Why does the child always have tonsillitis? 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 children 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 child open his mouth and observe the changes of tonsils and oropharynx, and you can 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 the child has tonsillitis. If possible, they should try not to go out. Severely ill children should rest more and drink water properly. Some children often have repeated infections, and their tonsils become swollen than usual. Some people are big 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?

Tonsils need to be removed in the following situations: frequent tonsillitis, or tonsillar lesions completely affect the health of children or interrupt learning, affecting hearing or breathing. However, sometimes tonsillectomy is unnecessary. If the diagnosis is in doubt, we should consider whether there are other problems.

The indications of tonsillectomy include: tonsillitis occurs more than four times 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 both advantages and disadvantages.

Some parents ask doctors to remove tonsils for their children because they often have tonsillitis, 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.

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Treatment:

Tonsillectomy is an effective treatment, while other treatments, such as crypt irrigation, electrotherapy and immunotherapy, are uncertain and can only be used for those who are contraindicated in surgery.

Tonsillectomy; Tonsillectomy

indicate

(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

(a) when acute tonsillitis attacks, 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

(a) seriously ask the medical history and physical examination, pay special attention to ask the history of bleeding and check the 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.

Surgical method

Stripping method and extrusion method are adopted.

(1) Stripping method (dissection method)

1. Anesthesia and posture: If local anesthesia is used, sit or semi-sit. Pharyngeal reflex sensitive person can spray 1% of caine on the pharynx, and then apply 1% of novocaine (plus 1: 1000 adrenaline) on the submucosa of glossopharyngeal arch and the external tonsillar sac.

2. Operating 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 machete, 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 anesthesia 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.

Polizel's therapy

(1) All patients were in 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.

Surgical complications and their 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 adhered 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:

The first is to 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.

Expert introduction

Zhang Zhenying: Department of Otolaryngology, Beijing Children's Hospital, has been engaged in the clinical work of children's otorhinolaryngology for a long time, and has deep attainments in tonsil surgery and diagnosis and treatment of tracheobronchial foreign bodies.

Zhang Yamei: Director of the Department of Otolaryngology, Beijing Children's Hospital, specializing in the diagnosis and treatment of pharyngeal obstruction, acquired esophageal stenosis and congenital maxillofacial surgical malformation.

Moderator: Let's listen to parents' thoughts on tonsillectomy for their children:

1, the child always wants to sleep when lying there, and his throat hurts after he has a fever. I went to the hospital to be diagnosed with tonsillitis. I was so swollen that I couldn't eat anything at all. I could only feed milk powder that I couldn't sleep. Now that I am old, I dare not touch her at night for fear that she will be out of breath. Now we are all hesitant to remove her tonsils, because my throat is a delicate place, and I am afraid that my voice will change after touching the vocal cords.

2, I think it should be done, because it is good for children, so there is no concern. If he doesn't do this, he will often breathe through his mouth, which is not good for his lungs and organs, and he is prone to other diseases.

Compere: Should tonsils be removed?

Zhang Zhenying's tonsils are a pair of lymphoid tissues that grow in the pharynx. They look like almonds, so they are called tonsils. They are the body's defense organization, so they are still very important for children aged 4-5.

Moderator: Why is the tonsil inflamed?

Zhang Yamei's tonsil itself is not big, but it has 10-20 recesses on its surface, and it goes straight to the deep part of the tonsil. There are many folds in the recess, bacteria, exfoliated epithelium, food residue and so on. In normal folds, if the body is healthy, it will not be inflamed. If the body's resistance drops, such as colds and acute infectious diseases, bacteria will multiply in large numbers. Therefore,

Compere: Should tonsils be removed?

Whether Zhang Yamei should have his tonsils removed depends on the situation of different children.

Moderator: Under what circumstances should tonsils be removed?

People who often have tonsillitis in Zhang Yamei (1 more than 5 times) should have their tonsils removed. Tonsillitis is very similar to upper respiratory tract infection, so we must distinguish it. The main symptoms of tonsillitis are high fever, severe sore throat, swollen tonsils, pus spots on the surface and swollen lymph nodes. If there is an abscess around the tonsil, that is, the space around the tonsil is inflamed and suppurated, the child will feel more pain.

Moderator: Anhui Ms. Luo's son 10 years old. His tonsils are so big that his throat is almost blocked. He eats slowly and gives vent to his anger when he is quiet. He even breathes when he is slightly active. He snores at night, breathes with his mouth open, and sometimes even doesn't breathe for 2 minutes, which makes his family afraid to sleep, but his tonsils have never been inflamed. Should he put his tonsils in this situation?

The situation in Zhang Zhenying should be children's tonsil hypertrophy. As shown in the picture, swollen tonsils block the pharynx, and the nose sends gas to the trachea and bronchus through the pharynx. After the pharynx is blocked, the patient will have dyspnea, snoring, apnea and other symptoms, and tonsil hypertrophy will also affect the growth and development of the child, so it should be removed at this time.

Moderator: Ms. Li's granddaughter in Beijing 12 years old. She used to have tonsillitis, but now she has basically been cured. But some time ago, her tonsils were inflamed again, and she had a sore throat, a fever and a particularly flustered heart. She went to the hospital to check the electrocardiogram, and there was an abnormal phenomenon, and the myocardial enzyme increased. The doctor said that she had myocarditis again. What is the relationship between myocarditis and tonsils? Should tonsils be removed in a situation like granddaughter?

After chronic tonsillitis in Zhang Yamei for a long time, there will be hyperimmunity and immune complex, which will lead to glomerulonephritis, rheumatic heart disease, rheumatic myocarditis, arthritis and other diseases. So in her case, the tonsils should be removed.

Moderator: Mr. Cui's child in Xinjiang has a low fever for a long time. I can't find out what the reason is and there is nothing wrong with it, but he has chronic tonsillitis. Does low fever have anything to do with tonsils? If so, should I cut it?

The general low-grade fever in Zhang Zhenying is complicated. If the tonsils are chronically inflamed for a long time, bacteria will produce a toxin, which will appear after being absorbed by the human body. We call it streptococcus infection syndrome. In this case, the tonsils should be removed.

In Zhang Yamei, the tonsils are often inflamed, causing peripheral abscess, hyperplastic hypertrophy, complications, low fever and other symptoms to be removed. If there is tonsillar lithiasis and many small stones are formed in the epithelium, the tonsils should also be removed; If there is a tumor, whether it is benign, cystic or malignant, tonsillectomy is necessary, but the incidence of malignant tumor is very low. Generally combined with surgery, radiotherapy and chemotherapy for comprehensive treatment.

Moderator: What age is appropriate for general tonsillectomy?

Zhang Zhenying's immune function is active before the age of 5, so tonsillectomy is more suitable for preschool children, but teenagers can also do it, and there is generally no age limit. Moreover, tonsils are not as urgent as other emergencies, so if the child's resistance is enhanced and nutrition is strengthened, it may not be inflamed often in the future, and there is no need to remove them.

There is a 2-year-old child in Zhang Yamei, whose tonsils are particularly swollen, and there has been apnea. At that time, parents thought the child was too young to have his tonsils removed. Later, when the child was 4 years old, he found that the electrocardiogram was abnormal and the myocardium was already enlarged. At this time, we performed tonsillectomy for him, and the child returned to normal after 1 year. Therefore, if you have difficulty breathing, you should have your tonsils removed.

Compere: Does Miss Lei Nanjing have any pain when doing tonsil surgery? How long will the operation take?

Generally speaking, any operation in Zhang Yamei will cause pain. At present, with the development of surgical technology, the pain has been reduced a lot, and the feelings of children and adults after surgery are different. Some adults still feel pain after the operation 1 week, but some children don't feel pain the next day. Generally, the pain will gradually decrease after 3 days of operation. The operation method includes extrusion and peeling; The squeezing method can be completed in a few minutes, and the postoperative pain is relatively light; Stripping method is mainly suitable for adults, but it can also be used for children. For example, the tonsil is extremely small and the tonsil is adhered, so this method must be adopted. Patients can operate under general anesthesia or local anesthesia, and children generally use general anesthesia to stop bleeding and recover after operation.

Moderator: Ms. Qiu's daughter's tonsils are often inflamed. She wants to have it removed, but she is afraid that her voice will be hoarse after removal. She is very artistic, and once removed, she is afraid that it will affect her children's singing in the future. Will expert surgery affect her vocal cords? Will there be sequelae after the operation?

Zhang Zhenying's vocal cords are in the throat and tonsils are in the pharynx, so removing tonsils will not damage the vocal cords. Some children have become hoarse because of improper use of voice before operation, so this is not caused by surgery, and some children have unclear pronunciation before operation and clear voice after operation, so parents feel as if their children have changed their voices, but this is not the case.

According to the investigation in Zhang Yamei, 85% of children with hoarseness are caused by vocal nodules and hypertrophy, which has nothing to do with tonsils.

Moderator: Will there be sequelae after the operation?

Zhang Zhenying, this is a small and medium-sized operation, so there should be no sequelae after the operation.

Moderator: Whose tonsils can't be removed?

In Zhang Zhenying, when children's tonsils are in acute attack period, children with thrombocytopenia and leukemia before and after menstruation, it is not advisable to remove tonsils. Because there is no suture after tonsillectomy, we do not advocate tonsillectomy if there is a problem with the child's coagulation mechanism, and we cannot remove tonsils if there are complications, such as acute glomerulonephritis. In addition, during the long-term use of hormonal drugs and the recovery of hepatitis, tonsillectomy cannot be performed.

Moderator: Ms. Liu's child in Wuhan is 4 years old. Two months ago, she had tonsillitis, a sore throat and a high fever of 40 degrees. Should this situation be cut?

Zhang Yamei, it depends on the number of inflammations. If he gets inflamed for the first time, you don't need to remove it. If he is inflamed many times, I think he can still be observed for a period of time. He can also go to an otolaryngologist for examination in acute inflammation.

Moderator: Ms. Wang from Hebei, will tonsillectomy affect the child's future growth and development?

Zhang Zhenying's tonsils will not affect the child's growth and development. If the tonsils are inflamed repeatedly, it will affect the child's appetite. After the operation, the child's appetite will recover, so the child will grow faster.

Moderator: Mr. Meng's children in Langfang often have a fever and swollen throat, and they have not improved after taking medicine. Can I have my tonsils removed?

Zhang Yamei, he must first find out whether the child has tonsillitis, because tonsillitis is similar to upper respiratory tract infection, and it may also be caused by acute pharyngitis. If it is, it is useless to remove tonsils, so he must first find out if the child has tonsillitis.

Moderator: What medicine did Mr. Wang take in the early stage of tonsillitis in Taiyuan? Take anti-inflammatory drugs often, okay?

When Zhang Zhenying has acute tonsillitis, it is necessary to take medicine to avoid the development of inflammation after bacterial infection, and let the children stay in bed and drink plenty of water to reduce the occurrence of complications.

Moderator: Two days after operation, the child felt pain, did not eat, and had a low fever. How to care for him after operation?

Zhang Zhenying has some pain after the operation, but children are lighter than adults. Generally, the pain will be relieved after 3 days. Because each child reacts differently to pain, the degree of pain is also different, but this kind of pain is still tolerable. There is no need to take painkillers. For example, we will give the child ice cream immediately after the operation, because the ice cream is not irritating after the operation and can stop bleeding. Therefore, patients are advised to eat some liquid food, such as cold milk, on the first 1 day after operation, and warm semi-liquid food, such as instant noodles and porridge, on the second day, but hard things, such as cakes and fried meat, must not be eaten, because a white film needs to grow on the wound after operation. If you eat hard food, it will easily lead to postoperative bleeding. You should also pay attention to keeping your mouth clean and the medicine prescribed by the doctor.

Moderator: Will the wound not be sutured and lead to bleeding?

Zhang Yamei has a child of 10 years old who ate a fried chicken leg on the 7th day after operation. As a result, the long white membrane was scraped off, leading to oral bleeding. The general bleeding rate is about 1%-5%. If the child has oral bleeding, he should go to the hospital immediately to stop the bleeding.

Moderator: Mr. Hou's child's tonsils are often inflamed, but he has no fever. Do you need to remove them?

Zhang Zhenying's inflammation and fever may be due to the child's low physical reaction, because fever is a human reaction, so his child's constitution may be very weak, and he should go to the hospital for examination before making a decision.

Moderator: Heilongjiang Wang has pharyngitis and tonsillitis. Is pharyngitis good after tonsillectomy?

Pharyngitis and tonsillitis in Zhang Yamei are two different diseases. Even if the tonsils are removed, pharyngitis cannot be cured. He should find an expert to treat pharyngitis.

Moderator: Ms. Qi from Guangzhou, will acute tonsillitis develop into chronic tonsillitis if it is not treated in time? What measures should be taken if it is treated?

Acute tonsillitis, sinusitis and otitis media are the three most common diseases in pediatrics in Zhang Zhenying. At present, the treatment technology is still very good, but if it is not treated in time, it will easily lead to other complications, while chronic tonsillitis is caused by repeated inflammation, not to say that it will become a disease if it is not treated once.

Moderator: Mr. Wang from Nanning. Just now, experts said that some people have almond attacks six times a year and need surgery, but my children only have almond attacks twice a year. So what should I do?

Zhang Yamei doesn't need surgery in this situation, but his children should be very weak, so don't let them go to public places when infectious diseases are high. Pay attention to let children rest more, add and subtract clothes for children, and pay attention to their oral hygiene.

Compere: Can tonsillitis be contagious?

Tonsillitis is not an infectious disease in Zhang Yamei.

Moderator: Ms. Wu's children in Tianjin usually don't catch a cold and are not too tired. Why are tonsils always inflamed?

Tonsillitis in Zhang Zhenying is related to personal physical factors, environmental factors and genetic factors. So it doesn't mean that a child must get tonsillitis after catching a cold or overworking.

In Zhang Yamei, some children who stay at home only go home once every 1 week, so parents will cook a lot of delicious food for their children and take them to play, which will lead to children's fatigue and sometimes fever, leading to tonsillitis.