I-BCG (ukugoma): imiphumela, izinkinga ezingenzeka, izinqunquthela

Isifo sofuba yisifo esiyingozi kakhulu esithathelwanayo, esibangelwa i-Mycobacterium isifo sofuba, noma isifo sofuba se-mycobacterium. Lesi sifo sithuthuka ngokushesha, sinemiphumela eminingi kanye nezinkinga, ishiya umshini emzimbeni wokuphila. Ngeshwa, njengabanye abaningi, lesi sifo kulula ukuvimbela kunokumisa ukutheleleka. Kuze kube manje, indlela kuphela yokuvimbela isifo sofuba i-BCG yokugoma. Imiphumela, izinkinga nokuphikisana - kulesi sihloko.

Ukumiswa kwe-BCG yokugoma

Iyini isifinyezo se-BCG? Ukuchazwa kwegama lesiLatini iBBC kuhunyushwa njenge-bacillus Calmette-Guerin. Ekuhunyushweni ngesiRussia lokhu kusho "i-Calmette-bacillus kaGeren". Ngakho, akusibo sonke isifinyezo se-BCG. Lokhu kunquma ukufundwa ngokuqondile kwesitfombe seLatini esibhalwe ngesiCyrillic.

Ukugonywa kwe-BCG: kuyini?

Umgomo we-BCG ukumiswa kwe-mycobacterium yezinkomo ezibuthakathaka ngokulahlekelwa yi-virulence kubantu. Kunezinhlobo ezimbili:

1. I-BCG - okuqukethwe kwe-Mycobacterium isifo sofuba emtholampilo kuncane kakhulu ukuthi kungabangela ukutheleleka. Kodwa-ke, lesi silinganiso sikwanele ukuvumela umzimba ukuba uhlakulele isifo sokuzivikela ngokumelene nesifo esiyingozi. Kuwo wonke amazwe, kungakhathaliseki ukuthi umkhiqizi, ukwakheka komgogodla kuyafana. Yingakho kungalungile ukuhlela "umjaho" wemikhiqizo yangaphandle ekukholweni komuntu siqu ukuthi kungcono kunekhaya elifuywayo.
2. I-BCG-M - ngenxa yezinto ezincishisiwe ezinemizimba emincane (isigamu ubukhulu bomgomo wokuvota we-BCG), igonywe isifo sofuba sezingane ezingakabiphi isikhathi, ezikhungethwe phansi. Ngaphezu kwalokho, uma ingane "ingaboni" esibhedlela nganoma yisiphi isizathu futhi ingangeni emgodini ngesikhathi, i-BCG-M isetshenziswa ezibhedlela.

Ingabe kuyadingeka ukuba inoculate?

Akuyona imfihlo ukuthi umgomo awuhlinzeki isiqinisekiso esingu-100% sokuthi ukutheleleka kwesifo sofuba ngeke kwenzeke. Ngakho-ke kuyini, ucela. Iqiniso liwukuthi i-BCG iqala ukuvikela umuthi wokuvikela isifo sofuba, okungahlinzeka ngokuvikeleka okunamandla uma kwenzeka ukutheleleka okuyisisekelo, kanye nalabo abathintana nabo abanezinkinga zokutheleleka kwesifo sofuba. Uma imvelo isabuthakathaka kunaleso sifo, khona-ke umgomo uzovimbela ukuthuthukiswa kwezinhlobo ezisemthethweni ezifakwe esibhedlela, isifo sofuba (ifomu kanye nesimo somthetho). Ngakho-ke, ukuhlinzeka ngokuvikeleka okuphelele ekuthelelekeni, ukugoma kuzokwenza ukuthi kube lula ukwenza lesi sifo uma kwenzeka ukutheleleka.

Ubani onconywa ukugoma kwe-BCG?

Ukugonywa kunconywa kubantu:

1. Izinsana. Kuzo zonke izingane, i-BCG kufanele igonywe ngonyaka. Ikakhulukazi ezindaweni ezinesifo sofuba.
2. Abantu abahlale bexhumana nesifo sofuba esithathelelekile (ngokuvamile abasebenzi bezokwelapha zesifo sofuba, njll).

I-BCG igonyelwe ngaziphi iminyaka?

I-BCG nini? Ukugonywa okuyinhloko kuvame ukuwenzelwa ingane enempilo esanda kuzalwa ngosuku lwesithathu lokuphila. Ngaphambilini, udokotela kumele ahlolisise ingane, asebenze i-thermometry (ekushiseni komzimba okwedlulele inqubo iphikisana), cabangela umlando nakho konke okungaphikisana. Ngaphezu kwalokho, ukugonywa kwezingane ze-BCG kwenziwa kuphela emva kokubonisana nodokotela ochwepheshe ngokuhlolwa okwenzelwe igazi kanye nokuhlolwa komchamo.

Umgomo kufanele uhanjiswe ngaphakathi kwe-intradermally, endaweni engaphandle kwehlombe lesokunxele, umthamo awufanele udlule u-0.05 mg. Inqubo yokwenza inqubo ihilela isingeniso esincane - ukuze uqiniseke ukuthi inaliti ingene ngendlela efanele. Uma konke kwenziwa ngendlela efanele, i-papule enobubanzi bamamitha angu-7-9, umbala omhlophe, ngokuvamile ilahleka imizuzu engu-15-20 ngemva kwenqubo, isakhiwe esakhiweni somjovo.

Izingane, ezingazange zigonywe esibhedlela ngenxa yezizathu ezithile, zigonywa ngesikhathi sokuqala. Uma sekuphelile izinyanga ezimbili kusukela ekuzalweni, ukusabela kweMantoux kumele kwenziwe ngaphambi kokugoma . Ngomphumela omuhle, i-BCG ayivumelekile.

Emrekhodini wezokwelapha usana, udokotela kumele enze inothi mayelana nokugoma, okukhombisa usuku lokugoma, uchungechunge kanye nenombolo yokulawula umuthi. Ngaphezu kwalokho, umlando womkhiqizo wangena ufakiwe emlandweni, kanye nomkhiqizi.

Kubalulekile! Beka umgomo uvunyelwe ukusingatha noma yiziphi izixazululo. Ukusetshenziswa kokugqoka akuvumelekile.

Kungani kugijima okunjalo?

Futhi, odokotela bavame ukubuza ukuthi kungani kusencane kakhulu ukwenza i-BCG. Uma begonywe, abazali bayamangala ukuthi kungani usana olusanda kuzalwa, lusengumntwana osanda kuzalwa ngosuku lwesithathu luvivinywa. Iqiniso liwukuthi isimo ngesifo sofuba singukuthi zonke iziguli ziyazi ngenkinga yazo, qhubeka uhola indlela yokuphila evamile. Ukuba abathwali bokutheleleka okuyingozi, bavakashela ngokukhululekile izindawo zomphakathi, okubangela ukwesaba okukhulu, ikakhulukazi kwengane encane. Ingozi yokuhlangana nomntwana one-bacterium iphezulu kakhulu. Yingakho ukugoma kwenziwa ngokushesha ngangokunokwenzeka, ukuze ngesikhathi sokukhukhulwa kwe-Mycobacterium isifo sofuba sesivele saqala ukwakha ingane.

Revaccination of BCG

Izingane ezineminyaka engu-7 no-14 ubudala kufanele zijowe kabusha, kodwa kuphela uma zihlukumeza ukuhlolwa kweMantoux. Isikhathi esiphakathi kweMantoux ne-revaccination akufanele sidlule amasonto amabili.

Ngeshwa, ezindaweni eziphambene nezifo ezingenakulungiswa zezwe, izingane zinegciwane lesandulela ngculaza isikhathi eside ngaphambi kokuba i-booster yokuqala, ngakho ayikho enye i-BCG.

Yiziphi izinqubo emzimbeni ezenzeka emva kwe-BCG?

Ama-Macrophages (noma ama-monocytes, ahlukahlukene ama-leukocytes) athatha ngokushesha i- mycobacterium yesifo sofuba ngokushesha aqala ukufika endaweni yokuphatha umgomo . I-pathogen ifa kanye nama-macrophages, okuholela ekubunjweni kwezixuku ezibandayo. Ukuphuma ngaphandle, bavusa ukubunjwa kobunzima endaweni yokugoma.

Impendulo ku-BCG

Ukusabela kungukuthuthukiswa kwe-papule esakhiweni somjovo, okuvame ukuvela emasontweni 4-6 emva kokugoma. Kumele kuvezwe umuthi endaweni yokugoma, ngokusho ukuthi kungenzeka kangakanani ukugwema igciwane lesandulela ngculaza elitholakalayo. Ngakho-ke, uma ngemuva kwe-BCG kwakha ubude obuyi-2-4 mm ngobukhulu, base bethi ukuthi inyama yegciwane izokuvikela lesi sifo eminyakeni engama-3-5. Uma ubukhulu buyi-5-7 mm - khona-ke umzimba ovikelwe iminyaka engu-5-7, futhi u-8-10 mm - iminyaka engu-10.

Ngokuvamile, umgomo ubekezelela kahle, kodwa ngezinye izikhathi kukhona ukuphendula:

• I-BCG yaxuba. Uma ubomvu bungafaki emathisini azungezile futhi kubonakala kuphela ngesikhathi sokugoma, lokhu kuyinto evamile. Ezimweni ezingavamile, ngaphezu kokubomvu, ukuvuvukala kanye ne- keloid scar kungakha . Azikho izizathu zokukhathazeka kulokhu: ngakho-ke, isikhumba siphenduka kumuthi.
• I-BCG ifaka. Ukuxoshwa kanye nama-abscesses yi-reaction evamile ezigabeni zokugoma, okuzokwenzeka esikhathini esizayo esiseduze. Kuzuzisa ukubona udokotela uma, ngaphezu kokususwa kwendawo yokugoma, ukubomvu nokuvuvukala kwavela: mhlawumbe, ukutheleleka kwesilonda kwenzeka, okumele kuphathwe.
• I-BCG isiye yavutha. Ukukhathazeka nokubhekana nezindleko zodokotela noma ukuma kuphela uma kusatshalaliswa i-edema nokuvuvukala esikhunjeni se-brachium, ukuze kube nemingcele yendawo yokugoma.
• I-BCG ithola. Ukubheka endaweni yokujola kuyinto evamile, kodwa odokotela beluleka ukuba basebenzise i-napi ye-gauze kwilonda ukuze ingane ingaboni.
• Ukushisa ngemuva kwe-BCG. Ukwanda komshini wokushisa komzimba osanda kuzalwa kuya kuma-38 degrees kuyinto evamile, kodwa uma ingane eneminyaka eyisikhombisa inomkhuhlane ngemuva kokuphindaphinda, udokotela kufanele axoxwe ngokushesha.

Kuyini ukuntuleka kokuphendula?

Uma, emva kokugoma, isibazi asizange sakhiwe endaweni yomjovo, lokhu kuyisibonakaliso sokuthi umuthi wokugoma wawungasebenzi, ngoba ukuzivikela kwesifo esiyingozi kakhulu kwakungabonwanga. Akufanele kube khona isizathu sokukhathazeka ngalesi simo: emva kwesikhashana ngemuva kokuthola ukusabela okungalungile kuvivinyo lweMantoux, i-revaccination ingenziwa, ngaphandle kokulinda iminyaka engu-7 ubudala.

Ukuntuleka kokuphendula emgodini wokuqala wokugoma kungavamile, kubonakala ku-5-10% wezingane. Ngaphezu kwalokho, cishe u-2% wabantu emhlabeni wonke banomkhuhlane we-TB. Lokhu kusho ukuthi esikhathini sokuphila abakwazi ukugula.

Ukuphikisana nokugoma

Ukungafani kokuya kwe-BCG akusiyo kakhulu, kufaka phakathi:

1. Isisindo somzimba wengane esanda kuzalwa singaphansi kuka-2500 g (nge-2-4 degree of prematurity).
2. Ukugula okujulile noma isikhathi sokwehla kwezifo ezingapheli. Ukugonywa kulesi simo kufanele kwenziwe ngemuva kokuphiliswa okuphelele, lapho ukubonakaliswa kwemitholampilo yesifo kuyoba okugcina.
3. I-congenital immunodeficiency.
4. Ukuba khona emndenini wokutheleleka okuzalwa okusha kwe-BCG.
5. Ukutheleleka nge-HIV komama.
6. I-leukemia.
7. Lymphoma.
8. Ukwelashwa kungumuthi wokuzivikela.

Ukuqhathaniswa nokuphindaphinda

Ukungafani kokuphindaphindiwe ku-revaccination yilokhu:

1. Ukweqisa kwezifo ezingapheli noma ukugula okunzima ngesikhathi sokugoma kwe-BCG. Ukushisa komzimba (okuphakanyisiwe) kuyisici esiyinkimbinkimbi sokudluliswa kwegciwane. Ngokuvamile i-revaccination yenziwa inyanga ngemva kokululama.
2. Ama-neoplasms angalungile.
3. Isimo se-immunodeficiency.
4. Isifo sofuba (kufaka phakathi esiteji sokuphumula).
5. Ukusabela okuhle ekuvivinyweni kweMantoux.
6. Izinkinga emva kokugoma okuyinhloko.

Abantu abadedelwa okwesikhashana ngenxa yokugonywa ngenxa yokuphikisana kufanele baphathwe futhi babhekwe ngabasebenzi bezokwelapha baze bavuselele ngokugcwele futhi bagonywe. Labo abatholwa kabusha baphinde babheke phansi futhi kufanele bahlole ukuthi isifo sokugoma siphenduka kanjani, 1, 3, 6, izinyanga ezingu-12 emva kwenqubo.

Uhlolo lokuphendula ngegciwane lubandakanya ini?

Lesi sheke senziwa ngemuva kwezinyanga ezingu-1-3, isigamu sonyaka nonyaka ngemuva kokugoma nokuphindwa kabusha, kufaka phakathi:

• Ukubhaliswa ngobukhulu bokuphendula kwendawo.
• Ukubhaliswa kwemvelo yokusabela (kulinganiselwa ukuthi ukwakhiwa kwamapuleli, ama-pustules ne-crust, noma i-hem). Ngaphezu kwalokho, ukuguqulwa kwesigqabhezana kwisayithi ye-inoculation kuhlolwa.

Ukugonywa kwe-BCG: izinkinga zingenzeka?

Ingabe igciwane liphephile ngokuphelele? Ingabe umgomo wokugoma we- BCG unenkinga ? Imiphumela ingavela efomini:

• I-Osteitis - isifo sofuba sethambo. Ukuthuthukiswa kwalesi sifo ngokuvamile kwenzeka eminyakeni engu-0.5-2 emva kokugoma, kubangela ukulimala okukhulu esimisweni somzimba sokuzivikela.
• Ukutheleleka kwe-BCG okujwayelekile - kwakha lapho ingane isifo sezifo zohlobo lwe-immune.
• Ukuvuvukala kwe-lymph node - ukungenelela okusheshayo okudingekayo uma kudingeka ukunyuka okubukhali ku-lymph node ngobukhulu (ngaphezulu kuka-1 cm ububanzi).
• Ukwehla kwamakhaza - kudinga ukungenelela okuhlinzayo. Lesi simo siwumphumela we-subcutaneous (esikhundleni se-intradermal) ukuphathwa kwe-BCG yokugoma. Umuthi wokugoma, imiphumela yalokho, awufundile.
• I-Keloid scar - yisikhumba esibomvu, esikhukhulayo endaweni ye-inoculation. Ngaphambi kobunzima, ukuphindaphinda lapho uneminyaka engu-7 kungenziwa.
• Isilonda esikhulu sibonisa ukuzwela okukhulu kwengane kuya ezingxenyeni zomuthi. Ngokuvamile, ukwelashwa kwendawo kunqunywe.

Ukuhambisana neminye imigomo

I-BCG imithi yokugoma ethile, ukusetshenziswa ngesikhathi esisodwa lapho ezinye izidakamizwa ezingamukeleki. Ngaphezu kwalokho, ukugonywa okungeziwe akuvunyelwe ngosuku lokuphatha kwe-BCG, kodwa futhi nangamaviki angu-4-6 ngemuva kokuphendula kumuthi. Ngemuva kokujola kwe-BCG ngaphambi kokuba enye inoculation ingadluli okungenani izinsuku ezingu-35-45.

Ngaphambi kokugoma, i-BCG ivunyelwe ukugoma ingane kusuka esibhedlela se-hepatitis B. Isimo esisodwa kuphela isikhathi sokuphumula kwe-immunological, okungukuthi, kuze kufike ezinyangeni ezingu-3, noma yikuphi ukugoma okuphikisana nomntwana.

Ukunakekela izingane ngemuva kwe-BCG

Ngokuvamile, azikho imiphumela emva kokugoma, noma kunjalo, kufanele kwenziwe okuthile ukuze "uqinisekise kabusha":

• Okokuqala, ukudla kwengane kufanele kuhlale okufanayo. Ngemuva kokugoma, umntwana angase abe nesitoreji esivulekile, umkhuhlane, nokuhlanza. Yonke le miphumela ibhekwa njengokujwayelekile, ayibonakali izingozi empilweni nasezempilo.
• I-Antipyretics (uma nje ingane ingaguli) kufanele inikezwe ngobusuku ekushiseni okungaphezu kwama-38.5 degrees. Ngokuphefumula kwe- febrile, ukushisa kungadonsa amazinga angu-37.5.
• Ukusetshenziswa kwama-antihistamine akuthandeki kakhulu. Ukubomvu nokuvuvukala kufanele kudlule ngokwabo: umzimba ophilile uzobhekana naso.
• Ukugeza akuvunyelwe.

Xhumana nodokotela uma izinga lokushisa alikwazi ukwehliswa yi-febrifugal (i-paracetamol) uma ingane ingenalutho futhi inqaba ukudla isikhathi eside. Ngokudumala, ukulahlekelwa kwengqondo kanye nesithumba se-purulent endaweni yomjovo, ngokushesha shayela i-ambulensi.

Ukunikezelwa kwe-BCG

Namuhla, ngokuvamile abazali bezingane baveza ukunganeliseki ngeminye imigomo ehleliwe, kubhekwa njengengozi. Imfashini ihlanganisa umkhuba wokwenqaba ukugoma. Ukugoma kwe-BCG, imiphumela yokushiywa yiyona edabukisayo kakhulu, akuyona into ehlukile.

Umgomo wokulwa nesifo sofuba ungashiywa kanye nanoma yimuphi omunye. Umthetho weRussian Federation uqinisekisa leli lungelo, ngaleyo ndlela liguqule umthwalo wemfanelo kubantwana kubazali babo.

Yini engingathanda ukuyiqaphela ngalokhu? Namuhla, ekufinyeleleni okuvulekile ulwazi oluningi mayelana nakho konke. Umuntu ngamunye ukwazi ukufunda ngokuzimela ngokuphathelene nokuphila nempilo yakhe nomndeni wakhe, enze izinqumo futhi abe nesibopho sezinkolelo zabo.

Uma unquma ukugoma ingane yakho - akekho ozosho lutho ngokumelene nalo. Udinga kuphela ukubhala ukwenqaba kwakho ekhadini, njalo ebonisa ukuthi ngeke ube nezimangalo kubasebenzi bezokwelapha ngemuva kwalokho.