Cov menyuam mos yug tshiab tau txhaj tshuaj tiv thaiv dab tsi hauv xub pwg? Lo lus nug no yog qhov txaus siab rau cov niam uas muaj lawv thawj tus menyuam. Lub xub pwg txhaj yog hu ua BCG. Nws tiv thaiv ntau hom tuberculosis. Yog tias leej niam txiav txim siab tsis kam txhaj tshuaj tiv thaiv no, nws yuav tsum nkag siab txog qhov tshwm sim. Ces tus me nyuam yuav kis tau tus kab mob. Yuav tsum ua tib zoo saib seb yog vim li cas cov menyuam yaus txhaj tshuaj tiv thaiv lub xub pwg.
Thaum twg?
Yuav txhaj tshuaj tiv thaiv dab tsi hauv xub pwg ntawm lub tsev kho mob maternity thiab thaum twg? Kev txhaj tshuaj BCG tau ua tiav hauv tsev kho mob maternity hnub 4-6 ntawm tus menyuam lub neej. Thaum lub hnub nyoog no, nws tau ua rau cov menyuam yaus uas qhov hnyav tsis tsawg dua 2500 grams. Kuj tseem muaj tshuaj tiv thaiv BCG-M - cov tshuaj tiv thaiv no muaj ib nrab ntawm cov tshuaj tiv thaiv. BCG-M yog muab rau cov menyuam yaus uas muaj contraindications rau kev txhaj tshuaj BCG. Piv txwv li, cov menyuam mos ntxov ntxov uas hnyav tshaj 2 kg, cov menyuam yaus uas muaj kev cuam tshuam hauv nruab nrab lub paj hlwb, nrog rau cov menyuam mos uas tsis tau txhaj tshuaj tiv thaiv lub xub pwg ntawm lub tsev kho mob maternity.
rau leej twgcontraindicated?Yaj
Categorically nws tsis tuaj yeem txhaj tshuaj tiv thaiv menyuam yaus uas muaj los yog tau txais kev tiv thaiv kab mob los ntawm kab mob HIV; teeb meem tom qab revaccination nyob rau hauv cov kwv tij los yog cov muam ntawm tus me nyuam. Lawv kuj tsis txhaj tshuaj tiv thaiv menyuam mos uas muaj tuberculosis.
Nws ua li cas?
Cov niam txiv uas paub dab tsi lub xub pwg nyom yog los ntawm yuav tsum paub lawv tus kheej nrog cov txheej txheem ntawm nws qhov kev siv. Ua ntej txhaj tshuaj, nws yog diluted nrog ib qho tshuaj ntsev tshwj xeeb uas txuas nrog rau cov tshuaj tiv thaiv. Txhawm rau txhaj tshuaj tiv thaiv, siv lub syringe tshwj xeeb tuberculin. Cov tshuaj tiv thaiv yog muab intradermally rau sab laug xub pwg. Ib hlis thiab ib nrab tom qab txhaj tshuaj, ib qho chaw tshwm rau ntawm qhov chaw, tom qab ntawd ib qho infiltrate, uas yog, cov ntaub so ntswg loj hlob hauv ntim thiab ua ntom ntom, nrog txoj kab uas hla tsis tshaj 5-10 mm. Tom qab ntawd lub npuas yog tsim - ib qho abscess, nws yuav tsum tsis txhob ntau tshaj ib centimeter nyob rau hauv loj. Cov ntsiab lus ntawm cov npuas yog pob tshab los yog pos huab me ntsis, ces ib qho crust yuav tshwm.
Tshuaj tiv thaiv kab mob ntawm lub xub pwg
Tom qab 5-6 lub hlis, tus me nyuam loj hlob 3-10 mm ntev. Cov caws pliav hais txog kev txhaj tshuaj tiv thaiv thiab kev txhim kho los ntawm lub cev ntawm kev tiv thaiv tshwj xeeb tiv thaiv Mycobacterium tuberculosis. Qhov chaw uas lawv tau txhaj tshuaj yuav tsum tsis txhob kov, smeared nrog antiseptics, ntaub qhwv yuav tsum tau siv. Txawm tias lub npuas tau qhib, nws tseem yuav tsum tsis txhob kov nyob rau hauv txhua rooj plaub, tom qab ib pliag nws yuav qhuav tawm thiab ib tug crust yuav tsim.
kws kho mob TB
Yog lub qhov txhab loj heev (ntau tshaj 10 hli), lub xub pwg nyom mob tom qab txhaj tshuaj, lossis tsis muaj npuas tsis tau tsim ntawm qhov chaw txhaj tshuaj, koj yuav tsum hu rau tus kws kho mob. Tus kws kho mob phthisiatrician yog tus kws kho mob uas kuaj mob, sau tshuaj kho lossis tiv thaiv kab mob. Yog tias tus me nyuam tsis tau txhaj tshuaj tiv thaiv rau qee yam hauv tsev kho mob maternity hauv 4-6 hnub, nws yuav tsum tau txhaj tshuaj tiv thaiv nws tom qab tshem tawm cov contraindications. Yog tias koj xav tau ua BCG rau tus menyuam hnub nyoog qis dua 2 lub hlis, ua ntej lawv sim Mantoux. Yog tias qhov kev xeem Mantoux tsis zoo, tus menyuam tuaj yeem ua BCG, tab sis tsis pub dhau 2 lub lis piam tom qab Mantoux. Tsis tas li ntawd, cov niam txiv yuav tsum tsis txhob hnov qab tias yog tias tus menyuam raug coj los tsev los ntawm tsev kho mob maternity, nws yuav tsum tsis txhob ntsib nrog cov neeg uas tsis tau txais tshuaj fluorography.
Tom qab koj paub tias cov tshuaj tiv thaiv hauv lub xub pwg (sab laug) yog dab tsi, koj yuav tsum paub seb qhov tshuaj tiv thaiv yog dab tsi. Rov txhaj tshuaj tiv thaiv yog ua thaum muaj hnub nyoog tshaj 6 xyoo. Txhawm rau sib sau ua ke qhov tshwm sim thiab tsim kom muaj kev tiv thaiv kab mob rau tuberculosis. Ua ntej rov txhaj tshuaj tiv thaiv, tus menyuam tau txhaj tshuaj tiv thaiv nrog Mantoux. Kev kuaj Mantoux yog ib qho kev sim rau kev txhim kho kev tiv thaiv kab mob. Qhov no yog txoj hauv kev nyab xeeb tshaj plaws los kuaj mob, yam tsawg kawg muaj kev nyab xeeb dua li x-rays ntawm lub ntsws. Yog tias qhov ntsuas tau zoo, ces yuav muaj qhov o, liab thiab induration ntawm qhov chaw grafting nrog ib txoj kab uas hla ntawm 10 mm. Qhov no txhais tau hais tias tus me nyuam lub cev muaj kev sib cuag nrog tus neeg sawv cev ntawm tuberculosis, tab sis qhov no tsis yog qhov qhia tias tus me nyuam mob. Yog tias muaj qhov tshwm sim zoo li no, ces tus menyuam yuav tsum nyob hauv qabsaib xyuas ntawm pediatric pulmonologist thiab pediatrician. Lub sij hawm ntawm Mantoux thiab BCG txhaj tshuaj yog li ntawm 3 mus rau 14 hnub.
Kev txhaj tshuaj tiv thaiv thaum yug hauv lub xub pwg yog contraindicated rau cov menyuam mos uas yug los muaj qee yam teeb meem, nws tuaj yeem ua rau mob hauv plab, thawj qhov kev tiv thaiv kab mob thiab HIV hauv leej niam thiab lwm yam kab mob loj. Txawm hais tias yuav tau txhaj tshuaj tiv thaiv hauv tsev kho mob poj niam los yog tom qab, leej niam yuav tsum txiav txim siab, thiab yog tias muaj cov contraindications, nws yuav tsum tau qhia txog qhov no los ntawm tus kws kho mob neonatologist uas tshuaj xyuas tus menyuam hauv thawj feeb ntawm nws lub neej.
Kev txhaj tshuaj BCG rov (thaum muaj hnub nyoog 6-7 xyoos) tuaj yeem ncua yog tias tus menyuam muaj kev ua xua, tiv thaiv kab mob, mob qog noj ntshav lossis lwm yam kab mob hnyav. Yog tias thawj zaug txhaj tshuaj tiv thaiv Mantoux yog qhov zoo, tom qab ntawd rov txhaj tshuaj tiv thaiv yog ua kom ceev faj heev. Hauv tus menyuam noj qab nyob zoo, cov teeb meem tom qab BCG tsis tshwm sim. Tab sis tsis txhob hnov qab tias txhua yam tshuaj kho mob tuaj yeem muab cov tshuaj tiv thaiv tsis txaus ntseeg thaum raug rau ib qho kab mob, uas yog, qhov no tuaj yeem tshwm sim ntawm tus kheej. Qee lub sij hawm nws nyuaj rau kev kuaj mob qee yam kab mob hauv tus menyuam ua ntej txhaj tshuaj tiv thaiv, thiab tom qab ntawd qhov kev txhaj tshuaj tau ua dhau los ua qhov tsis zoo rau tus menyuam. Thiab pom tias tus menyuam tau txhaj tshuaj thaum tus menyuam mob, tab sis tsis muaj leej twg paub txog nws.
Muaj Teeb Meem
Yog li no, tej zaum yuav muaj teeb meem hauv qab no:
- Ua npaws - nws tuaj yeem yog 38-38, 5 ° C, tom qab ntawd koj yuav tsum tau muab cov tshuaj tua kab mob rau tus menyuam, thiab yog tias hnub thib ob muaj qhov kub thiab txias dua,koj yuav tsum hu rau tus kws kho mob. Cov tshuaj tiv thaiv zoo li no tuaj yeem ua rau menyuam yaus lub cev tsis muaj zog, nws lub cev tiv thaiv kab mob tsis muaj zog txaus.
- Ib qhov ntswg, hnoos lossis liab ntawm caj pas - cov tshuaj tiv thaiv no tuaj yeem tshwm sim vim kev tiv thaiv tsis muaj zog. Txhua yam no kho tau, thiab tus menyuam tsis tas yuav mus pw hauv tsev kho mob.
- Nyob rau yav tsaus ntuj tom qab txhaj tshuaj, tus me nyuam yuav muaj kev qaug zog, tsis qab los noj mov, tus me nyuam yuav capricious. Yog tias muaj cov tshuaj tiv thaiv zoo li no, koj yuav tsum ua kom tus menyuam mos, tsis txhob noj zaub mov, muab kev thaj yeeb rau nws thiab, yog tias ua tau, muab nws pw ua ntej. Cov tsos mob no feem ntau ploj mus tom qab ntau tshaj 3 hnub.
- Yog qhov chaw txhaj tshuaj tiv thaiv kab mob los yog pib mob raws sij hawm, koj yuav tsum mus ntsib kws kho mob tam sim ntawd.
Tag nrho cov tsos mob no tsis loj thiab tsis ua rau mob thiab lub neej ntawm tus menyuam.
Lwm cov tshuaj tiv thaiv rau kev txhaj tshuaj
Tseem tuaj yeem tshwm sim hnyav heev rau cov tshuaj tiv thaiv, lawv tsis tshua muaj tab sis tshwm sim:
- Lymphadenitis yog hu ua mob ntawm cov qog nqaij hlav, uas yog nrog los ntawm kev nce hauv qog, thiab qee zaum suppuration. Yog tias cov qog nqaij hlav festering, lawv yuav tsum tau muab tshem tawm tsuas yog phais xwb, yog li, nrog cov tshuaj tiv thaiv zoo li no, tus menyuam yuav tsum tau mus pw hauv tsev kho mob.
- Cov suppuration hnyav tau tsim nyob rau hauv qhov chaw txhaj tshuaj, uas cuam tshuam rau daim tawv nqaij ib ncig ntawm nws. Cov tshuaj tiv thaiv zoo li no muaj peev xwm ua tau rau tus menyuam uas muaj kev tiv thaiv kab mob, thiab kev soj ntsuam kev phais thiab kev kho mob yuav tsum tau ua.
- Cov kab mob khaub thuas tuaj yeem tshwm sim. Qhov laj thawj yog kev txhaj tshuaj tsis raug, uas yog, kev txhaj tshuaj tsis yog subcutaneously, tab sis intramuscularly. Qhia 3-4 lub lis piam tom qab txhaj tshuaj. Tom qab lub sijhawm zoo li no, lub qhov txhab pib tawg. Txhawm rau tiv thaiv cov teeb meem zoo li no, nws yog ib qho tsim nyog yuav tsum tau txhaj tshuaj tiv thaiv hauv chaw ua haujlwm uas cov kws tshaj lij tau txhaj tshuaj tiv thaiv.
- Osteomyelitis yog kab mob pob txha uas tsim ob peb lub hlis tom qab kev tswj hwm. Qhov laj thawj yuav yog cov tshuaj tiv thaiv tsis zoo. Yog li ntawd, cov kws kho mob pom zoo kom txhaj tshuaj tiv thaiv hauv tsev kho mob nkaus xwb thiab tsis txhob yuav los ntawm leej twg paub qhov twg thiab leej twg paub.
- Yog tias kev txhaj tshuaj tsis raug, uas yog, tsis yog intramuscularly, tab sis subcutaneously, cov caws pliav keloid tshwm sim kaum ob lub hlis tom qab txhaj tshuaj.
- Ib qho mob tshwm sim ntawm qhov chaw txhaj tshuaj - qhov no qhia txog qhov kev nkag siab ntawm tus menyuam lub cev rau cov khoom ntawm cov tshuaj tiv thaiv BCG. Lub plab yog qhov txaus ntshai los ntawm kev qhia tus kab mob, yog li ntawd, yuav tsum tau saib xyuas los ntawm tus kws phais. Qhov no tshwm sim tsawg heev, tab sis nws tshwm sim.
Los ntawm tag nrho cov no peb tuaj yeem txiav txim siab tias kev txhaj tshuaj BCG muaj qhov tshwm sim loj rau tus menyuam, tab sis tsuas yog yog tias tsis quav ntsej txog cov tshuaj tiv thaiv, cov tshuaj tiv thaiv tsis zoo tau qhia, lossis kev tswj hwm tau ua tsis raug. Yog tias txhua yam ua tiav lawm, ces txhaj tshuaj tiv thaiv BCG yog tib txoj hauv kev tiag tiag los tiv thaiv tus menyuam los ntawm tuberculosis.
