Meningococcal kab mob yog ib yam kab mob uas ua rau muaj kab mob ntau ntxiv tuaj yeem ua rau mob hnyav. Tshwj xeeb, meningitis, sepsis, nasopharyngitis, pneumonia, sinusitis lossis meningococcemia.
Meningitis
Meningitis yog kab mob meningococcal uas tuaj yeem ua tau ob hom: thawj thiab theem nrab. Hauv thawj kis, cov kab mob pathogenic nkag mus rau hauv lub cev los ntawm cov tee dej. Los ntawm lub caj pas, thiab tom qab ntawd los ntawm kev kov yeej cov ntshav-hlwb teeb meem - mus rau hauv lub plhaub ntawm lub hlwb. Daim ntawv no ntawm tus kab mob no tuaj yeem ua purulent lossis serous.
Nyob rau hauv serous meningitis, muaj ntau cov lymphocytes nyob rau hauv lub cerebrospinal kua. Nws yog tshwm sim los ntawm kab mob los yog kab mob uas ua rau tuberculosis. Nyob rau hauv purulent meningitis, neutrophils sau nyob rau hauv lub cerebrospinal kua. Qhov no tshwm sim vim muaj kab mob. Feem ntau meningococci A thiab C. Ze li ntawm 40% ntawm cov neeg mob yog vim Haemophilus influenzae B. Thiab tsuas yog 2% yog vim mob ntsws.
Tus mob meningitis thib ob cuam tshuam rau txoj hlab pa, oropharynx, pob ntseg, lossis qog qaub ncaug. Tej zaum koj yuav ntsib cov tsos mob xws limob ntsws los yog mob plab hnyuv. Tom qab ntawd cov kab mob nkag mus rau hauv cov qog ntshav thiab cov ntshav, ua rau mob hlwb. Tus mob meningitis thib ob yog tshwm sim los ntawm staphylococci, streptococci, E. coli, Candida, kab mob, salmonella thiab lwm yam kab mob.
Puas muaj kab mob sib kis?
Kev kis tus kab mob meningococcal tau pom nyob hauv Russia xyoo 1968. Cov mob ntawm tus kab mob no heev heev. Yog li ntawd, kev txhaj tshuaj tiv thaiv kab mob meningococcal tau dhau los ua qhov tseem ceeb. Nws yog tus kab mob sib kis tiag tiag. Tab sis ua tsaug rau cov tshuaj tiv thaiv, nws maj mam ploj mus. Thiab tam sim no tus kab mob no tsis yog li ntawd. Piv txwv li, xyoo 2000, muaj 8 tus neeg kis tus kabmob rau 100,000 tus neeg Lavxias.
Cov menyuam yaus raug tus kab mob no ntau dua. Thiab yog vim li cas nyob rau hauv kev txhaj tshuaj tsis txaus. Tab sis nasopharyngitis tuaj yeem yog qhov sib txawv ntawm etiologies, thiab qee zaum nws nyuaj heev kom paub qhov txawv ntawm lwm tus kab mob. Yog li ntawd, lo lus teb rau lo lus nug ntawm seb puas yuav tsum tau txhaj tshuaj tiv thaiv kab mob meningitis yog muaj. Nws yog qhov zoo dua los tiv thaiv tus kab mob thaum pib dua li kev kho kom ntev.
Dab tsi ua rau mob meningococcal?
Tus kab mob ua rau mob meningococcal yog Neisseria meningitides kab mob. Tus kab mob tuaj yeem ua ntau hom. Feem ntau nyob rau hauv daim ntawv ntawm meningitis (mob ntawm daim tawv nqaij ntawm lub hlwb). Tus neeg sawv cev ua rau (Vekselbaum meningococcus) yog Gram-negative diplococcus. Nws tsis muaj tshuaj ntsiav thiab flagella, tsis ua haujlwm. Tsis tsim kev sib cav. Qhov kub zoo rau cov kab mob loj hlob yog 37 degrees.
Tus kab mob meningococcal pom nyob qhov twg?
Tus kab mob Meningococcalmuaj nyob hauv txhua lub tebchaws. Tab sis qhov tshwm sim ntau tshaj yog nyob rau hauv Central thiab West Africa. Nyob rau thaj tsam ntawm Russia, me me foci ntawm tus kab mob tau tawg ob peb zaug. Yog li ntawd, tshuaj tiv thaiv kab mob meningococcal yog qhov tseem ceeb los tiv thaiv tus kab mob los ntawm kev kis tus kab mob.
Kev mob ntawm meningitis
Tus kab mob no txaus ntshai heev. Yog tias qhov tshuaj tiv thaiv kab mob tsis ua tiav raws sijhawm, cov teeb meem loj tuaj yeem tshwm sim. Feem ntau lawv ua rau tuag. Yog tias tus mob meningitis tsis kho raws sijhawm, nws tuaj yeem ua rau muaj kev tsis taus. Muaj ob peb hom teeb meem:
- mob cerebral, uas yog: cerebral edema, cerebral infarction, ventriculitis. Ntxiv rau qhov saum toj no, subdural effusion, occlusion, thiab cov tsos mob ntawm qhov tsis tsim nyog ADH excretion feem ntau tshwm sim.
- Mob ntshav qab zib. Cov neeg mob meningitis tuaj yeem ua rau poob siab. DIC thiab hemorrhagic syndromes, hypoglycemia, lub cev qhuav dej, mob caj dab, mob ntsws tshwm sim. Meningitis tuaj yeem cuam tshuam rau txoj hnyuv (ulcers, gastritis).
- Kev nyuaj siab. Cov no muaj xws li hydrocephalus, ataxia, lag ntseg, dig muag, cystic-adhesive arachnoiditis. Cov teeb meem ntawm meningitis tuaj yeem ua rau cov paj hlwb atrophy, lub paj hlwb abscess, ua haujlwm tsis zoo ntawm lub caj pas pituitary. Nrog rau cov teeb meem lig, cov kab mob neurological tshwm sim, mus txog rau dementia. Qee zaum muaj ntshav qab zib. Hauv daim ntawv khiav - coma.
Cov tshuaj tiv thaiv dab tsi?
Nyob rau hauv Russia, txawv teb chaws tshuaj tiv thaivMeningococcal kab mob "Meningo A + C". Lossis hauv tebchaws A thiab C. Cov tshuaj tiv thaiv, uas muaj W-135 thiab Y, tsuas yog muab rau cov neeg taug kev tawm mus rau Mecca. Pab pawg B meningococci tsis tau siv dav. Nws muaj cov tshuaj tiv thaiv kab mob tsawg thiab muaj ntau cov tshuaj tiv thaiv kab mob, uas tuaj yeem ua rau muaj kev phiv thiab teeb meem.
Txhawm rau tiv thaiv qhov mob ntawm lub hlwb, txhaj tshuaj tiv thaiv kab mob meningococcal. Lub npe yuav txawv, txij li cov tshuaj tiv thaiv tau tsim nyob deb ntawm ib leeg: Akt-Khib, Hiberix, Tetr-Akt-Khib, Pentaxim thiab lwm tus. Koj tuaj yeem tau txais lawv feem ntau dawb, hauv yuav luag txhua lub tsev kho mob hauv nroog. Muaj tseeb, qee qhov muag tsuas yog tau nyiaj thiab tuaj yeem kim heev.
Kev tiv thaiv kab mob pneumococcal meningitis, siv tshuaj tiv thaiv Pneumo-23. Nws yog tsim nyob rau hauv Fabkis. Kev txhaj tshuaj tiv thaiv tsuas yog pub dawb rau cov menyuam yaus uas muaj kev pheej hmoo. Tag nrho lwm cov neeg thov - raws li kev them nyiaj. Cov tshuaj tiv thaiv no txo qis kev pheej hmoo ntawm tsis yog mob meningitis nkaus xwb, tab sis kuj muaj lwm yam kab mob (sepsis, pneumonia, thiab lwm yam).
Thaum twg thiab txhaj tshuaj tiv thaiv dab tsi?
Cov tshuaj tiv thaiv uas siv ntau tshaj plaws muaj cov polysaccharides. Lawv raug muab rau cov menyuam yaus hnub nyoog 2 xyoos. Cov tshuaj tiv thaiv no tuaj yeem tiv thaiv tus menyuam tau 3 xyoos. Tab sis feem ntau (ntau tshaj 50% ntawm cov neeg mob) meningitis tshwm sim rau cov menyuam yaus hnub nyoog qis dua ob xyoos. Lawv txhaj tshuaj tiv thaiv kab mob tsis muaj zog. Cov tshuaj tiv thaiv kab mob meningococcal ntawm pawg A tsuas yog siv rau cov menyuam yaus hnub nyoog qis dua ib xyoos, pawg C - tsuas yog muaj hnub nyoog txog ob xyoos xwb. Cov tshuaj tiv thaiv tsuas yog muab ib zaug xwb.
Puas muaj tshuaj tiv thaiv kab mob meningitis rau menyuam mos?
Tshuaj tiv thaiv rau menyuam mos tam sim no tau ua haujlwm rau. Txawm hais tias kev txhaj tshuaj serotype C twb tau ua pov thawj lawv tus kheej zoo lawm. Ua tsaug rau cov tshuaj tiv thaiv no, qhov tshwm sim ntawm tus mob meningitis yog txo los ntawm 76%. Hauv cov menyuam yaus hnub nyoog qis dua ob xyoos - los ntawm 90%. Tam sim no, kev ua haujlwm tseem tab tom ua rau cov tshuaj tiv thaiv ua ke, uas yuav tsum muaj 4 serotypes ntawm meningococcus. Koj yuav tsum nrog koj tus kws kho mob tham ua ntej txhaj tshuaj tiv thaiv. Koj yuav tsum tsis txhob xaiv tshuaj tiv thaiv rau tus menyuam ntawm koj tus kheej, yam tsis tau sab laj nrog kws kho mob tshwj xeeb.
Yuav tsum tau txhaj tshuaj tiv thaiv kab mob meningococcal?
Kev txhaj tshuaj tiv thaiv kab mob meningococcal yog ua tsis tau tsuas yog rau kev tiv thaiv, tab sis kuj yog thaum muaj kev sib kis. Feem ntau siv cov tshuaj tiv thaiv A + C, uas yog siv los ntawm kev pheej hmoo ntawm kev sib kis. Tag nrho cov pej xeem uas nyob hauv qhov chaw txaus ntshai rau qhov tseem ceeb ntawm kev kis kab mob yog txhaj tshuaj tiv thaiv. Tab sis qhov kev kis mob kis thoob plaws hauv ib lub tebchaws txawv. Yog tias tus naj npawb ntawm cov neeg mob dhau los ua ntau dua li ib qho kev teeb tsa, ces kev txhaj tshuaj tiv thaiv ntawm cov pejxeem yog qhov tsim nyog.
Tshwj xeeb rau menyuam yaus. Lub sij hawm txhaj tshuaj tiv thaiv yog muab raws li daim ntawv qhia hnub txhaj tshuaj tshwj xeeb. Raws li nws, lawv tau ua rau cov menyuam yaus hnub nyoog qis dua ob xyoos, cov tub ntxhais hluas thiab cov neeg laus uas muaj kev mob siab rau meningococcal kab mob, uas yog tshwm sim los ntawm cov kab mob ntawm serogroups A thiab C.
Nrog rau cov tib neeg muaj kev pheej hmoo kis tus kab mob ntau ntxiv. Cov tub ntxhais kawm theem pib nyob hauv cov tsev kawm ntawv nce qib thiab cov chaw zov menyuam ntsuag, hauv tsev neeg hostels. Tib yam mus raucov me nyuam los ntawm cov tsev neeg tsis ua hauj lwm uas tau ua txhaum txoj cai huv thiab huv. Txij li cov kab mob meningitis tuaj yeem mob txawm tias tsis tau ntxuav tes los yog txiv hmab txiv ntoo. Yog li ntawd, kev tsim cov tshuaj tiv thaiv ua ke, tshwj xeeb tshaj yog rau cov menyuam mos, yog qhov tsim nyog.
tshuaj tiv thaiv polysaccharide
Raws li tau hais los saum no, cov tshuaj tiv thaiv A + C feem ntau yog siv rau kev txhaj tshuaj. Muaj qee qhov hyperemia thiab mob ntawm qhov chaw txhaj tshuaj (feem ntau hauv 5% ntawm cov tshuaj tiv thaiv). Tsawg tsawg zaus, qhov kub siab tshwm sim, uas normalizes hauv 1.5 hnub. Nrog qee cov tshuaj tiv thaiv, nws tsis tshwm sim kiag li. Qhov siab tshaj plaws yog liab ntawm qhov chaw txhaj tshuaj. Cov tshuaj tiv thaiv yog contraindicated tsuas yog nyob rau hauv cov neeg uas muaj kab mob ntev los yog ua xua rau cov khoom uas muaj nyob rau hauv lawv.
Kuv puas xav tau tshuaj tiv thaiv kab mob meningococcal?
Hauv tebchaws Russia, ob peb xyoos dhau los, kev txhaj tshuaj tiv thaiv kab mob meningitis raug qhia. Tus kab mob no tshwm sim los ntawm cov kab mob hu ua Haemophilus influenzae. Nws tuaj yeem ua rau ntau tshaj qhov mob meningitis xwb. Thiab piv txwv li, otitis media, pneumonia thiab sinusitis. Muaj tseeb tiag, peb yuav tsum tsis txhob hnov qab tias mob meningitis tuaj yeem tshwm sim tsis yog los ntawm Haemophilus influenzae xwb, tab sis kuj los ntawm ntau lwm cov kab mob.
Kev txhaj tshuaj tiv thaiv kab mob no tau ua nyob rau txhua lub tebchaws hauv ntiaj teb. Kev mob ntawm lub hlwb tuaj yeem ua rau tuag taus. Kev txhaj tshuaj yog muab raws li cov txheej txheem kev txhaj tshuaj tiv thaiv kab mob nyob rau tib lub sijhawm raws li DTP. Cov tshuaj tiv thaiv niaj hnub no muaj cov tshuaj tiv thaiv kab mob Hib. Haemophilus influenzae, raws li kws tshawb fawb tau pom, tuaj yeem muaj rau hom. Hom B microbes yog qhov txaus ntshai tshaj plaws rau tib neeg. Kev txhaj tshuaj yog ua tiav,muaj ib feem ntawm tus kab mob no txhawm rau txhim kho kev tiv thaiv kab mob.
Meningitis kab mob (Hemophilus influenzae) yog qhov txaus ntshai heev rau cov menyuam yaus hnub nyoog qis dua 5 xyoos. Tom qab ntawd nws tsis muaj txiaj ntsig rau txhaj tshuaj tiv thaiv, txij li thaum muaj hnub nyoog, kev tiv thaiv kab mob hauv tib neeg tau tsim kho. Txawm hais tias nws tsis tuaj yeem tiv thaiv tus neeg los ntawm tus mob meningitis. Koj tsuas tuaj yeem txo qhov kev pheej hmoo ntawm kev ntes nws. Pneumococcus kuj muaj peev xwm ua rau muaj ntau hom kab mob meningitis. Tab sis muaj cov tshuaj tiv thaiv rau cov kab mob no. Cov kab mob txaus ntshai tshaj plaws uas feem ntau ua rau mob hlwb hu ua meningococci.
Yog muaj kev tiv tauj nrog tus neeg mob
Kev txhaj tshuaj yog qhov tseem ceeb los tiv thaiv kab mob meningitis. Immunoglobulin yog siv rau cov menyuam yaus hnub nyoog qis dua 7 xyoos, tab sis tsis pub dhau ib lub lis piam tom qab kev sib cuag nrog tus neeg mob. Hauv qhov no, cov menyuam yaus hnub nyoog qis dua 2 xyoos raug muab tshuaj 1.5 ml, thiab laus dua - 3 ml ntawm cov tshuaj tiv thaiv. Yog hais tias ib tug neeg yog tus kab mob, ces chemoprophylaxis yog nqa tawm rau plaub hnub. Yog tias qhov no yog ib tus neeg laus, nws tau muab tshuaj rifampicin ob zaug hauv ib hnub ntawm 0.3 grams.
Kev txhaj tshuaj tiv thaiv kab mob meningitis tau ua tiav ua ntej, tsis tas tos tus neeg mob. Amoxicillin yog siv los hloov ampicillin. Nws muaj txiaj ntsig zoo rau cov kab mob pathogenic. Hauv ntau lub tebchaws, txhaj tshuaj tiv thaiv rau txhua tus neeg uas tau ntsib nrog cov neeg mob. Kev txhaj tshuaj yog nqa tawm hauv ob hnub. Txog rau ib xyoos - los ntawm 5 mus rau 10 mg / kg ib hnub, los ntawm ib xyoos mus rau 12 xyoos - 10 mg / kg ib hnub, lossis ib qho tshuaj tiv thaiv ntawm "Ceftriaxone" ntawm 200 mg yog ua tiav. Cov tshuaj tiv thaiv no muabCov txiaj ntsig zoo heev tsis yog tsuas yog tiv thaiv kab mob meningitis, tab sis kuj nyob rau hauv kev sib cuag nrog cov neeg mob uas muaj kab mob meningococcal. Tus mob meningitis thib ob tuaj yeem tshwm sim hauv ib hlis. Txhawm rau zam qhov no, thawj 5 hnub tom qab sib cuag nrog tus neeg mob, yuav tsum tau txhaj tshuaj tiv thaiv kab mob.
