2022年中医耳鼻喉科学复习总结2 .pdf

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1、1/16（一）耳部解剖耳 分 为 外 耳,内 耳,中耳.1.外耳:包括耳廓和外耳道.外耳道由骨部和软骨部组成.两者交界处较狭窄,称外耳道峡部,异物常嵌顿于此2.中耳包括鼓室,咽鼓管,鼓窦及乳突.鼓室是不规则含气空腔.外侧壁其位置与外耳道底呈45-50 角,鼓膜分松驰部和紧张部.鼓脐:鼓膜中心凹点相当于锤骨柄尖端.内侧壁:中央隆起部为耳蜗底周突向鼓室所形成称鼓岬.鼓岬后上方是前庭窗,为通入内耳前庭部的孔,后下方是蜗窗,向内通入耳蜗的鼓阶.上壁岩鳞裂在 2岁前未闭合,成为中耳感染进入颅内的途径之一听小骨由锤骨,砧骨,镫骨组成.咽鼓管:成人鼓室口高于咽口1.5-2.5mm,而儿童短粗平直,易引起中耳

2、感染.鼓窦外侧壁相当于外耳道上三角,此处表面有小孔,又称筛区,是乳突手术进路的标志.乳突小房又称乳突气房,可分为蜂窝型(气化型或含气型),板障型,硬化 型(坚 质 型)和 混 合型.3.内耳包括骨迷路和膜迷路.骨迷路包括耳蜗，前庭，骨半规管。膜迷路包括窝管，椭圆囊球囊，膜半规管耳生理功能:平衡，听觉。（二）鼻部解剖鼻由外鼻,鼻腔,鼻窦组成1.外鼻由骨部,软骨部2/16 及外覆皮肤组成。静脉回流:外鼻的静脉主要经过内眦静脉和面静脉汇入颈内静脉，内眦静脉又可经眼上、下静脉与海绵窦相连通,面部静脉管内无瓣膜,血液可双向流动,当鼻或上唇有疖肿时，勿挤压，可能引起海绵窦血栓性静脉炎的危险。2.鼻腔内侧壁

3、:即鼻中隔，鼻中隔前下部的黏膜 内 动 脉 血 管 组 成 网丛，此处称为利特尔区，又称易出血区。外侧壁：有三个呈阶梯状排列的长条骨片，外覆黏膜，由下向上依次称为下、中、上鼻甲。各鼻甲的外下方均有一裂隙样空间，对应地依次称为下、中、上鼻道。鼻窦是鼻腔周围颅骨内的含气空腔，有4 对。分别为上颌窦、筛窦、额窦和蝶窦。3.前组鼻旁窦：上颌窦、前组筛窦和额窦，开口于中鼻道；后组鼻旁窦包括后组筛窦和蝶窦，前者开口于上鼻道，后者窦口位于蝶筛隐窝.上 颌 窦 为 鼻 窦 中 最 大者。鼻的生理:呼吸,清洁,加湿,嗅觉,共鸣和反射.（三）咽部解剖咽自上而下可分为鼻咽,口咽,喉咽.鼻咽：咽峡（悬 雍 垂 和 软

4、 腭 游 离缘，下有舌背及两侧舌腭弓和咽腭弓组成），双侧为咽侧索。喉咽中，在喉口入口的两侧和甲状软骨板内侧面之间，各有两个较深的隐窝，称梨状窝。在舌根与会厌之间有两个浅凹，称为会厌谷。咽壁从内到外分为粘膜层，纤维层，文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T

5、10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6

6、 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2

7、Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7

8、文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:C

9、D9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7

10、O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 H

11、M3K10T10O6O6 ZM1X2Y6H4T73/16 肌肉层，外膜层。特点是无明显的粘膜下组织层，纤维层与粘膜紧密附着。腭扁桃体习称扁桃体，位于口咽两侧腭舌弓与腭咽弓围成的三角形扁桃体窝内，为咽淋巴组织中最大者。扁桃体内侧面有盲管称扁桃体隐窝，隐窝内易潜藏病原体。腺样体又称咽扁桃体，位于鼻咽顶与后壁交界处，6-7 岁时最显著，10 岁以后逐渐萎缩，至成年则消失。舌扁桃体位于舌根部，含有丰富的粘液腺。咽鼓管扁桃体为咽鼓管咽口后缘的淋巴组织，炎症肥大时可阻塞咽鼓管口而致听力减退或中耳感染。咽的生理功能：吞咽，呼吸，言语，防御保护，调节中耳气压，扁桃体的免疫功能。（四）喉部解剖喉:呼吸的重要通道

12、，上通喉咽腔，下连气管。会厌软骨：通常呈叶片状，甲状软骨：为喉部最大软骨。是颈部中线及 喉 部 手 术 的 重 要 标志。成年男性称为喉结。环状软骨是保持外形及保证呼吸道通畅的重要作用。喉韧带分为喉外韧带和喉内韧带。喉腔以声带为间隔，分成:声门上区，声门区，声门下区。声门上区:喉腔上界为喉入口。声带上方与 之 平 行 的 皱 襞 为 室带。声带和室带之间，开口呈椭圆形的腔隙称为喉室。声门区:声带张开时，出现一个顶向前的等腰三角形的裂隙称声门裂，简称声门，为喉腔最狭窄处。喉的生理功能：呼吸功能，发文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9

13、K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9

14、T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3

15、K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10

16、O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 Z

17、M1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6

18、H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档

19、编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T74/16 声功能。喉是唯一的发音器官，喉部发出之音称为原音，经咽腭舌齿唇鼻腔鼻窦等的协调或共鸣作用，使之音节清晰，形成语音。（五）耳部疾病A 耳瘘（先天性耳前瘘管）：因先天禀赋不足，耳部皮肤腠理失养而发生 于 耳 前 或 耳 后 的 瘘管。症状：局部红肿疼痛，流脓，反

20、复发作，而后瘘常流清稀脓液，经久不愈，多伴耳内流脓。耳前瘘开口多位于耳轮脚前缘，按压时可有少许白色分泌物溢出，探针可探知瘘管深度染毒可见瘘口周围红肿，时有脓液溢出。控制感染后可行楼管切除术。辩证论证：1.禀赋不足复感邪毒-五味消毒饮2.气血耗伤拖毒无力-托里消毒散。外敷、切开排脓、挂线。B旋耳疮（外耳道湿疹）：因风热湿邪犯耳或血虚生风化燥所致的外耳道或 旋 绕 耳 周 而 发 的 湿疮，以耳部皮肤潮红、瘙痒、黄水淋漓或脱屑、皲裂为主的耳病。风热湿邪浸渍-消风散；血虚生风化燥-地黄饮。C 断耳疮：耳郭损伤染毒、火毒上攻所致耳郭红肿疼痛、溃烂流脓、甚至软骨坏死，耳郭变形疾病D耳疖：邪热搏结耳窍而发

21、生于外耳道的疖肿，以耳痛、外耳道局限性红 肿 突 起 为 特 征 的 耳病。多发生于外耳软骨段，局限于单个毛囊。外治法：排脓。切脓三原则：切熟不切生，切文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9

22、T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3

23、K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10

24、O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 Z

25、M1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6

26、H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档

27、编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T75/16 软不切

28、硬，切直不切横。E耳疮：是指湿热邪毒搏结耳窍外耳道弥漫性红肿疼痛为主要特征的疾病。好发于夏秋季节。病史：多有挖耳、污水入耳或耳流脓史。临床症状：耳内灼热疼痛，少许流脓，或耳内发痒不适。检查：耳屏压痛，耳郭牵拉痛，外耳道弥漫性红肿，可有少许分泌物。反复发作可见外耳道皮肤增厚、皲裂、脱屑、甚则外耳道狭窄。症型：1.风热湿邪上犯：疏风清热，解毒祛湿-银花解毒汤2.肝胆湿热上攻：清泄肝胆、利湿消肿-龙胆泻肝汤3.血虚生风化燥：养血润燥，祛风止痒-地黄饮。外敷，排脓，滴耳。F 耳胀（分泌性中耳炎、气压损伤性中耳炎）：由于外邪、湿浊上蒙清窍所致的以耳内胀闷、堵塞感为主的耳病。诊断要点：病史：感冒史，冬夏多

29、见。临床症状：以耳内胀闷堵塞感、耳鸣、听力下降、自听增强为主要症状。病变有久新不同，病初患耳胀闷堵塞感，或有微痛不适，耳鸣时如机器声、风声，打哈欠、喷嚏或擤鼻时稍觉好转。病久耳聋逐渐加重，耳鸣声低，耳内压迫感。检查：早期可见鼓膜轻度充血内陷，若中耳有积液，则可在鼓膜上见到液平面，或见鼓膜外凸。若反复发作，可见鼓膜增厚凹陷，或见灰白色斑块，或萎缩疤痕粘连。听力检查呈传导性聋，反复发作者可呈混合性聋。鼓室导抗图呈B 型文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD

30、9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O

31、9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM

32、3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T1

33、0O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6

34、ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y

35、6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文

36、档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T76/16 或 C 型。症型：1.风邪袭耳：荆防败毒散（银翘散）2.肝胆蕴热：龙胆泻肝汤 3.脾虚湿困：-参 苓白术散4.气 血 瘀阻：通窍活血汤。滴鼻滴耳。分泌性中耳炎：咽鼓管功能障碍，感染，免疫反应。H脓耳（急、慢性化脓性中耳炎）：因脏腑失调湿浊邪毒停聚耳窍所致的以鼓膜穿孔，耳内流脓，听力下降为主要特征的耳病。以小儿及青年为多见。小儿的咽鼓管短、

37、宽、平；且位置低。当患呼吸道感染时，致病菌就非常容易通过咽鼓管进入到中耳，引起化脓性中耳炎。因小儿脏腑娇嫩，容易染患各种传染病，以致体质虚弱，邪毒容易乘虚而入，引致脓耳之患。病因：细菌感染，途径即咽鼓管，鼓膜，血行感染。I 急性脓耳起病急，耳膜穿孔、耳内流脓。主要症状：起病急，耳痛，逐渐加重，搏动性痛或跳痛，耳内流脓，耳鸣，听力下降。全身可有恶寒发热、怠倦，食欲减退。小儿全身症状较重，常伴呕吐、腹泻。检查：耳膜呈鲜红色、肿胀，血脉显露或标志不清，耳膜穿孔位置多在中央部边缘或松驰部。若穿孔较小，脓液常随搏动流出，穿孔较大则无搏动现象。听力检查为传导性耳聋。乳突部有压痛，鼓膜一旦穿孔流脓，耳痛顿减

38、，全身症状明显减轻。慢性脓耳是以耳内长期或间歇流脓，耳膜穿孔，听力下降为特点。分1.文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:C

39、D9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7

40、O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 H

41、M3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T

42、10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6

43、 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2

44、Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T77/16 单纯型：耳流脓，多呈间歇性，伤风感冒时流脓增多，脓液粘黄或粘白，无臭味 2

45、.骨疡型（坏死型或肉芽型）耳流脓持续，脓液粘稠或带血丝，常有臭味3.胆脂瘤型：耳内长期持续流脓，量多少不等，有恶臭味。症型：风热外袭：蔓荆子散.肝胆湿热：龙胆泻肝汤.脾虚湿困：托里消毒散。肾元亏损：知柏地黄丸（肾气丸）。外治：清除脓液，滴耳，吹药，涂敷，滴鼻，鼓膜切开，手术。J 耳眩晕：因邪犯耳窍或脏腑虚弱，耳窍失养或痰浊水湿泛溢耳窍引起的以头晕目眩，耳鸣耳聋、如坐舟车，恶心呕吐为主要特征的疾病。症状：眩晕，突发旋转性，自身与周围物体旋转，转头加重，闭目静卧减轻；耳鸣，眩晕发作之前持续性低音调风声或流水声，后卫高调蝉鸣声或汽笛声；耳聋；头脑涨满感。检查：自发震，外耳道鼓膜检查，听力检查。1.风

46、邪外袭：桑菊饮2.痰浊中阻：半夏白术天麻汤3.肝阳上扰：天麻钩藤饮4.寒水上泛：真武汤5.髓海不足：杞菊地黄丸6.气血亏虚：归脾汤。7.气滞血瘀：通窍活血汤K耳异物：1.昆虫类，先用酒精，植物油等使虫体失去活力，用镊子取出，或外耳道冲洗。2.圆形异物，可用刮匙或耳钩取出，切用镊子夹取 3.质轻而细小异物，凡士林或胶粘涂在棉签头上，将异物取出4.不规则异物，对已膨胀、文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 Z

47、M1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6

48、H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档

49、编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9

50、K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9T9 HM3K10T10O6O6 ZM1X2Y6H4T7文档编码:CD9K9F7O9