Txhaj tshuaj tiv thaiv CCP: contraindications thiab kev phiv

Cov niam txiv ntawm cov me nyuam yog nce nug yuav tsum thiab feasibility ntawm niaj hnub txhaj tshuaj tiv thaiv ntawm lawv cov me nyuam. Peb yuav tham txog yuav ua li cas qhov tshuaj tiv thaiv yog PDA. Cov neeg laus tsis ntseeg tshuaj tiv thaiv manufacturers, qhov zoo ntawm lawv cov khoom, mas thauj mus los thiab cia tej yam kev mob. Nyob rau hauv tas li ntawd, cov kev kho mob ntawm peb cov me nyuam yog ua txhaum thiab tsis muaj zog txaus los ntawm ib puag ncig yam tseem ceeb - cov me nyuam feem ntau txom nyem ua xua, mob khaub thuas. Muaj lus nug txog yuav ua li cas tus me nyuam yuav noj cov tshuaj tiv thaiv, uas yuav tsum tau ua raws li los ntawm ib tug nruab teb, li cas thiab lub tau txim rau tus me nyuam txoj kev noj qab haus huv. Thawj yam thawj nyob rau hauv peb tsab xov xwm.

Los ntawm tej yam kab mob kev txhaj tshuaj tiv thaiv PDA?

Grafting CCP - yog cov kev taw qhia ntawm kev txhaj tshuaj tiv thaiv kab mob xws li qhua pias, kab mob ua qog (popularly hu ua ib tug "npua") thiab rubella. Txhaj tshuaj tiv thaiv tiv thaiv cov kab mob tej zaum yuav nyob rau hauv lub complex los yog lub monovalent tshuaj tiv thaiv. Kuv xav tau ib tug me nyuam tiv thaiv los ntawm cov kab mob tshaj lawv yog txaus ntshai?

Measles - yog ib yam kab mob uas yog nrog los ntawm ib tug yam ntxwv pob thiab ua npaws. Tom qab hais txog 5 hnub, cov pob pib kom txo tau lub cev kub rov qab mus rau li qub. Luv-lub sij hawm tus kab mob uas sau ntawm nws tus kheej - li nws yog txaus ntshai rau tus me nyuam? Cov kev txaus ntshai dag nyob rau hauv txoj kev loj hlob ntawm ntau yam loj teeb meem: mob ntsws, encephalitis, otitis media, thiab lwm yam qhov muag puas. Ib tug feature ntawm tus kab ntawm tus kab mob no yog hais tias thaum nyob rau hauv kev sib cuag nrog ib tug neeg mob, ib tug me nyuam txhaj tshuaj tiv thaiv yuav luag 100% ntawm cov kab mob. Muab qhov tseeb, cov me nyuam ua tsawg zaus txhaj tshuaj tiv thaiv PDAs, lub txim twb tsis ntev nyob rau hauv los - tus neeg mob yog ua txhua txhua xyoo.

Rubella sij hawm thaum yau zam nyuaj, feem ntau txawm tsis muaj kub ib ce. Cov tsos mob me me pob, thiab o lymph node. Tab sis tus kab mob no sawv cev rau ib tug loj txaus ntshai rau lub cev xeeb tub poj niam, namely nws fetus. Yog hais tias tus hluas nkauj twb tsis tau txhaj tshuaj tiv thaiv rubella raws li ib tug me nyuam los yog mob nrog nws, nws loj hlob li, nws hits ntawm kev pheej hmoo thaum lub sij hawm cev xeeb tub. Rubella tes nrog cov kev loj hlob ntawm lub fetus, feem ntau raug tus kab mob expectant niam ua rau miscarriage los yog ntxov ntxov yug. Thaum yug los, tus me nyuam yuav ua tau nyob rau hauv loj heev tsis xws luag ntawm tus me nyuam mos, feem ntau incompatible nrog lub neej. Yog li ntawd txhaj tshuaj tiv thaiv CCP yog qhov tseem ceeb rau cov ntxhais.

Mumps muaj feem xyuam rau cov parotid muaj qaub caj pas. Muaj mob taub hau, muaj yog ib tug siab kub, 40 degrees, nyob rau hauv lub caj dab thiab ib ncig ntawm lub pob ntseg o yog tsim. Tus me nyuam yog ib qhov nyuaj rau zom, nqos. Tau teeb meem ntawm mumps kev txom nyem: otitis media, o ntawm lub paj hlwb, cov tub hluas feem ntau tsim o ntawm noob qes (orchitis), uas yuav ua tau kom ntxiv lawm tshob nyob rau hauv lub neej yav tom ntej.

Tag nrho cov saum toj no cov kab mob yuav kis tau los ntawm plav mob thiab los ntawm txhua hnub, uas yog, leej twg yuav ua tus kab mob unvaccinated neeg, tsis hais ntawm kev tiv thaiv.

Lub hauv paus ntsiab lus ntawm cov lag luam ntawm MMR

Txhaj tshuaj tiv thaiv kab mob uas siv cov kev los yog monovalent. Lub cev lus teb nyob rau hauv 92-97% ntawm tshuaj tiv thaiv cov neeg.

Muaj cov khoom teejtug uas yog tag nrho cov kev npaj rau txhaj tshuaj tiv thaiv PDAs - lawv muaj nyob (attenuated) pathogens. Yuav ua li cas puas muaj tus CCP (txhaj tshuaj tiv thaiv)? Coj cov ntsiab lus rau qhov ncaj tib neeg kab mob tom qab thawj coj ntawm cov tshuaj. Tab sis qhov tshuaj tiv thaiv yog muab rau tus xov tooj ntawm nyob kab mob rau lub cev pib mus ua hauj lwm tag nrho cov kev ruaj ntseg zog, nrog rau cov zus tau tej cov tshuaj rau pathogens. High-qib kab mob tsis tsim. Txawm li cas los, ntau yam sab tshua yog ua tau. Hais txog lawv peb yuav qhia ntxiv rau yav tom ntej.

Yuav ua li cas yog cov MMR tshuaj tiv thaiv?

Niaj hnub no nyob rau hauv lub CIS lub teb chaws siv tau cov no cov khoom rau PDAs txhaj tshuaj:

Measles tshuaj tiv thaiv:

1. Cov tshuaj L-16 Lavxias teb sab-ua. Nws ua rau lub hauv paus ntawm quail qe, uas yog ib qho zoo dua, raws li cov qaib protein (namely, nws yog siv nyob rau hauv feem ntau txawv teb chaws tshuaj tiv thaiv) nyob rau hauv cov me nyuam feem ntau yog ib tug tsis haum cov tshuaj tiv thaiv.

mumps:

1. Lavxias teb sab nyob tshuaj tiv thaiv L-3, raws li zoo raws li qhov kev npaj ntawm L-16, uas ua los ntawm quail qe.
2. "Pavivak» Czech tshuaj.

rubella:

1. "Rudivax" ua nyob rau hauv Fabkis.
2. "Ervevax", England.
3. Indian SII tshuaj tiv thaiv.

Complex tshuaj tiv thaiv:

1. Lavxias teb sab kev npaj ntawm qhua pias thiab kab mob ua qog.
2. "Priorix" - Belgian txhaj tshuaj tiv thaiv PDA. Xyuas ntawm cov tshuaj zoo. Nws yeej txoj kev ntseeg ntawm tus kws kho cov tub txawg thiab tau txais kev pab. Nyob rau hauv private tsev kho mob rau txhaj tshuaj tiv thaiv ntawm 3 kab mob - qhua pias, kab mob ua qog thiab rubella - tshuaj tiv thaiv yog pom zoo precisely qhov no raws li cov feem ntau muaj kev ruaj ntseg thiab zoo.
3. Dutch tshuaj tiv thaiv "MMP-II» muaj ib tug tov lub koob npe nrov - muaj ib tug xaav hais tias cov tsos mob ntawm tsi txawj has lug tshwm sim tom qab txhaj tshuaj tiv thaiv nrog cov tshuaj no nyob rau hauv cov me nyuam, tab sis muaj tseeb tseeb cov lus qhia txog nws thaum lub caij tsis muaj nyob.

Yuav ua li cas yog qhov tshuaj tiv thaiv?

Feem ntau tsis ua teeb meem nyob rau hauv cov cai ntawm qhov CCP-txhaj tshuaj tiv thaiv. cov tshuaj tiv thaiv ntawm tus me nyuam thaum lub sij hawm ntawm thawj coj tej zaum yuav manifested nyob rau hauv daim ntawv ntawm ib tug muaj zog nyob tsis tswm quaj. Post-txhaj tshuaj tiv thaiv mob yuav tshwm sim tau tsuas yog nyob rau hauv lub thib tsib hnub tom qab txhaj tshuaj tiv thaiv. Nyob rau hauv thiaj li yuav txo tau phiv los ntawm nrauv txheej txheem yuav tsum tau nqa tawm nyob rau hauv raws li nrog tag nrho cov qauv kev ruaj ntseg. Nws yog ib nqi hmoog rau lub fact tias cov tshuaj txhaj tiv thaiv yuav tsum tau Unpacked tam sim ntawd ua ntej mus rau lub txheej txheem. Dissolve lub tshuaj yuav tsum tsuas yog ib tug tshwj xeeb tshuaj, uas yog txuas mus rau qhov tshuaj tiv thaiv.

Me nyuam mos yog nyob rau hauv lub hip los yog xub pwg, cov laus cov me nyuam - nyob rau hauv lub subscapular cheeb tsam txhaj tshuaj tiv thaiv PDA. Teeb meem uas tsis ua kev ntxhov siab vim paramedics yuav muaj xws li: tau mob, nqaij tawv liab, o nyob rau hauv lub cheeb tsam ntawm yeeb tshuaj koom haum saib xyuas nyob rau hauv ob hnub. Tab sis yog hais tias tus saum toj no cov tsos mob ua pronounced thiab nrog lwm phiv tshuaj yuav tsum tau nrog ib tug cov menyuam yaus.

Cov tshuaj txhaj tiv thaiv lub sij hawm

Kuj ntawm lub CPC nyob xyoo-laus kas, thiab ces rov txhaj tshuaj thaum muaj hnub nyoog 6. Nyob rau hauv tej rooj plaub, cov kev kho mob graft thiab cov neeg laus. Piv txwv li, ib tug poj niam thaum lub sij hawm cev xeeb tub npaj. Nws yuav tsum tau muab sau tseg tias pib ntawm conception yuav tsum tau npaj tom qab ib tug tsawg kawg nkaus ntawm 3 lub hlis tom qab txhaj tshuaj tiv thaiv PDA.

Qhov tshuaj tiv thaiv yog ua ke nrog lwm yam tshuaj rau txhaj tshuaj tiv thaiv: lub CCP yuav ib txhij nqa tawm nrog txhaj tshuaj tiv thaiv tiv thaiv Hib, tus kab mob siab A, KDP, tetanus, polio tshuaj tiv thaiv.

Tsis contraindications rau txhaj tshuaj tiv thaiv PDAs

Muaj tsis thiab ib ntus contraindications txhaj tshuaj rau PDAs. Muaj rau tso txhaj tshuaj tiv thaiv nyob rau hauv cov nram no tej yam kev mob ntawm tus neeg mob:

• congenital los yog kis tau immunodeficiency;
• xub ntiag ntawm cellular tiv thaiv tsis xws luag;
• mob loj heev haum rau lub yav dhau los txhaj tshuaj;
• lub xub ntiag ntawm haum cov tshuaj Cheebtsam.

ib ntus contraindications

Nyob rau hauv cov kev tshwm sim ntawm ib ntus kev teeb meem txhaj tshuaj tiv thaiv tus me nyuam los yog neeg laus ua tom qab ua tiav rov qab thiab kho tshiab ntawm lub cev tiv thaiv kab mob txhaj tshuaj tiv thaiv PDA. Contraindications muaj xws li:

• corticosteroids, immunomodulating tshuaj, radiotherapy thiab cov kws khomob;
• mob ua pa kab mob;
• exacerbation ntawm tus kab mob cov kab mob;
• kho tau cov kab mob ntawm lub plawv system;
• raum teeb meem;
• kub cev thiab kub taub hau;
• cev xeeb tub.

Common phiv tshuaj

Feem ntau kis favorably PDA (txhaj tshuaj tiv thaiv). Phiv xwm txheej tshwm sim nyob rau hauv 10% ntawm cov neeg. Ib txhia teeb meem uas tshwm sim taus tsis ua kev txhawj xeeb ntawm cov kws kho mob, lawv xa mus rau hauv daim ntawv ntawm ib txwm tiv thaiv kab mob cov lus teb rau cov tshuaj. Nws yog ib qho tseem ceeb rau koj nco ntsoov tias txhua yam tshuaj tiv thaiv rau tus tiv thaiv MMR yuav tshwm sim tsuas yog los ntawm 4 mus rau 15 hnub tom qab txhaj tshuaj tiv thaiv. Yog hais tias tej deviations nyob rau hauv lub noj qab haus huv ntawm cov txhaj tshuaj tiv thaiv tus neeg los tshwm ua ntej los yog tom qab cov hnub, lawv yuav tsis muaj feem xyuam rau cov tshuaj tiv thaiv, tsuas yog liab ntawm lub qhov koob ntawm cov thawj coj, uas yog pom nyob rau hauv thawj ob hnub.

Mus rau li ib txwm tshua tom qab txhaj tshuaj tiv thaiv PDA muaj xws li:

• kub nce (mus txog 39 degrees);
• los ntswg qhov ntswg;
• hnoos;
• lossis puas liab liab ntawm lub caj pas;
• parotid qaub ncaug;
• Cov kev tsis haum: pob, urticaria (feem ntau xws tshua tshwm sim rau tshuaj tua kab mob "Neomycin" thiab cov protein yog ib feem ntawm cov kev npaj);
• nyob rau hauv cov poj niam tshwm sim tom qab txhaj tshuaj tiv thaiv kev tsis txaus siab ntawm qhov mob nyob rau hauv cov nqaij thiab pob qij txha. Tej tshua nyob hauv cov me nyuam thiab cov txiv neej tsuas cai nyob rau hauv 0.3% ntawm cov neeg.

teeb meem

Mob ntawm loj teeb meem tom qab txhaj tshuaj tiv thaiv PDAs. Qhov zoo ces, lawv tsis tshua muaj, nyob rau ib tug tom qab ntawm lwm yam mob nyob rau hauv lub cev. Cov ua kev phiv tshuaj yuav ua tau tus neeg mob tus kab mob, txhaj tshuaj tiv thaiv yog ib yam uas tsis zoo, kev siv ntawm cov tshuaj. Teeb meem tom qab txhaj tshuaj tiv thaiv PDA muaj xws li:

1. Convulsions, tsim nyob rau hauv lub keeb kwm yav dhau los ntawm ib tug siab kub. Nrog rau qhov no cov tsos mob taw antipyretics paracetamol, raws li zoo raws li pom zoo kom nais maum yuav kuaj los ntawm ib tug neurologist kav tawm lub keeb kwm yav dhau ntawm txoj kev loj hlob ntawm lub paj hlwb.
2. Post-txhaj tshuaj tiv thaiv lub hlwb puas tsuaj (encephalitis). Thaum qhov kev txiav txim rau kev los yog tsis kam ntawm txhaj tshuaj tiv thaiv CCP yuav tsum coj mus rau hauv tus account hais tias xws li ib tug yam tab kaum tom qab txhaj tshuaj tiv thaiv no tshwm sim 1000 lub sij hawm tsawg tshaj li nrog tag nrho cov kab mob ntawm qhua pias los yog rubella.
3. Tom qab kuj ntawm lub complex los yog kab mob ua qog tshuaj tiv thaiv, uas muaj xws li tus kab mob no, 1% ntawm cov neeg ntawm meningitis tej zaum yuav tsim, whereas rho kab mob, qhov no daim duab nce mus txog 25%.
4. Tsis pub dhau 30 feeb tom qab lub CCP grafting cov tshuaj tiv thaiv yog tau raws li anaphylactic poob siab. Txuag ib lub neej nyob rau hauv xws li ib tug teeb meem no yuav tsuas epinephrine. Yog li ntawd, tsis txhob rau lawv tus kheej - xa rau txhaj tshuaj tiv thaiv nyob rau hauv lub tshwj xeeb pej xeem los yog lwm qhov chaw kuaj mob, raws li tau zoo raws li raws li tag nrho tus kws kho mob cov lus qhia, nrog rau cov cim tseg cov lus teb rau cov tshuaj txhaj tiv thaiv rau ib nrab ib teev nyob rau hauv cov phab ntsa hauv cov kev kho mob hauv tsev. Tsim nyog thiab patronage nurse sab laj nyob rau hauv lub thib tsib thiab thib kaum hnub tom qab kuj.
5. Nyob rau hauv tsis tshua muaj heev neeg mob sau npe thrombocytopenia - ib tug txo ntawm platelets nyob rau hauv cov ntshav.

Kev npaj rau txhaj tshuaj tiv thaiv

Nyob rau hauv thiaj li yuav txo txoj kev pheej hmoo ntawm kev tsim ib tug ntau yam ntawm post-txhaj tshuaj tiv thaiv mob, nws yog tsim nyog los ua kev cai pre-txiag kev cob qhia rau txhaj tshuaj tiv thaiv. Tshwj xeeb tshaj yog zoo li no ntsuas yog ib qho tseem ceeb rau txhaj tshuaj tiv thaiv ntawm cov me nyuam. Ua ntej niaj hnub txhaj tshuaj tiv thaiv, ua raws li cov txheej txheem:

1. Tsis txhob nkag mus rau hauv cov khoom noj ntawm tus me nyuam cov khoom tshiab. Yog hais tias ib tug me nyuam noj niam mis, cov kev pub niam mis niam yuav tsum tau ua raws li cov ib txwm noj cov zaub mov.
2. Nyob rau hauv cia li ib tug ob peb hnub ua ntej txhaj tshuaj tiv thaiv yog tsim nyog los dhau ib qho ntshav thiab zis kev ntsuam xyuas los kav tawm thaum, smoldering kab mob.
3. Cov me nyuam uas yog cov nquag mus kev tsis haum tshuaj los yog muaj xws li mob thaum lub sij hawm yav dhau los txhaj tshuaj yuav tsum muab antihistamines 2 hnub ua ntej txhaj tshuaj tiv thaiv thiab ib tug ob peb hnub tom qab txhaj tshuaj tiv thaiv.
4. Tom qab kuj ua PDAs, lub cev kub yog feem ntau tsa rau theem. Tab sis, cuaj kaum, cov kws kho mob tsis pom zoo kom noj antipyretic cov tshuaj raws li ib tug tiv thaiv kev ntsuas. Lawv muab tsuas yog rau cov me nyuam nrog ib tug predisposition mus febrile qaug dab peg. Noj tshuaj sai li sai tau tom qab thawj coj ntawm qhov tshuaj tiv thaiv.
5. Yog hais tias koj tus me nyuam yog noj qab nyob zoo thiab muaj tsis muaj pov thawj tau txais cov tshuaj ua ntej txhaj tshuaj tiv thaiv kev ruaj ntseg cov hom phiaj, kom paub tseeb tias lub tsev muaj ib tug thawj-aid tshuaj - antipyretics ( "Nurofen", "Panadol") thiab antihistamines, piv txwv li, "Suprastin".
6. Tam sim ntawd ua ntej kuj ntawm tus me nyuam yuav tsum tau soj ntsuam los ntawm ib tug cov menyuam yaus: ntsuas qhov kub thiab txias, mus ntsuam xyuas tag nrho cov xeev kev kho mob.

Yuav ua li cas tom qab lub CCP lub txhaj tshuaj?

Tus me nyuam no muaj PDA txhaj tshuaj tiv thaiv? lub cev teb tsuas los rau hauv lub 5 hnub. Yuav kom txo tau qhov tshwm sim ntawm cov kev phiv, lo nrog ib co tswv yim. Yog li ntawd, tom qab txhaj tshuaj tiv thaiv thiab tsis txhob cia koj tus menyuam sim ua khoom noj tshiab. Tsis tas li ntawd, tshem tawm junk zaub mov, koj yuav tsis overfeed tus me nyuam. Ua kom koj dej kom tsawg.

Nyob rau hauv thawj ob hnub yog zoo dua nyob twj ywm hauv tsev, vim lub cev tsis muaj zog txaus thiab tej yam khoom noj yooj yim raug rau kab mob los ntawm ib tug ntau yam ntawm cov kab mob. Tsis pub dhau ob lub lim piam tsuas pub kev sib cuag nrog lub surrounding. Tsis txhob hypothermia los yog overheating koj tus me nyuam.

Thaum nws yog tsim nyog los hu rau ib tug kws kho mob?

Tom qab txhaj tshuaj tiv thaiv zoo saib xyuas tus me nyuam: tsis tu ncua ntsuas kub, saib rau nws tshua, tus cwj pwm, kev tsis txaus siab. Yog hais tias koj pom cov nram qab no cov tsos mob ntawm ib tug kws kho thaum muaj xwm ceev:

• raws plab;
• ntuav;
• kub, uas yuav tsum tsis txhob tawg antipyretics;
• kub saum toj no 40 degrees;
• tsis haum cov tshuaj tiv thaiv;
• o los yog txhaj rau ntawm qhov chaw induration, amounting mus ib lub cheeb ntau tshaj li 3 cm, los yog rwj;
• heev irrational tus me nyuam quaj;
• convulsions;
• Angioedema;
• zawm;
• tsis nco qab.

Thaum txiav txim siab seb puas yuav ua lub CCP (txhaj tshuaj tiv thaiv) rau tus me nyuam los yog mus muab, luj qhov pros thiab cons. Xav txog cov disappointing statistics uas hais tias nrog rau tag nrho cov kab mob nrog qhua pias, kab mob ua qog los yog rubella, txoj kev pheej hmoo ntawm cov teeb meem ntawm cov zaubmov ntawm heev nyob rau hauv cov pua pua ntawm lub sij hawm siab tshaj tom qab txhaj tshuaj tiv thaiv uas niaj hnub tshuaj. Nyob rau hauv tas li ntawd, tiag tiag tus poj niam kuj tham txog cov theem siab ntawm kev ruaj ntseg ntawm txhaj tshuaj tiv thaiv PDA - feem coob ntawm cov txhaj tshuaj tiv thaiv cov me nyuam twb tsis sau tseg tej post-txhaj tshuaj tiv thaiv teeb meem. Ua raws li cov kev tiv thaiv thiab kev kho mob tshuaj - yog hais tias qhov tshuaj tiv thaiv yuav tsuas muaj txiaj ntsim rau koj yam khoom noj thiab kev tiv thaiv tiv thaiv loj cov kab mob.