Anti-diphtheria serum yog ib qho tshuaj tiv thaiv kab mob diphtheria uas tau los ntawm cov ntshav nees (cov tsiaj no tau txhaj tshuaj tiv thaiv kab mob diphtheria toxoid). Tom qab whey raug cais los ntawm enzymatic hydrolysis, nws yog purified thiab concentrated.
Composition
Raws li tau hais los saum no, cov tshuaj tiv thaiv kab mob diphtheria muaj ib feem ntawm cov protein (tshwj xeeb immunoglobulins) muab rho tawm los ntawm cov ntshav nees (tsiaj txhu yav dhau los hyperimmunized nrog diphtheria toxoid), concentrated thiab purified los ntawm ntsev feem thiab peptic digestion.
Cov tshuaj no yog pob tshab, me ntsis opalescent, yellowish los yog pob tshab kua uas tsis muaj precipitate.
Dhau li ntawm cov khoom xyaw tseem ceeb, cov khoom muaj 0.1% chloroform ua cov tshuaj khaws cia.
Immunobiological zog
1 ml ntawm cov tshuaj tiv thaiv kab mob diphtheria muaj tsawg kawg yog 1500 IU (International antitoxic kev ua haujlwm chav tsev), uas ua rau cov kab mob diphtheria cov kab mob toxin. Qhov ntau npaum ntawm cov tshuaj yog nyob ntawm daim ntawv ntawm tus kab mob, tus mob ntawm tus neeg mob thiab nwslaj.
Kev qhia
Kev siv cov tshuaj tiv thaiv kab mob diphtheria yog qhov tsim nyog thiab muaj txiaj ntsig zoo hauv kev txhim kho ntau hom kab mob diphtheria rau cov neeg laus lossis menyuam yaus.
Ib daim ntawv
Cov tshuaj diphtheria uas muaj zog yog ntim rau hauv 10 ml ampoules, ntxiv rau, 1 ml ampoules tau suav nrog hauv cov khoom siv, uas yog siv rau kev kuaj intradermal (cov ntshav yog diluted 1: 100 hauv lawv). Lub pob muaj 10 ampoules.
Daim ntawv lo ntawm txhua lub ampoule yog muab nrog cov ntaub ntawv hauv qab no:
- IU kom muaj nuj nqis;
- hnub tas sij hawm;
- lub raj mis thiab tus lej xov tooj;
- tshuaj npe;
- npe ntawm lub koom haum thiab cov chaw tsim khoom (thiab lawv qhov chaw);
- OC tus lej.
Cov ntaub ntawv tib yam yuav tsum tau luam tawm ntawm lub ntim, ntxiv rau, nws yuav tsum muaj cov ntaub ntawv hais txog cov chaw tsim khoom (lub npe tag nrho, chaw nyob thiab lub chaw haujlwm uas tswj hwm nws), lub npe ntawm cov khoom hauv Latin, cov txheej txheem ntawm kev thov, as well as tej yam kev cia.
Khaws cov ntshav hauv qhov tsaus, qhuav qhov chaw ntawm qhov kub ntawm 3-10 degrees. Ib yam khoom uas tau khov thiab tom qab thawed yam tsis tau hloov nws lub cev lub cev yog xam tau.
Nyob rau hauv rooj plaub ntawm turbidity, sedimentation los yog txawv teb chaws inclusions (fibers, flakes) uas tsis tawg thaum shaken, nws yog txwv tsis pub siv whey. Tsis tas li ntawd, nws tseem tsis tuaj yeem siv cov khoom lag luam yog tias tsis muaj daim ntawv lo rau nws lossis yog tias cov ampoules raug puas tsuaj rau txhua txoj kev.
Rules of application
Taw qhiaantidiphtheria serum yog ua tau ob qho tib si subcutaneously thiab intramuscularly nyob rau hauv lub pob tw (sab nrauv sab sauv quadrant) los yog ncej puab (saum toj peb ntawm nws anterior nto).
Ua ntej siv cov tshuaj ampoule yuav tsum tau ua tib zoo xyuas. Kev txhaj tshuaj, raws li txoj cai, yog ua los ntawm kws kho mob, tab sis nws kuj tuaj yeem ua los ntawm kws kho mob, tab sis tsuas yog nyob rau hauv kev saib xyuas ntawm kws kho mob.
Qhia txog tshuaj tiv thaiv kab mob ntshav qab zib raws li txoj kev Bezrareko
Ua ntej siv cov ntshav, tus neeg mob qhov kev nkag siab zoo rau nees (heterogeneous) protein yuav tsum tau txiav txim siab, uas yog ua los ntawm kev siv cov tshuaj intradermal nrog cov ntshav ntawm dilution ntawm 1 txog 100, uas los nrog cov tshuaj tseem ceeb. Qhov kev sim no yog nqa tawm nrog lub koob txhaj tshuaj uas muaj qhov sib faib ntawm 0.1 ml, thiab ib rab koob nyias. Ntxiv mus, rau txhua tus qauv zoo li no, siv ib rab koob thiab ib lub syringe cais.
Ua qhov kev ntsuam xyuas raws li hauv qab no: diluted antidiphtheria serum raws li txoj kev Bezredko (0.1 ml) yog txhaj rau hauv pliaj (rau hauv nws qhov chaw flexor) intradermally, tom qab ntawd cov tshuaj tiv thaiv yog saib xyuas rau 20 feeb. Ib qho kev sim hu ua tsis zoo yog tias txoj kab uas hla ntawm cov papule tshwm sim tsawg dua 0.9 cm thiab muaj qhov liab me ntsis nyob ib ncig ntawm nws. Kev kuaj pom zoo yog tias cov papule loj dua 1 cm thiab qhov liab nyob ib puag ncig nws yog qhov tseem ceeb.
Yog tias qhov kev kuaj pom tsis zoo, cov tshuaj tsis muaj tshuaj lom (0.1 ml) raug txhaj rau hauv qab ntawm daim tawv nqaij, thiab yog tias tsis muaj tshuaj tiv thaiv rau 30 (txog 60) feeb, thovtag nrho cov tshuaj yuav tsum tau kho.
Yog tias tsis muaj cov tshuaj diluted uas muaj, tom qab ntawd cov tshuaj tsis muaj tshuaj nyob hauv tus nqi ntawm 0.1 ml yog txhaj rau hauv qab ntawm daim tawv nqaij ntawm lub hauv pliaj (rau hauv nws qhov chaw flexor) thiab cov tshuaj tiv thaiv rau nws raug soj ntsuam 30 feeb tom qab txhaj tshuaj.
Yog tias tsis muaj cov tshuaj tiv thaiv, ib qho ntxiv ntawm cov ntshav hauv cov nyiaj ntawm 0.2 ml yog txhaj rau hauv qab ntawm daim tawv nqaij thiab pom dua, tab sis rau 1-1.5 teev. Yog tias qhov txiaj ntsig zoo (tsis muaj tshuaj tiv thaiv), tag nrho cov tshuaj kho mob diphtheria antiserum yog siv.
Yog tias qhov kev ntsuam xyuas intradermal yog qhov zoo lossis qhov tshwm sim anaphylactic tshwm sim, cov tshuaj pleev xim raws li kev kho mob tsuas yog siv rau hauv cov xwm txheej hnyav (qhov muaj cov cim qhia tsis xwm yeem), ua tib zoo, nrog kev koom tes ntawm tus kheej thiab kev tswj hwm ntawm tus kws kho mob. Nyob rau hauv cov ntaub ntawv no, diluted serum yog siv (uas yog siv rau intradermal kuaj): thawj 0.5, ces 2, thiab tom qab 5 ml (lub ncua sij hawm ntawm txhaj tshuaj yog 20 feeb).
Yog tias tsis muaj cov tshuaj tiv thaiv zoo, cov tshuaj tsis muaj tshuaj lom nyob rau hauv ib lub ntim ntawm 0.1 ml yog txhaj subcutaneously thiab tus neeg mob tus mob raug soj ntsuam rau ib nrab ib teev. Yog tias tsis muaj cov tshuaj tiv thaiv, ces qhov kev txhaj tshuaj yog nqa tawm ntawm tag nrho cov tshuaj uas yuav tsum tau kho.
Yog tias nws tsis tuaj yeem siv cov tshuaj tiv thaiv kab mob diphtheria vim qhov tshwm sim ntawm cov tshuaj tiv thaiv zoo rau ib qho ntawm cov koob tshuaj saum toj no, cov koob tshuaj kho mob yuav tsum tau muab tshuaj loog, tau npaj cov koob txhaj tshuaj yav dhau los nrog 5% "Ephedrine" los yog "Adrenaline" (1 txog 1000).
Nyob rau hauv cov ntaub ntawv ntawm anaphylactic shock vimKev tswj hwm tus kab mob diphtheria, yuav tsum tau kho sai sai: kev siv ephedrine lossis adrenaline, tshuaj loog, glucocorticosteroids, plawv glycosides, calcium chloride, novocaine.
Qhov kev ua tau zoo ntawm diphtheria serum ncaj qha nyob ntawm qhov raug xaiv ua ntej, nrog rau cov chav kawm ntau npaum li cas thiab qhov siv tau ntxov tshaj plaws ntawm cov tshuaj no tom qab lees paub qhov kev kuaj mob.
- Nyob hauv cov islet localized diphtheria ntawm lub pharynx (qhov ncauj ntu ntawm lub pharynx), thawj koob tshuaj yog 10-15 txhiab IU, thiab cov koob tshuaj yog 10-20 txhiab IU.
- Nyob rau hauv daim ntawv membranous: los ntawm 15 mus rau 30 txhiab (thawj koob), thiab chav kawm - mus txog 40 txhiab IU.
- Nrog cov kab mob diphtheria ntawm lub pharynx, qhov koob tshuaj thib 1 yog 30-40 txhiab IU, thiab cov tshuaj txauv, feem, yog 50-60 txhiab IU.
- Nyob rau hauv daim ntawv subtoxic uas tau tsim nyob rau hauv lub qhov ncauj ntu ntawm lub pharynx, qhov ntau npaum yog 40-50 txhiab, thiab tus nqi pauv yog 60-80 txhiab IU.
Anti-diphtheria serum: ib qho algorithm rau kev tswj hwm hauv daim ntawv tshuaj lom ntawm pathology
- 1 degree - thawj koob tshuaj 50-70 txhiab IU, chav kawm 80-120 txhiab IU;
- 2 degree - thawj koob tshuaj 60-80 txhiab IU, chav kawm 150-200 txhiab IU;
- 3 degree - pib (thawj) koob tshuaj 100-200 txhiab IU, chav kawm 250-350 txhiab IU.
Nyob rau hauv daim ntawv tshuaj lom, cov tshuaj yuav tsum tau siv txhua 12 teev rau 2-3 hnub, thiab tom qab ntawd cov koob tshuaj thiab zaus ntawm kev tswj hwm raug kho raws li qhov muaj peev xwm ntawm tus kab mob. Thiab nyob rau hauv thawjrau ob peb hnub, tus neeg mob tau muab 2/3 ntawm qhov kev noj tshuaj.
- Nyob rau hauv cov ntaub ntawv ntawm hypertoxic diphtheria ntawm lub qhov ncauj ntu ntawm lub pharynx, qhov siab tshaj plaws ntawm cov tshuaj tau sau tseg. Yog li, 1 koob tshuaj yog 100-150 txhiab IU, thiab cov koob tshuaj tsis ntau tshaj 450 txhiab IU.
- Nyob hauv cov neeg mob hauv zos: 1 koob - 30-40 txhiab IU, thiab chav kawm 60-80 txhiab IU.
- Thaum muaj kab mob diphtheria nyob rau hauv qhov ntswg ntu ntawm lub pharynx, koob tshuaj yog 15-20 txhiab thiab 20-40 txhiab IU (thawj zaug thiab cov koob tshuaj, raws li).
Kho rau kab mob diphtheria
- Thaum qhov muag raug cuam tshuam. Thawj koob tshuaj 10-15 txhiab IU, chav kawm - 15-30 txhiab IU.
- kab mob diphtheria ntawm qhov chaw mos - 10-15 txhiab IU, pauv tus nqi - 15-30 txhiab IU.
- daim tawv nqaij: koob tshuaj thawj zaug - 10 txhiab IU, chav kawm - 10 txhiab IU.
- qhov txhab qhov txhab: thawj koob 10-15 txhiab IU, thiab chav kawm - 20-30 txhiab IU.
- Umbilical lesions: thawj koob tshuaj - 10 txhiab IU, thiab chav kawm - kuj 10 txhiab IU.
Tus naj npawb ntawm kev txhaj tshuaj nrog cov tshuaj tiv thaiv kab mob diphtheria yog tshuaj nyob ntawm daim ntawv kho mob ntawm cov kab mob. Piv txwv li, ib qho kev txhaj tshuaj yog muab rau cov neeg mob uas muaj cov kab mob hauv zos lossis cov kab mob sib kis ntawm qhov ncauj pharynx lossis qhov ntswg.
Yog tias qhov ploj ntawm cov quav hniav tsis tshwm sim hauv ib hnub tom qab kev teem sijhawm ntawm cov ntshav, tom qab 24 teev cov tshuaj siv dua.
Serum raug tso tseg tom qab kev txhim kho tseem ceeb hauv tus neeg mob tus mob (poob lawm ntawm edema ntawm lub ncauj tsev menyuam,pharynx (nws qhov ncauj qhov ncauj), plaque thiab txo intoxication).
Side effects
Tau yuav:
- tam sim (tshwj xeeb tam sim tom qab siv cov serum);
- ntxov (4-6 hnub tom qab siv tshuaj);
- remote (ob lossis ntau lub lis piam tom qab txhaj tshuaj).
Cov kev mob tshwm sim hauv qab no tuaj yeem tshwm sim: hyperthermia (ua npaws), tawv nqaij ua pob, ua daus no, cuam tshuam hauv kev ua haujlwm ntawm cov hlab plawv, convulsions, thiab lwm yam. Cov xwm txheej no tsis kav ntev tshaj li ob peb hnub. Tsis tshua muaj, kev tawg yog ua tau. Nyob rau hauv cov xwm txheej ntawm qhov tshwm sim ntawm cov kev phiv tshwm sim, nws yog ib qho tsim nyog yuav tau muab tshuaj kho mob raws sij hawm.
