Ugonyo nezifo Pneumococcal kubantwana: indlela nengxelo

Ngokutsho WHO, pneumococci badla babe zii-arhente kwezifo ebantwini. Namhlanje, amanani kukuba eziphilayo ngunobangela wokufa ngenxa 1.2 yezigidi. Abantu unyaka wonke. Kule inani labantu abangaphezulu kwama-40% abantwana abangaphantsi kweminyaka emi-5 ubudala. Of ekuthiwa- pneumonia ezifunyenwe yoluntu-, inani apho lowo Russian kunye nesiqingatha sesigidi ngonyaka, ukuya kwi-75% amatyala abantu abadala umkhwetha ezi Cya - pneumococci. Ngokumalunga abantwana nobudala beminyaka engama ukuya ku-5, kukho ipesenti inxaxheba kwinkqubo pneumococci ifikelela 90.

Bonke abantwana bafumane otitis abagulayo kunye kumanqanaba angafaniyo ubungnqongqo. Malunga nama-30-35% yazo zonke iimeko kumajelo otitis etsolo kwizigulane abaselula iqalwa pneumococci. Ezi zifo luphawulwa amanzi ayo, benokundileka ophezulu kunye namathuba ophezulu kakhulu perforation le indlebe. Ngokufuthi uyakwazi ukuva kwiingcaphephe malunga nophuhliso orthogene iingxaki intracranial, balahle ekufuneka yenziwe tympanostomy rhoqo ngokwaneleyo. Le nkqubo a ungenelelo ngotyando ukuya ukulungiswa phakathi indlebe kwisisu kwaye igcina kwakhona i imeko amathambo indlebe eliphakathi.

Ugonyo nezifo Pneumococcal abadala kunye nabantwana kakhulu ukuphucula imeko izehlo yale umqalisi.

isifo Pneumococcal: Ngubani na lowo?

IStreptococcus pneumoniae yenye amacandelo microflora yesiqhelo inkqubo eliphezulu nokuphefumla yomntu esempilweni. Ukuya ku-70% yenani labemi - ixhasa iintlobo enye okanye ngaphezulu silwanyana. Phakathi kwabantwana, inqanaba 'ebumelwaneni' ingaphezulu phakathi abadala. Inqanaba ubuninzi buyo kwabo ubomi, ukusebenza kwaye sikhule ngamaqela (pre-school kunye namaziko emfundo, amaqela asebenza, njalo njalo).

Le ephilayo sakhiwa isingxobo polysaccharide elikwaziyo ukucinezela uphuhliso sifo kubantwana abancinane ngaphezu kweminyaka 2. Namhlanje, inzululwazi uyazi malunga ubukho iintlobo zeHPV zingonobangela 84 pneumococcus. Kunye nophuhliso ixesha elwa kakhulu leentsholongwane engenabungozi iStreptococcus pneumoniae sele Cya zilwe ngamandla ukumelana kumachiza nemithi isambuku yemveli. Inqanaba yokumelana penicillin ngoku malunga-50%, ukuze chloramphenicol kunye tetracycline - 30%. Ekubeni iqela penicillin-ntsholongwane ubanzi ngokwaneleyo, ngoko ke akuyi kubakho olusebenzayo wokosulela kokuphilayo ezifana pneumococcus. Ugonyo kwiimeko ezinjalo - ekuphela kwendlela ukuphumelela kunye ilahleko kancinci ukulwa nalo silwanyana. Kufanelekile ukuba sikhankanye ukuba sifo sidla phuhlisa ngokukhawuleza (iintsuku ngokuqhelekileyo akukho ngaphezulu kwe-3), kunye nexesha ukwenza uphando inkcazelo iqondo uvakalelo iintlobo ezithile antibiotics ungekho.

Ngoku umbuzo ukumelana Pneumococcal elwa iye ibaluleka, kuya kusiba yingxaki ngakumbi engxamisekileyo.

Ziziphi amachiza asetyenziswa?

Okwangoku, Russia isebenzisa iindidi ezimbini ugonyo ukuba inkqubo ezifana nogonyo kusulelo Pneumococcal: polysaccharide kunye conjugated ukuya nemixube protein.

Iqela lokuqala (polysaccharide) oyena eyaziwa lugonyo Pneumo-23 (sanofipaster). Isisombululo ngumxube 23 polysaccharide ndenziwe nyulu ukusuka serotypes inani elifanayo. Eli qela serotypes ngayo ngokukhuselekileyo kubangelwa-90% ye-Ozahlulayo egazini, kwaye uninzi kunye neentlobo ezichongiweyo kummandla Russia. Ke kaloku nqanaba sobhaliso olunye ugonyo efanayo - ". Pneumovax-23"

Ukususela uhlobo zokugonya conjugated baseRashiya yabhaliswa ngokomthetho kwaye ngoku sebenzisa "Prevenar 7". serotypes ezisixhenxe ezibandkanywe kumafa yayo, zidibene 87% of Ozahlulayo Pneumococcal babekade abantwana abagulayo ukusuka eUnited States nakwamanye amazwe athile. Ngenxa yokuba serotipovaya umfanekiso eUnited States iRussia ifana kakhulu, siya kuthathwa ngokuthi "Prevenar 7" Kwakhona uya kuba ngempumelelo kwi Russian Federation, kwakunye eUnited States.

Ibanga lobudala babase kwisitofu nxamnye pneumococcus

"Pneumo-23" babase kwisitofu ilawulwa kanye kwesikhumba okanye intramuscularly. Ngaba zigonywe esuka ku-2-hletnego ubudala, idosi - 0.5 ml. Re-ugonyo enokwenziwa hayi ngaphambi kwe emva kweminyaka emi-3 emva inaliti yokugqibela.

Ugonyo nezifo Pneumococcal abantwana usebenzisa "Prevenar 7" kunokwenzeka kunye nobudala 2-hmesyachnogo. Ugonyo oluqhutywa ngaxeshanye kunye Dube (ngokwamanqanaba 3). Revaccination lungenziwa ngendlela umntwana abaminyaka yobudala eyi-1.5. Nangona kunjalo, olu hlobo lokugonya, kukho imiboniso eziliqela zisigonyelwe. Kukho ulwazi malunga nokusebenza gonyo ngokwamanqanaba-2 (phakathi kwi-2 isiqingatha sonyaka-), ilandelwe yi booster. Lukhona nge scheme ugonyo i ngezigaba-2 kunyaka wesibini ebomini, kube kanye kwixesha eliyiminyaka-2 ukuya ku-5.

Inqanaba ukhuseleko nogonyo polysaccharide

ngempumelelo High ekuthintelweni yinyumoniya wabonisa lugonyo Pneumococcal. Ukuphonononga abasemagunyeni manani zithi malunga 80 ukukhuselwa ekhulwini ngalinye. Iingcali-epidemiologists bacebisa ugonyo nabantu "Pneumo-23" abaneminyaka eyi-18 ukuya 21 kwimibutho ezinkulu kunye namaqela (ezifana neeyunithi zomkhosi). Emva kwexesha elithile (iinyanga ezi-2 ukuya ku-5) emva kogonyo unokulindela ukuhla izehlo izifo ezihlasela zosulele ngokuphefumla kwi mali oluphindwe-2 ngaphezulu, iphika - up to izihlandlo ezili-13, inyumoniya - hayi amaxesha ngaphantsi kwe-6. Xa pneumonia enzima, meningitis kunye nezinye iintlobo Pneumococcal ziibhakteriya usulelo ngendlela ipesenti nemiqulu engama-56 ukuya 81.

Inqanaba ngempumelelo kwale nkqubo ezifana nogonyo nxamnye pneumococcus, ichaphazela yobudala vaccinees. In osikelwe ubudala beqela ukuya kwiminyaka engama-55, babengama-93%, ukusuka kwiminyaka engama-55 ukuya kuma-64 ukusebenza yehle ukuya ku-88%. Inqanaba nokhuseleko pneumococcus kweminyaka yobudala engama-65 ukuya kwengama-74 - 80%,-75 leminyaka ubudala - 67%.

Kuba izigulane abaphethwe zizifo sentliziyo kunye broncho-pulmonary, inqanaba ukukhuselwa zokugonya polysaccharide (ingakumbi 'pneumo-23 ") nama-69% (as in kubantu abasempilweni). Bonisa ngezinga eliphezulu ukusebenza isitofu sokugonya onjalo xa isetyenziswa amaqela abantwana. umsebenzi olungileyo ubonisa "Pneumo-23" kunye zokugonya influenza.

Ngokuphathelele abanye isitofu ifakwe Russian - "Pneumovax-23" - kunokuthiwa ukusebenza kwayo kubantu abanesifo seswekile yi-84%, kunye ischemia - 73%. Kuba izigulana sisifo sentliziyo, le pesenti 69, kunye imiphunga buhlungu kunye sombefu - 65 amadoda kwiqela lobudala kwama-65 eminyaka ukusebenza ichiza uyabaleka 75%.

Inqanaba ukhuseleko nogonyo udibaniso

Ukusetyenziswa udibaniso ugonyo sokugonya nezifo Pneumococcal abantwana babonisa iqondo eliphezulu ngobuchule. Ngokuphawulekayo kunciphise kuphela inani lokwamkelwa esibhedlele abantwana pneumonia nawuphi na imvelaphi, kodwa nezihlandlo ukundwendwela kwezigulane kwagqirha. Ngokuphawulekayo ngcono imeko nokudodobala Pneumococcal meningitis.

Pneumococci abamelana okuphakamileyo penicillin. "Prevenar-23" uyakwazi ukukhusela nxamnye iintlobo kunye uzinzo eliphakathi kwaye ephezulu 80-100%. Ukongeza, le sokugonya kunye kahle eliphezulu ukudityaniswa ngokomlinganiselo influenza.

Ngokutsho kwe World Health Organization, ukusetyenziswa sokugonya udibaniso-nkqubo efana ugonyo nxamnye nesifo Pneumococcal abantwana (bonke abahlala kumazwe asakhasayo 72 ehlabathini lonke), unako ukuthintela ukuya ekuswelekeni 407.000 ngonyaka.

ngayo kunokwenzeka ukuba ugonyo

Ugonyo nxamnye iingcali sifo Pneumococcal bavumelekile ukwenza ngalo naliphi na ixesha lonyaka kwaye kudityaniswe nayiphi namanye amachiza (umnyinyiva senziwa kuphela BCG). On ulawulo zombini iindidi imithi impendulo kunokwenzeka pneumococci ezithile emzimbeni womntu. Kwi "Pneumo-23" kwizigulane kuvumelekileyo kwenzeka indlela basekuhlaleni ngohlobo bomvu, iintlungu. Ngobunzulu ukusabela idla buthathaka kwaye elinokuthatha ukuya kuma kwiiyure ezingama-48. Ugonyo nxamnye umntwana Pneumococcal (reviews of abasebenzi bezempilo kunye nabazali bayavumelana le ngongoma) kwezinye iimeko (hayi kaninzi) kunokubangela irhashalala, iintlungu kwamalunga.

Kukho iimeko apho izigulane purpura thrombocytopenic idiopathic (kwisigaba cwaka) emva iintsuku ukusuka ku-2 ukuya kwi-14, sisifo ephuhliswe ngokwandisa ukuya kwiiveki ezi-2. Kunqabile ukuba ukuva States anaphylactic.

Isitofu sokugonya "Prevenar" luphawulwa tolerability abantwana olungileyo. Loo lugonyo kubunzima Pneumococcal (sithetha naziphi na iingxaki ezinkulu), njengoko umthetho, a wu endli. Noko ke, ngokufuthi wabonakalaliswa njengoko reactions zasekuhlaleni nochuku, zokulala, ububomvu lobulali kwaye ukudumba, ukunyuka lobushushu emzimbeni 38 inani elincinane C. A abantwana (5%), iqondo lobushushu ukuze kuvuka ngaphezulu 39˚ C.

Ingaba kukho naziphi na Izimo ukuba ugonyo nxamnye pneumococcus?

Naziphi Izimo jikelele okanye elikhethekileyo ugonyo ayikho ukuba naziphi na zitofu, ngaphandle kokuba indlela ukuya isitofu Pneumococcal ngexesha elidlulileyo. Kukho ezinye iingcebiso malunga nokusetyenziswa Zizifo "Pneumo-23" ayikho ngaphantsi kweentsuku ezingama-10 phambi kokuba iqale ikhondo unyango immunosuppressive. Ukungaphumeleli ukulandela le imiyalelo kungakhuthaza ukuhla kumanqanaba unalo.

Ugonyo kwabasebenzi bezempilo abasetyhini abakhulelweyo zivumelekile kuphela ezintathu lokugqibela. Nangona kunjalo, ngaphandle kokuba kunyanzelekile, kucetyiswa ukuba ayeke kule nkqubo.

Iziganeko sifo Pneumococcal: iqela kwengozi

Ukushiywa inkqubo efana ugonyo nezifo Pneumococcal? iingxaki kumaqela athile abantu zingabangela ngaphezu ihambo yakhe. Iingcali ukuncoma abantu ukuba ukugonywa ngaphezu kweminyaka engama-65. Kwamanye amazwe ziphuhliswe, ugonyo kweli qela lobudala akangenanga iinkqubo zomthetho.

Kufuneka zigonywe ngokuchasene Pneumococcal buthathaka, egula yaye ngokuxhomekeke esibhedlele abantu abanesifo seswekile, iphika engapheliyo, ukunqongophala kumsebenzi ezesifuba zokuphefumla, ukusebenza kwesibindi.

Ufuna ugonyo nxamnye pneumococcus (paramedics reviews - ubungqina) kubantu abanamajoni omzimba buthathaka. Apha izigulane abasemngciphekweni uqhaqho izalwe ukuba kususwe eli udakada, abaphethwe syndrome nephrotic, irhengqa-cell anemia. Kwakhona, eli qela kuquka abantu abaye evuzayo fluid spinal.

Kakade ke, musa ukulibala malunga isizukulwana ekhulayo. Gonya wancomela abantwana nabayimilwelwe (kubandakanywa nabo bosulelwe tuberculosis), ukufika kumaqela amakhulu (nursery, enkulisa, isikolo). C. 2-hletnego podiatrists ubudala ukucebisa ukuba agonye izigulane abatsha ukubandezeleka liquorrhea, asplenic, ukuswela amacandelo ngumphelelisi badlula inkqubo ye uyofaka cochlear.

Ugonyo nezifo Pneumococcal abantwana unga nciphisa ngokubaluleka ukwanda kwesifo kunye nokunciphisa lokubhubha kulo silwanyana eloyikekayo.

Ngokutsho iingcali zonyango, izigulane, abazali

bezifo Mbiko, iingcali zonyango nezinye iinkalo ezininzi amayeza kulo mbuzo eziqhitsini - ugonyo nezifo Pneumococcal (ezifana ukubuyekeza apho icala townsfolk abaqhelekileyo kakhulu ingacaci) - into efunekayo. Oogqirha kuyihl 'amahlongwane le ndlela yokukhusela sisebenzayo ekulweni nezifo mass etymology eyahlukileyo kakhulu. Kuba lula kwaye zazixabisa ngaphantsi ukuthintela isifo kunokuba ukuthatha amayeza (ngaphezu kwesinye, yaye ngokuqhelekileyo eziliqela okanye kakhulu elimnandi) ukulawula usulelo kakhulu kunye neziphumo zayo iingxaki.

Phakathi abazali wezifo iingcebiso olungamandla ugonyo nxamnye pneumococcus akusoloko usizo. Umntu ongaqondiyo, kungekhona ugqirha, kubulelwe eendaba "ngokuqinisekileyo uyakwazi 'ukuba iintlobo ze pneumococcus baninzi kakhulu, kwaye ingaba isitofu sogonyo uya kubakhusela umntwana, nekucetyiswa ngoogqirha - umbuzo omkhulu. Nangona uninzi abazali badla ukuphulaphula ngokoluvo oyingcaphephe kwaye baye kufumana ugonyo.

Ukususela kumaxesha ngamaxesha uyakwazi ukuva ukuba ugonyo nxamnye izifo Pneumococcal, iingxaki ekukho ekukhuliseni lobushushu wayengekho olusebenzayo - umntwana kusenjalo egulayo. Kwiimeko ezinjalo kuyimfuneko ukuba banikele ingqalelo ngobunzulu kwesi sifo. Ukuba umntwana ukukhohlela, waba lobushushu iqondo-38, yaye wayesifa iintsuku 7 - oku kuyaqondakala. Ngaphandle ugonyo kungaba nemiphumela mandundu kakhulu, iphika, inyumoniya, esibhedlele, amachiza amaninzi akunguye ilula, kunye neentsuku ezingama-21 ze unyango.

UPawulos

izifo Pneumococcal kukhokelela wonke umhlaba ukuze uphuhliso izifo ezihlasela zosulele ngokuphefumla, isifo kwemiphunga, njl Kwaye namhlanje, xa yobudala eziphakamileyo zobugcisa zale mihla, izinga lokusweleka kule silwanyana liphezulu ngokwaneleyo. Ngoko ke, inxalenye lwabazali ugonyo nxamnye umntwana pneumococcus (feedback - hayi uhlobo ulwazi oluya kufuneka bakhokelwe kwiimeko ezinjalo) - eli lithuba lokuba akhusele umntwana wakhe, ukuba ukuthintela ukunwenwa kwezifo phantsi kude iyintsomi, musa ukuba phantsi ngokwayo akukho bungqina, pretexts.