Pirke bvunzo: kuverenga, kuongorora

Tiibhii - zvakasiyana vanowanzochema zvirwere inogona kuwanikwa anenge kwese munyika. The chirwere chinogona kuitika nokuda ingestion mabhakitiriya siyana kana Koch kuti bacillus. Kazhinji The chirwere pachishandiswa kuenda neherikoputa mumate uye ane inorema zviratidzo, zvinoti:

• dzungu;
• kunyorova chikosoro;
• vangakosora ropa;
• simba;
• fivhiri;
• yokudeura uremu;
• sweats usiku.

Tuberculin kuita contraindicated pamberi siyana ganda zvirwere, neutachiona, asima, pfari, zvirwere zvinotapuriranwa. Regai kuita mharidzo uye kuti mwedzi mumwe pashure Kubayiwawo jekiseni immunoglobulin kana zvipenyu mharidzo.

diagnosing TB

Hwaro simba, iro damage tibhii - ndiye chiedza. Other zvomukati vanotambura zvisinganyanyi kuitika mune chirwere ichi. Possible rokuongorora tiibhii vachishandisa fluoroscopy, CT (computed Tomography), X-ray, tuberculin ganda bvunzo (Pirquet munhu akaidza) uye dzimwe mhando mumarabhoritari nemiedzo. Kuti rokuongorora kubaya rinoitwa kamwe gore chirwere.

Chii sei chigamba nekuongororwa?

Mumwe nzira yokudzivisa tsvakurudzo vana TB ndiye Pirke mharidzo. bvunzo iyi immunological anogona kuratidza kuti pane munhu kukura muviri, kunyange tanga TB hweHIV. Maonerwo Akaitwa pakuonekwa tuberculin maitiro akadana Pirke, uye inorondedzera muviri wacho susceptibility kuti Mycobacterium tibhii. Pirke mharidzo iri akaitawo uye murwere kwava akura zera boka ari kudzora kuongorora kuongorora kubudirira kurapwa.

Zvinoumba mharidzo

The Zvinoumba mharidzo anopinda tuberculin - inokosha mushoma kubva vakaparadza bacilli Koch, yakaitwa shure muna 1890 nachiremba wokuGermany Robert Koch. Hazvina chiremba uyu akanga akawana zvirwere zvakadai tibhii. Washington akashandisa kutanga muna 1907. Pakutanga, zvakanga kugonyesa ganda uye murinde maitiro, uye mushure tuberculin akatanga kuedza kupiwa subcutaneously.

Today Pirke yokuenzanisira ane sezvamunoita rinosanganisira musanganiswa auraya mycobacteria tsika filtrate kwevanhu uye bovine nemifananidzo, pane vanhu vakawanda dzemazera akasiyana-siyana. Kunze yezviri fuma chinoumba - tuberculin Pirquet yokuenzanisira zvinosanganisira vakadaro yokuwedzera zvinhu:

• munyu pamusoro phosphate buffer mhinduro ;
• yavaibvisa chloride.

Izvi zvinoitika sei?

Nheyo kushanda dzokuenzanisira ane nziyo hwakavakirwa tuberculin, ndiye cutaneous pokushandisa zvinodhaka. The paganda honokono kana mafudzi tsime disinfected chete carbolic acid, nekuti doro-kwakavakirwa fuma akasiya paganda mapuroteni, riri zvisingadiwi kuti kuchena kuongorora. The cheka akaita paganda uchishandisa zvinokubaya kudzika asina kupfuura 5 mm. Murwere ungamirira kuti maminitsi 5, kusvikira mushonga wefodya uye zvasara zvinyoronyoro pukuta ne pepa nejira. Mushure nzira, murwere zvichiongororwa chiri kuitwa kwemaawa 48 uye vakaongorora kuti kuita zvaanoda.

Somugumisiro tuberculin panzvimbo muvare unovapo chaiyo kuzvimba (papule) icho kukonzerwa ane kuunganidza T-lymphocytes. Zviri masero aya ropa ndivo TB kutapata. The ganda anogona kushandura ruvara uye arambe achirema ari papules. Ichi chirwere nzira unoshandiswa kazhinji nokuda kwayo pasi mashoko kugutsikana uye pasi chirwere kunyatsoshanda. asina yakarumbidza mushure kutongwa uye pamberi zvabuda zvakaitwa:

• soka nzvimbo apo mharidzo ikatorwa;
• pukuta papule mishonga siyana kana nezvizoro
• papule namira purasita;
• kuzora mafuta kana kukuvara.

zvabuda

Paavhareji, kana munhu Pirke bvunzo, kunyatsoongorora migumisiro rinoitwa mushure memazuva 2-3, kureva 48-72 maawa. At nzvimbo anokwenya, paiva chinangwa bundu akaita. nzvimbo yake kuyerwa navanachiremba. Migumisiro dzinoiswa saka kana mharidzo Pirquet:

• inoenzanirana kwakacherechedzwa kuti shoma exponent metering papules (avhareji kusvika 5 mm);
• Nhamba 3 mm inoratidza kudiwa kunenge kubaya uye apiwa dzishande munhu akaidza mugumisiro;
• kana akawanikwa papule siyana kukura kubva 4 kusvika 10 neMM, zvingangodaro kuti chirwere netiibhii kana munhu ari boka pangozi (kureva zvachose kugara vachionana munhu ane HIV);
• Kana kutsamwa centre ane kukura kubva 10 kusvika 15 mm kana maronda dzawanikwa nzvimbo kubaya, chakarurama iyi kunoratidza refu ndingangokuvara tibhii hweHIV.

kudzidza kutongwa

Izvi mhando ekudzidza nani uye cutaneous chikumbiro chigadzirwa Via anokwenya akawanda. Kusiyana zvetsika shanduro kudzidza, mharidzo iri graded kuziva differential chirwere kukosha kwacho kuona yezvakaita chisimbwa kuti tuberculin. Skin kunovhenekwa rinoitwa nokushandisa ganda tuberculin pamwe 100%, 25%, 5% uye 1% yevasungwa. Preparation ganda rinoitwa zvakafanana sezvo chinyakare kunhaka Pirke mharidzo. The cheka anechekuita kunoparirwa kuitira, uye panguva imwecheteyo pane siyana nemuumbi pipette. Nokuti mumwe murwere kushandisa chete chena zvinhu. Pashure pakuonekwa "chena mupumburu" unogona kubvisa vakasara tuberculin. Izvi rworudzi nechirwere kakawanda kuitwa kuti kuona kubudirira nokurapa tibhii.

Izvi zvakatibatsira graded mharidzo

Skin kunovhenekwa kudzidza Grinchara Karpilovskaya uye dzinoongororwa pashure maawa 48-72 mushure nzira. Kusiyanisa Maitiro zvakadaro kuwanda siyana tuberculin:

• anergic maitiro (hapana maitiro ari muenzaniso);
• nonspecific maitiro (anogona chete kuchengeta zvishomanana akatsvuka iri mharidzo ane 100% wevasungwa chemhinduro) ;
• normergicheskaya maitiro (mwero akaona kwaiita Muviri kuti tuberculin uye Achipindura mharidzo pamwe 5% uye 1% mhinduro vasiri aripo);
• hyperergic maitiro (mugumisiro kunoratidzwa mhinduro mhando dzose ivhu, dzakanga wevasungwa ane tuberculin mhinduro, kunokonzera response);
• yokuenzanisa zvakaitwa mhando (akaita ivhu zvose vane papules, ganda mavara uye hukuru pamusoro foci ose kuzvimba);
• gangaidzo maitiro (panguva yepamusoro wevasungwa munguva wezvaizogona tuberculin vakachengeta kupfuura raidudzwa kuita).

Saka, takurukura nzira nechirwere sezvo Pirke mharidzo. Inowanika hazvina kutaura localization chirwere pamuviri, kana ari munhu anogona kukanganisa vanhu hwakanaka. Iye chete anoratidza zvinoitwa kune causative nomumiririri tibhii. Pirke yokuenzanisira (Mantoux bvunzo - ayo nzira) anonzi fanira mwana.