Vaccination pamusoro pneumococcal chirwere kuvana: maitiro uye zvaunofunga

Maererano neWHO, pneumococci kazhinji kuva vamiririri zvinokonzerwa noutachiona muvanhu. Nhasi, nhamba iri kuti nhengo chinokonzera rufu mamiriyoni 1,2. Vanhu rose gore. Of nhamba iyi vanhu vanopfuura 40% vana pasi 5 makore. Of vanonzi munharaunda-vawana nemabayo, uwandu izvo zviri Russian mumwe uye rimwe gore mamiriyoni nehafu, kusvikira 75% Muzviitiko vakuru kutanga tusingaoneki izvi - pneumococci. Panyaya vana nemakore boka kusvika 5 makore, pane chikamu kuita nedanho pneumococci rinosvika 90.

vana vose vawane otitis vachirwara kunosiyana inosiyana zvakaoma. Inenge 30-35% vose nyaya chakasimba otitis vezvenhau muvarwere vaduku ndiye anosarudza pneumococci. zvirwere izvi dzinoratidzwa avo yakakwirira giravhiti aibuda rurefu mukana pakati perforation of eardrum. Kazhinji unogona kunzwa kubva nyanzvi pamusoro pokumuka orthogene intracranial matambudziko, kubvisa iyo yaifanira tympanostomy kakawanda zvakakwana. Masero ane kuvhiya kupindira kuti remediation yapakati nzeve mhango uye kudzorera nzvimbo yapakati nzeve mapfupa.

Vaccination pamusoro pneumococcal chirwere mune vakuru nevana vanogona yekudyidzana kuvandudza zvinhu pamwe kuitika initiator ichi.

Pneumococcal chirwere: ndiani uyo?

Streptococcus pneumoniae ndomumwe zvinoumba kunowanzoitika microflora rokumusoro kufema hurongwa hwakanaka munhu. 70% yevanhu - nayo rinotsigira mumwe kana kupfuura marudzi microorganism. Pakati pavana, ufanane 'munharaunda' riri kupfuura pakati vakuru. The kunonyanyisa pamwero chingoro vaya vanorarama, kushanda uye kukura mune mapoka (pre-kuchikoro uye masangano dzidzo, kushanda mapoka, etc.).

Muviri uyu rinoumbwa imwe polysaccharide Kamudzira kuti anokwanisa kudzvinyirira kukura kutapata muvana vaduku pane 2 years. Nhasi, sainzi anoziva nezvokuvapo 84 subtypes ose pneumococcus. With kukura yaitonga inorwisa mabhakitiriya rakanyatsojeka chisingakuvadzi microbe Streptococcus pneumoniae rava kumbonyanya zvechisimba tusingaoneki husingakwanisi kutsika nemishonga hombe zvinodhaka. Padanho kuramba kuti penicillin iri kumativi 50% ikozvino, kuti chloramphenicol uye tetracycline - 30%. Sezvo penicillin boka inorwisa mabhakitiriya rakafara zvakakwana, ipapo havazovi inobudirira panguva yekutapurira muviri zvakadai pneumococcus. Vaccination Pakadaro - chete nzira kuhwina shoma nezvinhu pakurwisa microorganism ichi. Zvinokosha kutaura kuti chirwere kazhinji anovandudza nokukurumidza (kakawanda hapana kupfuura 3 Mazuva) zvikuru, uye nguva tsvakurudza tsanangudzo mwero aikanganiswa mamwe inorwisa mabhakitiriya usipo.

Zvino mubvunzo pneumococcal kuramba nemishonga iri kuramba kukosha, zviri kungoramba kukurumidza dambudziko.

Chii yokudzivirira anoshandiswa?

Pari, Russia anoshandisa nezvemarudzi maviri yokudzivirira kuti muitiro akadai kubaya pamusoro pneumococcal chirwere: polysaccharide uye conjugated kuti mapuroteni Formulations.

The boka rokutanga (polysaccharide) rinonyanya kuzivikanwa mushonga Pneumo-23 (sanofipaster). The mhinduro iri musanganiswa 23 Yakanatswa polysaccharide kubva serotypes zvakafanana chitsama. Ichi boka serotypes zvinogona zvakanaka kunzi 90% of oga kubva ropa, uye vazhinji okuva kuzivikanwa munharaunda Russia. Zvino padariro kunyoresa ndechimwe yakafanana mushonga - ". Pneumovax-23"

Kubva chimiro conjugated yokudzivirira mu Russia yakanga pamutemo uye pari kushandiswa "Prevenar 7". serotypes nomwe dziri ayo sezvamunoita, mubatanidzwa 87% kubva pneumococcal oga akanga vana vachirwara kubva kuUnited States uye navamwe nyika. Nokuda kuti serotipovaya mufananidzo muUnited States uye Russia ndiyo anoita zvakafanana, tinogona kufunga kuti "Prevenar 7" kuchavawo nyanzvi Russian Federation, uyewo muUnited States.

The zera chikuva kubaya pamusoro pneumococcus

"Pneumo-23" kuti kubaya chinotarisirwa kamwe subcutaneously kana intramuscularly. Inogona nhomba kubvira 2-hletnego zera, chipimo chemushonga - 0.5 Rine mamiririta. Re-kubaya anogona kuitwa asina kwokutanga pane pashure 3 makore okupedzisira jekiseni.

Vaccination pamusoro pneumococcal chirwere vana vachishandisa "Prevenar 7" zvinogoneka chete 2-hmesyachnogo zera. Vaccination rinoitwa munyika zvakafanana pamwe DTP (muna 3 mumatanho). Revaccination anogona ichiitwa mwana makore makore 1.5. Zvisinei, ichi mhando mushonga, pane zviitiko zvakawanda kubaya. Pane ruzivo pamusoro kubudirira kubaya muna 2 nzendo (mukati 2nd hafu-gore), anoteverwa booster. Uyewo kuwanikwa vaine kubaya zano muna 2 zvishoma nezvishoma mugore upenyu rechipiri, uye kamwe kwenguva 2 kusvika 5 years.

Padanho chokudzivirirwa polysaccharide yokudzivirira

High efficacy ari kudzivirirwa nemabayo vakaratidza mushonga pamusoro pneumococcal chirwere. Reviews ari Statistical zviremera vanoti vanenge 80 muzana kudzivirirwa. Nyanzvi-epidemiologists vanokurudzira kubaya ne "Pneumo-23" Vanhu vane makore 18 kusvika 21 makore masangano mapoka (zvakadai dzakabatana muchiuto) guru. Pashure imwe nguva (2 kusvika 5 months) pashure kubaya anogona kutarisira vasanyanye kuitika chakasimba zvirwere kufema anopfuura 2-muchirugu yakawanda, bronchitis - kusvika ka13, mabayo - kwete asingasviki 6 nguva. In yakaoma nemabayo, yomumuzongoza uye nezvimwe pneumococcal noutachiona kunyatsoshanda kubva muzana neeSultan kubva 56 kusvika 81.

Padanho Kushanda muitiro akadai kubaya pamusoro pneumococcus, kunokanganisa zera vaccinees. In zera boka kusvika makore 55, nhamba yacho yaiva 93%, kubva 55 kusvika 64 makore kunyatsoshanda yakaderera kusvika 88%. Padanho kudzivirira pneumococcus zera kubva pamakore 65 kusvika 74 - 80%, anopfuura 75 nemakore - 67%.

For varwere nechirwere zvemwoyo uye broncho-pulmonary zvirwere, padanho kudzivirira polysaccharide yokudzivirira (kunyanya "pneumo-23") riri anenge 69% (sezvo muvanhu utano). Ratidza yakakwirira mwero kunyatsoshanda ane mushonga zvakadaro kana kushandiswa vana mumapoka. waivako Good kunoratidza "Pneumo-23" akabatana yokuSpain yokudzivirira.

Achitaura mamwe mushonga achitaurwa nevanopinda Russian - "Pneumovax-23" - zvinogona kutaurwa kuti ayo efficacy vanhu vane chirwere cheshuga 84%, pamwe ischemia - 73%. For varwere vanenge mwoyo kukundikana, kubva muzana iri 69, pamwe akatambudzika mapapu uye asima - 65 vanhu nemakore boka anopfuura 65 makore kubudirira zvinodhaka ruchigona 75%.

Padanho chokudzivirirwa Conjugate yokudzivirira

Nokushandiswa Conjugate mushonga majekiseni pamusoro pneumococcal chirwere vana akaratidza yakakwirira mwero kunyatsoshanda. Sezvineiwo kuderedzwa kwete chete kuwanda muchipatara admissions vana nemabayo upi mavambo, asiwo kakawanda outpatient kushanyira chiremba. Sezvineiwo nani mamiriro ezvinhu hwevanhu vanorwara pneumococcal yomumuzongoza.

Pneumococci chaizvo husingakwanisi penicillin. "Prevenar-23" anokwanisa kudzivirira utachiona pamwe zvenguva uye yakakwirira kugadzikana riri 80-100%. Uyezve, mushonga uyu mukuru kunyatsoshanda kunosanganisira inorwara yokuSpain.

Maererano neWorld Health Organization, kushandisa Conjugate mushonga kuti muitiro akadai kubaya pamusoro pneumococcal chirwere vana (zvose vanogara 72 kusimukira munyika), kunogona kusvika 407,000 nzufu pagore.

Possible siyana pavakanzwa kubaya

Vaccination pamusoro pneumococcal chirwere nyanzvi vanobvumirwa kuita chero nguva yegore uye pamwe neimwe yokudzivirira (zvagara anoitwa bedzi BCG). On kwokubatsira vaviri mhando yokudzivirira pamusoro zvimwe pneumococci zvichibvira apindure dzemuviri. On the "Pneumo-23" Varwere nomumwe zvingaitika vemunzvimbo maitiro muchimiro akatsvuka, marwadzo. Kuwanda kuita kazhinji simba uye anogona kugara maawa 48. Vaccination pamusoro pneumococcal mwana (wongororo vashandi zvoutano uye vabereki vanofadza iyi) mune zvimwe zviitiko (kwete kazhinji) anogona kukonzera mapundu, marwadzo majoini.

Pane zviitiko apo varwere idiopathic thrombocytopenic purpura (mu yakanyarara danho) pashure kubva 2 kusvika 14 days, dzakabudirira recurrences paakaitira kusvika 2 weeks. Kashoma chaizvo kunzwa pamusoro anaphylactic inoti.

The mushonga "Prevenar" kunoratidzwa vana zvakanaka tolerability. mushonga akadaro pamusoro pneumococcal chirwere yematambudziko (tiri kutaura chero matambudziko akakura), sezvo mutemo, haakonzeri. Zvisinei, kazhinji richiratidzwa sezvo omunzvimbo kuita kushatirwa, hope zvirwere, vemunyika akatsvuka uye kuzvimba, kuwedzera tembiricha muviri kuti 38 C. A vashomanana nevana (vanenge 5%), tembiricha inogona hwokukurira 39˚ C.

Pane contraindications kuti kubaya pamusoro pneumococcus?

Chero mukuru kana chaiwo contraindications kuti kubaya hakusi chero yokudzivirira, asi kuti nezvinoita kuti mushonga pneumococcal noutachiona munguva yapfuura nguva. Pane dzimwe dzave kushandiswa Immunology "Pneumo-23" haasi mazuva asingasviki 10 asati mararamiro immunosuppressive mishonga inotanga. Kukundikana kutevera mirayiro iyi inogona kusimudzira vasanyanye antibody siyana.

Vaccination vashandi vakadzi vane pamuviri utano vanobvumirwa chete pazuva rokupedzisira trimester. Zvisinei, kana zvichikodzera zvachose, Zvinokurudzirwa varegedze nzira iyi.

Kuitika pneumococcal chirwere: boka panjodzi

Kuramba mumwe muitiro akadai kubaya pamusoro pneumococcal chirwere? yematambudziko mamwe mapoka evanhu vanogona kukonzera kupfuura mufambiro wake. Nyanzvi vanokurudzira hazvo nhomba vanhu pamusoro nemakore 65. Mune dzimwe nyika dzakabudirira, kubaya pazera iri boka kusvika pachinzvimbo chevatatu fanira dzokuvhiya.

Zvinofanira nhomba pamusoro pneumococcal simba, kurwara uye pasi muchipatara vanhu vane chirwere cheshuga, chirwere bronchitis, kushayiwa mu cardiac uye kufema basa, kushanda chiropa.

Kuva kubaya pamusoro pneumococcus (vakashinga wongororo - uchapupu) vanhu vane simba zvirwere. Pano pane varwere pangozi ainge avhiyiwa kuvhiyiwa kubviswa chirwatata, kutambura kubva nephrotic urwere, nejeko-sero kupererwa neropa. Uyewo, boka iri rinosanganisira vanhu vanga usabuda musana mvura.

Uye, chokwadi, usakanganwa pamusoro kukura chizvarwa. Baya akakurudzira vana ndonda (kusanganisira vaya nechirwere chorurindi), kusvika mumapoka makuru (chevana, kukireshi, kuchikoro). C. 2-hletnego zera podiatrists angarayira kuti baya varwere vaduku kutambura liquorrhea, asplenic, kushayikwa mukwanisi zvinoriumba kuti vakapfuura nzira yose cochlear kudyara.

Vaccination pamusoro pneumococcal chirwere vana vanogona yekudyidzana kuderedza chirwere uye kuderedza kufa kubva ichi inotyisa microorganism.

Maererano nenyanzvi dzokurapa, varwere, vabereki

Opinion pediatricians, vanachiremba nemamwe minda mushonga yakawanda mubvunzo uyu zvinonyatsoteerera - kubaya pamusoro pneumococcal chirwere (akadai wongororo pamusoro idivi zvavo townsfolk chaizvo zvakawanda) - rotsvakwa. Doctors funga nzira iyi kudzivirira zvikuru mukurwisa zvirwere vakawanda zvakasiyana chaizvo Mabviro. Zviri dzose nyore uye yaisadhura kudzivirira chirwere pane kutora mushonga (anopfuura rimwe, uye kazhinji vanoverengeka kana kupfuura kusina basa) kutarisira uye zvikuru utachiona uye nemigumisiro yayo uye matambudziko.

Pakati vabereki wevana vanorumbidza simba pamusoro kubaya pamusoro pneumococcus haisi nguva dzose anoshandawo. Murume nyore, kwete chiremba, nemhaka vezvenhau "nokuti chokwadi anoziva" kuti okuva pneumococcus vakawandisa, uye kana mushonga achadzivirira mwana, icho ndakarumbidzwa vanachiremba - mubvunzo guru. Kunyange zvazvo vakawanda vabereki vachiri vanowanzotevedzera kuteerera zvinofungwa nyanzvi uye achiona kubaya.

Kubva nguva nenguva unogona kunzwa kuti kubaya pamusoro pneumococcal chirwere, matambudziko ose randinogara pakurera tembiricha haana inobudirira - mwana achiri achirwara. Muzviitiko zvakadaro zvakafanira kuteerera kusimba chirwere. Kana mwana ari vangakosora, aiva tembiricha kusvika 38 madhigirii, uye akanga achirwara 7 days - ichi kunonzwisisika. Pasina kubaya zvaigona kuva zviipe, bronchitis, mabayo, muchipatara, mishonga yakawanda havasi nyore, uye mazuva anenge 21 pakurapwa.

Achiratidza

Pneumococcal chirwere chinotungamirira munyika nokuda kukura chakasimba kufema chirwere, obstructive zvemapapu chirwere, etc. Uye nhasi, mune ano yepamusorosoro zera, mwero wokufa kwevanhu kubva microorganism iri kumusoro zvakakwana. Saka, chikamu vabereki kubaya pamusoro pneumococcus mwana (inofambiswa - kwete rudzi mashoko izvo zvinofanira kutungamirirwa Muzviitiko zvakadaro) - iyi mukana kudzivirira mwana wake, kudzivirira kukura kwezvirwere zvakakomba pasi kure-akadzitora, regai kuva pasi pacharo hapana uchapupu, pretexts.