Kev txhaj tshuaj tiv thaiv yog ib txoj hauv kev los txhawb kev tiv thaiv tib neeg. Kev txhaj tshuaj tiv thaiv yog qhov yuav tsum tau ua, uas yuav tsum tau muab rau yuav luag txhua tus menyuam yaus nrog qee qhov kev zam, thiab muaj cov uas tau sau tseg rau qee qhov qhia. Ua ntej koj yuav txhaj tshuaj tiv thaiv tus menyuam tsis tau teem sijhawm, koj yuav tsum ua tib zoo kawm cov ntaub ntawv hais txog nws, sab laj nrog kws kho mob thiab nyeem cov tshuaj xyuas. "Prevenar" tsuas yog cov tshuaj tiv thaiv, nrog rau kev qhia thiab contraindications uas koj yuav tsum tau ceev faj.
Form and composition
Cov tshuaj tiv thaiv Prevenar tsis yog tsim nyob rau hauv Russia, tab sis yog tuaj ntawm txawv teb chaws (USA, Europe). Muab nyob rau hauv 0.5 ml syringes npaj rau kev txhaj tshuaj. Xws li cov kab mob pneumococcal (polysaccharide + CRM197), suav nrog polysaccharides ntawm serotypes: 4 (2mcg), 6B (4mcg), 9V (2mcg), 14 (2mcg), 18C (2mcg), 19F (2mcg) (2 µg), Cov kab mob diphtheria carrier protein CRM197 (20 µg).
Cov khoom siv pabcuam hauv cov khoom raug tshem tawm yog: txhuas phosphate, sodium chloride,purified dej distilled.
Prevenar, uas muaj ntau yam kev tshuaj xyuas, ua tau raws li tag nrho cov qauv tsim nyog WHO rau kev tsim thiab tswj cov tshuaj tiv thaiv kab mob pneumococcal conjugate. Npaj rau kev tiv thaiv kab mob los ntawm kab mob pneumococcal.
Tus nqi ntawm cov tshuaj tiv thaiv yog los ntawm 3,500-4,000 rubles.
tshuaj kho mob
Kev ncua Prevenar muaj xya, kaum peb lossis nees nkaum-peb kab mob pneumococcal. Lawv tus lej nyob ntawm hom tshuaj tiv thaiv. Cov serotypes yog pneumococcal polysaccharides muab tau los ntawm ntau pawg ntawm cov kab mob gram-positive Streptococcus, txhua tus uas ua raws cov kab mob diphtheria carrier protein CRM197 thiab adsorbed ntawm txhuas phosphate.
Kev txhaj tshuaj nrog Prevenar, tshuaj xyuas qhov tsis sib xws, pib tsim cov tshuaj tiv thaiv kab mob tiv thaiv polysaccharides ntawm Streptococcus pneumoniae strains 4, 6B, 9V, 14, 18C, 19F, 23F. Cov txheej txheem no txhawb lub cev tiv thaiv kab mob. Cov tshuaj tiv thaiv yog tsim los tiv thaiv kab mob pneumococcal.
Cov tshuaj tiv thaiv kab mob
Cov menyuam mos ntawm cov menyuam mos, pib txij li ob lub hlis ntawm lub neej, tau txhaj tshuaj tiv thaiv raws li qee lub tswv yim. Qhov kev txiav txim ntawm kev txhaj tshuaj no yog xav tau los tsim kom muaj kev tiv thaiv kab mob hauv lub cev, uas tshwm sim nws tus kheej tom qab txhaj tshuaj tiv thaiv thawj zaug, thib ob thiab tom qab. Nws tau raug tshawb fawb pov thawj tias tus nqi ntawm cov tshuaj tiv thaiv yog qhov tseem ceebnce tom qab txhaj tshuaj tiv thaiv thawj zaug. Nyob rau hauv tag nrho, tom qab ib lub sij hawm, peb koob tshuaj Prevenar 13 txhaj tshuaj, tshuaj xyuas uas hais tias nws muaj peev xwm ua tau kom tus me nyuam txoj kev tiv thaiv kab mob thiab tsim cov tshuaj tiv thaiv rau txhua hom kab mob tom qab thawj txheej txheem.
Kev tsim cov tshuaj tiv thaiv kab mob rau cov tshuaj tiv thaiv kab mob kuj tau pom tom qab txhaj tshuaj intramuscular ib zaug hauv cov menyuam hnub nyoog li ob mus rau tsib xyoos. Ntawm no, kev tiv thaiv kab mob ntawm lub cev yog tib yam li cov menyuam yaus hnub nyoog qis dua ob xyoos.
Ua ntej tshaj tawm cov tshuaj tiv thaiv Prevenar 13, kev tshuaj xyuas uas ua rau peb xav txog qhov kev tawm tswv yim ntawm nws cov lus qhia, kev sim tshuaj loj tau ua nyob rau hauv kev txhawb nqa lub cev tiv thaiv kab mob. Txoj kev tshawb no koom nrog txog 18 txhiab tus menyuam hnub nyoog 2-15 lub hlis. Cov txiaj ntsig tau ua pov thawj qhov ua tau zoo ntawm qhov kev ncua no hauv kev tawm tsam cov kab mob pneumococcal los ntawm 97%. Nyob rau tib lub sijhawm, feem pua ntawm cov menyuam yaus Asmeskas yog 85%, hauv cov menyuam yaus nyob sab Europe nws txawv ntawm 65 txog 80%.
Kev ua tau zoo ntawm kev tiv thaiv kab mob ntsws uas tshwm sim los ntawm serotype ntawm Streptococcus pneumoniae tau mus txog qib 87.5%, uas tau lees paub los ntawm ntau qhov kev tshuaj xyuas.
"Prevenar" pom nws cov txiaj ntsig (54%) hauv cov neeg mob hnub nyoog 2 - 15 lub hlis. Nws raug kho ntawm no rau nruab nrab rau mob otitis media vim yog mob ntsws pneumococcal.
Nyob rau hauv cov menyuam yaus txhaj tshuaj tiv thaiv, lub cev tiv thaiv kab mob rau cov kab mob tsis suav nrog hauv cov tshuaj yog 33% siab dua. Tab sis, txawm li cas los xij, tus naj npawb ntawm cov kab mob tshwm sim los ntawm serotypes hauv kev txhaj tshuaj txo qis34%. Yog li, tus naj npawb ntawm cov neeg mob otitis media txo qis los ntawm 6-18%, nrog rau cov mob hnyav dua li ntawm 9-23%. Thiab qhov kev xav tau ntawm tympanostomy hauv cov menyuam yaus tau txhaj tshuaj tau txo qis los ntawm 24-39%.
Kev qhia thiab contraindications rau kev txhaj tshuaj
Cov tshuaj tiv thaiv Prevenar 13, tshuaj xyuas uas pom zoo kom kawm tag nrho cov ntaub ntawv, tau qhia tias siv los ua cov tshuaj tiv thaiv kab mob los tiv thaiv kab mob Streptococcus pneumoniae hom 4, 6B, 9V, 14, 18C, 19F thiab 23F (ntawm no suav nrog sepsis, pneumonia, bacteremia, meningitis thiab otitis ntawm ntau qib sib txawv) hauv cov menyuam hnub nyoog ntawm ob lub hlis txog tsib xyoos.
Tshuaj tiv thaiv contraindications yog ntau yam kab mob. Cov no yog cov kab mob sib kis thiab tsis kis kab mob: mob khaub thuas, SARS, mob khaub thuas, tonsillitis thiab lwm yam. Tsis txhob txhaj tshuaj tiv thaiv thaum lub sij hawm exacerbation ntawm cov kab mob ntev. Tsis txhob muab tshuaj Prevenar rau cov menyuam yaus uas muaj qhov tsis haum rau cov tshuaj thiab nws cov excipients, nrog rau diphtheria toxoid.
Nyob rau hauv cov xwm txheej no thiab lwm yam, kev txhaj tshuaj tiv thaiv tsuas yog ua tom qab tus menyuam rov zoo los yog nyob rau theem ntawm kev tshem tawm tus kabmob.
tshuaj tiv thaiv Prevenar: cov lus qhia rau kev siv
Cov tshuaj tiv thaiv yog rau txhaj tshuaj intramuscular nkaus xwb hauv anterolateral ncej puab ntawm cov menyuam yaus hnub nyoog qis dua ob xyoos, lossis hloov pauv hauv cov leeg deltoid ntawm caj npab sab sauv hauv cov menyuam hnub nyoog tshaj ob xyoos.
Tsis muaj, nyob rau hauv ib qho xwm txheej, cov tshuaj tau muab tso rau hauv cov hlab ntsha!
Kev txhaj tshuaj tiv thaiv yuav tsum tau ua raws li qee lub tswv yim. Yog li ntawd, cov me nyuam hnub nyoog2-6 lub hlis, peb txhaj tshuaj 0.5 ml. Lub sijhawm nruab nrab ntawm lawv yuav tsum yog tsawg kawg ib hlis. Thawj koob tshuaj tiv thaiv raws li txoj kev npaj yog muab rau ob lub hlis, thiab thib plaub (revaccination) - nyob rau xyoo thib ob ntawm tus menyuam lub neej, qhov zoo ntawm 12-15 lub hlis.
Yog tias tus menyuam tsis tau txhaj tshuaj tiv thaiv thawj rau lub hlis ntawm lub neej, ces cov tshuaj tiv thaiv Prevenar, tshuaj xyuas uas txawv, tau nkag rau hauv lub cev raws li cov qauv hauv qab no. Nyob rau menyuam yaus 7- Thaum muaj hnub nyoog 11 hli, ob koob tshuaj yog muab nrog ib lub ntim 0.5 ml txhua. Lub sijhawm nruab nrab ntawm kev txhaj tshuaj yuav tsum yog tsawg kawg ib hlis;
Thaum muaj hnub nyoog 12 txog 23 lub hlis, tus menyuam tau txhaj tshuaj ob zaug, qhov ntim ntawm ib koob yog 0.5 ml. Lub sijhawm nruab nrab ntawm kev txhaj tshuaj yuav tsum yog tsawg kawg 60 hnub. Rau cov menyuam yaus hnub nyoog 2-5 xyoos, cov tshuaj tau muab tshuaj ib zaug ntawm 0.5 ml.
Kev txhaj tshuaj ntxiv, tshwj tsis yog rau cov phiaj xwm npaj, tsis muaj.
Cov tshuaj tiv thaiv "Prevenar", tshuaj xyuas ntawm cov kws kho mob txog qhov uas feem ntau zoo, yog homogeneous raug tshem tawm ntawm cov xim dawb. Cov tsos ntawm cloudy dawb precipitate yog heev txais. Co cov tshuaj tiv thaiv tam sim ua ntej siv kom txog thaum tau txais cov xim sib xws. Ua ntej txhaj tshuaj, ua tib zoo tshuaj xyuas cov ntsiab lus ntawm cov koob txhaj tshuaj kom pom cov khoom txawv teb chaws. Yog hais tias lawv nyob los yog ncua kev kawm ntawv muaj xim uas tsis yog dawb, ces cov tshuaj yuav tsum tsis txhob siv.
Side effects
Prevenar 13 tau kawm hauv cov menyuam yaus noj qab nyob zoo hnub nyoog rau lub lis piam mus rau kaum yim hli. Cov tshuaj tiv thaiv tau muab tshuaj rau tib hnub raws li lwm cov tshuaj tiv thaiv menyuam yaus tau pom zoo los ntawm Ministry of He alth. Ntawm cov teebmeempom: mob thiab induration ntawm qhov chaw txhaj tshuaj, kub taub hau.
Nyob rau hauv cov txheej txheem ntawm kev txhaj tshuaj, muaj qhov tsis xis nyob sai sai ntawm qhov chaw txhaj tshuaj nyob rau hauv 36.5% ntawm cov neeg mob, nce mus txog ntua ntua ntua - 18.5%. Hauv cov menyuam yaus hnub nyoog qis dua 2 xyoos, qhov kev siv zog ntawm cov tshuaj tiv thaiv hauv zos tau kaw ntau dua li cov neeg mob hnub nyoog qis dua 1.5 xyoos, tab sis lawv nyob luv heev. Cov me nyuam mos (txog 28 lub lis piam) uas muaj keeb kwm ntawm lub ntsws tsis paub qab hau yuav muaj kev pheej hmoo rau pw tsaug zog apnea.
Cov menyuam yaus uas tau txais Prevenar 13 tib lub sijhawm raws li DTP muaj tus nqi siab dua tom qab txhaj tshuaj tiv thaiv thiab muaj teeb meem. Yog li, lub cev kub siab tshaj 38 ° C tau pom nyob rau hauv 41.2%, siab dua 39 ° C - hauv 3.3%, piv nrog 1.2% - qhov no yog ib pawg menyuam yaus uas tau txais ib qho tshuaj tiv thaiv DTP nkaus xwb.
Cov xwm txheej zoo sib xws tau pom thaum Prevenar ncua kev kawm ua ke nrog cov tshuaj tiv thaiv hexavalent feem ntau siv rau hauv kev xyaum menyuam yaus, feem ntau nrog cov tshuaj tiv thaiv:
- hnoos;
- tetanus;
- Haemophilus influenzae type B;
- kab mob siab B;
- polio.
Nyob rau hauv kev sim tshuaj, cov kev mob tshwm sim hauv qab no tau raug txheeb xyuas. Qhov no yog, ua ntej ntawm tag nrho cov, liab nrog ib txoj kab uas hla ntawm ntau tshaj 2.4 cm, o, mob, induration nyob rau hauv lub cheeb tsam ntawm txhaj tshuaj. Cov tshuaj tiv thaiv ntawm lub cev no hauv qee kis tau ua rau muaj kev txwv ib ntus ntawm kev ua haujlwm ntawm cov leeg qis. Muaj tsawg zaus, qhov chaw txhaj tshuaj tau ua khaus, dermatitis lossisurticaria.
Ntau zaus pom lub cev kub txog li 38 ° C thiab siab dua, nrog rau kev chim siab, tsaug zog, qaug zog, pw tsaug zog tsis zoo, ua kua muag ntau dhau. Cov xwm txheej ntawm hyperthermia saum 39 ° C tau raug kaw. Qee lub sij hawm arterial hypotension, hypergia, kev tsis haum tshuaj ntawm lub cev, suav nrog kev poob siab anaphylactic, edema ntawm qhov sib txawv ntawm qhov nyuaj, pulmonary spasm, ua tsis taus pa, convulsions tshwm sim.
Cov tsos mob ntawm plab hnyuv muaj xws li raws plab, ntuav, xeev siab, tsis muaj lossis txo qis qab los noj mov. Cov tsos mob ntawm erythema multiforme lossis lymphadenopathy tsis raug txiav tawm.
cov lus qhia tshwj xeeb rau kev siv tshuaj
Tsuas yog cov menyuam yaus hnub nyoog qis dua tsib xyoos tau txhaj tshuaj Prevenar. Cov lus qhia hais tias txhaj tshuaj tiv thaiv rau cov neeg laus. Tsis tas li ntawd, nws cov txiaj ntsig ntawm kev loj hlob ntawm fetus thaum cev xeeb tub tsis tau qhia tawm. Cov nyhuv ntawm cov tshuaj rau tus menyuam los ntawm cov kua mis tsis tau kawm txaus.
Cov tshuaj tiv thaiv no tau pom zoo kom siv rau tus menyuam noj qab haus huv nkaus xwb, nws yuav tsum tsis txhob siv thaum mob ua pa thiab lwm yam kab mob. Tshwj xeeb tshaj yog tias muaj qhov nce hauv lub cev kub. Hauv qhov no, koj yuav tsum tos kom tus menyuam rov zoo.
Txhawm rau npaj muab cov kev pabcuam tsim nyog thaum muaj kev poob siab anaphylactic, tus kws kho mob yuav tsum saib xyuas tus neeg mob cov tshuaj tiv thaiv tsis pub dhau 30 feeb tom qab siv tshuaj.
Txhawm rau zam qhov kev pheej hmoo ntawm apnea, tus neeg mob yuav tsum tau soj ntsuam li ntawm 48-72 teev, tshwj xeeb tshaj yog rau kev txhaj tshuaj thawj zaug rau cov menyuam yaus hnub nyoog qis dua 28 lub lis piam.
Tshuaj tiv thaiv"Prevenar" (cov kws kho mob tshuaj xyuas txog nws hais tias nws muaj txiaj ntsig zoo rau tus menyuam lub cev tiv thaiv kab mob), yuav tsum tau tswj hwm nruj raws li cov txheej txheem, yog li koj yuav tsum tsis txhob ncua cov txheej txheem.
Cov tshuaj no tsuas yog muab kev tiv thaiv kab mob Streptococcus pneumoniae uas yog ib feem ntawm kev ncua, tab sis tsis yog los ntawm lwm tus, suav nrog cov kab mob sib kis.
Raws li kev txhaj tshuaj tiv thaiv, qhov tshwm sim ntawm kev mob ntsws tau txo qis piv rau cov menyuam yaus uas tsis tau txhaj tshuaj hauv thawj xyoo los ntawm 32.2%, thiab hauv thawj ob xyoos - los ntawm 23.4%.
tshuaj tiv thaiv kab mob tau qhia kom cov menyuam yaus txhaj tshuaj tiv thaiv kab mob ua ke nrog kev txhaj tshuaj pertussis txhawm rau tiv thaiv kev loj hlob ntawm febrile. Lawv kuj raug sau tseg rau cov menyuam yaus uas ua rau muaj qhov tshwm sim ntawm convulsive.
Prevenar yog tsim nyob rau hauv ib lub syringe npaj rau txoj kev txhaj tshuaj. Nws cov ntsiab lus yuav tsum tsis txhob muab nchuav rau hauv lwm cov tais diav lossis ua ke nrog nws tus kheej nrog lwm cov tshuaj.
Kev noj tshuaj ntau dhau thiab kev cuam tshuam tshuaj yeeb tshuaj
Yav dhau los, cov neeg mob tau txhaj tshuaj tiv thaiv ntau dhau, tsis ua raws li lub sijhawm txhaj tshuaj thiab ua txhaum lub sijhawm txhaj tshuaj tiv thaiv. Cov xwm txheej no tuaj yeem ua rau muaj qhov tsis zoo. Txhawm rau zam lawv, nws raug nquahu kom txhaj tshuaj tiv thaiv raws li cov lus qhia. Qhov no yog raws nraim li qhov kev tshuaj xyuas hais.
"Prevenar" yog txhaj rau tib hnub raws li lwm cov tshuaj tiv thaiv tsim nyog, tshwj tsis yog txhaj tshuaj tiv thaiv BCG. Cov tshuaj tuaj yeem ua ke nrog cov tshuaj tiv thaiv kab mob tiv thaiv kab mob Hib thiab nrog tshuaj tiv thaiv Infanrix. Hauv qhov no, txhaj tshuaj tiv thaiv yuav tsum tau ua nyob rau ntau qhov chaw ntawm lub cev.
Cov tshuaj tau muab tshuaj nruj me ntsis raws li daim ntawv tshuaj. Nws yuav tsum tau khaws cia rau hauvqhuav, txias thiab tawm ntawm qhov ncav cuag cov menyuam yaus, ntawm qhov kub ntawm 2 ° txog 8 ° C. Nws tsis khov. Cov tshuaj tiv thaiv muaj lub neej txee peb xyoos.
Qhov twg zoo dua: Prevenar lossis Pneumo 23
Feem ntau, cov kws kho mob tau sau tshuaj tiv thaiv "Prevenar 13", "Prevenar" lossis "Pneumo 23". Kev tshuaj xyuas yog sib xyaw. Thawj koob tshuaj muaj kaum peb serotypes, qhov thib ob muaj xya, thiab thib peb muaj nees nkaum peb. Cov kws tshaj lij hais tias yog tias koj pib txhaj tshuaj nrog ib qho tshuaj tiv thaiv, piv txwv li, Prevenar, ces koj yuav tsum ua kom tiav cov chav kawm nrog nws. Txawm hais tias nws raug tso cai los hloov cov tshuaj tiv thaiv 7-valent nrog Prevenar 13
Koj tuaj yeem txhaj tshuaj tiv thaiv cov neeg laus dua 50 xyoo lossis cov uas twb tau txhaj tshuaj tiv thaiv kab mob pneumococcal. Hauv cov xwm txheej no, cov tshuaj "Prevenar" yog siv ib zaug.
Cov lus qhia, tshuaj xyuas thiab WHO pom zoo kom txhaj tshuaj tiv thaiv kab mob no rau txhua tus menyuam yaus hnub nyoog qis dua ob xyoos. Cov tshuaj tiv thaiv pab txhim kho kev tiv thaiv kab mob los ntawm pneumococcus: bronchitis, otitis media, pneumonia, meningitis.
Cov kab mob ua rau cov kab mob no tuaj yeem yog lwm yam kab mob, tab sis nws yog cov kab mob pneumococcal uas tuaj yeem tsim kev puas tsuaj rau menyuam yaus txoj kev noj qab haus huv, suav nrog kev ua rau nws tuag. Yog tias xaiv ntawm Prevenar 7 thiab Prevenar 13 cov tshuaj tiv thaiv, nws raug nquahu kom xaiv cov tom kawg, vim nws muaj ntau hom kab mob. Nws raug sau tseg rau cov menyuam yaus txij li 6 lub hlis mus rau ob xyoos. Cov tshuaj tiv thaiv muaj lub sij hawm kis tau ntev.
"Prevenar 23", tsis zoo li "Prevenar", tsuas yog raug tshuaj raws li cov lus qhia rau pawg hnub nyoog tshaj li ob xyoos. Cov tshuaj no txawvcuam tshuam. Yog tias tus menyuam tau txhaj tshuaj Prevenar, tom qab ob xyoos nws muaj peev xwm txhaj tshuaj tiv thaiv Prevenar 23. Cov tshuaj kawg yog muab rau cov menyuam yaus uas tsis muaj zog thiab feem ntau mob nruj raws li tus kws kho mob sau ntawv. Qhov zoo ntawm qhov tsis txaus ntseeg yog ntau hom kab mob - 23. Cov tshuaj tiv thaiv yog pheej yig dua.
"Pneumo-23" tsis tsim kev tiv thaiv ntev, thiab yog li ntawd, txhua 3-5 xyoos yuav tsum rov txhaj tshuaj dua.
Kev txhaj tshuaj tiv thaiv kab mob: tshuaj xyuas
Prevenar tau tsim ntau qhov kev tsis sib haum xeeb. Cov lus cog tseg ntawm cov kws kho mob los txhim kho kev noj qab haus huv ntawm tus menyuam thiab kev vam meej ntawm ntau tus niam uas nws cov menyuam tau tso tseg tsis muaj mob tom qab txhaj tshuaj tiv thaiv no ua rau ntau tus neeg mob siab rau nws. Tab sis tsis yog txhua yam yog du raws li nws zoo nkaus li thaum xub thawj siab ib muag. Tom qab txhaj tshuaj tiv thaiv, ntau tus menyuam yaus ob leeg tau mob thiab txuas ntxiv mob. Qee zaum, cov tshuaj tiv thaiv ua rau kub taub hau, mob ntsws, mob ntsws thiab lwm yam kab mob uas muaj lub sijhawm rov zoo. Cov nyhuv zoo li lawv tsis tau txhaj tshuaj. Cov niam txiv ntawm cov menyuam yaus uas tau txhaj tshuaj tiv thaiv kuj tsis txaus siab txog qhov induration, liab uas cov tshuaj tiv thaiv tawm tom qab ntawm qhov chaw txhaj tshuaj. Ntau tus menyuam yaus nyuaj taug kev tom qab nws qhia.
Muaj ntau tus neeg tau txhaj tshuaj tiv thaiv kab mob thiab tshem tawm ntau yam kab mob. Thiab qee qhov tau los xaus tias nws yuav tsum ua raws li cov lus qhia, uas yog, cov menyuam yaus tsis muaj zog thiab feem ntau mob, nrog rau cov uas coj txoj kev ua neej nyob.
Cov kev xav ntawm cov kws kho mob txog kev qhia txog cov tshuaj tiv thaiv Prevenar rau cov menyuam yaus tau muab faib. Ib leegqhia kom txhaj tshuaj tiv thaiv. Qhia kom muaj kev tiv thaiv kab mob. Lwm tus tham txog hom 1 thiab 5, uas lawv tus kheej muaj peev xwm ua rau muaj kab mob pneumococcal. Tsis tas li, cov tshuaj tiv thaiv no raug txwv nyob hauv ntau lub tebchaws.
Los ntawm cov lus hais saum toj no, peb tuaj yeem txiav txim siab tias cov tshuaj tiv thaiv Prevenar tsis yog ib qho tshuaj tiv thaiv kab mob rau txhua tus mob, tab sis, ua kom zoo, nws tuaj yeem ua rau tus menyuam tiv thaiv kab mob ntau ntxiv.
