Antibotulinum serum (hom A, B, E) belongs rau qeb ntawm cov tshuaj tiv thaiv kab mob. Cov tshuaj yog tsim nyob rau hauv daim ntawv ntawm kev daws rau kev txhaj tshuaj, uas yog nyob rau hauv daim ntawv ntawm ib tug ntshiab los yog me ntsis opalescent, tsis muaj kob los yog yellowish kua, tsw.
Ib daim foos
Cov tshuaj yog tsim nyob rau hauv ampoules ua tiav nrog cov purified nees serum diluted 1:100, tsib ampoules nyob rau hauv ib lub thawv ntawv.
Cov tshuaj muaj pes tsawg leeg ntawm cov tshuaj tiv thaiv botulinum muaj cov tshuaj immunoglobulins tshwj xeeb thiab cov feem pua ntawm cov ntshav cov ntshav ntawm cov nees uas tau raug hyperimmunized nrog botulinum toxins A, B, E. Cov tshuaj muaj pes tsawg leeg ntawm cov khoom kho mob muaj cov tshuaj tiv thaiv kab mob uas cuam tshuam rau qee hom ntawm botulinum toxins.
tshuaj muaj txiaj ntsig
Botulinum serum yog ib feem ntawm cov protein ntawm cov ntshav nees uas txhaj tshuaj tiv thaiv kab mob E, B, A lossisbotulinum toxoid, uas muaj cov immunoglobulins tshwj xeeb. Cov khoom siv tshuaj no muaj cov tshuaj tua kab mob uas pab tiv thaiv botulinum toxins.
Cov lus qhia rau kev siv thiab contraindications
Cov tshuaj yog npaj rau kev kho mob thiab tiv thaiv kab mob botulism. Antibotulinum serum yog contraindicated nyob rau hauv lub xub ntiag ntawm ib tug kab mob kev tsis haum tshuaj tej yam kev mob thiab cov teeb meem rau yav dhau los cov ntshav qab zib, ib tug ua ke ntawm monovalent sera (hom B, A thiab E), los yog monovalent serum. Tsis tas li ntawd, koj tsis tuaj yeem siv cov tshuaj nrog hypersensitivity. Tsis tas li ntawd, kev txwv tsis pub siv cov tshuaj tiv thaiv botulinum hauv cov neeg mob botulism yog qhov tshwm sim ntawm anaphylactic poob siab thaum txiav txim siab rhiab heev rau equine protein.
Khoom noj khoom haus
Antitoxic anti-botulinum serum yog siv los kho thiab tiv thaiv lub hom phiaj. Rau cov hom phiaj kho mob, nws yuav tsum tau muab tshuaj kom ntxov li sai tau txij li qhov pib tshwm sim ntawm botulism. Ua ntej kev tswj hwm cov ntshav, 10 ml ntawm cov ntshav yuav tsum tau muab los ntawm tus neeg mob, nrog rau cov zis thiab ntuav rau kev kuaj xyuas txhawm rau txheeb xyuas tus kab mob botulism thiab botulinum toxin. Nws tseem pom zoo kom xa cov khoom noj uas ua rau muaj kev loj hlob ntawm tus kab mob rau kev tshawb fawb.
Nyob rau hauv kev kho mob ntawm pathologies tshwm sim los ntawm ib qho tsis paub hom botulinum toxin, sib tov ntawm monovalent sera (hom A, B thiab E) yog siv. Nrog rau daim ntawv paubtshuaj lom, ib tug monovalent serum ntawm qhov tsim nyog yog siv. Txawm hais tias qhov mob hnyav ntawm cov tsos mob, ib qho kev kho mob ntawm cov khoom siv tshuaj tau muab tso rau hauv cov hlab ntsha, uas yuav tsum tau ua ntej diluted hauv 200 ml ntawm sodium chloride tov rau txhaj tshuaj 0.9%, rhuab mus rau qhov kub ntawm 37 ± 1 ° C ua ntej kev tswj hwm. Tus nqi ntawm infusion yog 60-90 tee ib feeb. Hauv cov xwm txheej tshwj xeeb, yog tias nws tsis tuaj yeem nqa cov drip, lub dav hlau txhaj tshuaj ntawm cov tshuaj uas siv cov koob txhaj tshuaj yam tsis muaj qhov ua ntej raug tso cai. Txhawm rau zam kev txhim kho ntawm kev tsis haum tshuaj, 60-90 mg ntawm prednisolone yog txhaj rau hauv tus neeg mob ua ntej kev txhaj tshuaj ntawm cov ntshav. Tshuaj yog txhaj ib zaug.
Kev tiv thaiv lub hom phiaj
Rau lub hom phiaj tiv thaiv, cov tshuaj no yog siv rau tib neeg, ib txhij nrog tus neeg mob uas tau noj cov khoom uas ua rau muaj kev loj hlob ntawm botulism. Nyob rau hauv cov ntaub ntawv no, nws yog ib qhov tsim nyog los qhia ib nrab ntawm cov tshuaj kho mob (ib nrab ntawm ampoule) ntawm tus coj hom ntshav. Yog tias hom tshuaj lom tsis raug txiav txim siab, ib nrab koob tshuaj ntawm txhua hom monovalent sera yog tswj hwm. Cov tshuaj yuav tsum tau muab intramuscularly.
Ua ntej siv, ampoule nrog tshuaj tau ua tib zoo tshuaj xyuas. Cov tshuaj nyob rau hauv ampoules uas tsis muaj daim ntawv lo, tawg kev ncaj ncees, kev hloov ntawm lub cev zoo (muaj flakes, discoloration), tsis tsim nyog cia los yog hnub tas sij hawm tsis haum rau siv.
Qhib ampoules, cia (tsis pub ntau tshaj ib teev) thiab cov txheej txheem tswj hwmKev noj tshuaj yog ua nrog kev ua raws li cov qauv aseptic thiab tshuaj tua kab mob.
Intradermal test
Ua ntej kev taw qhia ntawm cov tshuaj tiv thaiv botulinum los tsim kom muaj kev nkag siab zoo rau cov protein txawv teb chaws, ib qho kev sim intradermal yog qhov yuav tsum tau ua, uas suav nrog cov tshuaj.
Ampoules nrog cov ntshav nees, diluted 1:100 thiab purified, yog cim liab, thiab nrog antibotulinum - dub lossis xiav.
Nees serum yog muab tshuaj ntawm 0.1 ml intradermally hauv lub hauv pliaj. Qhov kev ntsuam xyuas tsis zoo yog tias, tom qab li 20 feeb, qhov o lossis liab ntawm qhov chaw txhaj tshuaj tsawg dua 1 cm. Qhov kev kuaj pom zoo yog tias cov tshuaj tiv thaiv no ncav cuag 1 cm lossis ntau dua. Nrog rau kev kuaj tsis zoo, 0.1 ml ntawm cov tshuaj tiv thaiv botulinum yog txhaj subcutaneously. Yog tias tsis muaj cov tshuaj tiv thaiv tom qab ib nrab teev, tag nrho cov koob tshuaj ntawm cov ntshav tau muab tshuaj intramuscularly lossis intravenously.
Nyob rau hauv cov ntaub ntawv ntawm ib tug zoo kuaj los yog nyob rau hauv cov ntaub ntawv ntawm kev loj hlob ntawm kev tsis haum tshuaj rau kev txhaj tshuaj, cov tshuaj yog siv rau cov hom phiaj kho mob nyob rau hauv kev saib xyuas ntawm tus kws kho mob tshwj xeeb thiab kev ceev faj tshwj xeeb: tom qab intramuscular txhaj tshuaj antihistamines thiab prednisolone. Dab tsi ntxiv yog cov lus qhia rau cov tshuaj tiv thaiv kab mob ntshav qab zib qhia peb?
Cov kev mob tshwm sim thiab cov lus pom zoo rau kev siv cov tshuaj no
Kev taw qhia ntawm nws tuaj yeem nrog qhov tshwm sim ntawm qhov tshwm sim tsis haumhom tam sim ntawd, suav nrog kev poob siab anaphylactic thiab mob ntshav qab zib.
Vim tias muaj peev xwm ua rau muaj kev poob siab hauv tus neeg mob, kev saib xyuas kev kho mob yuav tsum tau muab rau cov neeg txhaj tshuaj rau 30 feeb tom qab qhov kawg ntawm kev txhaj tshuaj lossis txhaj tshuaj.
Chaw uas botulinum sera raug tswj yuav tsum muaj kev kho kev poob siab (adrenaline).
Taw qhia ntawm sera (diluted thiab anti-botulinum) yuav tsum tau sau tseg hauv keeb kwm kev kho mob, qhia txog qhov ntau npaum li cas, lub sijhawm thiab cov txheej txheem ntawm kev tswj hwm, tus neeg mob teb, batch naj npawb, lub npe ntawm cov chaw tsim khoom.
Thaum cev xeeb tub thiab lactation, kev siv cov tshuaj no tsuas yog tso cai rau kev noj qab haus huv xwb, suav nrog cov txiaj ntsig tau rau leej niam thiab kev pheej hmoo rau tus menyuam hauv plab.
Tsis muaj tshuaj tiv thaiv botulinum hauv kev muag khoom dawb, nws siv hauv tsev yog txwv tsis pub. Cov tshuaj no tsuas yog muab rau cov tsev kho mob thiab kev tiv thaiv xwb.
Qhia txog qhov cuam tshuam ntawm cov tshuaj no rau tus neeg mob lub peev xwm tsav tsheb lossis lwm yam kev ua haujlwm nyuaj thiab txaus ntshai tsis tau muab.
Cia
Txias ntawm kev tiv thaiv botulinum sera raug txwv. Nws yog ib qho tsim nyog yuav tsum khaws cov tshuaj no ntawm qhov kub ntawm 2-8 ° C, rau qhov siab tshaj plaws ntawm 2 xyoos. Tom qab lub sijhawm no tau dhau muscov tshuaj yuav tsum muab pov tseg. Ib qho qhib ampoule nrog cov tshuaj tua kab mob tau tso cai khaws cia rau hauv qhov chaw txias rau ib teev. Yog tias lub sijhawm no tsis tau siv tshuaj, nws yuav tsum muab pov tseg.
Cov algorithm rau kev tswj hwm cov tshuaj tiv thaiv kab mob ntshav qab zib yuav tsum tau ua nruj me ntsis.
