60 xyoo txhaj tshuaj tiv thaiv tuberculosis. Cov txiaj ntsig

2024 Tus sau: Seth Attwood | [email protected]. Kawg hloov kho: 2023-12-16 16:06

Yuav luag tag nrho cov pej xeem ntawm Lavxias teb sab Federation tau kis tus kab mob mycobacterium tuberculosis, tab sis tsuas yog 0.07% tau mob. Kev txhaj tshuaj tiv thaiv puas pab? Hnub no kuv yuav tham txog qhov ua tau zoo thiab kev nyab xeeb ntawm kev txhaj tshuaj tiv thaiv kab mob ntsws, thiab vim li cas cov tshuaj tiv thaiv BCG tseem siv rau qhov no.

Txawm tias ua ntej yuav tsum tau txhaj tshuaj tiv thaiv BCG, raws li Lub Tsev Haujlwm Saib Xyuas Tuberculosis xyoo 1955, tus kabmob kis ntawm cov pejxeem ntawm USSR yog:

- hnub nyoog preschool - 20%

- Cov tub ntxhais hluas 15 - 18 xyoo - 60%

- tshaj 21 xyoos - 98%

Ntxiv mus, kev loj hlob ntawm tuberculosis tau pom tsuas yog hauv 0.2% ntawm cov neeg mob.

Noj mus rau hauv tus account qhov xwm txheej epidemiological, nws tau txiav txim siab los txhaj tshuaj tiv thaiv ntawm cov menyuam yug tshiab. Kev txhaj tshuaj tiv thaiv yog ua los ntawm kev ua neej tsis muaj zog ntawm BCG, txij li cov kab mob mycobacteria tua tsis tuaj yeem ua rau lub cev tsis muaj zog. "Kev qaug zog" ntawm mycobacterium yog nqa tawm los ntawm nws rov ua dua tshiab ntawm cov khoom noj khoom haus, raws li qhov tshwm sim ntawm cov pathogenicity txo. Tom qab txhaj tshuaj intradermal, mycobacterium nrog cov ntshav kis thoob plaws lub cev, tsim foci ntawm cov kab mob mus ntev hauv cov qog ntshav qab zib, yog li tswj kev tiv thaiv nruj ntawm 2 mus rau 7 xyoo. Qhov no yog qhov sib txawv tseem ceeb ntawm kev txhaj tshuaj BCG thiab lwm yam tshuaj tiv thaiv nyob, uas muaj peev xwm tsim cov tshuaj tiv thaiv kab mob tsis muaj kev tsim cov kab mob nyob hauv lub cev.

Kev ua tau zoo ntawm BCG. Kev siv cov tshuaj tiv thaiv no, ob qho tib si hauv Lavxias Federation thiab thoob ntiaj teb, tsis tiv thaiv kev kis tus kabmob, uas tau rov ua dua tshiab hauv txoj haujlwm ntawm WHO. Tsis tiv thaiv kev txhaj tshuaj BCG thiab kev loj hlob ntawm tuberculosis, tshwj tsis yog lub hlwb tuberculosis hauv cov menyuam yaus. Yog li, WHO pom zoo kom yuav tsum txhaj tshuaj tiv thaiv BCG rau cov menyuam yug tshiab hauv cov tebchaws uas muaj mob ntsws ntsws rau cov menyuam yaus hnub nyoog qis dua 5 xyoos tau sau ntau dua 1 kis ntawm 10 lab tus tib neeg (p. 14). Yog li ntawd, nyob rau hauv Russia, mob ntsws tuberculosis nyob rau hauv cov me nyuam tau sau 4 lub sij hawm tsawg tshaj li qhov chaw pib - tsuas yog 5 tus neeg mob rau 142 lab lub teb chaws (p. 103). Txawm li cas los xij, Ministry of Health ntawm Lavxias Federation tsis thim qhov yuav tsum tau txhaj tshuaj tiv thaiv BCG. Tab sis ntawm qhov tod tes, cov niam txiv muaj cai tsis kam lees, tshwj xeeb tshaj yog vim WHO pom zoo!

Feem ntau cov teb chaws tsim kho nyob hauv Europe tau tshem tawm cov tshuaj tiv thaiv thoob ntiaj teb. Hauv tebchaws Yelemes, txij li xyoo 1998, qhov yuav tsum tau txhaj tshuaj tiv thaiv menyuam yug tshiab tau raug tso tseg vim "tsis muaj pov thawj ntseeg tau ntawm kev ua tau zoo thiab qhov yuav tshwm sim ntawm cov kev mob tshwm sim siab." Hauv Finland, BCG raug tso tseg hauv xyoo 2006 vim muaj kev sib kis ntawm cov teeb meem. Tebchaws Asmeskas thiab Netherlands yeej tsis tau siv BCG ntau ntau. Qhov no yog daim duab qhia ntawm Tebchaws Europe zoo li, qhov twg hauv cov tebchaws tsim kho kev txhaj tshuaj tiv thaiv tsis tau ua tiav (Lub Tebchaws Yelemees, Fabkis, Austria, Switzerland, Netherlands, Norway, Czech koom pheej, thiab lwm yam):

Cov teb chaws uas tau hais los saum no tau ua tiav qhov muaj txiaj ntsig zoo los ntawm kev siv dag zog rau kev tshawb pom ntxov thiab kev kho kom zoo, nrog rau kev nce qib kev sib raug zoo thiab kev nyiam huv. Russia, thov kev txhaj tshuaj tiv thaiv, pom nws tus kheej hauv cov tuam txhab ntawm cov teb chaws txom nyem tshaj plaws hauv Tebchaws Europe - Belarus, Ukraine, Azerbaijan, Bulgaria, Romania, Moldova, thiab lwm yam. Nws feem ntau lees paub tias qhov tshwm sim ntawm tuberculosis nyob ntawm kev ntsuas kev noj qab haus huv. Visually, nws yog ib qho yooj yim los ntsuam xyuas los ntawm saib daim ntawv qhia ntawm lub ntiaj teb no:

morbidity thiab tuag los ntawm tuberculosis poob ntev ua ntej invention ntawm cov tshuaj tiv thaiv. Tuberculosis pib ploj mus los ntawm Askiv thaum ntxov li xyoo 1850, thaum kev loj hlob ntawm cov nroog tuaj txog qhov kawg. Cov kev cai lij choj ntawm pej xeem kev noj qab haus huv tau muab lub hauv paus rau kev txhim kho kev huv huv, cov qauv hauv tsev tshiab, thiab kev ua dej hauv cov slum. Txoj kev tau nthuav dav, cov kav dej phwj tuaj thiab qhov cua tau cais tawm, thiab cov neeg tuag raug faus rau sab nraum lub nroog. Txawm tias tom qab tsim cov tshuaj tiv thaiv, cov teb chaws uas tsis tau siv BCG hauv lawv cov kev txhaj tshuaj tiv thaiv (piv txwv li, Tebchaws Meskas) tau ntsib tib qhov kev poob qis hauv kev tuag los ntawm tuberculosis xws li hauv cov tebchaws uas yuav tsum tau txhaj tshuaj tiv thaiv (txuas txuas).

Yog li, yog tias menyuam yaus nyob hauv tsev neeg muaj kev vam meej thiab nyob hauv tsev niaj hnub no, tau txais kev noj zaub mov txaus thiab muaj kev nyab xeeb hauv zej zog, kev txhaj tshuaj BCG tuaj yeem raug tso tseg kom nyab xeeb, vim tias qhov kev pheej hmoo ntawm cov teeb meem tom qab txhaj tshuaj yuav ntau dua li nws cov txiaj ntsig.

Cov teeb meem ntawm kev txhaj tshuaj BCG. Qhov kev pheej hmoo siab ntawm BCG tau lees paub thawj zaug rov qab rau xyoo 1960, thaum WHO tau ua qhov kev sim tshuaj tiv thaiv loj tshaj plaws ntawm 375,000 tus neeg hauv Is Nrias teb nrog kev tshuaj xyuas txog qhov tshwm sim rau 7.5 xyoo. Yog li ntawd, qhov tshwm sim tau siab dua nyob rau hauv pab pawg neeg txhaj tshuaj.

Hauv xyoo 2011, 437 tus neeg mob tom qab txhaj tshuaj tiv thaiv kab mob tau sau npe hauv Russia, 91 ntawm lawv tau mob hnyav. Nws zoo li me ntsis, tab sis qhov no tshaj qhov tshwm sim ntawm tuberculosis hauv cov menyuam yaus los ntawm 30%! Kuv yuav zom nws thiab muab tso rau hauv kuv lub qhov ncauj: cov tshuaj tiv thaiv BCG provokes tuberculosis ntau dua li tus kab mob tshwm sim ib txwm muaj! Thiab nws tsis yog rabid tshuaj tiv thaiv kab mob uas tuaj nrog nws - nws tau sau nyob rau hauv tsab ntawv ceeb toom Analytical ntawm Ministry of Health (p. 112). Piv txwv li, 60% ntawm cov neeg mob hnyav osteoarticular localization ntawm tuberculosis hauv cov menyuam yaus yog txuam nrog kev ua kom cov tshuaj tiv thaiv BCG (p. 102), uas tau pom nyob rau nruab nrab ntawm 5 tus menyuam yug tshiab ntawm 100,000 txhaj tshuaj tiv thaiv. Qhov no ib zaug ntxiv qhia tias mycobacteria ntawm cov tshuaj tiv thaiv nkag mus rau hauv tag nrho cov ntaub so ntswg ntawm lub cev, nrog rau cov pob txha.

Yog li, qhov teeb meem ntawm kev txhaj tshuaj tiv thaiv BCG yog qhov ua kom muaj kab mob ntawm cov tshuaj tiv thaiv kab mob hauv lub cev ntawm cov tshuaj tiv thaiv, uas tau pom ntau dua li tuberculosis nws tus kheej. Xws li tus menyuam yuav tau txais kev kho mob nrog cov tshuaj tua kab mob ntau lub hlis. Tom qab ntawd, nws yuav tsum tau sau npe nyob rau hauv tuberculosis dispensary rau xyoo.

Cov lus xaus:

1. Peb txhua tus tau kis tus kab mob mycobacterium tuberculosis, tab sis txoj kev loj hlob thiab qhov tshwm sim ntawm tus kab mob nyob ntawm qhov xwm txheej ntawm kev lag luam hauv zej zog thiab qib ntawm kev saib xyuas TB.

2. Cov tshuaj tiv thaiv BCG tau tsim 100 xyoo dhau los thiab lub sijhawm no nws tsis tau tiv thaiv kev kis tus kab mob thiab qhov tshwm sim ntawm tuberculosis.

3. Cov tshuaj tiv thaiv BCG feem ntau yuav ua rau muaj teeb meem ntau dua li tuberculosis nws tus kheej.

4. Cov kws kho mob tuberculosis pom zoo kom cov tsev neeg muaj txiaj ntsig tso tseg BCG.

Kuv vam tias cov ntaub ntawv no yuav pab cov niam txiv txiav txim siab txog kev txhaj tshuaj tiv thaiv lawv cov menyuam. Hauv cov ntawv tom ntej, nyeem txog kev txhaj tshuaj tiv thaiv lwm yam kab mob - peb yuav txheeb xyuas tag nrho lub teb chaws daim ntawv txhaj tshuaj.