ä ١

  ä١
 
  
ʹչ´բҴ (Adenoid Hypertrophy)


  
üҵѴʹչ´͡ (Adenoidectomy)


  
ѧҵѴʹչ´͡ (Post Adenoidectomy)

üҵѴʹչ´ ȹʹ PARAYA ASSANASEN
 

üҵѴʹչ´

 

. .    ȹʹ

ҤԪʵ ԡ ԧԷ
Faculty of Medicine Siriraj Hospital

ᾷʵҪҺ

 

ʹչ´ (adenoid) 繵ͧǹѧͧç١ (nasopharynx)  çҧ§Ѻ͹ (tonsils)  ˹ҷä мԵҧԤѹкҧԹǹ   ʹչ´з˹ҷҡ㹪ǧ (1-10 ) Шз˹ҷŧ  ѧҡ鹨ŴҴŧ պҷӤѭ㹡ûͧѹä㹼˭       

ʹչ´ѡբҴ (adenoid hypertrophy) (㹵١еӹǹ) աѡʺѧ (chronic adenoiditis) (չ١ ŧ ѧ ) 㹼·ä١ѡʺ (allergic rhinitis), ä١ѡʺԴ (non-allergic rhinitis), ä䫹ѡʺѧ (chronic rhinosinusitis), äѴ (common cold or acute viral rhinitis) Ѵ ( Ѻҡ 硷ç¹͹غ ʶҹѺ§) ͧҡաѡʺ  СФͧͧçѧ١

ѡʺͧʹչ´ (adenoiditis) зԴ

1. ҡ÷ҧ١ Ѵ١  㨷ҧҡ  Ӻҡ ١ 㹤 ҡ١ŧ    ͹ù  ٴѴ § §鹨١  ҡѡʺѧѧ 繹ҹ ҨԴäá͹ 䫹ѡʺ ա¹ŧͧ˹ ͧҡͧһҡҹҹ ջҡغʹԷ, ѹ (adenoid facies)

2. ҡ÷ҧ ͧҡѡʺѧ Ҩ¹ (繷ͷҧ٪鹡ҧçѧ١) ӧҹԴ (Eustachian tube dysfunction)  ҨչӢѧ٪鹡ҧ (otitis media with effusion) ٪鹡ҧѡʺºѹ (acute otitis media)

3. ͹ù  ͹Ѻ  ش㨡ҧ׹繾ѡ (obstructive sleep disordered breathing)

ʹչ´֧äӤѭѺä䫹 ٪鹡ҧѡʺ  ѡҵʹչ´ ѡʺ Сͺ ´蹨١ (intranasal steroids) antileukotriene ҵҹŪվ Сҧ١ Ǻä١ѡʺ ()

üҵѴʹչ´͡ (adenoidectomy) зբͺ觪ͧͧõԴѧ 䫹ѡʺ (, Ѵ١, ١, ) ٪鹡ҧѡʺ (, Ǵ, , չӢѧ٪鹡ҧ ˹ͧŨҡ٪鹡ҧ)  úǹسҾԵͧ (ͧش¹) աش鹷ҧԹǹ Դҡù͹ù / ش㨢Ѻ (obstructive sleep apnea) Ǩҡ á͹ͧش鹷ҧԹ㨵к ͧҧ

ʹչ´ⵢ鹨ҡѡʺ ͧ͢˹ҷҧԤѹж١᷹;ѧ״ (fibrosis) Դѧѡʺ ֧˹ҷŧ ǡѹҧѧյͧաӹǹҡ㹺dzФ ˹ҷҧԤѹä ѧ鹡õѴʹչ´㹼·բͺ觪 ֧ԤѹС üҵѴ͹ ʹչ´öӾѹ㹡üҵѴ ͷ§ҧҧ˹ҷբͺ觪

üҵѴʹչ´繡üҵѴҹҧͧҡǡѺüҵѴ͹  ᾷͧͷҧͧҡҹҹѧçѧ١  ¨֧պҴ ͧҡ¹͡

 

͹ҵѴ  üҵѴʹչ´ͧôź ѭᾷоҺŨдŤóͧҧ¼¡͹ҵѴ 蹡õǨʹ   Ǩ Ҿꡫʹ   Ǩ俿 ¨еͧçҺ 1 ѹ͹ҵѴ ѭᾷѺôźѹ觢鹷мҵѴ ׹ѹ͹ҵѴ ᾷ駴ѧ§׹ ͡͹ҵѴҧ 6 ͻͧѹѡйŧʹҴź

㹡óբͧ çй觷黡ͧеͧ仵觢ͧᾷ觤Ѵ  ͺ ͹  С ҨԴѡҧźҨѹ¶֧Ե    ҡ黡ͧҺ駴йӵᾷѹҵѴͧպᾷ;ҺŷҺ ͹ѹҵѴ͡仡͹

͡ҡ üҵѴʹչ´ ÷ͼҧçó ѴաõԴͧ͢кҧԹºѹ ѡ͹§ ºҧ·ѺзҹҺҧԴ aspirin ҵҹ秵Ǣͧʹ ҨͧشҴѧǡ͹ҵѴ

 

 ôź  ͡§Դá͹ §˺ҡ§  Ӻҡ Ҩͧͪ (endotracheal tube) ˹ѧҵѴ  ʹѡʺҡٴѡ

 

ѧҵѴ        

            1. ¨ѺѡҵçҺ мǹ˭öѺҹѧҵѴ 24-48 ҡѺзҹ § á͹  Ҿѡ鹷ҳ 7-10 ѹ    ·ѺüҵѴʹչ´§ҧҵѴ͹Ũ㹪ͧ  ŷçѧ١ҹ  ֧öѺзҹ黡ѧҵѴ    Ҩҡçѧ١ͧҡżҵѴ  Ҩչ͹١ʹ͡ҧ硹   Ҩҡ纤ҧҡͪҧôź

            2. Ҩ ҡú ֡Դ Ѵ ֧ šdzѧç١ §¹   ҡôѧѡ 1 ѻ

            3. ѧüҵѴ 1-2 ѹá ྴҹ͹ çѧ١Ҩҡ ִѴ дǡ Ҩ§ѧҡáùҡ  ѧ鹨֧ù͹٧ ͹˹ع ͹͹͹öѺ§  лФ秺 㹪ǧѻá Ŵҡúʹ͡dzӼҵѴ ҡдǡ ҡ ֧عç ѧ͡ҡçҺ  պçҺͻ֡ᾷѹ

            4. ¨Ѻѡʺ  Ǵ  Ŵ    ҡǤ ¤èѺзҹҴѧ ҡèдբ ʹ;蹨١ʹ  öѺзҹǴ ૵ ͨ  Ш͵Դᢹ  ͼѺзҹվͤ ᾷ͡      

            5. ա§觹١ͨç  ͡çҡ  蹡ҷѡ ¡ͧ˹ѡ ѧҵѴ 24-48 á Ҩʹ͡ҡŷçѧ١  ʹ͡ҡͧ١ͻҡ ù͹ѡ  ¡٧  㹻ҡ  ʹʹ١ʹᾷ 3-4 ´ ç١Тҧ  ӹ cold pack һФdz˹Ҽҡͤ  ʹش  ûФ ûФҳ 10 ҷ Ǩ֧͡ҳ 10 ҷ Ǥ»Ф 10 ҷ  蹹Ѻѹ  ʹ͡ش͡ҡԴ պçҺͻ֡ᾷѹ

            6. » ѧҵѴҳ 4 ѻ  Ũ繻

 

á͹ äá͹ҨԴ ʹ͡ҡ١ ŧ ѡ͡ҡشͧ ᾷ֧ѡ˴ʹʹ (topical decongestant ephedrine, oxymetazoline) ʹ١ʹѧҵѴ 觶͡ҡеͧ价ӡʹͧҵѴ   żҵѴԴ (辺) 

硷ѺüҵѴʹչ´ͧҡբͺ觪ͧӺҡشѺ ੾м·ǹҡ äдѺ͡ਹʹѺǨ͹ҵѴ 繼ѵ§ͧԴá͹ҡ硷ѺüҵѴ¢ͺ觪ͧõԴͺ ҡӺҡ͹͹ù

            á͹عçҨԴ 辺÷Һѧǧ˹ Ӻҡҡú㹷ҧԹǹ  ش  ӷʹ  ·ѵ§ͧԴá͹ҹѺôԴԺѭ (ICU) 繡ûͧѹ͹

            · üҵѴʹչ´ 繡üҵѴӺ   ѡѺҹ 1-2 ѹѧҵѴ á͹  ҧ  黡ͧѺᾷоҺ㹡ôżѧҵѴѡüҵѴѡŴ

 

ùѴǨѧ͡ҡçҺ  ᾷйѴҴҡ пѧŪ (ա觵Ǩ) ҳ 1 ѻѧҵѴ ѧҡ 2-4 ѻ ͵Դšѡ

 

 

 

 
12/6/2556 13:59:55
 
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