Tonsils are often inflamed, and the method is simple. Wash the killed silver carp, cut off the fish belly, steam the cut fish belly with old tea, and drink soup after steaming. Tonsillitis also has a good indigenous method: it takes effect quickly. Pour half a cup of hot water and a few drops of sesame oil to gargle and swallow it, and it will soon be comfortable. It lasts for 3-5 days. A Chinese medicinal formula comprises Flos Chrysanthemi Indici, Radix Sophorae Tonkinensis, Herba Taraxaci, Radix Platycodi, Radix Isatidis, Radix Glycyrrhizae and Radix Ophiopogonis. With a little boiled water, the tonsils are inflamed, so just drink a few times. Reference dose: 25g dandelion and 6g others. = = = = = = = = = = = = = = = = = Many patients have symptoms of tonsillitis, some are often inflamed, and some want to see a doctor for surgery to remove tonsils. So what should tonsillitis do? Tonsils contain anti-infective cells, which are a kind of lymphoid tissue in the throat cavity and located on both sides of the junction between pharynx and oral cavity. Why is tonsil inflamed? Why is tonsil always inflamed? Tonsil is one of the defense organs of respiratory tract, which can filter germs and produce antibodies to protect respiratory tract and esophagus from germs. It is the most perfect period when it is three to five years old. Like other lymphatic glands, if germs invade, they will proliferate and swell. Therefore, many respiratory tract infections will cause swelling and inflammation of tonsils and throat lymph glands. If the tonsil inflammation is particularly serious, there will be suppuration. There are quite a few pathogenic microorganisms that invade the body and cause tonsillitis, 70% of which are viral infections, such as rhinovirus, coronavirus, adenovirus, influenza virus, parainfluenza virus and enterovirus. The rest are caused by bacterial infection. After virus infection, bacterial infection is easy to occur, leading to serious clinical manifestations. The symptoms of tonsillitis are different because of different body resistance and different bacteria, and there are many manifestations. Some people will have mild colds, swollen neck lymph nodes, oral ulcers and other symptoms. Of course, there may be more serious cold symptoms and general malaise. Sometimes the tonsils are too swollen, which prevents the nose from breathing smoothly. Some viruses even make tonsils swell to the extent of upper respiratory tract obstruction, making it difficult for patients to breathe. Is tonsillitis serious? Is tonsillitis serious? Will there be any bad sequelae? Basically, tonsillitis itself is a very benign disease, but the problem will lie in the pathogen itself, the severity of infection and the strength of physical resistance. If this pathogen only caused local tonsil infection, the course of infection in the past would be fine. However, some pathogenic bacteria will have systemic effects, and may have complicated course of disease or bad sequelae, such as arthritis, nephritis, myocarditis, endocarditis and so on. The onset of tonsillitis is very direct, seeing is believing, and the condition of tonsils can be seen intuitively. Let the patient open his mouth and observe the changes of tonsils and oropharynx to know whether there is tonsillitis. But in addition to diagnosing tonsillitis, doctors have an important task to distinguish between bacterial infection and viral infection, whether there is systemic infection and whether there will be other complications. Usually bacterial diseases may need to be treated with antibiotics, while viral diseases do not need antibiotics. If necessary, a blood test can be performed to help the diagnosis. These infections are contagious, so patients will have tonsillitis. If possible, they should try not to go out. Severe patients should rest more and drink water properly. Some people often have repeated infections, and their tonsils become more swollen than usual. Others are bigger at birth and tend to get bigger after infection. Sometimes it will affect breathing, or cause loud snoring during sleep, and even affect the quality of sleep. Consider tonsillectomy. When do you need to have your tonsils removed? Tonsillectomy is needed in the following situations: frequent tonsillitis, or tonsillar lesions completely affect health or interrupt studies, affecting hearing or breathing. However, sometimes tonsillectomy is unnecessary. If the diagnosis is in doubt, we should consider whether there are other problems. Indications for tonsillectomy include: tonsillitis occurs four times or more a year; Tonsillitis more than three times a year within two years; Tonsillar enlargement causes upper respiratory tract obstruction, causing severe snoring, dysphagia and unclear pronunciation. Suffering from one or more tonsil abscesses; Tonsils cause systemic diseases and become focal tonsils; Repeated inflammation of tonsils causes recurrent attacks, such as rhinitis, otitis media and tracheitis. Or incurable for a long time. The operation was performed under general anesthesia. When the patient falls into a deep sleep state and loses pain, the tonsils are stripped and removed. Most incisions heal naturally without suturing. The postoperative hospitalization time of patients is generally more than 24 hours. It is generally believed that tonsillectomy will not have any adverse effects on later life. -Tonsillectomy has advantages and disadvantages. Some parents ask doctors to remove their children's tonsils because their children's tonsils are often inflamed, but doctors usually think carefully. Why can't tonsils be removed casually? The tonsil is the largest lymphoid tissue in the pharynx. In childhood, it is an active immune organ, containing lymphocytes at various stages of development, such as T cells, B cells, phagocytes and so on. Therefore, it not only has humoral immunity and produces various immunoglobulins, but also has certain cellular immunity. Immunoglobulin IgA produced by tonsils has strong immunity, which can inhibit the adhesion of bacteria to respiratory mucosa, inhibit the growth and spread of bacteria, and neutralize and inhibit viruses. IgA can also enhance the function of phagocytes by activating complement. These are the most active between the ages of two and five. From the point of view of immunity, tonsils should not be removed casually because of their immune function to the body. Tonsil hypertrophy in children is a normal physiological phenomenon. If hypertrophy does not affect breathing and swallowing and does not produce serious clinical manifestations, it should not be removed. Because excision may affect the local immune response and reduce the body's ability to resist infection. If tonsillitis recurs, which hinders breathing and swallowing and causes diseases such as rheumatism and nephritis, it should be removed in time. Generally, tonsillectomy in children should be performed after the age of four, and it is more appropriate to wait for two to three weeks after the inflammation subsides. However, if the attack is too frequent and can't wait, you can consider performing surgery after the attack subsides for a few days. Tonsillectomy is an effective treatment, while others are crypts. Indications for tonsillectomy (1) Recurrent acute attack of chronic tonsillitis. (2) Those with a history of abscess around tonsils. (3) Excessive hypertrophy of tonsils hinders swallowing and breathing, leading to malnutrition. (four) rheumatic fever, nephritis, arthritis, rheumatic heart disease and other patients. It is suspected that tonsil is the focus. (5) Chronic exudative otitis media is affected by hypertrophy of tonsils and proliferators, and conservative treatment is ineffective. (six) diphtheria carriers, who are ineffective after conservative treatment. (seven) unexplained long-term low fever, and chronic inflammation of tonsils. (eight) all kinds of tonsil benign tumors and malignant tumors should be carefully selected. Contraindications (1) When acute tonsillitis occurs, surgery is generally not performed, and it takes 3-4 weeks after the inflammation subsides. (2) Hematological diseases, hypertension, heart disease with compensatory dysfunction and active tuberculosis are not suitable for surgery. (3) When systemic symptoms such as rheumatic fever and nephritis are not controlled, surgery is not suitable. (4) In the case of leukoplakia of spinal cord and influenza, it is not suitable for women to have surgery during menstruation and menstrual period. (5) Family members of patients with immunoglobulin deficiency or high incidence of autoimmune diseases. White blood cell count is below 3000. Preoperative preparation (1) Ask the medical history and physical examination carefully, and pay special attention to the inquiry of bleeding history and the examination of bleeding and coagulation mechanism. (2) Routine coagulation time of blood, urine and stool. (3) chest x-ray and electrocardiogram examination. Under general anesthesia, the liver and kidney functions were examined. (4) Fasting before general anesthesia and local anesthesia, and taking a small amount of food or fasting before operation. Atropine was injected subcutaneously half an hour before operation. (Extrusion and cutting are not allowed). Nervous patients can take sedatives. There are two surgical methods: peeling and squeezing. (1) Anatomy 1. Anesthesia and posture: for those who use local anesthesia, sit or semi-sit. Pharyngeal reflex sensitive person can spray 1% of caine in the pharynx, plus 1: 1000 of adrenaline. 2. Operation steps (1) Incision: clamp the tonsil with tonsil forceps, pull it inward to expose the mucosal fold between the free edge of glossopharyngeal arch and tonsil, cut the mucosa here with a sharp knife, and cut back part of the mucosa between glossopharyngeal arch and tonsil. (2) Stripping: insert a vascular clamp or stripper at the incision of glossopharyngeal arch, free the upper pole of tonsil upward and backward, then clamp the upper pole of tonsil with the stripper, and then separate the tonsil from the surrounding tissue outside its capsule from top to bottom until its lower pole. (3) Tonsillectomy: Use the steel wire of the tonsil snare to cover the tonsil, at the same time, lift the tonsil upwards, press the steel wire downwards, tighten the steel wire ring, twist off the inferior polar pedicle of the tonsil, and completely remove the tonsil. (4) Hemostasis: Immediately after tonsillectomy, press the tonsil fossa with a large cotton ball to stop bleeding. If there is blood vessel bleeding, it should be ligated. Finally, the lingual palatal arch was opened with a palatal arch retractor, and the tonsil fossa was fully exposed for examination. If the bleeding has stopped completely and there is no residual tonsil tissue, the operation on one side is completed. The opposite tonsil was removed in the same way. 3. During general anesthesia, the patient should lie on his back with his head tilted back, put a small pillow under his shoulder, and roll the operating table down so that his head is slightly lower than his chest to avoid blood being sucked into the airway during operation. Put a David's mouth gag, and be careful not to squeeze your tongue and lips or your teeth. (2) guillotine method 1. Anesthesia: general or local anesthesia. 2. Operation: The patient takes a supine position or a sitting position, and the assistant fixes the head. After placing the mouth gag, the operator presses the tongue with the tongue depressor to expose the inferior tonsil pole, holds the squeezing knife in his right hand, puts it in from the inferior tonsil pole, then turns the knife ring so that it is located between the tonsil and the palatopharyngeal arch, puts it in the posterior and upper tonsil poles, and lifts it in the direction of the glossopharyngeal arch. At this time, the tonsil bulges into a "mass" under the glossopharyngeal arch. The opposite tonsil was removed in the same way. The assistant quickly turned the patient's head to one side to make him spit out blood. Hemostasis method is the same as stripping method. Postoperative treatment (1) All patients were taken to lateral position. Instruct the patient under local anesthesia to drain the secretions in the oral cavity along the oral cavity, and do not swallow them to observe whether there is bleeding. Patients under general anesthesia should pay attention to whether they have swallowed before waking up, and if so, check whether there is bleeding. (2) You can eat liquid food three hours after operation and rinse your mouth with salt water six hours later. When the wound hurts, you can apply cold compress to the neck. (3) On the second day after operation, a white film appeared on the wound, which was a normal reaction. About 5~7 days after operation, the white membrane began to fall off, granulation was formed on the wound surface, and the surface epithelium began to grow. If the white membrane is dirty and gray, we should pay attention to the possibility of infection. You can rinse your mouth with antibiotics and 0.5~ 1% hydrogen peroxide. Complications of operation and its management (1) Bleeding: Bleeding within 24 hours after operation is primary bleeding, which is more common and occurs within 6 hours after operation. It may be due to careless operation, residue left or incomplete hemostasis, or vasodilation after the vasoconstriction of adrenaline in anesthetic disappears; It may also be a small bleeding spot that has been bleeding. It may also cause bleeding due to throat activity, cough or temporary increase in blood pressure, vitamin C deficiency, decreased prothrombin content, sudden weather change, etc., and may also promote postoperative bleeding. Secondary bleeding often occurs 5 ~ 6 days after operation, mainly when the white membrane begins to fall off, which can be prevented if attention is paid. If it is secondary infectious bleeding, it is necessary to strengthen treatment, such as anti-infection. 1. If there is a blood clot in the tonsil fossa, it should be taken out and pressurized with gauze ball 10 ~ 15 minutes. When checking the bleeding point, we should pay attention to the hidden place above and below the tonsil fossa. There are bleeding points near the base of the tongue and behind the lingual palatine arch, which are difficult to see. If there is obvious bleeding point, clamp it with a vascular clamp and ligate it to stop bleeding. 2. Diffuse oozing blood can be pressed at the bleeding place with hemostatic powder and gelatin sponge. In case of failure, the tonsil fossa can be filled with sterilized gauze balls, and the glossopharyngeal arch and pharyngeal arch can be sewed with 3 to 4 stitches, and the gauze can be left in the tonsil fossa for 24 hours. 3. Sometimes patients will swallow blood and accumulate it in the stomach unconsciously. When it reaches a certain amount, sometimes they suddenly spit out a lot of bloody substances. Patients with frequent pulse, pale face, cold sweat and other early shock phenomena. Measures such as fluid replacement, blood transfusion and hemostasis should be taken to actively rescue. 4. Internal carotid artery surgery injury: rare, if not treated in time, it can lead to massive bleeding and death. The main prevention is that tonsil dissection should be close to the outer membrane of tonsil during operation, and the separation should not be too deep. It is forbidden to cut the adhesion tissue with a knife or scissors. Once unfortunate happens, immediately compress the bleeding and suture the internal carotid artery from the neck. (2) Wound infection: The patient's resistance is low, the aseptic operation during operation is not strict, or postoperative bleeding may be complicated with wound infection. Explain that there is no long white membrane on the wound, or the white membrane is unclean and incomplete, and the throat is congested, swollen and sometimes accompanied by fever. Apply enough antibiotics and 0.5 ~ 1% hydrogen peroxide to gargle. (3) In addition, lung abscess, bronchopneumonia, atelectasis, deep neck abscess or cellulitis, foreign bodies in respiratory tract, etc. Prevention: first, strengthen the body's resistance and pay attention to the combination of work and rest. Many people often work overtime, which easily leads to tonsillitis. Secondly, we should reduce the stimulation of alcohol and tobacco and develop good study and living habits. At the same time, we should also actively treat diseases of neighboring organs, such as acute and chronic rhinitis.

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