过敏性鼻炎的诊断与治疗.ppt

变应性鼻炎的病因学 内在因素──遗传因素：有家族史者较无家族史者发病危险高２～６倍母系第１１对染色体长臂ｑ段 外在因素（环境因素）：基因表达受非遗传因素影响。７０００对孪生儿，同时有AR 症状者为２１％ 易感个体在一定环境条件作用下才发病 成人Acute bacterial rhinosinusitis (ABS)病因 儿童Acute bacterial rhinosinusitis (ABS)病因 ABS主要病原体：肺炎链球菌、嗜血流感杆菌和卡他莫拉菌 Antral pain——from inner canthus downwards across the cheek, upper alveolus on the affected side. Ethmoidal pain——over bridge of the nose inner canthus behind the eye. Frontal pain——forehead, periodicity, persist for an hour or tow after getting up in the morning, and clear during the afternoon. Sphenoidal pain——occipital or vertical headache. Diagnosis： History， Signs, Anterior rhinoscopy, Nasal endoscopy, Radiological examination, Puncture and irrigation of maxillary sinus Treatment：Eradicate causes，keep drainage；control infection and prevent complications 1、General treatment：take rest，antibiotics，antihistamine (if necessary ) 2、Local treatment 3、Body drainage 4、Physical therapy 5、 Puncture and irrigation of maxillary sinus Maxillary sinus puncture and irragation Chronic suppurative sinusitis Etiology：Acute——?Chronic Symptoms Signs： General~: Local~： rhinorrhea, nasal obstruction, headache, hyposmia, vision disorder Diagnosis： 1、History； 2、Examination：anterior rhinoscopy, nasal endoscopy 3、Radiological examination：CT or MRI 4、Puncture and irrigation of sinus Normal image of nasal endoscopy Maxillary sinusitis——pus in the middle meatus Maxillary sinusitis(R) * Nasal mucosal hyperreactive rhinopathy Allergic Rhinitis (AR) Perennial~(PAR), Seasonal~(SAR) （Pollinosis） Morbidity: 10%~20% Inhalant allergens——dust mite, house dust, pollen, fungi, animal danders, cockroach； Food allergens——milk, eggs, fish and shrimp, meat, vegetables, fruits. ????????????????