Ntseeg kuaj pom tus kab mob ntsws pulmonary yog kho nyob rau lub sijhawm ntawm 10 lub hlis mus rau 1.5 xyoo. Kev kho mob yuav kav ntev npaum li cas yog nyob ntawm qhov hnyav ntawm tus kab mob txheej txheem thiab ntawm kev teem caij ntawm cov tshuaj uas tsim nyog tshaj plaws rau tus kheej xaiv.
Tuberculosis hauv peb lub sijhawm yog kab mob kho tau
Kev kho mob sib xyaw ua ke yog nyob rau hauv qhov muaj txiaj ntsig ntawm kev kho kab mob niaj hnub no ntawm tuberculosis. Qhov no yog vim hais tias thaum tau txais cov tshuaj sib txawv nyob rau tib lub sijhawm, kev tiv thaiv ntawm microbacteria rau cov tshuaj tsim qeeb dua. Tus neeg mob tau muab tshuaj 2 lossis 3 zaug ib zaug rau ib chav kawm. Hmoov zoo, muaj peev xwm ntawm cov tshuaj niaj hnub no yog qhov dav. Nws tuaj yeem tsuas yog cov tshuaj tiv thaiv kab mob ntawm kab 1 lossis lawv cov kev sib xyaw ua ke ntawm cov kab sib xyaw ntawm 1st thiab 2nd kab.
Kev faib cov tshuaj tiv thaiv kab mob yog tsim raws li qib ntawm lawv cov txiaj ntsig. Los ntawm txoj kev, ntau ua tsaug rau peb lub koom haum tshawb fawb rau kev tsim cov tshuaj xws li Isoniazid. Qhov no yog ib qho ntawm cov tshuaj tiv thaiv tuberculosis tseem ceeb, nws cov txiaj ntsig zoo heevsiab bacteriostatic kev ua haujlwm. Nyob rau tib lub sijhawm, nws cov kev tswj hwm tau zoo tshwj xeeb rau cov neeg mob uas tau mob thawj zaug.
Nco ntsoov ntawm daim ntawv
Kev kho mob thib ob zoo tshaj tom qab Isoniazid yog Rifampicin. Nws kuj yog ib qho cuab yeej zoo thiab siv tau zoo. Cov kev ua ntawm cov tshuaj tom ntej tuaj yeem muab faib ua ntu ntu: "Streptomycin", "Kanamycin", tom qab ntawd "Pyrazinamide", "Ethionamide", ua raws li "Prothionamide", "Ethambutol", thiab 3 ntxiv: "Florimycin", "Pask ", tshuaj tiv thaiv tuberculosis "Thioacetazone".
Txhua cov tshuaj uas ua rau mycobacteria thiab pab daws cov teeb meem kho mob ntawm cov neeg mob tau muab faib ua pawg tshuaj tiv thaiv kab mob:
- 1 kab tshuaj tua kab mob tseem ceeb TB,
- 2nd kab cia tshuaj.
Dab tsi yog qhov txawv ntawm cov tshuaj ntawm 1st thiab 2nd kab
Nyob rau hauv thawj kab yog cov tshuaj tseem ceeb, thov qhov kev ua tau zoo tshaj plaws ntawm cov tshuaj kws khomob thiab lawv cov derivatives. Muaj toxicity tsawg kawg nkaus.
2nd kab tshuaj tiv thaiv kab mob, uas suav nrog cov tshuaj khaws cia, tsis muaj qhov tshwm sim siab hauv kev tawm tsam Koch's bacillus, thaum lawv muaj tshuaj lom heev. Lawv raug sau tseg rau cov neeg mob yog tias lawv lub cev tiv thaiv kab mob 1st kab lossis muajintolerance rau cov tshuaj no.
Cov txheeb cais tu siab qhia tau tias txhua yam tshuaj ua rau lub sijhawm ntev, uas yog, qhov ua tau zoo tau txo qis. Tsis tas li ntawd, cov tshuaj tiv thaiv kab mob tseem ceeb ua rau muaj kev quav tshuaj tom qab qee lub sijhawm, thiab yog li ntawd cov kab mob mycobacteria tuaj yeem tiv thaiv lawv. Piv txwv li, yog tias tsuas yog ib qho tshuaj tshwj xeeb raug muab cais tawm, tom qab ntawd mycobacteria tsis kam rau nws tau pom tom qab 2-4 lub hlis.
tshuaj tua kab mob: siv thiab muaj zog
Cov tshuaj tiv thaiv kab mob ntau ntau muaj cov kab mob bacteriostatic ntawm mycobacteria, uas yog, lawv txo lawv txoj kev ua phem thiab ua rau muaj peev xwm ua kom ntau ntxiv. Ib yam li ntawd, "Isoniazid" thiab "Rifampicin" nyob rau hauv cov koob tshuaj muaj zog muaj peev xwm ua cov kab mob bactericidal. Txhawm rau kom tau txais cov txiaj ntsig kho mob ruaj khov, nrog rau kev tiv thaiv thiab zam kev rov qab los, kev noj tshuaj tiv thaiv kab mob yuav tsum txuas ntxiv mus ntev.
Nrog tag nrho cov no, kev xaiv thiab tshuaj noj ntawm kev sib xyaw ua ke zoo tshaj plaws ntawm cov tshuaj, nrog rau lub sijhawm ntawm lawv siv, ncaj qha nyob ntawm daim ntawv ntawm cov kab mob ntsws uas tshwm sim hauv tus neeg mob lub sijhawm ntawd, ntawm kev txhais tau tias los ntawm uas qhov kev kho mob yav dhau los tau ua tiav (yog tias muaj), ntawm tus neeg mob lub siab ntev rau qee yam tshuaj, ntawm seb Mycobacterium tuberculosis rhiab npaum li cas rau cov tshuaj xaiv.
Zoo sib phim
kev sib hlubCov tshuaj tiv thaiv kab mob yog npaj raws li qhov tseeb tias qhov kev kho mob yuav tsum muaj xws li ib lossis ob hom tshuaj thawj zaug. Tau kawg, yog tias lawv tsis muaj contraindications lossis tsis kam rau lawv. Hauv qhov no, qhov koob tshuaj ntawm tag nrho cov tshuaj noj, raws li txoj cai, tsis txo qis.
Thaum muab tshuaj (phthisiologist's memo), nws yuav tsum raug coj mus rau hauv tus account tias cov tshuaj tiv thaiv kab mob xws li streptomycin thiab nws cov derivatives tsis tuaj yeem ua ke nrog florimycin, kanamycin thiab lwm yam tshuaj tua kab mob uas muaj nephrotoxic thiab ototoxic cuam tshuam.
Yuav tshuaj "PASK"
"PASK" yog cov tshuaj tiv thaiv kab mob uas muaj cov kab mob bacteriostatic. Thov kom cov hnub ntawm cov kws kho mob kawm tau tsim nws ntev. Active tiv thaiv tuberculosis mycobacteria. Nws muaj txiaj ntsig zoo hauv kev kho mob ntawm ntau hom thiab ntau qhov chaw ntawm tuberculosis. Nws muab cov txiaj ntsig zoo dua thaum lwm cov tshuaj tiv thaiv kab mob ua ke nrog nws.
Cov tshuaj muaj Latin lub npe "PASK-AKRI". Nws yog tsim nyob rau hauv sachets ntawm 4 g los yog nyob rau hauv ib lub hub ntawm 100 g. Ib sachet ntawm cov tshuaj "PASK" muaj 3.2 sodium aminosalicylate, thiab ib ntsiav tshuaj muaj 1 g ntawm sodium para-aminosalicylate. Cov ntsiav tshuaj yog coated nrog lub plab-tiv thaiv txheej thiab yog muag ntim rau hauv 50/100/500/1000 pcs. ntim.
Yuav ua li cas nrog
tshuaj tiv thaiv tuberculosis "PASK" hais txog tuberculostaticKev ua haujlwm tsis zoo rau cov tshuaj xws li isoniazid thiab streptomycin, yog li nws yuav tsum tau sau ib txhij nrog cov neeg ua haujlwm nquag. Combination therapy slows down the development of drug resistance and improves the effect of concomitant drug.
Pharmacokinetics ntawm "PASK"
Cov tshuaj muaj qhov nqus tau siab (90%). Metabolized hauv daim siab. Nws muaj peev xwm nkag tau yooj yim los ntawm cov kab mob histohematic thiab muab faib rau hauv cov ntaub so ntswg. Qhov siab tshaj plaws ntawm cov tshuaj yog pom nyob rau hauv lub ntsws, ob lub raum thiab lub siab. Ntau qhov nruab nrab, "PASK" (ib qho tshuaj tiv thaiv kab mob) nkag mus rau hauv cov kua dej cerebrospinal. Tab sis nyob rau hauv cov ntaub ntawv ntawm o ntawm daim nyias nyias nyob rau hauv lub cerebrospinal kua, qhov concentration ntawm aminosalicylic acid yog 10-50% ntawm nws cov concentration nyob rau hauv cov ntshav plasma. Feem ntau (80%) ntawm cov tshuaj yog tawm hauv cov zis.
thib ob tshuaj
Cov tshuaj tua kab mob ntawm kab thib 2, thaum xaiv kom raug thiab raws sijhawm, muaj cov txiaj ntsig kho tau zoo, qhia txog kev tshem tawm ntawm lub cev, ntxiv rau qhov tseem ceeb ntawm kev hloov pauv ntawm cov kab mob hauv lub ntsws, thiab txawm tias nyob hauv lub cev. kho mob bronchial tuberculosis.
Raws li kev tshawb fawb txog kev kho mob, thaum kho cov menyuam yaus thiab cov neeg laus uas muaj cov kab mob nyuaj, mob ntev thiab puas tsuaj ntawm cov kab mob nrog ntau yam kev sib txuas ntawm cov tshuaj series II, muab cov neeg mob ntawm cov tshuaj tiv thaiv thiab tiv thaiv kab mob rau cov tshuaj ntawm cov tshuaj. Kuv series, hauv 65 feem pua ntawm cov neeg tau txais, uas yog qhov txaus siab, ntxivtshuaj kho mob.
Tuberculosis tshuaj phiv
Thiab, tau kawg, cov neeg siv cov tshuaj tau piav qhia hauv tsab xov xwm yog txaus siab rau lawv cov kev mob tshwm sim. Ntxiv mus, ntawm cov tshuaj tau qhia rau hauv kev xyaum hauv xyoo tas los no, cov tshuaj tiv thaiv kab mob tsim nyog tau txais kev txiav txim siab tshwj xeeb. Qhov no yog vim lub fact tias tus kab mob no yuav sai sai no hla lub epidemiological pib, txawm tias ib tug tseem ceeb txo nyob rau hauv tus nqi tshwm sim tom qab Tsov Rog Ntiaj Teb thib Ob. Nws tseem yog ib qho tseem ceeb uas kev kho mob ntawm tuberculosis, raws li tau hais los saum no, yog ib txoj kev ntev, thiab cov txiaj ntsig tsis zoo ntawm cov tshuaj tau tshwm sim los ntawm kev siv tshuaj ntau dhau, lossis nrog nws siv mus ntev.
Qee cov txheeb cais
Nrog rau kev kho mob los tiv thaiv tuberculosis, raws li cov ntaub ntawv ntawm cov neeg sawv cev txawv teb chaws thiab txawv teb chaws ntawm cov tshuaj, cov kev mob tshwm sim ntawm cov tshuaj thiab qhov zaus ntawm lawv qhov tshwm sim yog txawv raws li qhov xwm txheej ntawm tus kab mob. Piv txwv li, tawm ntawm 3148 tus neeg mob tau kho nrog cov neeg ua haujlwm tawm tsam mycobacteria, kev tsis zoo tshwm sim tsuas yog hauv 12.2% ntawm tib neeg, thiab feem ntau ntawm lawv yog qhov tshwm sim ntawm kev tsis haum tshuaj, thiab tsuas yog 74 tus neeg mob tsim muaj tshuaj lom lom.
Raws li cov ntaub ntawv luam tawm, nws tuaj yeem xaus lus tias cov kev mob tshwm sim ntawm cov tshuaj tiv thaiv kab mob sib txawv hauv qhov ntau zaus ntawm cov tshuaj tiv thaiv. Lawv qhov kev hloov pauv loj tau piav qhia los ntawm kev kho mob heterogeneous,Thaum tsis tsuas yog cov tshuaj siv tseem ceeb, tab sis kuj yog daim ntawv ntawm tuberculosis, nrog rau cov hnub nyoog ntawm cov neeg mob, txawm tias cov tsev kho mob (tsev kho mob, sanatorium, tsev kho mob, lub koom haum).
Kev tshawb fawb txuas ntxiv
Cov tshuaj uas ua rau Koch's bacillus muaj xws li ntau cov khoom siv ntuj thiab cov khoom siv hluavtaws uas muaj ib qho khoom sib xws - lawv cov haujlwm tawm tsam, uas yog, Mycobacterium tuberculosis (M.tuberculosis). Cov tshuaj tiv thaiv kab mob, kev faib tawm uas, raws li tau hais nyob rau hauv qhov pib ntawm tsab xov xwm, faib cov tshuaj rau hauv 2 kab (piv txwv thiab cia), yog qhov txaus siab rau cov kws tshawb fawb.
Kev saib xyuas tshwj xeeb yog them rau kev txhim kho ntawm kev tiv thaiv tuberculosis mycobacteria. Tag nrho cov kev tshawb fawb tau ua tiav hauv chav kuaj, thiab ntawm qhov teeb meem no, cov txiaj ntsig tau pom tias hauv cov neeg mob feem ntau, qib ntawm cov tshuaj tiv thaiv thaum kev kho mob tuaj yeem hloov pauv ob qho tib si nce thiab nqis, qee zaum ncav cuag yuav luag ua tiav kev kho kom zoo dua qub.
Txo cov kev phiv tshwm sim
Thaum muaj kev phiv tshwm sim thaum kho, thawj kauj ruam yog txo cov tshuaj lossis hloov qee cov tshuaj nrog lwm tus. Hauv qhov xwm txheej hnyav ntawm qhov tsis zoo tshwm sim, cov tshuaj tiv thaiv kab mob yog txwv tsis pub noj ib ntus, tom qab ntawd hloov nrog lwm tus. Txhawm rau tiv thaiv thiab tshem tawm cov tsos mob ntawm coronary insufficiency, tus neeg mob tau muab tshuaj, nyob ntawm qhov qhia, ib qho ntawm cov tshuaj ntawm ib tug xov tooj ntawm antispasmodics, piv txwv li:"Eufillin", "Papaverine", "Teofedrin", "Zelenin" tee, thiab lwm yam.
Cov yam ntxwv thiab qhov hnyav ntawm cov kev mob tshwm sim hauv kev kho kab mob ntsws muaj ntau yam. Cov tshuaj tiv thaiv tuberculosis, uas muaj tib yam tshuaj cais tawm ntawm qhov tshwm sim tshwj xeeb, tau muab tso ua ke rau hauv ib pab pawg kom yooj yim rau kev tshawb fawb ua haujlwm.
Tuberculosis Therapy
Nyob rau hauv kev kho cov kab mob tuberculosis hauv peb lub sijhawm, kev tiv thaiv kev kis tus kabmob kuj yog ib txoj haujlwm tseem ceeb. Qhov kev hem thawj yog los ntawm cov neeg mob uas qhib pulmonary tuberculosis. Lawv txoj kev kho mob hnyav yuav pab txo qis tus kab mob, nrog rau tiv thaiv tus mob tshiab ntawm tus kab mob tsis zoo no.
Vim tias kev kho mob ntev, tus neeg mob xav tau kev ua siab ntev thiab kev qhuab qhia tus kheej. Tom qab tag nrho, tuberculosis ua rau kev puas tsuaj tsis yog rau lub cev, tab sis rau tag nrho cov kab mob. Nws yog ib qho tseem ceeb heev uas yuav tau pib kho cov tshuaj tua kab mob raws sij hawm, uas siv cov phom loj tshaj plaws, uas yog, cov tshuaj tiv thaiv kab mob tseem ceeb. Ua tsaug rau lawv, nws muaj peev xwm txwv tsis pub cov bacilli excretion thaum ntxov, uas yuav pab txhawb kev kho cov kab mob cuam tshuam nrog me me lossis tsis muaj kev puas tsuaj rau tag nrho cov kab mob.
Kev kho mob nyuaj, uas yuav raug sau rau hauv tus account lub hnub nyoog thiab daim ntawv txheeb xyuas ntawm tus kab mob, suav nrog kev cuam tshuam ntawm cov txheej txheem pathological hauv cov kab mob hauv nruab nrog cev, txo qis cov tsos mob ntawm concomitant (mob, hnoos) siv inhalations thiab ntau txoj kevphysiotherapy.
Cov tshuaj kws tshuaj yuav tsum tau noj tsis tu ncua, vim tias txoj hauv kev tsis zoo tuaj yeem ua rau muaj kev tiv thaiv rau lawv. Kev kho mob yuav tsum tau ua nyob rau hauv lub tsev kho mob raws li kev saib xyuas ntawm ib tug kws kho mob. Tom qab tso tawm, kev soj ntsuam los ntawm tus kws kho mob yog qhov yuav tsum tau ua.
Ib txoj hauv kev loj thiab ua tiav ntawm txhua daim ntawv kho mob thiab teem caij yog tus yuam sij rau kev rov zoo tag nrho. Tuberculosis tsis yog kev tuag niaj hnub no.
