Katemera wa matendawa pneumococcal ana: anachita ndi mayankho

Malinga WHO, pneumococci nthawi zambiri nthumwi za matenda bakiteriya anthu. Lero, ziwerengero ndi kuti chamoyo chifukwa cha imfa chifukwa 1.2 miliyoni. Anthu chaka chonse. Ya nambala ya anthu oposa 40% ndi ana osakwana zaka 5 zaka. Wa otchedwa chibayo dera yotengedwa, chiwerengero cha imene wina Russian miliyoni ndi theka chaka, mpaka 75% a milandu akulu kuyambitsa tizilombo awa - pneumococci. Pankhani ana gulu zaka zaka 5, pali kuchuluka nawo ndondomeko za pneumococci ukufika 90.

ana onse otitis odwala ndi osiyana a mwamphamvu. Pafupifupi 30-35% milandu onse atolankhani pachimake otitis odwala achinyamata amasankha ndi pneumococci. matenda amenewa yodziwika ndi otaya mkulu yokoka ndi Mwina mkulu wa perforation wa likalowa m'makutu a. Kawiri kawiri mutha kumva kuchokera kwa akatswiri za chitukuko orthogene mavuto intracranial, kuchotsa zimene ziyenera kuchitidwa tympanostomy kawirikawiri zokwanira. ndondomeko ndi phukusi opaleshoni kuti remediation wa M'mimbamo pakati khutu n'kulola malo a mafupa pakati khutu.

Katemera wa matendawa pneumococcal akuluakulu ndi ana akhoza kwambiri kusintha zinthu ndi zochitika za Mlengi izi.

matenda Pneumococcal: ndi ndani?

Streptococcus pneumoniae ndi chimodzi mwa zigawo za microflora wabwinobwino wa chapamwamba dongosolo kupuma wa munthu wathanzi. 70% ya anthu - izo amathandiza mitundu chimodzi kapena zingapo bakiteriya. Pakati pa ana, mlingo wa 'm'dera' ndi apamwamba kuposa mwa akulu. Mlingo pazipita ophimba anthu amene moyo, ntchito ndi kukula mu magulu (chisanadze sukulu ndi sukulu, magulu ntchito, etc.).

chamoyo umenewu wapangidwa ndi polysaccharide kapisozi akhoza kuletsa kukula kwa chitetezo chokwanira ana osakwana zaka 2. Lero, sayansi amadziwa za kukhalako 84 subtypes wa pneumococcus. Ndi kukula nyengo ya mankhwala si vuto lililonse tizilombo toyambitsa matenda Streptococcus pneumoniae wakhala tizilombo mwachilungamo aukali kugonjetsedwa ndi miyambo mankhwala opha chochuluka. Mlingo wa kulimbikira penicillin tsopano ali mozungulira 50%, kuti ndi chloramphenicol ndipo amafunika tetracycline - 30%. Popeza penicillin gulu la mankhwala opha lonse zokwanira, ndiye iwo sadzagwira ntchito pa matenda chamoyo monga pneumococcus. Katemera mu Zikatero - njira yokhayo kupambana ndi zomvetsa kochepa polimbana ndi bakiteriya izi. Ndi ofunika ponena kuti matenda zambiri akufotokozera mofulumira ndithu (zambiri zosaposa 3 masiku), ndi nthawi kuchita kafukufuku pa tanthauzo la mlingo wa kudziwa mitundu ina ya mankhwala si pano.

Tsopano funso pneumococcal kukana kuti mankhwala choyenera zofunika kwambiri, kuyenera zambiri mwamsanga vuto.

Kodi katemera ntchito?

Panopa, Russia amagwiritsa mitundu iwiri ya katemera ndondomeko monga katemera ku kachirombo pneumococcal: polysaccharide ndi conjugated kwa formulations mapuloteni.

Gulu loyamba (polysaccharide) ndi wodziwika katemera Pneumo 23 (sanofipaster). Yankho osakaniza 23 polysaccharide oyera kuchokera serotypes kuchuluka ofanana. Gulu la serotypes akhoza bwinobwino zimachitika 90% cholekanitsa ndi mwazi, ndipo ambiri tizilombo ta omwe munapeza mu gawo la Russia. Tsopano pa siteji ya kulembetsa ndi katemera wina wofanana - ". Pneumovax 23"

Mawonekedwe a katemera conjugated mu Russia inali yololedwa mwalamulo ndipo panopa ntchito "Prevenar 7". Zisanu serotypes m'gulu kapangidwe kake, pamodzi ndi 87% wa cholekanitsa pneumococcal anali ana kudwala ku United States ndi mayiko ena. Chifukwa chakuti serotipovaya chithunzi mu United States ndi Russia ndi pafupifupi yomweyo, ife tikhoza kuganiza kuti "Prevenar 7" kudzakhala mogwira la Russia, komanso ku United States.

The zaka osiyanasiyana katemera motsutsana pneumococcus

"Pneumo 23" katemera chikuyendetsedwera kamodzi subcutaneously kapena intramuscularly. Akhoza katemera kuyambira 2-hletnego zaka, mlingo - 0.5 ml. Re-katemera angathe kuchitidwa osati kale kuposa patapita zaka 3 pambuyo jekeseni lomaliza.

Katemera wa matendawa pneumococcal ana ntchito "Prevenar 7" n'zotheka ndi zaka 2-hmesyachnogo. Katemera ikuchitika mu kufanana ndi DTP (mu masiteji 3). Revaccination akhoza amachitika mwana zaka 1.5. Komabe, mtundu wa katemera, pali zitsanzo zingapo za katemera. Pali zambiri pa mphamvu ya katemera magawo 2 (mkati 2 theka chaka), kenako chilimbikitso ndi. Likupezeka ndi katemera chiwembu mu magawo 2 chaka chachiwiri cha moyo, ndi kamodzi kwa nthawi ya zaka 2 mpaka 5.

Mlingo wa polysaccharide katemera chitetezo

Mkulu efficacy kupewa chibayo anasonyeza katemera ku kachirombo pneumococcal. Reviews akuluakulu zowerengera kuti pafupifupi 80 pa chitetezo cent. Akatswiri-epidemiologists amalangiza katemera "Pneumo 23" Anthu zaka 18 mpaka 21 mabungwe lalikulu ndi magulu (monga mayunitsi nkhondo). Patapita nthawi zina za nthawi (miyezi 2 kapena 5) pambuyo katemera angayembekezere kuchepa mu zochitika za matenda pachimake kupuma koposa 2 khola ndalama, matenda - maulendo 13, chibayo - osati nthawi zosakwana 6. Mu chibayo zovuta bongo ndi zina pneumococcal matenda Mwachangu kuchuluka ranges ku 56 kuti 81.

Mlingo wa mphamvu ya ndondomeko monga katemera motsutsana pneumococcus, zimakhudza zaka vaccinees. Mu zaka gulu zaka 55, chiwerengerochi chinali 93%, kwa zaka 55 mpaka 64 Mwachangu ndi kuchepa kwa 88%. Mlingo wa chitetezo pneumococcus kuyambira zaka zaka 65 74 - 80%, pa zaka 75 zakubadwa - 67%.

Kwa odwala matenda matenda a mtima ndi broncho-m'mapapo mwanga, mlingo wa chitetezo ndi katemera polysaccharide (makamaka "pneumo 23") pafupifupi 69% (monga anthu athanzi). Kusonyeza mkulu wa dzuwa la katemera amenewa pamene ntchito magulu ana. ntchito umasonyeza "Pneumo 23" osakaniza ndi katemera fuluwenza.

Ponena za katemera wina kuwonjezekeredwa mu Russian - "Pneumovax 23" - tinganene kuti kugwira kwake kwa anthu ndi shuga ndi 84%, ndi ischemia - 73%. Kwa odwala matenda ndi matenda a mtima, kuchuluka izi ndi 69, ndi mapapo wadabva mphumu - 65 chifukwa amuna mu msinkhu zaka 65 wa mphamvu ya mankhwala amamuchititsa 75%.

Mlingo wa conjugate katemera chitetezo

Ntchito conjugate katemera katemera wa matendawa pneumococcal ana anasonyeza digiri yapamwamba ya dzuwa. Kwambiri yafupika osati chiwerengero cha kuchipatala Kulembetsa ana chibayo chiyambi aliyense, komanso pafupipafupi maulendo outpatient kwa dokotala. Kwambiri bwino zinthu odwala pneumococcal meninjaitisi.

Pneumococci ndi mwachilungamo penicillin. "Prevenar 23" akhoza kuteteza motsutsana tizilombo ndi kukhazikika wapakatikati ndi yapamwamba 80-100%. Komanso katemera ndi dzuwa mkulu pamodzi ndi chiwerengero cha fuluwenza.

Malinga ndi World Health Organization, ntchito katemera conjugate kwa ndondomeko ndi monga katemera wa matendawa pneumococcal ana (zonse ku mayiko 72 osauka padziko lonse), chingalepheretse mpaka imfa 407.000 pachaka.

zochita zotheka katemera

Katemera ndi akatswiri matenda pneumococcal saloledwa kuchita nthawi iliyonse chaka ndi pamodzi ndi katemera wina uliwonse (zosiyana wapangidwa okha BCG). Pa makonzedwe a mitundu onse katemera ndi zina pneumococci ayankhe zotheka kwa thupi. Pa "Pneumo 23" odwala akhoza zimachitika anachita m'dera mu mawonekedwe a redness, ululu. Mphamvu zotani ndi zambiri ofooka ndi ukhoza maola 48. Katemera ndi pneumococcal mwana (ndemanga za azaumoyo ndi makolo akugwirizana pa mfundo iyi) zina (osati kawirikawiri) zingachititse totupa, kupweteka malo.

Pali milandu kumene odwala idiopathic thrombocytopenic purpura (mu gawo chete) patatha masiku kuchokera 2 14, anayamba recurrences anakafika kwa masabata 2. N'kovuta kwambiri kumva za limati anaphylactic.

Katemera "Prevenar" amakhala ndi tolerability ana yabwino. Chotero katemera ndi mavuto pneumococcal matenda (tikulankhula za mavuto aakulu), monga ulamuliro, sayambitsa. Komabe, nthawi zambiri chidawoneka zosiyanasiyana m'dera irritability, matenda tulo, isanafalikire redness ndi kutupa, kuwonjezeka thupi kutentha kwa 38 C. A ochepa ana (pafupifupi 5%), kutentha kukwera pamwamba 39˚ C.

Kodi pali contraindications aliyense kuti katemera motsutsana pneumococcus?

Aliyense ambiri kapena wapadera contraindications kuti katemera si aliyense katemera, koma kuti anachita katemera matenda pneumococcal mu nthawi yapita. Pali ena ayamikira pa ntchito Immunology "Pneumo 23" si masiku osachepera 10 pamaso pa njira ya mankhwala immunosuppressive akuyamba. Satsatira malangizo amenewa angathe kuchepa madzi a oteteza.

Katemera wa azaumoyo amayi apakati saloledwa yekha pa trimester lomaliza. Komabe, ngati kuli koyenera kutero Ndi bwino kupewa njirayi.

Kuchuluka kwa nthendayi pneumococcal: a gulu la chiopsezo

Kusiyidwa wochita ndi monga katemera wa matendawa pneumococcal? zosokonezeka kwa magulu ena a anthu zingachititse kuposa khalidwe lake. Akatswiri amalangiza anthu kwenikweni katemera pa zaka 65. M'mayiko ena akupangidwa katemera wa gulu m'badwo ku Mulingo wa njira kuvomerezedwa.

Ayenera katemera pneumococcal wofooka, nadwala ndipo akudikila m'chipatala cha anthu odwala matenda a shuga, chifuwa, akusowa ntchito mtima ndi kupuma, kugwira ntchito kwa chiwindi.

Tikusowa katemera motsutsana pneumococcus (akuchipatala ndemanga - umboni wa) anthu ndi chitetezo wofooka. Pano pa odwala chiopsezo amene anachitidwa opaleshoni akukonza pofuna kuchotsa ndulu ya, akudwala matenda nephrotic, chikwakwa-selo magazi m'thupi. Komanso, gulu zikuphatikizapo anthu amene akhala ikudontha madzimadzi msana.

Ndipo, ndithudi, musaiwale za m'badwo kukula. KATEMERA analimbikitsa ana wodwalika (kuphatikizapo anthu amene akutsogoleredwa ndi TB), kufika mu gulu (nazale, sukulu ya mkaka, sukulu). C. 2-hletnego zaka podiatrists kulangiza katemera achinyamata amene akudwala mavuto liquorrhea, asplenic, akusowa zigawo zikuluzikulu womuyenerera kuti zapita ndondomeko ya analili cochlear.

Katemera wa matendawa pneumococcal ana angathe kuchepetsa mphamvu ya matenda ndiponso kuchepetsa imfa kwa bakiteriya oopsa.

Malinga ndi madokotala, odwala, makolo

Opinion madokotala, madokotala m'minda zina zambiri za mankhwala pa funso limeneli mosapita m'mbali - katemera wa matendawa pneumococcal (monga ndemanga za mbali iti ya townsfolk wamba osokoneza ndithu) - chofunika. Madokotala tikambirane njira kuteteza yabwino kwambiri polimbana ndi matenda misa osiyana kwambiri etymology. Ndi nthawi kosavuta komanso zosawonongetsa ndalama zambiri kuteteza matenda kusiyana ndi kumwa mankhwala (kuposa wina, ndipo kawirikawiri ambiri kapena ambiri inoffensive) kusamalira ndi ambiri matenda ndi zotsatirapo zake ndipo zosokonezeka.

Mwa makolo Dokotala ayamikira kwambiri katemera motsutsana pneumococcus si nthawi zonse anayankha zikusonyeza. A munthu wamba, osati dokotala, chifukwa atolankhani "motsimikiza akudziwa" tizilombo ta pneumococcus anthu ochuluka kwambiri, ndipo ngati katemera adzateteza mwana, amene analimbikitsa ndi madokotala - funso lofunika. Ngakhale ambiri makolo akadali amakonda kumvetsera maganizo a katswiri ndi kubatizidwa katemera.

Nthawi mungathe kumva kuti katemera wa matendawa pneumococcal, mavuto amene amabwera chomwe polera kutentha sanali ogwira - mwanayo akadali odwala. Zikatero m'pofunika kulabadira mphamvu ya matenda. Ngati mwana kutsokomola, iye anali kutentha mpaka madigiri 38 ndipo anali kudwala masiku 7 - zimenezi n'zomveka. Popanda katemera zotsatira angakhale zikuipiraipirabe, matenda, chibayo m'chipatala, mankhwala ambiri sali chophweka, ndi masiku osachepera 21 mankhwala.

Polongosola mwachidule

matenda Pneumococcal amatsogolera padziko lonse pa chitukuko cha matenda pachimake kupuma, obstructive matenda a m'mapapo, etc. Ndipo lero, mu m'badwo wamakono zina zamakono, chiŵerengero kwa bakiteriya izi ndi mkulu mokwanira. Choncho, gawo la makolo katemera motsutsana pneumococcus mwana (ndemanga - osati kudziwa zimene ayenera kutsatira mu Zikatero) - uyu ndi mwayi kuteteza mwana wake, kupewa chitukuko cha matenda aakulu pansi N'zokayikitsa, mulibe pansi yokha palibe umboni, pretexts.