"Diaskintest": ndemanga. "Diaskintest" pakudziŵika kwa chifuwa chachikulu

Kudziwa matenda a chifuwa chachikulu kumakhala kosavuta. Njira zakale zimalowetsedwa ndi zatsopano, zolondola komanso zangwiro. Zitha kuphatikizapo diaskintest.

Ndi chiyani?

Diaskintest - zomwe zimafanana ndi Mantoux, koma zimakhudzidwa kwambiri ndi matenda a chifuwa chachikulu cha mycobacterium. Monga momwe Mantoux amachitira, amagwiritsidwa ntchito makamaka kwa ana, ngakhale kuti nthawi zina amawonetsedwanso kwa akuluakulu.

Njirayi yakhala yatsopano. Chotsitsimutsa ku chilengedwe chake chinali chakuti njira ya Mantoux sinapereke ndondomeko yeniyeni yokhudzana ndi ma antibodies omwe mitsempha ya mycobacteria ilipo mthupi (popeza imapangitsa kuti tizilombo toyambitsa matenda, tizilombo toyambitsa matenda ndi mavobabacteria).

Chodziwika bwino cha jekeseni ndi pafupifupi 90 peresenti, pamene mphamvu ya chitsanzo ndi tuberculin siiliposa 50. Chifukwa chaichi, zotsatira za zabodza ndi zolakwika ndi zotsatira.

Ndikofunika kumvetsetsa momwe diaskintest ikugwirira ntchito, komanso kuti mudziwe amene ali ndi zotsatirazi.

Kodi njirayi imachitika motani?

Diaskintest yokha, omwe ndemanga zawo zimakhala zabwino kwambiri, sizikusiyana mwanjira iliyonse kuchokera kuchitidwe cha Mantoux. Chitsanzocho chimayikidwa mkati mwa chingwe. Nthano imalowetsedwa mwachangu kwa millimeters angapo. Pambuyo poyambitsa mankhwala pa malo opangira jekeseni, papule yomwe ili ndi "lemon peel" pamwamba pake imapangidwa. Patapita kanthawi (kawirikawiri pambuyo pa masiku awiri) kuyesa kwa mapuleti amapangidwa.

Diaskintest kwa chifuwa chachikulu ndilololedwa m'zipinda zamakono kapena zipinda zamankhwala. Zaletsedwa kubwezera kunyumba, komanso osakonzekera ogwira ntchito popanda zochitika zaumphawi. Izi zingayambitse mavuto pambuyo pa ndondomekoyi.

Kuti mudziwe zotsatira za phunzirolo, yesani kusintha kumalo kumene diaskintest inkachitidwa.

Kufufuza kwa zotsatira zowunikira kumachitika molingana ndi zifukwa zina. Ngati zotsatira zowonongeka zimapezeka (palibe zovomerezeka zomwe zimadziwika), phunzirolo limabwerezedwa kapena kutumizidwa kukapitiliza maphunziro kuzipatala zapadera.

Kodi ndi zizindikiro ziti zomwe zimagwiritsidwa ntchito pofufuza momwe ntchitoyi ikuyendera komanso mkhalidwe wa thanzi?

Zotsatira zoyendera

Pambuyo pa diaskintest ikuchitika, zotsatira zimayesedwa ndi kukhalapo kwa kusintha mu malo osungira.

Kawirikawiri, malo amtunduwu ayenera kupanga malo a jekeseni. Maonekedwe ake amachokera chifukwa cha kuwonjezeka kwa magazi ku malo opangira jekeseni, kuphatikizapo kuwonongeka kwa malo komweko.

Kukula kwa papule kumadalira kukula kwa chitetezo cha mthupi. Zowonjezera kukula kwake kwa papule, zimakhala zolimba kwambiri ndi momwe chitetezo cha mthupi chimakhudzidwira. Komabe, mochepa kwambiri, kapena mosiyana, kukula kwakukulu kwa mapepala ndi zizindikiro zosavomerezeka, chifukwa zimasonyeza kuti chitetezo cha m'thupi chimakhala chofooka kapena chopitirira malire komanso chimayankha kuika ma antigen.

Kuphatikiza apo, mapulogalamu opangidwa ndi papule amafaniziridwa ndi zotsatira zapita, kudziwitsa kusintha kwa kusintha. Ngati pali chithunzi chabwino cha diaskintest, zithunzi ndi miyeso ya papule ziyenera kuyerekezera ndi zotsatira zapitazo. N'zotheka kuti kwa nthawi yapadera (chaka kuchokera kumapeto kotsiriza), munthu wapezeka ndi chifuwa cha TB. Pankhaniyi, kuyerekezera ndi zotsatira zapitazo n'kofunika.

Diaskintest kwa TB imalingaliridwa kuti ikuchitika molingana ndi malamulo onse ndi zikhalidwe, ngati pali zifukwa ziwirizi pamwambapa.

Kutanthauzira kwa zotsatira

Kodi tingadziwe bwanji kukhalapo kwa ma antibodies ku mycobacteria?

Kuyeza kwa Diaskintest kumachitika molingana ndi zifukwa ziwiri: kufiira mu jekeseni ndi kukula.

Ngati palibe malo okonzera jekeseni, izi zikusonyeza kuti njirayi inkachitika molakwika kapena chitetezo chochepa chimakhala chofooka kwambiri moti sichitha kuyankha ma antigen. Izi zimasonyezedwanso ndi kupezeka kwa papule pamalo ojambulidwa.

Ngati pali mapulosi, ndipo papule ndi yaing'ono (mpaka 4 mm), mawonekedwe a chitetezo cha mthupi amaweruzidwa. Chotsatira chomwecho chinganenenso kuti pali ma antibodies ochepa kwambiri, ndipo chamoyo sichikhoza kuthana nacho ngati icho chilowa.

Chotsatira cha munthu wathanzi ali ndi diaskintest ndi chiyani? Zomwe zimayambira zimakhala za 4 mpaka 12 mm, zomwe zimasonyeza ntchito yeniyeni ya chitetezo cha mthupi komanso kukhalapo kwa ma antibodies oyenera.

Ngati mwadzidzidzi mapulogalamu akuluakulu oposa 12 mm amapangidwa pa malo opangira jekeseni, izi zimasonyeza kuti thupi limateteza mthupi mwathu, i.es. Poyang'ana kulowera kwa mycobacterium, zotsatira zowopsa zimatha.

Komabe, ziyenera kukumbukiridwa kuti zotsatira za akulu ndi ana zingakhale zosiyana kuchokera kwa wina ndi mnzake. Kwa akuluakulu, omwe adalandira diaskintest, chizoloŵezi chidzakhala chachikulu - kuyambira 4 mpaka 16 mm. Chodabwitsa ichi chikuchitika chifukwa chakuti thupi la munthu wamkulu wamkulu wamagazi ambiri kuposa mwana. Zina mwa izo zimatha kuchitidwa pamaso pa antigenic mimicry - antigen ya mycobacterium ikhoza kudziwika monga mapuloteni akunja a tizilombo tina, ndipo potengera izi, maselo ena akhoza kuyambitsa, zomwe zingalimbikitse zomwe zimachitika.

Nthawi zina kupezeka kwa papule kapena kukula kwake kungasonyeze kuti ndondomekoyi siinayende molondola. Chimodzi chinanso chiyenera kuchitidwa kuti chifotokozedwe. Ngati chotsatiracho chibwerezedwa mobwerezabwereza (mobwerezabwereza chosokoneza kapena chitsimikiziro chotsimikizika), kuwonetsa kwa phthisiatric kukusonyezedwa.

Anthu omwe anafunsidwa amawafunsa

Ndani akuwonetseredwa?

Phunziroli ndilololedwa kwa ana osakwana zaka 17. Izi ndizo chifukwa njira yayikulu yowunikira chifuwa chachikulu cha TB (fluorography) - imagwiritsidwa ntchito ndi miyeso ya X ray, yomwe ingakhudze kukula kwa thupi la mwanayo. Ichi ndi chifukwa chake makondwerero amaperekedwa ku kuyambitsa ma antigen, mmalo mowopsyeza.

Kupweteka kwapatsidwa kwa ana pafupifupi miyezi isanu ndi umodzi chitatha chithandizo cha BCG. Panthawiyi ma antibioti a antigen a nthawi yambiri amatha kupanga, zomwe zimapangitsa kuti phunzirolo likhale loyenera.

Kuonjezerapo, nkofunikira kuyendetsa ndondomeko ya anthu omwe amalembedwa ndi munthu wodwala matenda a shuga chifukwa cha shuga.

Zonse mosasamala, diaskintest imachitidwa ngati pali kusintha kwakukulu mu papule poyerekeza ndi phunziro lapitalo (njirayi ikuchitika kamodzi pachaka, koma n'zotheka kuchita kafukufuku nthawi zitatu zosakonzedweratu).

Kawirikawiri diaskintest yokhazikika imayikidwa ndi anthu otumikira ziganizo (m'ndende, m'madera ena), kotero amakhala ndi kafukufuku kangapo pachaka.

Zisonyezo

Diaskintest, monga momwe Mantoux amachitira, ndi njira yeniyeni yowunikira yomwe ikuwongolera kuwonetsetsa kwa chifuwa chachikulu cha TB mu ubwana.

Kawirikawiri kafukufukuyu amachitika mwachizoloŵezi, koma pali zizindikiro zina zogwira ntchito zosavuta.

Zomwe zimagwiritsidwa ntchito poyambitsa izi ndizo kutembenuzidwa kwa Mantoux, kusintha kwakukulu kwa mapuleti opangidwa poyerekeza ndi zotsatira zapitazo. Kwa ana okhala ndi nthawi yayitali (yoposa mwezi) ndi kukhalapo kwa chifuwa chouma, kufufuza mobwerezabwereza, kuphatikizapo diaskintest, kuyenera kuchitidwa. Chithunzi cha chifuwa (fluorogram) panopa chikuchitika ndi chilolezo cha makolo a mwanayo ndipo amagwiritsidwa ntchito pofotokozera chidziwitso.

Kuonjezera apo, phunziroli ndilololedwa kwa ana ndi achikulire omwe ali ndi shuga (popeza matendawa amachititsa kuti chitukuko cha thupi chikhale chonchi, chimathandiza kuti tizilombo toyambitsa matenda tilowe m'thupi komanso kuti tizilombo toyambitsa matenda tiyambe).

Ndikofunika kuchita mayeso osaphunzitsidwa ana omwe makolo awo amapezeka kuti ali ndi chifuwa chachikulu.

Contraindications

Monga njira iliyonse, diaskintest ili ndi zotsutsana ndi khalidwe. Izi zimaphatikizapo kuwonjezereka kwa zigawo zikuluzikulu za mankhwala, kuphatikizapo kupezeka kwachangu mu malo ophunzira (diaskintest sichigwiritsidwa ntchito, chifukwa chakuti jekeseniyo imagwiritsidwa ntchito pamphuno, pomwe khungu limakhala lochepa kwambiri, lomwe limalola mapangidwe a papules. Nthawizonse n'zotheka kupeza zotsatira zofunikira).

Palinso malire a zaka. Njirayi siinapangidwe kwa ana obadwa kumene ndi ana amene sanatengepo katemera ndi BCG.

Mwachisamaliro, phunziroli likuchitidwa kwa anthu omwe ali ndi mawonekedwe a immunodeficiency, popeza kuyambitsa ma antigen kungapangitse yankho lolakwika la thupi.

Ubwino wa Diaskintest

Monga momwe akudziwira, a diaskintest anabwera m'malo mwa Mantoux. Izi zinali chifukwa chakuti zochita za Mantoux sizipereka zotsatira zenizeni ponena za mapangidwe a antibody omwe amatsutsana ndi anthu a mycobacterium tuberculosis (amatsimikizira kukhalapo kwa ma antibodies motsutsana ndi michere ya mycobacterium). Zowonongeka kwambiri, ndemanga zamatsutso zokhudzana ndi zomwe zili zabwino, ndizovuta kwambiri, chifukwa mankhwala ojambulidwawo ali ndi ma antibodies okha. Chifuwa chachikulu.

Pali malo amodzi okha, pamene, pambuyo pa jekeseni, mchitidwe wa Mantoux unayamba kukhala ndi chifuwa chachikulu. Mu dongosolo la matenda, matenda a diaskintest ndi otetezeka, chifukwa alibe mankhwala a mycobacteria, koma ndi ma antigen omwe amachititsa kuti mapuloteni apangidwe. Kutengera kwa hypersensitivity pafupifupi sikukuyenda ndi kayendedwe ka mankhwala.

Popeza kuti ndondomekoyi si yosiyana ndi kafukufuku wa tuberculin, alongo ambiri ophunzitsidwa bwino angayende.

Maganizo a odwala ndi madokotala

Kwa kanthaŵi kochepa kamene kanagwiritsa ntchito diaskintest, adalandira zowonjezera zowonjezera kwa odwala onse ndi madokotala.

Pofufuza maulendo ambiri omwe odwala, chifuwa chachikulu cha TB kapena achibale awo omwe adapatsidwa chithandizo chachisokonezo, nthawi zambiri ndemangazo zimakhala zabwino. Malingana ndi anthu, ndondomekoyi ndi yosavuta kuigwiritsa ntchito, sikuti imafunikanso maphunziro.

Madokotala amaganiza chiyani za nkhaniyi? Ambiri a phtisiatriya amatsutsa kuti diaskintest ndi njira yodalirika kwambiri kuposa momwe Mantoux akuchitira kapena kuyesera khungu la Pirke (osati pakali pano). Kutsimikiza kwa mankhwalawa kumapangitsa kutsimikizira ndi kutsimikiza kotheratu kukhalapo kwa mycobacterium mu thupi ndikuyamba chithandizo nthawi. Anthu ambiri akulimbikitsa odwala kuti asasankhe fluorogram (zomwe zimatithandiza kuti tidziwe matenda okhawo), koma timadutsa diaskintest. Malingaliro a madokotala ponena za ndondomekoyi nthawi zonse amakhala abwino, gawo limodzi laling'ono lawo limakonda mafilimu kapena Mantoux.

Kodi ndingapeze kuti?

Ngati mukukayikira kuti muli ndi chifuwa chachikulu, nthawi zambiri imadzutsa funso la komwe mungatembenuke. Maganizo oterewa amawonekera pambuyo poti radiologist yawona mthunzi pachithunzi cha mapapo, kapena kuti chifuwa kwa nthawi yayitali, umakhala wofooka komanso wosweka. Zonsezi zikutanthauza kuti pali chifuwa chachikulu cha TB, ndipo simungathe kukayikira ndi matendawa.

Poyamba, diaskintest ikhoza kuchitidwa m'madera odziwika - mabungwe a chifuwa chachikulu kapena polyclinics. Kawirikawiri ndondomekoyi imachitika ndi onse amene amapereka malipiro, ngakhale kuti n'zotheka komanso kofunikira kuti apite kumeneko komanso kutsogolo kwa wodwalayo.

Kuonjezerapo, kuti mutha kuchita izi, mukhoza kuyankhulana ndi malo omwe amapezeka kuchipatala (mwachitsanzo, zipatala za chigawo) kapena kusungirako ukhondo. Kawirikawiri payenera kukhala osachepera amodzi ku chigawo omwe angathe kukufufuza moyenera ndipo, ngati kuli koyenera, kuti apeze chifuwa chachikulu cha diaskintest.