Yintoni nechiza elichasene-TB kungcono esetyenziselwa unyango?

Akubonakali isifo sephepha pulmonary iyanyangeka kwisithuba seenyanga zekhalenda-10 ukuya kwiminyaka 1.5. Koda kube nini na unyango ixhomekeke ebukhulwini inkqubo sifo kunye nokuqeshwa ichiza elungiselelwe wona kakhulu efanelekileyo.

Isifo sephepha kweli xesha lethu - isisifo esinyangekayo

Xa unyango lwesifo sephepha zintsholongwane mihla Lilungelo unyango udibaniso. Oku kungenxa yokuba xa ngexesha elinye Ukungafunyanwa iziyobisi ezahlukeneyo elicothayo kakhulu ukukhula ukumelana mycobacteria ukuya ichiza. Isigulane wabelwa ukuya kwikhosi kwangoko Ilixa 2 okanye 3 iziyobisi. Ngethamsanqa, amathuba amayeza namhlanje zininzi ngokugqithisileyo. Oku kuphela linani kwamachiza 1 TB okanye indibanisela nemixube odityanisiweyo I no II series.

Ukuhlelwa arhente anti-TB ezakhiwa iqondo ngempumelelo yabo. Hi ndlela leyi, ngenxa ezininzi Institute wethu wenza uPhando ngenxa wayila iziyobisi ezifana "INH". Le yenye amachiza anti-tuberculosis omkhulu, oko esinokusibambisa kumsebenzi ophezulu kakhulu bacteriostatic. Kulo mzekelo, oko ubuchule ingakumbi imveliso kwizigulana abasandula sifo.

Elandelayo kuluhlu

Owesibini-ukusebenza konyango emva "isoniazid" - ngu "rifampicin". entle kakhulu kwaye ngempumelelo iindlela. amalungiselelo Active okulandelayo yabiwe kule ndlela ilandelayo: "streptomycin", "kanamycin", ngakumbi "Pyrazinamide" "Ethionamide" elandelwa "Prothionamide" "Ethambutol", no-3 ngaphezulu 'florimitsina "" Pask, "TB "Thioacetazone" iziyobisi.

Onke amayeza vozdeystuyuschie ku Mycobacterium nokunceda nokusombulula iingxaki kwezonyango izigulane ziye kubekwa phezu iqela amachiza-TB:

1. amachiza Antibacterial ezinkulu anti-TB 1 series
2. iziyobisi reserve II series.

Amalungiselelo ezahlukeneyo 1 nezintlu 2

Kumqolo wokuqala ke amachiza eziphambili ezithi ukuya ukusebenza eliphezulu le arhente chemotherapeutic kunye nezakhi zawo. Yiba letyhefu sakugcina.

iziyobisi Antituberculosis imikrozo-2, kubandakanywa amachiza backup, musa ukuba onjalo japan elungileyo ekulweni Goch wand, kunye kakhulu ayityhefu. Bona zilawulwa kwizigulane kwimeko ukuba umzimba xhungu amayeza inombolo 1 nobandlululo kwala machiza uyabonakala.

manani Okubuhlungu kubonisa ukuba naliphi na ixesha amachiza ezirhurhayo ngomzimba, ngamanye ukusebenza liyehla. Kwakhona, amachiza alwa i-TB eziphambili emva kwexesha elithile, ukuba bona iziyobisi kuba mycobacteria asinde kubo. Umzekelo, ukuba bodwa ukwamkela enye kuphela ichiza elithile, ngoko ukumelana oko mycobacteria waphawula kwiinyanga 2-4.

amachiza e-TB: ukusetyenziswa amandla kunye nefuthe

Ubuninzi lokuhlaselwa iziyobisi TB isiphumo bacteriostatic kwi mycobacteria, oko kukuthi, banciphisa virulence zabo gqiba amathuba ukuze nande. Ngokufanayo, le "INH" yaye "rifampicin" ngeedosi kanzulu bayakwazi ukwenza bactericidal. Ukuze ufumane isiphumo zonyango izinzile, kwakunye ukulumkisa, zingabi sawakhathalela ukwenzeka anti-TB kunokwenzeka kufuneka kuqhube ixesha elide.

Kuko konke oku ukhetho ndawonye nokunyulwa indibanisela kakhulu iziyobisi, kwakunye ngethuba isicelo yabo ixhomekeke ngqo kwi nokuhamba isigulane ngelo xesha iintlobo sephepha, ngoko iindlela lwaqhutywa unyango yangaphambili (ukuba ikhona), njengoko zivunwe ogulayo amayeza athile kwi njengoko Mycobacterium tuberculosis avelana ichiza ekhethiweyo.

ehambelanayo best

Indibaniso anti-TB zicwangciselwe kwingcinga ukuba inkqubo yonyango kufuneka abe mnye langoku okanye iziyobisi ezimbini lodidi lokuqala. Kakade ke, ukuba ngaba akukho naziphi Izimo okanye ubabonise uzinzo. Kweli ithamo onke amalungiselelo ezidibeneyo adla lincitshiswe.

Xa kunikwa (memo ftiziologa) kufuneka ithathelwe ingqalelo ukuba ichiza anti-TB ezifana, njengoko streptomycin kunye nezakhi zayo ayikwazi ukudityaniswa florimitsina, kanamycin kunye nezinye antibiotics ezinempembelelo nephrotoxic kunye ototoxic.

Enjani elungiswa "PAS"

"PAS" - imiphumela bacteriostatic iziyobisi TB. Ewe kuthatha iintsuku izazinzulu pharmacologists wabudalayo. esebenzayo kakhulu nxamnye bacilli TB. Ngempumelelo unyango iintlobo ezahlukeneyo kunye kwendawo ezahlukeneyo sephepha. Inika isiphumo nokuba ngcono xa kudityaniswe ngokuqeshwa elinye inyathelo amachiza e-TB.

Eli chiza igama Latin "PASK-AKRI". Efumanekayo nokuba kwiingxowa-4 g okanye 100 g kwi ebhankini kwingxowa amayeza "PAS" eziqulathwe 3.2 aminosalicylate isodiyam, ngangokuba elucwecweni single - 1 g sodium para-aminosalicylate. Amacwecwe legqunyiwe iqokobhe likhusela esiswini kunye nokuthengiswa zibekwa up ngamaqhosha 50/100/500/1000. kwiphakheji.

Yintoni Kungcono ukudibanisa

iziyobisi TB "PAS" ngokubhekiselele kumsebenzi tuberkulostaticheskoy iziyobisi enasilela ezifana isoniazid streptomycin, yaye ngenxa yokuba kufuneka zingasetyenziswa ngokusebenzisana ne-arhente esebenzayo ngakumbi. therapy kolimo ehla uphuhliso yokunganyangeki ngamachiza kwaye iphucula nefuthe amayeza ezihamba.

Pharmacokinetics "PAS"

Eli chiza eliphezulu (90%) ye ukufunxeka. It umzimba esibindini. Uyakwazi ukuba zingene lula imiqobo igazi-zomzimba yaza yathunyelwa ezikolweni ngo emzimbeni. Izinga eliphezulu ukuzikisa iziyobisi waphawula emiphungeni, nezintso nomhlehlo wesibindi. Okunye abangaxhalabisiyo "PAS" (antituberculosis iziyobisi) lingena singene ulwelo fluid. Kodwa kwimeko ukudumba kwi kweqokobhe cerebrospinal ulwelo aminosalicylic acid xi yi 10-50% ye xi kwi plasma yegazi. Uninzi (80%) ka iziyobisi idubule kakhulu nomchamo.

Amalungiselelo II series

2 amachiza anti-TB eziliqela ukuba bakhethe kunye nokuqeshwa ngexesha zibe nesiphumo enyangayo obalaseleyo ngokwemiqathango detoxification, kunye nayo nokushiywa ebonakalayo utshintsho ukudumba kwi inwebu emiphungeni, nkqu ekunyangeni isifo sephepha le bronchi.

Ngokutsho Uphando lwezonyango ngexesha unyango abantwana kunye nabantu abadala kunye neefom enzima, ezingapheliyo etshabalalisayo nasisihlo lwesifo sephepha kunye zizifundo ezahlukeneyo kwemithi eziliqela II, ngenxa izigulane ukumelana lwezonyango, kunye ezimelene nemithi iintsholongwane ukuba amachiza I series, ngowama-65 ekhulwini amatyala sifunyenwe, oko kukholekileyo kakhulu , isiphumo olunye unyango.

amayeza e-TB: ziziphumo ebezingalindelekanga

Kwaye, kakade, abanomdla kuloo iziyobisi zichazwe kweli nqaku, zazo kunokwenzeka iziphumo ebezingalindelekanga. Ingakumbi ngenxa wangena kule kwiminyaka yakutshanje kulo mkhuba amayeza amachiza-TB bafanelwe ingqalelo ekhethekileyo. Oku kungenxa yokuba kungekudala esi sifo siya babewela umbundu bhubhane, nangona kakhulu emva kweMfazwe Yehlabathi II ukunciphisa izinga lezifo. Enye into ebalulekileyo kukuba le unyango lwesifo sephepha, njengoko kuchaziwe apha ngasentla, inkqubo kakhulu elide, kunye nefuthe elibi kwamachiza kubonakaliswa nje ngokwayo, okanye libanda, okanye ngexesha elide ulwamkelo yakhe.

ezinye izibalo

Xa amayeza therapy TB iingxelo ezixeliweyo amazwe kunye nabameli zasekhaya ziziphumo ebezingalindelekanga iziyobisi kunye rhoqo kwabo ukwenzeka ukuze ezahlukahlukeneyo uhlobo sifo. Ngokomzekelo, ukususela izigulane 3148 kunyango aphathelele amagosa asebenzayo ngokuchasene mycobacteria, reactions ezibi zaye kuvandlakanywa% 12.2 kuphela abantu, uninzi kubo, ngokubonakala endalo nawo, yaye kuphela izigulane 74 kwabakho ityhefu ityhefu.

Ngokusekelwe data epapashwe, sinokugqiba ukuba iziphumo ebezingalindelekanga ebona anti-TB iimpendulo rhoqo ezahlukeneyo. okunzulu ezinkulu zichazwe yi kunyango lwabo non-uniform ngeemeko ezibalulekileyo kusetyenziselwa kuphela iziyobisi, kodwa uhlobo lwesifo sephepha, kwakunye nobudala izigulane, nkqu iintlobo izibonelelo zonyango (esibhedlele, sibhedlele, iklinikhi, iziko).

uphando uyaqhubeka

ke amayeza yingozi inegciwane Goch kaThixo, zibandakanya eziliqela iikhompawundi zendalo kunye semi-zokwenziwa apho kukho enye into efanayo - ngayo umsebenzi wabo nxamnye, okt Mycobacterium tuberculosis (M.tuberculosis). amachiza e-TB, kucalulo apho, njengoko kuchaziwe ekuqaleni kweli nqaku, yahlula iziyobisi zibe-2 series (zaseprayimari backup), umdla omkhulu zesayensi.

ingqalelo oluthile uphuhliso kweelana le bacilli TB. Zonke uphando laboratory iyenziwa, kwaye kulo mba iziphumo yabonisa ukuba uninzi lwezigulane iqondo yokunganyangeki ngamachiza ngexesha unyango zisenokwahluka, yaye phezulu kwaye kwehlisa, ukuya maxa wambi ukuze ekubuyiselweni phantse ngokupheleleyo uvakalelo.

Ukuncitshiswa basabele ezibi

Xa iziganeko ezibi kwenzeka ngexesha unyango, idosi lokuqala amayeza kufuneka licuthwe okanye ukubuyisela ezinye amalungiselelo. Kwimeko side reaction iziyobisi kakhulu antituberculous ukuba ithintele okwexeshana ulwamkelo kunye nokutshintshwa ekugqibeleni ngomnye. Ukwenzela ukunqanda ukuphelisa iimpawu isigulane isifo sentliziyo yabelwa ngokuxhomekeke ubungqina naliphi na inani iziyobisi antispasmodics, ezifana: "Eufillin", "papaverine", "Teofedrin" ilahla "Zelenin," njalo-njalo ...

Iimpawu kunye nobukhali iziganeko ezibi ngexesha unyango TB kakhulu zahlukahlukene. iziyobisi Antituberculosis, uhlelo apho wabonakala ezithile msebenzi olufanayo imichiza, zihlelwa kunye ukuze kuququzelelwe uphando.

unyango TB

Xa unyango lwesifo tuberculous ngexesha lethu Kwakhona ingqalelo umsebenzi Kubalulekile ukuthintela ukosuleleka. Le ngozi livela izigulane kunye nesifo sephepha yemiphunga ifomu evulekileyo. unyango lwabo olunzulu kuya kunceda ekunciphiseni inani zosulelo, ngokunjalo ekuthinteleni iimeko ezintsha kwesi sifo krakra.

Ekubeni kunyango ixesha elide, isigulane kuthatha umonde samodistsiplinirovannost. Eneneni, isifo sephepha iyingozi nje kuphela usindwa umzimba, kodwa wonke umzimba uphela. ixesha kubaluleke kakhulu ukuba ukuqala unyango elwa, apho khosi zokudubula unamandla, amachiza estosnovnye TB. Enkosi kubo, kodwa ukupheliswa eli bacilli kwi zigaba zokuqala, nto leyo eya kuba negalelo nokubuyiselwa welungu achaphazelekayo umonakalo encinane okanye hayi yonke eziphilayo.

unyango olupheleleyo luza kulawulwa kuthathelwa ingqalelo ubudala kunye neefom ezichongiweyo sifo, kuquka iziphumo kwiinkqubo zophendlo lwezifo ze ilungu zizifo, ukunciphisa iimpawu esihamba kunye (iintlungu, ukhohlokhohlo) kunye inhalations ezahlukeneyo kunye nobuchule impilo yomzimba.

Ukwamkelwa elijongene iqela amayeza kufuneka mfuneko yokuba abe rhoqo njengoko ndlela mbutho kungabangela uphuhliso ukuxhathisa kubo. Unyango kufuneka kwenziwe esibhedlele phantsi kweliso gqirha. Emva osenyameni phthisiatrician esweni ngenyameko.

indlela esibi kunye nokusetyenziswa nemigqaliselo zonyango kunye neenjongo ngundoqo ukugqibezela alulame. Kule mihla TB akukho isivakalisi.