皰疹性咽頰炎

1、herpangina   ,h:pæn'dain皰疹性咽峽炎是由腸道病毒引起的以急性發(fā)熱和咽峽部皰疹潰瘍?yōu)樘卣鞯募膊?，以糞-口或呼吸道為主要傳播途徑，感染性較強(qiáng)，傳播快，呈散發(fā)或流行，夏秋季為高發(fā)季節(jié)，一般病程46日，重者可至2周。Herpangina is caused by intestinal virus with acute fever and pharynx isthmus, herpes ulcer disease, characterized by dung - the mouth as the main route of tran

2、smission, or respiratory tract infection, transmission is fast, a distributed or popular, fall for the season, the general course of 4 6, the person that weigh can be to 2 weeks.病因1.本病病原體種類很多，以柯薩奇A組病毒（16、8、10、22）、皰疹病毒、EB病毒較多見，偶爾也有其他腸道病毒所引起。當(dāng)勞累過度，過敏體質(zhì)，氣溫突變、身體受涼或某些物理、化學(xué)因素等刺激，使身體免疫能力低下，易患此病。2.呼吸道屏障功能不足

3、，呼吸道黏膜柔嫩，呼吸道分泌抵抗細(xì)菌、病毒的免疫物質(zhì)不足，呼吸道上的這種纖毛活動比較微弱，“自潔”功能差。The cause of1. A lot of more phyletic, the disease pathogens with coxsackie virus group A (1 6, 8, 10, 22), herpes virus, epstein-barr virus more see, occasionally there are other intestinal virus caused.When overworked, allergic constitution, and

4、 the temperature mutations, the body catch cold catch cold, or some physical and chemical factors stimulation, make the body's immune ability is low, susceptible to the disease.2. Lack of respiratory barrier function, respiratory tract mucous membrane, soft, respiratory tract secretion to resist

5、 bacteria, viruses, immune material shortage, the cilia on the respiratory activity is weak, "self-cleaning" function.臨床表現(xiàn)該病主要表現(xiàn)為急驟發(fā)熱，可持續(xù)高熱或反復(fù)高熱，咽痛，吞咽時(shí)尤甚，有時(shí)訴頭痛、腹痛或肌痛；血常規(guī)檢查大多是血細(xì)胞計(jì)數(shù)正常或略低。起病2日內(nèi)口腔黏膜出現(xiàn)少數(shù)（很少多于12個）小的（直徑12mm）灰白色皰疹，周圍繞以紅暈，多見于扁桃體前部，但也可位于軟腭，扁桃體，懸雍垂，舌部等，在以后的24小時(shí)內(nèi)水皰破潰變?yōu)闇\潰瘍，直徑一般在5毫米以下，1

6、5日內(nèi)愈合。檢查實(shí)驗(yàn)室檢查白細(xì)胞計(jì)數(shù)增高，取咽部皰液或糞便，經(jīng)組織培養(yǎng)或接種于乳鼠可得致病病毒，同時(shí)可取急性期及恢復(fù)期血清進(jìn)行特殊的中和抗體、補(bǔ)體結(jié)合或血凝抑制試驗(yàn)，以助確診。診斷可根據(jù)癥狀和特征性口腔損害作出診斷。最好通過從損害處分離到病毒或通過特征性抗體滴度升高加以證實(shí)，但這些檢查并不推薦常規(guī)采用。鑒別診斷1.皰疹性口腔炎，Herpetic stomatitis其特點(diǎn)為任何季節(jié)均可發(fā)病，呈現(xiàn)更大的，持續(xù)更久的潰瘍。2.復(fù)發(fā)性口瘡和貝氏（Bednar）口瘡很少發(fā)生于咽部，而且一般無全身癥狀。3.柯薩奇A組10型病毒也會引起類似病變（淋巴結(jié)性咽炎），但口咽部損害突出，呈現(xiàn)白色到黃色小結(jié)，治療為

7、對癥處理。治療主要是對癥治療。注意口腔衛(wèi)生，保持口腔清潔?？捎玫}水漱口，用10%硝酸銀涂于潰瘍處或用咽喉靈丹，冰硼散等吹播咽部以減輕咽痛癥狀?？诜S生素C及B等?？股貙Σ《拘匝恃谉o效。但如有發(fā)熱，應(yīng)給予抗菌藥物治療，以便控制繼發(fā)性細(xì)菌感染。Mainly symptomatic treatment.Pay attention to oral hygiene, keep the mouth clean.Available weak brine gargle, with 10% of silver nitrate on canker sore or with throat magic, ice boron powder such as blowing pharyngeal to alleviate the symptoms of sore throat.Oral vitamin C and B, etc.Antibiotics for viral pharyngitis is invalid.But if you have fever, should give antibacterial drugs, in order to control secondary bacterial infection.1.原發(fā)病治療2.局部治療（1）采用