Ukugonywa yokulwa nezifo Pneumococcal ezinganeni: ukusabela futhi impendulo

Ngokwe-WHO, pneumococci ngokuvamile baba ejenti ye izifo ezibangelwa amagciwane e abantu. Namuhla, izibalo ukuthi umzimba siyimbangela yokufa ngenxa 1,2 million. Abantu unyaka wonke. Kuleli nani labantu abangaphezu kuka-40% abantwana abangaphansi kweminyaka 5 ubudala. Of okubizwa ngokuthi i-pneumonia umphakathi aluthola, isibalo okuyinto eyodwa Russian kanye ngonyaka eziyisigidi nesigamu, kuze ku-75% amacala abadala ukuqalisa alawa magciwane - pneumococci. Ngokuphathelene izingane iqembu engu- eminyakeni engu-5, kukhona iphesenti iqhaza inqubo pneumococci ifinyelela 90.

Zonke izingane uthole otitis egula ntshashintshe of kobukhulu. Cishe 30-35% azo zonke amacala kwabezindaba acute otitis e seziguli ezisencane iqalwa pneumococci. Lezi zifo zinezikhathi okusezingeni eliphezulu yabo adonsela phansi ukugeleza awokuthi ka perforation we eardrum. Ngokuvamile ungezwa ezivela kochwepheshe ngalokho ukuthuthukiswa orthogene yezinkinga intracranial, ukuqeda lapho kumele kwenziwe tympanostomy njalo ngokwanele. Inqubo ukungenela kuhlinzwa ukuze kulungiswa phakathi indlebe ingaphakathi nokubuyisela isikhundla phakathi indlebe amathambo.

Ukugonywa yokulwa nezifo Pneumococcal e abadala kanye nezingane kungaba ukwenza ngcono isimo nge izigameko zalesi umqalisi.

isifo Pneumococcal: ngubani ongubani?

Streptococcus pneumoniae ingenye yezingxenye microflora ejwayelekile elingenhla umgudu wokuphefumula umuntu enempilo. Kufika ku-70% abantu bakuleli batholakale - ke isekela eyodwa noma ngaphezulu izinhlobo silwanyana. Phakathi izingane, ezingeni 'endaweni' ingaphezu kwe phakathi abadala. Izinga esiphezulu ekalishi zalabo abahlala, basebenze futhi sikhule amaqembu (pre-school kanye nezikhungo zemfundo, amaqembu okusebenza, njll).

Lokhu umzimba yakhiwa capsule polysaccharide ukuthi uyakwazi ukucindezela ukuthuthukiswa amasosha omzimba kubantfwana labancane kunalabo engu-2. Namuhla, isayensi uyazi mayelana nokuba khona kwamakamu 84 subtypes ka pneumococcus. Nge ukuthuthukiswa kwe-inkathi yemithi elwa namagciwane kuyinto ngempela bacterium ayinangozi Streptococcus pneumoniae isibe nezilwanyana ezincane sasivumela nolaka amelana bendabuko imithi elwa namagciwane ngobuningi izidakamizwa. Izinga ukumelana ne-penicillin manje emhlabeni 50%, ukuze chloramphenicol ne-tetracycline - 30%. Njengoba iqembu i-penicillin elwa namagciwane ubanzi ngokwanele ke ngeke ngempumelelo ngesikhathi zokuthelela umzimba ezifana pneumococcus. Ukugonywa ezimweni ezinjalo - indlela kuphela ukunqoba nokulahlekelwa sakugcina ekulweni le silwanyana. Kuhle kokusho ukuthi isifo ngokuvamile eba ngokushesha impela (ngokujwayelekile hhayi ningi than 3), kanye nesikhathi sokwenza irhubhululo yencazelo degree of luvelo ezithile kwamaphilisi ungekho.

Manje umbuzo ukumelana Pneumococcal nemithi buya ngokuya ezibalulekile, futhi kuya kuba inkinga kakhudlwana futhi kwaphuthuma.

Yini imithi yokugoma asetshenziswa?

Okwamanje, i-Russia isebenzisa izinhlobo ezimbili yokugoma inqubo efana lokugoma ezifweni Pneumococcal: polysaccharide futhi conjugated ukuze amaprotheni ukwakhiwa.

Iqembu lokuqala (polysaccharide) is wokugoma eyaziwa best Pneumo-23 (sanofipaster). Isixazululo inhlanganisela 23 ka polysaccharide ukuhlanzwa kusukela serotypes inani elifanayo. Leli qembu serotypes kungenziwa ngokuphepha kuchasiselwe 90% lehlukanisa kusukela egazini, futhi iningi nesigqi ezikhonjwe endaweni yeRussia. Manje at the stage of ukubhalisa enye wokugoma efanayo - ". Pneumovax-23"

Kusukela ifomu yokugoma conjugated eRussia yabhaliswa ngokusemthethweni futhi okwamanje lisetshenziswa "Prevenar 7". serotypes Seven kufakwe ngezithako zawo, kuhlangene 87% lehlukanisa Pneumococcal wayekade izingane ukugula-United States nakwamanye amazwe athile. Ngenxa yokuthi serotipovaya isithombe e-United States futhi eRussia cishe okufanayo, kuthathwa ngokuthi "Prevenar 7" futhi kuyoba ngempumelelo Russian Federation, kanye e-United States.

Ububanzi yobudala yokugoma ngokumelene pneumococcus

"Pneumo-23" yokugoma iqondiswa kanye phansi kwesikhumba noma intramuscularly. Zingagonywa kusukela 2-hletnego ubudala, umthamo - 0.5 ml. Phinda lokugoma kungaba kwenziwe ngaphambili kuka emva kweminyaka 3 emva umjovo zokugcina.

Ukugonywa yokulwa nezifo Pneumococcal izingane usebenzisa "Prevenar 7" kungenzeka ngezinyathelo ezingu-2 hmesyachnogo ubudala. Ukugonywa Kwenziwa ngokulinganisa ne DTP (ngezigaba 3). Revaccination kungase kwenziwe ingane abaneminyaka engu 1.5. Nokho, lolu hlobo lomuthi wokugoma, kukhona zimo ezimbalwa yokugoma. Kukhona ulwazi ukusebenza yokugoma ngezigaba 2 (phakathi nonyaka isigamu-2nd), kulandele booster. Futhi iyatholakala naleli cebo yokugoma ku 2 ngezigaba phakathi ngonyaka wokuphila wesibili, futhi uma isikhathi engu-2 kuya 5.

Izinga Ukuvikelwa polysaccharide yokugoma

kusebenta High ekuvimbeleni i-pneumonia yabonisa wokugoma ezifweni Pneumococcal. Izibuyekezo neziphathimandla kwezibalo bathini mayelana 80 ngamunye Ukuvikelwa isenti. Ochwepheshe-epidemiologists ukuncoma lokugoma nabantu "Pneumo-23" abaneminyaka engu-18 kuya ku-21 ezinkulu kanye nezinhlangano amaqembu (ezifana amayunithi wezempi). Ngemva kwenkathi ethile yesikhathi (2 kuya 5 izinyanga) emva yokugoma bangalindela ukwehla kwezehlakalo izifo sibi zokuphefumula mali ezingaphezu kuka-2-emhlanjini, ukucinana kwemigudu yokuphefumula - kuze kube izikhathi 13, inyumoniya - hhayi izikhathi ezingaphansi kwezingu-6. Ngo-pneumonia eziyinkimbinkimbi, meningitis nezinye izinhlobo Pneumococcal webhaktheriya ukutheleleka kahle iphesenti amabanga kusuka 56 kuya 81.

Izinga ukusebenza phakathi nenqubo efana lokugoma ngokumelene pneumococcus, kuthinta yobudala vaccinees. Esikhathini age group kuze kube iminyaka engu-55, babengamaphesenti 93%, kusukela kwabaneminyaka engamashumi 55 kuya ku-64 nekusebenta kwehle kuze 88%. Izinga isivikelo pneumococcus kweminyaka emibili nengu-65 ukuze 74 - 80%, engaphezu kuka-75 ubudala - 67%.

Ukuze iziguli izifo zenhliziyo nemithambo yegazi kanye broncho-yamaphaphu, izinga lokuvikeleka nge polysaccharide imigomo (ikakhulukazi "pneumo-23") cishe 69% (njengoba kubantu enempilo). Bonisa ngezinga eliphezulu nekusebenta wokugoma enjalo lapho esetshenziswa izingane amaqembu. ukusebenza okuhle sibonisa "Pneumo-23" lihambisana Umkhuhlane imigomo.

Ngokuqondene neminye wokugoma ifakwe ngesiRashiya - "Pneumovax-23" - kungashiwo ukuthi ngempumelelo yayo kubantu abanesifo sikashukela kuyinto 84%, kanye ischemia - 73%. Ukuze iziguli ukumelwa inhliziyo, lokhu Amaphesenti angu-69, yamaphaphu esicindezelekile kanye somoya - 65 ngoba amadoda kakhulu kulabo abaneminyaka yobudala engaphezu kwengu-65 Ukuphumelela lomuthi ivame ukuba 75%.

Izinga Ukuvikelwa conjugate yokugoma

With ukusetshenziswa conjugate lokugoma wokugoma yokulwa nezifo Pneumococcal izingane babethanda eliphezulu kahle. Kakhulu ziyancipha hhayi kuphela isibalo esibhedlela wokwamukela izingane samakhaza yanoma yimuphi umsuka, kodwa futhi ukuvama sinenkonzo yokunakekela iziguli kudokotela. Ngcono kakhulu isimo abagulela ukufa Pneumococcal meningitis.

Pneumococci kukhona sasivumela ukumelana ne-penicillin. "Prevenar-23" uyakwazi ukuvikela zamagciwane nge ukuzinza Lesisemkhatsini high 80-100%. Ngaphezu kwalokho, lokhu wokugoma nge ukusebenza kahle eliphezulu kuhlanganiswe ingxenye Umkhuhlane.

Ngokwe-World Health Organization, ukusetshenziswa umgomo conjugate inqubo efana lokugoma yokulwa nezifo Pneumococcal izingane (zonke abahlala emazweni 72 asathuthuka emhlabeni wonke), ungakwazi ukuvimbela ukufika ku-nokufa 407.000 ngonyaka.

ukusabela kungenzeka yokugoma

Ukugonywa ngokumelene Pneumococcal Ochwepheshe isifo avunyelwe ukwenza ngasiphi isikhathi sonyaka kanye kuhlanganiswe nanoma iyiphi enye imigomo (okuhlukile kwenziwa kuphela BCG) esinyeni. On nokuphathwa zombili izinhlobo yokugoma ngokumelene ezithile pneumococci impendulo kungenzeka nomzimba womuntu. On the "Pneumo-23" iziguli ngabanye kungenzeka ukuphendula bendawo ngesimo ububomvu, ubuhlungu. Amandla ukuphendula ngokuvamile ababuthakathaka futhi kungathatha amahora angu-48. Ukugonywa ngokumelene ingane Pneumococcal (izibuyekezo kwabasebenzi bezempilo nabazali bayavumelana ngaleli phuzu) kwezinye izimo (akuvamile) kungabangela ukuqubuka, ubuhlungu emalungeni.

Kukhona amacala lapho iziguli ezinesifo idiopathic purpura thrombocytopenic (ngo lwesigaba ethule) ngemva kwenkathi lezinsuku kusukela 2 kuya ku-14, recurrences athuthukile kuyoshaya amaviki angu-2. Akuvamile kakhulu ukuzwa uthi anaphylactic.

Umgomo "Prevenar" libhekene tolerability yezingane ezinhle sika. wokugoma ezinjalo ngokumelene yezinkinga ukutheleleka Pneumococcal (sikhuluma izinkinga sina), njengoba umthetho, akakubangeli. Nokho, ngokuvamile i-obonakala njengenhlangano ukusabela wendawo ukucasuka, izinkinga zokulala, ububomvu zendawo zokuzikhukhumeza, ukwanda izinga lokushisa lomzimba kuya 38 C. Idlanzana izingane (5%), izinga lokushisa lingase ahlule 39˚ C.

Ingabe ikhona contraindications lokugoma ngokumelene pneumococcus?

Noma yimuphi Izimo jikelele noma ekhethekile lokugoma akuyona yimiphi imigomo, ngaphandle ukuthi yokusabela kuya wokugoma ukutheleleka Pneumococcal esikhathini esedlule. Kukhona ezinye izincomo ukusetshenziswa Immunology "Pneumo-23" akuyona esingaphansi kwezinsuku 10 ngaphambi inkambo yokwelapha immunosuppressive iqala. Ukwehluleka ukulandela lezi ziqondiso zingase ukuthuthukisa ukwehla kwamazinga omzimba.

Ukugonywa kwabasebenzi bezempilo abesifazane abakhulelwe avunyelwe kuphela senyanga zokugcina. Nokho, ngaphandle kwalapho kudingeka ngempela, kutuswa ukuba ugweme le nqubo.

Izigameko zokushona isifo Pneumococcal: iqembu ingozi

Ukulaxazwa nenqubo efana lokugoma yokulwa nezifo Pneumococcal? yezinkinga amaqembu athile abantu kungabangela okungaphezu kokuziphatha wakhe. Ochwepheshe batusa abantu ngempela zigonywe abangaphezu kweminyaka engu-65. Kwamanye amazwe athuthukile, yokugoma kuleli qembu lobudala isikhundla sokuba nezinqubo saziso.

Kumele zigonyelwe isifo Pneumococcal buthaka, bayagula futhi kuncike esibhedlela yabantu abanesifo sikashukela, ukucinana kwemigudu yokuphefumula okungamahlalakhona, ukuntula in umsebenzi zenhliziyo zokuphefumula, ukusebenza isibindi.

Udinga lokugoma ngokumelene pneumococcus (abezimo eziphuthumayo Izibuyekezo - nobufakazi) abantu abane buthaka omzimba. Lapha iziguli engozini ngubani wahlinzwa zabhekana yokususa ubende, abaphethwe syndrome nephrotic, isikela-cell anemia. Futhi, leli qembu kuhlanganisa abantu abaye avuzayo uketshezi lomgogodla.

Futhi-ke, ungakhohlwa mayelana isizukulwane ezikhulayo. Goma Kunconywa izingane bexhwalile (kuhlanganise abangenwa isifo sofuba), efika namaqembu amakhulu (nursery, enkulisa, esikoleni). C. 2-hletnego yobudala podiatrists ukweluleka ukuba bagome seziguli ezisencane ukuhlupheka liquorrhea, asplenic, ukuntula izakhi umphelelisi abadlule inqubo ye nolwelwesi cochlear.

Ukugonywa yokulwa nezifo Pneumococcal izingane kungaba kakhulu ukunciphisa ukushuba isifo futhi sehlise ukushona kusukela kule silwanyana esabekayo.

Ngokusho ochwepheshe bezokwelapha, iziguli, abazali

Umbono nodokotela bezingane, ochwepheshe bezokwelapha kwamanye amasimu amaningi imithi kulo mbuzo ngokungananazi - lokugoma yokulwa nezifo Pneumococcal (ofana nokubuyekezwa mayelana nokuthi iziphi izinhlelo uhlangothi townsfolk abavamile abasakwazi kuyadida) - liyadingeka. Odokotela cabangela le ndlela wokuvikela ngempumelelo kakhulu empini yokulwa nezifo mass etymology ezahlukene kakhulu. Kulula njalo kancane ebizayo ukuvimbela isifo kuka ukuthatha imithi (ezingaphezu kweyodwa, kanye ngokuvamile eziningana noma ziwubala kakhulu) ukuphatha kanye ukutheleleka kakhulu nasemiphumeleni yaso, ukuxakeka.

Phakathi abazali nodokotela wezingane izincomo elinamandla lokugoma ngokumelene pneumococcus akuyona njalo ezikhona. Umuntu ovamile, akayena udokotela, sibonga abezindaba "ngokuqinisekile uyazi" ukuthi amagciwane pneumococcus baningi kakhulu, nokuthi noma ngabe umgomo lizoyivikela ingane, okuyinto Kunconywa odokotela - umbuzo obalulekile. Nakuba iningi labazali namanje bavame ukulalela umbono onguchwepheshe futhi ibhekane ngokugoma.

Ngezikhathi ezithile ungezwa ukuthi ukugoma yokulwa nezifo Pneumococcal, yezinkinga esakhiwa ekukhuliseni izinga lokubanda lalingu-hhayi ngempumelelo - ingane namanje ogulayo. Ezimweni ezinjalo kubalulekile ukuba banake ukushuba isifo. Uma ingane ukukhwehlela, wayenobuhlobo lokushisa kuze kube degrees 38, futhi wayegula njalo ezinsukwini ezingu-7 - lokhu kuyaqondakala. Ngaphandle lokugoma kungaba nemiphumela ebuhlungu khulu, ukucinana kwemigudu yokuphefumula, inyumoniya, esibhedlela, imithi eminingi ungeyena elula, futhi izinsuku ukwelashwa okungenani 21.

Efingqa

isifo Pneumococcal kuholela emhlabeni wonke sokuthuthukiswa acute nezifo zokuphefumula, obstructive wamaphaphu nesifo, njll Futhi namhlanje, kule ukusetshenziswa kwezindlela zobuchwepheshe obuphambili lonyaka wesimodeni, izinga lokufa kusukela kule silwanyana siphakeme ngokwanele. Ngakho-ke, ingxenye abazali lokugoma ngokumelene pneumococcus ingane (impendulo - hhayi uhlobo lolwazi okufanele ukuqondiswa Ezimweni ezinjalo) - leli yithuba ukuvikela ingane yakhe, ukuvimbela ukuthuthukiswa izifo ezingathi sína kwababhemayo ngaphansi uyimbudane, akudingeki ngaphansi ngokwayo nhlobo ubufakazi, kungaba pretexts.