Txoj hauv kev los tshuaj xyuas cov tshuaj tiv thaiv ntawm tib neeg lub cev rau kev qhia txog tus neeg ua haujlwm ntawm tuberculosis rau hauv nws yog kev sim Mantoux lossis kuaj tuberculin. Nws muaj npe tom qab tus kws kho mob Fab Kis uas thawj zaug tau thov kev tswj hwm subcutaneous ntawm tuberculin. Yuav kawm tau dab tsi los ntawm qhov kev sim no? Nws qhia tias tus menyuam muaj TB.
Mantoux test - tsis muaj dab tsi yuav ntshai
Hnub no, cov ncauj lus hauv qab no rau cov niam txiv yog cov ntsiab lus: Mantoux test, ntsuas qhov tshwm sim hauv cov menyuam yaus. Cov duab uas pom nyob rau hauv qhov chaw qhib feem ntau xav tsis thoob qhov kev xav thiab tsim kom muaj qhov dav rau niam txiv kev ntshai. Tom qab saib lawv thiab nyeem cov ntaub ntawv hauv Is Taws Nem, ntau tus niam txiv tsuas yog tsis kam muab cov tshuaj tiv thaiv no rau lawv cov menyuam. Txawm hais tias qhov tseeb Mantoux cov tshuaj tiv thaiv tsis siv rau kev txhaj tshuaj. Nrog nws cov kev pab, koj tuaj yeem paub seb puas muaj tubercle bacillus hauv lub cev thiab nyob rau theem twg tus kab mob yog, yog tias qhov kev kuaj mob tseem paub tseeb. Lub luag haujlwm tseem ceeb ntawm kev txhaj tshuaj tiv thaiv yog txhawm rau txheeb xyuas cov theem pib ntawm tus kabmob. Yog hais tias qhov kev ntsuam xyuas ntawm Mantoux xeem tau rau cov me nyuam tsis zoo, ces BCG muab tso.
Kev txhaj tshuaj Mantoux thawj zaug yog ua tiav ntawm tus menyuam muaj ib xyoosrov qab los. Txog li ib xyoos, cov tshuaj tiv thaiv tsis raug kuaj pom vim muaj hnub nyoog txog cov yam ntxwv ntawm kev loj hlob ntawm tus menyuam lub cev. Qhov tshwm sim tuaj yeem ua rau tsis ntseeg tau, tab sis nws tau txiav txim siab raws li qee cov qauv uas qhia tias kev txhaj tshuaj Mantoux yuav tsum zoo li cas. Thaum 4 lub hlis, nws tseem ua tsis tau zoo. Lub luag haujlwm tseem ceeb hauv cov tshuaj tiv thaiv ntawm qhov kev xeem yog ua los ntawm kev noj zaub mov zoo ntawm tus menyuam. Yog li ntawd, koj yuav tsum ua tib zoo saib xyuas nws cov zaub mov.
txhaj tshuaj tiv thaiv Mantoux tau ua txhua xyoo, ib zaug. Rau 14 xyoo, cov menyuam yaus yuav tsum tau xeem qhov kev xeem no nruj me ntsis raws li lub sijhawm, vim tias tsuas yog nyob rau hauv lub zog tuaj yeem pom muaj tus kab mob lossis txheeb xyuas qhov kev xav rau nws.
Thawj zaug
Kev xeem thawj zaug yog muab rau tus menyuam hnub nyoog 12 hli. Cov kws tshawb fawb tau ua pov thawj tias yav dhau los cov txheej txheem xws li kev xeem Mantoux tsis muaj qab hau. Kev ntsuas qhov tshwm sim hauv cov menyuam yaus hnub nyoog 1 xyoos yog qhov qhia tau, tab sis hauv cov menyuam mos uas tsis tau txog hnub nyoog no, cov tshuaj tiv thaiv feem ntau yog qhov tsis zoo.
Txawm li cas los xij, ntau tus kws kho mob sib cav tias yog tus menyuam tsis tau txhaj tshuaj tiv thaiv kab mob raws li daim ntawv qhia hnub - thawj hnub tom qab hnub yug, yuav tsum tau kuaj ob zaug, pib txij li hnub nyoog rau lub hlis.
Dab tsi tuaj yeem cuam tshuam rau "khawm"?
Muab Mantoux inoculation rau ntawm caj npab, ntawm nws sab hauv, nruab nrab ntawm lub luj tshib thiab dab teg. Ntxiv nrog rau qhov tseeb tias Mantu tsis tuaj yeem khawb thiab ntub dej rau peb hnub, nws tseem pom zoo kom tsis txhob lo nrog plaster, rub nws nyuaj, hnia nrog cov khoom, lossis ua rau lwm yam khaus ntawm daim tawv nqaij. Yog tias koj tsis ua raws li cov cai yooj yim no, qhov tsis zoo yuav tshwm sim. Qhov tshwm sim, nyob rau hauv rooj plaub twg koj yuav tau mus kuaj.
Mantoux xeem: kev ntsuam xyuas ntawm cov menyuam yaus
Daim duab hauv qab no qhia tau tias cov tshuaj tiv thaiv tau hais tau zoo heev. Hauv qhov no, qhov loj ntawm papule ncav cuag ntau dua 1.5 cm inch. Lwm qhov txiaj ntsig tau ntsuas li cas?
- Cov tshuaj tiv thaiv Mantoux hnyav tau pom thaum lub papule loj yog 15-16 hli inch.
- Reaction rau tus qauv yuav yog qhov kev siv nruab nrab thaum txoj kab uas hla yog 10-14mm.
- Cov tshuaj tiv thaiv me ntsis zoo - yog tias foob txoj kab uas hla yog 5-9mm.
- Cov tshuaj tiv thaiv zoo tau pom thaum qhov loj ntawm papule nce mus txog 5 mm.
- Cov tshuaj tiv thaiv hu ua tsis ntseeg yog tias lub pob muaj qhov loj ntawm 2 txog 4 hli. Qhov no kuj suav nrog cov xwm txheej yog tias qhov chaw xeem Mantoux muaj qhov liab ntawm qhov loj me, tab sis tsis muaj lub foob - lub npe hu ua "khawm".
- Negative Mantoux test - nrog rau qhov loj ntawm 0 txog 1 hli.
Cov niam txiv yuav tsum tsis txhob ntshai ua ntej yog tias tom qab txhaj tshuaj "khawm" muaj qhov tsis txaus ntseeg, vim tias qhov tshwm sim ntawm peb hnub yuav txawv ntawm qhov tshuaj tiv thaiv Mantoux yuav tsum zoo li thawj hnub.
Txo kev pheej hmoo
Thaum lub sijhawm kuaj mob, txhua yam khoom noj uas yuav ua rau muaj kev fab tshuaj yuav tsum raug cais tawm ntawm kev noj haus. Qhov no feem ntau yog chocolate, txiv kab ntxwv, tangerines thiab lwm yam txiv hmab txiv ntoo citrus.
Yog tias tam sim ntawd tus me nyuam ntub Mantoux, koj yuav tsum so daim tawv nqaij nrog ib daim ntaub mos, phuam los yog ntaub so ntswg, tsis tas siv zog. Tom qab ntawd, nws yuav tsum tau qhia rau tus kws kho mob txog qhov no thaum lub sijhawm kuaj. IbLub "khawm" yuav tsum tau ua tib zoo saib xyuas kom qhov kev ntsuam xyuas ntawm qhov kev xeem Mantoux yog qhov ntseeg tau.
Thiab yog muaj qhov liab liab?
Yog tias tom qab coj tus qauv, qhov chaw txhaj tshuaj tig liab, ces tsis txhob ntshai. Peb hnub tom qab, tus kws kho mob yuav xyuam xim tsis txhob kos npe, tab sis mus rau lub foob - papule.
Kev mob ntshav liab tsis yog qhov tshwm sim zoo thiab tsis yog qhov qhia tias muaj tus kab mob ntsws hauv tus menyuam.
Tus kws kho mob tuaj yeem ntsuas qhov chaw ntawm qhov liab thiab sau npe qhov tshwm sim yog tias tsis muaj "khawm" ntawm qhov chaw txhaj tshuaj.
Peb ntsuas peb tus kheej
Yog xav tau, cov niam txiv tuaj yeem txiav txim siab qhov tshwm sim ntawm tsev xya caum-ob teev tom qab txhaj tshuaj, tab sis qee tus tseem muaj cov lus nug txog seb cov tshuaj tiv thaiv Mantoux tsis zoo yuav zoo li cas. Yog hais tias, tom qab lub sij hawm teev tom qab txhaj tshuaj, lub resulting foob tsis pub tshaj 1 mm nyob rau hauv lub cheeb thiab redness tsis pom, ces qhov tshwm sim yog tsis zoo. Tsis ua li cas, koj tuaj yeem ua pa ntawm lub siab. Cov lus nug tshwm sim yog muab los ntawm "khawm" uas tsis pub tshaj 4 hli hauv qhov loj me, lossis qhov pom ntawm tsuas yog liab. Kev kawm, qhov loj ntawm qhov ntau tshaj qhov kev cai (los ntawm 5 hli - 16 hli) yog cov lus teb zoo. Qhov txiaj ntsig zoo kuj tseem tuaj yeem txhais tau tias muaj cov tshuaj tiv thaiv hyperergic, mob lossis pustules ntawm qhov chaw txhaj tshuaj, tsim cov foob loj dua 17 hli.
Nws yog qhov zoo dua kom paub tias qhov tshuaj tiv thaiv Mantoux yuav tsum zoo li cas rau hnub 3. Daim duab hauv qab no yog tus qauv.
Yog qhov kev xav tsis zoo siab
Cov tshuaj tiv thaiv tsis zoo tshwm sim thaum lub "khawm" ntawm Mantoux raug tswj tsis raug. Hauv qhov no, tus menyuam raug xa mus kuaj nrog nws niam nws txiv mus rau TB dispensary. Lawv yuav xeem tag nrho cov kev ntsuam xyuas tsim nyog, thiab tus kws kho mob yuav piav qhia qhov xwm txheej. Feem ntau lawv kuj muab pub ntshav - qhov kev sim no hu ua PCR (polymerase chain reaction). Nws yog siv rau qhov tsis zoo qhov tshwm sim uas qhov kev sim Mantoux muab.
Kev ntsuas qhov tshwm sim hauv cov xwm txheej ib txwm yog nyob ntawm qhov kev hloov pauv txhua xyoo. Qhov loj ntawm papule yuav tsum tau txo los ntawm ob peb millimeters ib xyoos twg, thiab thaum muaj hnub nyoog xya xyoo nws yuav tsum yuav luag tsis pom nyob rau hauv ib tug me nyuam.
Dab tsi tseem ceeb?
Tsis txhob ntshai yog tias koj tus menyuam raug xa mus rau chaw kho mob TB. Cov tshuaj tiv thaiv zoo yuav qhia tau tias tus menyuam mos yog tus nqa ntawm tus pas, tab sis tib lub sijhawm nws tsis kis tau. Nws tuaj yeem mus kawm ntawv, qib kindergarten. Cov nplaum zoo li no tsis kis los ntawm cov ntshav. Cov neeg nyob ib puag ncig tsuas kis tau los ntawm tus neeg muaj tus kab mob, los ntawm cov tee dej.
Txawm li cas los xij, thaum qhov kev xeem Mantoux zoo, tus menyuam yuav tsum raug soj ntsuam los ntawm tus kws kho mob TB. Tab sis yog tias tus kws kho mob tshwj xeeb ua qhov kev kuaj mob tsim nyog, tus neeg mob me yuav tau txais kev kho mob.
Ua ntej tshaj plaws, nws yuav raug xa mus rau lub hauv siab X-ray thiab hnoos qeev microbiology. Tsis tas li ntawd, txhua tus neeg hauv tsev neeg kuj yuav raug kuaj xyuas.
Phenol thiab kev ua xua - kev sib txuas yog dab tsi?
Cov menyuam yaus qee zaum muaj kev fab tshuaj rau cov tshuaj tiv thaivMantu. Yog vim li cas rau qhov no yog ib tug neeg intolerance rau lub Cheebtsam ntawm cov tshuaj los yog hereditary predisposition. Feem ntau qhov ua txhaum ntawm kev ua xua yog phenol, uas yog ib feem ntawm cov tshuaj tiv thaiv. Cov tshuaj no yog tshuaj lom, tab sis nyob rau hauv me me nws tsis ua mob. Muaj cov xwm txheej thaum tus me nyuam muaj kev tsis haum rau phenol, ces kev tsis haum tshuaj tshwm sim. Txawm li cas los xij, nws yuav tsum tau sab laj nrog tus kws kho mob tshwj xeeb thaum qhov kev sim Mantoux tau ua rau muaj kev tsis haum ntawm lub cev. Kev ntsuas qhov tshwm sim tom qab ib ntus yuav tsum tsis txhob nrog cov tsos mob ua xua hauv qab no:
- poob qab los;
- pob khaus;
- kub;
- tsis muaj zog;
- anaphylaxis.
Hauv qhov no, koj tuaj yeem kuaj xyuas lub sijhawm tom ntej. Tab sis koj yuav tsum nco ntsoov tias kev ua xua tuaj yeem tshwm sim nyob txhua qhov chaw ntawm tus menyuam lub cev: hauv puab tais, hauv qab lub hauv caug, sab hauv ntawm lub luj tshib thiab, ntawm chav kawm, nyob rau hauv qhov chaw uas qhov kev xeem Mantoux tau ua. Kev ntsuam xyuas ntawm qhov tshwm sim, uas suav nrog txawm tias cov tsos mob me me ntawm kev ua xua hauv menyuam yaus, yuam cov niam txiv mus ntsib kws kho mob tam sim ntawd. Nws yuav sau tshuaj antihistamines los txo cov tsos mob ntawm kev ua xua. Feem ntau, cov kev mob tshwm sim ntawm Mantoux tshwm sim vim muaj kab mob tsis ntev los no, thiab tuaj yeem nrog ntau yam mob.
Yog tus menyuam muaj kab mob ntawm daim tawv nqaij, kab mob sib kis, tshwj xeeb tshaj yog nyob rau theem mob hnyav, ua xua rau ib yam dab tsi, mob vwm lossis mob khaub thuas, ces Mantoux tsis tuaj yeem txhaj tshuaj tiv thaiv. Nws tsim nyog ncua qhov kev tshwm sim no thiab tuav nws tom qab ib hlis tom qabploj ntawm tag nrho cov tsos mob. Txhua qhov tshuaj tiv thaiv ua rau lub cev tsis muaj zog, yog li lawv yuav tsum tau muab rau lub sijhawm sib txawv. Txwv tsis pub, qhov kev ntsuam xyuas ntawm Mantoux cov txiaj ntsig yuav yog qhov tsis zoo.
Kev tsis lees paub ntawm Mantoux
Raws li txoj cai, cov niam txiv tuaj yeem tsis kam txhaj tshuaj tiv thaiv Mantoux. Nws yeem. Koj tuaj yeem tsis kam lees los ntawm kev sau ib nqe lus ntawm lub tsev kho mob. Qhov no yuav tsum ua kom tiav nrog 100% tseeb tias tus menyuam tsis tau ntsib nrog tus neeg mob tuberculosis. Kev kuaj Mantoux ua rau tus menyuam tsis muaj zog, zoo li lwm yam kev txhaj tshuaj. Txhawm rau zam qhov no, koj tuaj yeem siv lwm txoj hauv kev thiab pub ntshav los ntawm tus ntiv tes. Qhov tsis zoo ntawm qhov kev tshuaj ntsuam no tsuas yog ua tiav hauv cov chaw kho mob ntiag tug nkaus xwb rau tus nqi.
Mantoux xeem: kev ntsuas qhov tshwm sim hauv cov neeg laus
Cov duab saum toj no qhia tau zoo tias qhov tshuaj tiv thaiv rau Mantoux yuav tsum muaj rau menyuam yaus. Hauv cov neeg laus, nws xyaum tsis txawv.
Mantoux yog ib qho tshuaj tiv thaiv kab mob uas qhia tias muaj cov kab mob tubercle bacillus hauv lub cev.
Tom qab txhaj tshuaj uas muaj tuberculin, qhov tshwm sim tshwm sim. Nrog nws cov kev pab, koj tuaj yeem paub seb tus neeg mob puas yog. Ntawm qhov chaw txhaj tshuaj, qhov mob tshwm sim, tshwm sim los ntawm cov qe ntshav ua lub luag haujlwm rau kev tiv thaiv kab mob. Lymphocytes yog attracted los ntawm cov hlab ntsha nyob ze ntawm daim tawv nqaij nrog kev pab los ntawm fragments ntawm microbacteria. Tab sis tsis yog txhua tus lymphocytes tau nyiam, tab sis tsuas yog cov uas twb paub nrog Koch stick ua ntej.
Yog ib tug neeg kis taucov kab mob, ces qhov mob yuav loj, qhov tshwm sim yuav zoo, thiab yog hais tias muaj peev xwm kis tau ua ntej, tab sis nws tsis tshwm sim, ces cov tshuaj tiv thaiv yuav nrog pronounced, tab sis tsis khaus khaus. Tau kawg, los ntawm cov tshuaj tiv thaiv zoo nws ua raws li cov quav hniav tsis yog vim kev txhaj tshuaj nws tus kheej thiab ua rau tawv nqaij khaus vim nws, tab sis vim muaj qee yam tshwm sim.
Txoj Cai Ua Haujlwm
Tom qab qhia txog tuberculin, qee qhov kev tsis haum tshuaj tshwm sim. Thiab nyob rau hnub thib ob lossis thib peb, lub foob tau tshwm sim ntawm daim tawv nqaij, qhov chaw kuaj Mantoux tau muab tso rau. Kev soj ntsuam ntawm qhov tshwm sim (qhov "khawm" yuav tsum zoo li cas) yuav ntseeg tau tsuas yog thaum tag nrho cov cai rau kev saib xyuas qhov chaw txhaj tshuaj tau ua raws.
Feem ntau nws muaj qhov o ntawm lub qhov txhab uas nce siab tshaj qhov dav ntawm daim tawv nqaij, feem ntau reddened thiab ntom rau qhov kov. Cov kab mob tiv thaiv kab mob ntau dua hauv tib neeg lub cev uas tau ntsib tus kab mob bacillus, qhov ntau tshaj tawm thiab loj dua qhov induration yuav.
Reaction rau Mantoux hauv cov neeg laus
Hauv cov neeg laus, cov tshuaj tiv thaiv rau Mantoux yog peb hom:
- negative;
- false positive;
- positive.
Kev kuaj tsis zoo yog kuaj pom thaum qhov tsis tiav ntawm "khawm", lossis yog tias nws muaj qhov loj txog li 1 hli. Cov txiaj ntsig no suav tias yog qhov qub. Nrog rau cov quav hniav loj ntawm ob mus rau plaub millimeters, nws qhov liab, qhov tshwm sim tsis ntseeg thiab tuaj yeem suav tias yog qhov tsis zoo. Yog tias cov quav hniav loj dua 5 hli, cov tshuaj tiv thaiv zoo. Yog tias txoj kab uas hla ntawm lub foob ntawm qhov chaw txhaj tshuaj hauv cov neeg laus yog ntau tshaj 21 hli, cov tshuaj tiv thaiv yog hyperergic.
Yog li, txhaj tshuaj tiv thaiv Mantoux yuav tsum tau ua txhua xyoo txhawm rau txhawm rau txheeb xyuas qhov tsis zoo lossis kis tau. Piv txwv li, rau peb xyoos ua ke, qhov ntau thiab tsawg ntawm cov quav hniav tau sau tseg hauv 14 hli, thiab rau xyoo plaub nws tau nce mus rau 20 hli. Nws muaj feem yuav kis tau tus mob. Nws yog qhov tig ntawm Mantoux tuberculin test uas thawb tus kws kho mob kom sau tshuaj ntsuam ntxiv rau tus neeg mob.
Yog qhov kev xeem Mantoux ceeb toom
Kev ntsuas qhov tshwm sim (daim duab twb tau nthuav tawm saum toj no), uas ua rau muaj kev tsis ntseeg, yuav tsum ua qhov tseeb. Tom qab tag nrho, tseem muaj qhov ua rau muaj kev tsis haum tshuaj rau kev kuaj Mantoux, thiab cov kab mob tsis ntev los no lossis twb muaj kev tsis haum rau ib yam tshuaj kuj tseem tuaj yeem cuam tshuam. Hauv cov xwm txheej no, cov tshuaj tiv thaiv tuaj yeem ua rau pom qhov txiaj ntsig zoo, yog li txhua yam uas cuam tshuam rau Mantoux xeem yuav tsum tau qhia rau tus kws kho mob. Raws li txhua txoj cai, qhov tshwm sim yuav yog qhov kev ntseeg siab tshaj plaws.
Kev ntsuas qhov tshwm sim: qhov lawv them siab rau
Tom qab 72 teev, koj yuav tsum mus ntsib kws kho mob, qhov chaw kuaj Mantoux yuav raug kuaj. Kev ntsuam xyuas ntawm qhov tshwm sim, daim duab uas nyob hauv qab no qhia tias tsis muaj teeb meem. Tab sis tag nrho cov kev ntsuam xyuas pib nrog qhov chaw txhaj tshuaj. Hauv qhov no, peb lub xeev tuaj yeem teeb tsa:
- hyperemia;
- infiltration;
- no teb.
Nws yog ib qho tseem ceeb heev kom paub qhov txawv ntawm hyperemia ntawm infiltration. Ua li no, lawv tshawb xyuas "khawm", thiab tom qab ntawd thaj chaw noj qab haus huv ntawm daim tawv nqaij thiaj li yuavtxiav txim siab seal thickness. Yog tias cov tshuaj tiv thaiv yog infiltrate, ces qhov ntom ntawm daim tawv nqaij nyob rau hauv ib qho chaw noj qab haus huv thiab ntawm qhov chaw txhaj tshuaj yuav txawv. Nrog hyperemia, qhov ntom ntawm daim tawv nqaij yog tib yam.
Tom ntej no, koj yuav tsum ntsuas cov quav hniav nrog pob tshab millimeter kav. Ntsuas qhov transverse, txheeb ze rau axis ntawm tes, qhov loj ntawm infiltrate thiab sau npe rau nws. Nws yog nruj me ntsis txwv tsis pub ua cov manipulations nyob rau hauv ib chav tsis zoo siv cov cuab yeej improvised uas hloov tus kav. Tsuas yog lub foob loj yuav tsum ntsuas. Yog tias tsuas yog liab liab tshwm sim ntawm qhov chaw txhaj tshuaj, thiab tsis muaj papule, ces nws raug kaw, tab sis tsis yog vim li cas thiaj ntseeg tau tias tus neeg muaj cov tshuaj tiv thaiv zoo.
Qhov no yog qhov kev kuaj Mantoux tsis zoo zoo li.
Cov neeg mob hais li cas?
Tsis ntev los no, muaj ntau tus neeg tawm tsam kom lawv cov menyuam raug kuaj Mantoux. Kev soj ntsuam ntawm qhov tshwm sim, kev tshuaj xyuas ntawm cov niam txiv txog cov txheej txheem nws tus kheej yog categorical heev. Feem ntau, tus cwj pwm tsis zoo ntawm cov neeg laus tiv thaiv Mantoux yog qhov tseeb tias tom qab nws cov menyuam raug xa mus rau phthisiatricians. Qhov tseeb, nws hloov tawm tias lub tswb tsis muaj tseeb, thiab "khawm" tau ua rau mob rau vim li cas tsis cuam tshuam rau tuberculosis.
Tab sis nws tsim nyog nco ntsoov tias tseem yuav tsum tau xeem. Yog tias koj tsis nyiam qhov kev xeem Mantoux, muaj lwm txoj hauv kev los txiav txim siab kab mob hauv lub cevtib neeg.
