikwirakwiza umutuku (** selileite **), ububabare bukabije, kubyimba ugana mu mfuruka y'imbere y'ijisho, cyangwa umuriro, reba umuganga ** umunsi umwe ** kuri antibiyotike ya sisitemu (hamwe n'amavuta ya mupirocine yo mu mubiri niba byateganijwe).

Inyandiko itumanaho neza kuri 911/112/999 hamwe na triage y'ibitaro¶

Kuberako amavuriro ahuze byihutirwa hamwe nibyumba byo gutegereza byihutirwa bikunze kwibwira ko ijisho ryabyimbye ari "ijisho ryijimye (conjunctivitis)" cyangwa kurumwa nudukoko, koresha aya magambo yubuvuzi kuri triage:

• ** Kubakekwaho Posteptal (Orbital) Cellulitis: **

  • antibiyotike, hamwe na orbital CT scan kugirango wirinde ibibyimba bitagaragara. "*

• ** Kubakekwa Sinus Thrombose ikekwa (CST): ** . byihutirwa CT / MR. "

Ibibazo bikunze kubazwa¶

Nubuhe buryo bwihuse bwo kuvuga itandukaniro riri hagati ya selile yoroheje ya periorbital (preseptal) na selileite iteje akaga (postseptal)?¶

Fata witonze ufunguye amaso kandi usabe umuntu gukurikira urutoki rwawe n'amaso yerekeza ibumoso, iburyo, hejuru, no hepfo. Muri selile yoroheje ya preseptal, kwandura biri muruhu rwinyuma rwamaso gusa, kwimura ijisho rero biroroshye 100% kandi ntibibabaza hamwe no kubona bisanzwe; muri selile ya orbital selile, infection iri inyuma yumuriro wamaso, bityo kwimura ijisho bitera ububabare bukabije, kugenda gake, kureba kabiri, cyangwa ijisho ryerekeza imbere.

Nigute kwandura indwara ya Ethmoid sinus kumwana bihinduka ijisho ryabyimbye ijoro ryose?¶

Urukuta rwimbere rwijisho rwijisho rutandukanya ijisho na sinus ya Ethmoid imbere yizuru ni igufwa ryoroshye impapuro zitwa lamina papyracea, ritarenza igice cya milimetero z'ubugari kandi rigacumita nuduce duto twamaraso. Mu bana ndetse ningimbi, bacteri ikaze ya Ethmoid sinusitis isunika byoroshye gusunika muri aya magufa yoroheje mu jisho ryijisho, bigatera ibibyimba byo mu bwoko bwa subperiosteal orbital ikanda ku mitsi y'amaso no mu mitsi ya optique mu masaha.

Ese koko ni akaga kumanika imisatsi cyangwa gukuramo umusatsi imbere yizuru muri "Triangle Danger of the Face"?¶

Nibyo, imitsi ikuramo inyabutatu kuva ikiraro cyizuru kugera kumpande zumunwa ihuza neza inyuma binyuze mumaso yijisho binyuze mumitsi itagaragara ya valveless isumba iyindi kandi itagaragara cyane mumitsi yubuvumo muri sinus yubuvumo munsi yubwonko. Kuberako iyi mitsi ibura indiba imwe kugirango ihagarike gutembera inyuma, kunyunyuza imitsi cyangwa umusatsi wanduye imbere yizuru cyangwa kumunwa wo hejuru birashobora guhatira bagiteri no kwanduza udusimba dusubira mu gihanga, bigatera septique yica septique caveous sinus trombose.

Ni ukubera iki kugerageza uburyo ibara ritukura risa neza ("desaturation itukura") ikizamini gikomeye mumaso yabyimbye?¶

Imitsi yo mumitsi iri mumitsi ya optique itanga imyumvire yamabara atukura yumutuku niyo yunvikana cyane kumashanyarazi na ischemia. Kera cyane mbere yuko ibibyimba bya orbital cyangwa kubyimba bihuma amaso rwose, guhagarika imitsi ya optique bitera ikintu gitukura cyerurutse (nkumutwe wamacupa yumutuku) gisa nkicyacitse, cyarogejwe nicunga, cyangwa umukara wijimye wijimye iyo urebye nijisho ryanduye ugereranije nijisho ryiza, bikamenyesha abaganga ko hakenewe kubagwa byihutirwa kugirango ukize neza.

Inkomoko yagenzuwe¶

• ** Ishuri Rikuru ry’amaso ry’Abanyamerika (AAO, Amerika): ** * Amabwiriza y’ubuvuzi n’ubwumvikane bwa EyeWiki kuri Preseptal Cellulitis, Orbital Cellulitis (Amatsinda yo mu cyiciro cya Chandler I kugeza V), na Septic Cavernous Sinus Thrombose *.
• ** Indwara zanduza Sosiyete yo muri Amerika (IDSA, Amerika): ** * Amabwiriza ngenderwaho yo gusuzuma no gucunga indwara zanduza uruhu na yoroshye * na * Amabwiriza y’ubuvuzi ya Clinical for Acute Bacterial Rhinosinusitis mu bana no mu bantu bakuru * (ibibazo bya orbital na intracranial).
• ** Ikigo cy’igihugu gishinzwe ubuzima n’ubuvuzi (NICE, Ubwongereza) na Royal College of Ophthalmologiste (RCOphth, Ubwongereza): ** * Sinusite (Acute): Periorbital na Orbital Cellulitis Emergency Referral Criteria * (NG79).
• ** Ishuri Rikuru ry’Abanyamerika ryita ku bana (AAP, Amerika): ** * Ubuyobozi bwa Sinusite ikaze na Periorbital / Orbital Cellulitis mu barwayi b'abana *.
• ** Ihuriro ry’ibihugu by’i Burayi by’ubuvuzi Mycology (ECMM) hamwe nitsinda ryiga rya Mycose (MSG ERC): ** * Amabwiriza y’isi yose yo gusuzuma no gucunga Mucormycose * (Rhino-Orbital-Cerebral Mucormycose kumenyekanisha byihutirwa no kubaga / ubuyobozi bwa Liposomal Amphotericin B.).

Kuyobora¶

• Gutungurwa gutunguranye, gutandukana kwa retina, hamwe na glaucoma ikaze
• Gukomeretsa amaso: gutwika imiti, guhahamuka, na hyphema
• Necrotizing fasciitis (infection yo kurya inyama) hamwe na selile yamabendera atukura
• Sepsis hamwe na septike yo kumenyekana
• Diyabete ketoacidose (DKA) na hyperosmolar hyperglycemic leta