Emasontweni ambalwa edlule, kwaqubuka inkulumo-mpikiswano kwabezindaba mayelana nesidingo goma abesifazane abakhulelwe emqubeniLokhu kungenxa yokuthi kule minyaka edlule kube nokuqubuka kwezifo zalesi sifo kubantu, naso esithintayo izingane ezingaphansi kwezinyanga ezi-2okuyiminyaka lapho zithola khona umthamo wabo wokuqala wokugoma, ngakho lezi zinsana zisekhona Abanakho ukuzivikela okwaneleUma bevezwa amagciwane abangela lesi sifo, bangase batheleleke futhi bathuthuke i-pertussis, okungaba isimo esibi kakhulu. Lokhu kudale okubalulekile i-alamu yomphakathi kanye nezicelo zokugonywa kwabesifazane abakhulelwe zenyuke kakhulu, ngezinye izikhathi kubangela ukushoda komgomo.
Kuyini ukukhwehlela?
Ukukhwehlela yisifo sofuba izindiza phezulu, okubangelwa a amabhaktheriya (ikakhulukazi I-Bordetella pertussisKuyisifo esingathinta abantu banoma iyiphi iminyaka futhi sibe kubi kakhulu ezinganeni, ikakhulukazi ezincane ezingakaluqali uhlelo lokugoma.
Lapho umuntu onaleli gciwane ethimula noma ekhwehlela, akhipha amaconsi amancane anamagciwane. Lamathonsi ahamba emoyeni bese isifo sibhebhetheka. ukukhululeka okukhulu kusuka komunye umuntu kuya komunye. Iziguli ezingalashwa zingathathelwana amasonto ambalwa ngemva kokuqala kokukhwehlela futhi, ngokuvamile, ukutheleleka Iphezulu ekuqaleni kwezimpawu.
Iningi lezingane ezithola ukukhwehlela likhipha kubantu abazinikezayo unakekele noma uvakashele (umama, ubaba, izingane zakwabo, ogogo nomkhulu, noma abanakekeli), ngezinye izikhathi abazi nokuthi banalesi sifo. Yingakho kuthuthukiswa amasu ukuze ukunciphisa ukudluliswa kusukela endaweni eseduze nosana olusanda kuzalwa.
Izimpawu zokukhwehlela
Izimpawu ze-pertussis ngokuvamile zivela Izinsuku eziyi-7 kuye kwezingu-10 ngemva kokuba umuntu ehlangene nesifo, kodwa ngezinye izikhathi kungathatha kuze kufike Amaviki angu-6 ngaphambi kokuba bavele.
Ekuqaleni, izimpawu zalesi sifo ziyefana nalezo ze- umkhuhlane ojwayelekileUkuminyana emakhaleni, ikhala eligelezayo, ukuthimula, nokukhwehlela noma imfiva. Njengoba lesi sifo siqhubeka, izimpawu zendabuko ze-pertussis zivela, okuyizi:
- Ukukhwehlela kuyalingana,alandelwe wumsindo omkhulu wekhwela bedonsa umoya.
- Ukuqhafaza ngokukhwehlela.
- Ukuphelelwa ngamandla ngemva kokukhwehlela.
Ukukhwehlela okukhulu kuvame ukuhlala okumbalwa amasonto amabili futhi kusukela lapho kuqhubeke, yehla ngobuningi nokuqina, nakuba i ukululama okuphelele Kungase kuthathe amaviki ambalwa ngaphezulu. Ezinsaneni ezincane kakhulu, ngaphezu kokukhwehlela, ezinye izimpawu zingase zivele. i-apnea iyamai-cyanosis (umbala oluhlaza okwesibhakabhaka) noma ubunzima bokudla, okudinga ukuhlolwa kwezokwelapha ngokushesha.
Phakathi kwe izinkinga Izinkinga ezingase zenzeke zihlanganisa inyumoniya, i-otitis media, ukwehluleka ukuphefumula, i-encephalopathy, nokuquleka. Ukukhwehlela kungadala ngisho nokufa. ukufaNgakho-ke, ukuvimbela nokuxilongwa kusenesikhathi kubalulekile.
Ukuxilongwa nezincomo
El ukuxilonga kusenesikhathi Kubalulekile ukuqala ukwelashwa ngokushesha ngangokunokwenzeka. Okufanelekile, kufanele kuqale phakathi nesigaba sokuqala sokugula (isigaba lapho kungase kuthiwe umkhuhlane ovamile), njengoba lokhu kwenza kube maningi amathuba okunciphisa ukushuba nobude bezimpawu. Njengamanje, ukuxilongwa kuncike ekuhlolweni okufana ne- I-PCR Ukuxilongwa kwenziwa nge-nasopharyngeal swab, isiko, noma, ngezigaba zakamuva, i-serology. I-Pertussis iphathwa ama-antibiotics (ngokuvamile ama-macrolides), okufanele ngaso sonke isikhathi anikezwe udokotela wezingane noma uchwepheshe wezempilo oyinkomba.
Lapho ukuxilongwa kwe-pertussis sekuqinisekisiwe futhi isikhathi sokwelashwa, kungakuhle ukuthi:
- Nyusa ukuphumula wengane.
- Ukugcina izindlu engenazinto ezicasulayo (intuthu, amakhemikhali) ukuvimbela ukuhlasela kokukhwehlela ukuthi kwenzeke kalula.
- Anikele ingane izingxenye zokudla ezincishisiwe futhi njalo, ukuvimbela ukuhlanza, futhi umkhuthaze ukuba phuza uketshezi oluningi ukugwema ukuphelelwa amanzi emzimbeni.
- Landela imiyalelo ye ukuhlukaniswa kokuphefumula njengoba kunconywe uchwepheshe (ikakhulukazi emasontweni ambalwa okuqala).
- Hlola, ngokwemibandela yezempilo, i i-antibiotic prophylaxis abahlala ndawonye nabasondelene nabo.
Okokuqala Izinyanga ezingu-3-4 zokuphila Lezi yinkathi engcuphe enkulu yokufa kusukela ukukhohlela okubi, uma kubhekwa ukuthi kunamathuba amakhulu okuba nezinkinga zesifo, ikakhulukazi ngoba umthamo wokuqala wokugoma unikezwa Izinyanga eziyisithupha zokuphilaEzinsaneni ezine-apnea, izimpawu zokucindezeleka kokuphefumula, i-cyanosis, ukungondleki kahle, noma izimpawu zokuphelelwa amanzi emzimbeni, ukulaliswa esibhedlela kungase kudingeke.
Prevención
Isinyathelo esikhulu sokuvimbela ukukhwehlela ukukhwehlela ukugomaUkugoma kwabesifazane abakhulelwe, kusukela evikini lama-27 lokukhulelwa, kubonise ukuthi kuyindlela ephumelela kakhulu vikela umntwana osanda kuzalwaNgoba ukudluliswa kwamasosha omzimba (izivikelo) ku-fetus ngesikhathi sokukhulelwa, nge-placenta, kuzoyivikela kuze kube yilapho imithamo yokuqala yomgomo, elawulwa ezinyangeni ezi-2 nezi-4 ubudala. Umuthi wokugomela i-pertussis nakanjani futhi kubekezelelwa kahle ngabesifazane abakhulelwe.
Njengamanje, umthamo we dTpa (i-diphtheria, i-tetanus, ne-low-antigen-load pertussis) ngayinye sokukhulelwa, okungcono phakathi kwe amasonto 27 no-36 (Kuhle kakhulu phakathi kwamaviki 28 kanye nama-32), njengoba ukudlula kwamasosha omzimba ku-placenta kukhulu ngalesi sikhathi. Uma kunobungozi bokubeletha ngaphambi kwesikhathi, uchwepheshe wezokunakekelwa kwezempilo angase lungisa isikhathi wokugoma ukuze kukhuliswe ukuvikeleka. Izidingo zokugonywa, okungenani, cishe izinsuku eziyi-15 ukuthuthukisa amazinga okuvikela amasosha omzimba.
Ukudlulisa ukukhwehlela akuqinisekisi amasosha omzimba unomphelaNgakho-ke, ngisho nabantu abake banawo kufanele bagonywe. Ngokufanayo, ukuqeda ishejuli yokugoma ebuntwaneni noma ukuthola amashothi akhuthazayo lapho usumdala akuqinisekisi amazinga anele okugomela. vikela umntwana osanda kuzalwaNgakho-ke, ukugoma kuyanconywa. ekukhulelweni ngakunyekungakhathaliseki ukuthi umthamo wokugcina we-tetanus noma i-diphtheria watholwa nini.
Ngaphezu kwalokho, kunconywa ukuthi ukugoma imvelo yengane, okungukuthi, kubo bonke abantu abaxhumana nosana (abazali, izingane zakubo, ogogo nomkhulu ...), ukuze bavikeleke baze bathole imithamo yokuqala yokugoma. Ochwepheshe bayibiza ngokuthi isu lesidleke (noma i-cocooning) futhi kulinganiselwa ukuthi inganciphisa kufika ku-70% amacala e-pertussis ezinganeni ezingaphansi kwezinyanga ezi-3 ubudala. Leli qhinga a umphelelisiAyithathi indawo yokugoma kowesifazane okhulelwe, okuyikhona okunikeza isivikelo esiqondile kusana olusanda kuzalwa kusukela ekuzalweni.
Ezikhathini zamuva nje, kuye kwenziwa izinguquko ezinkulu ezinyathelweni zokuvimbela lesi sifo. Emazweni ahlukahlukene, okulandelayo kuye kwatuswa: ukugoma kwabesifazane abakhulelwe ku-trimester yesithathu, uma kubhekwa ukwanda kwamacala kanye nokuqina kwawo ezinganeni ezincane, kwabonakala kamuva ukwehla okukhulu esimweni se-pertussis enzima ezinganeni ezingaphansi kwezinyanga ezi-3. Esimweni sethu, ukugoma ngesikhathi sokukhulelwa kuhlanganiswe ku- izinhlelo zezempilo Futhi, kancane kancane, izindawo ezahlukene bezihlanganisa lesi silinganiso ngendlela ezinzile.
Mayelana nokuphatha ngokubambisana, umgomo we-dTpa uwumgomo akusebenzi (ayiqukethe ama-microorganisms aphilayo) futhi ingalawulwa ngalolo suku kuneminye imithi yokugoma enconywa ngesikhathi sokukhulelwa, njenge umkhuhlaneezindaweni ezahlukene ze-anatomical. Ingase futhi iqondiswe ku izinsuku ezahlukene uma uthanda.
Ingabe abesifazane abakhulelwe badinga ukugonyelwa i-pertussis (ukukhwehlela)?
Impendulo ithi yebo: ukugoma ngesikhathi sokukhulelwa Isinyathelo esiphumelela kakhulu sokuvikela ngokumelene ne-pertussis ukugoma. usanda kuzalwa phakathi nezinyanga zokuqala zokuphila, lapho bengakakwazi ukuthola imithamo yezingane. Ukuphatha i-dTpa engxenyeni yokugcina yokukhulelwa kwandisa ukuzivikela komamaedlula ku-placenta futhi inikeze ukuvikeleka kwengane kuze kube yilapho ithola umthamo wayo wokuqala phakathi neminyaka yobudala izinyanga ezimbili.
Ukukhwehlela yisifo kuthelelana kakhulu eqhubeka ukwethula imijikelezo yobhubhane njalo Iminyaka engu-3-5Futhi ukuvikeleka emithini yokugoma noma ezifweni ezedlule kuncipha ngokuhamba kwesikhathi. Yingakho ukugoma kunconywa. ekukhulelweni okusha ngakunyengisho noma umama egonywe ngendlela efanele noma enalesi sifo eminyakeni edlule. Lokhu kugoma komama kufanele kuhunyushwe ngokuthi a isivikelo kabili: kumama futhi, ngaphezu kwakho konke, okosana.
Umuthi wokugoma onconyiwe wabesifazane abakhulelwe umgomo we-Tdap ozosetshenziswa kuwo abadalaephinde ivikele ku-diphtheria kanye ne-tetanus. Iphathwa ngo-a umthamo owodwa, intramuscularly (imvamisa ku- deltoids kwengalo). Ngokuvamile kunjalo uvikeleke kakhuluIphrofayili yayo yokusabela engathandeki ngokuvamile ikhawulelwe ekungaphatheki kahle kwendawo (ubuhlungu, ububomvu, ukuvuvukala) emahoreni angu-48 okuqala; ngezikhathi ezithile, ikhanda elibuhlungu, ukudangala, ukukhathala, noma imfiva yezinga eliphansi yesikhashana kungenzeka. Lokhu kungakhululeka ngokufaka... amakhaza wendawo ngaphandle kwengcindezi futhi, uma kungekho contraindication, nge paracetamol ngokwemiyalelo esepheshaneni lephakheji noma kuchwepheshe wezokunakekelwa kwempilo.
Nini futhi kuphi ukugoma? Ukuphepha, ukuhambisana, nemibuzo evamile
- Isikhathi esikahle: phakathi kwamasonto I-27 ne-36 yokukhulelwa, okungcono phakathi kwe- I-28 ne-32Uma kulindelwe ukulethwa ngaphambi kwesikhathi, kuhle ukucabangela ukuphathwa ngaphambili ukuqinisekisa ukudlula kwama-antibodies.
- Ukusebenza kwesikhashana: Kulinganiselwa ukuthi impendulo yokuzivikela komzimba iqala ukusebenza ngemva kwalokho cishe izinsuku ezingama-15 wokugoma.
- Ukuhambisana: Ingasetshenziswa kanye nomgomo we umkhuhlane ekuvakasheni okufanayo (ezingalweni ezihlukene) noma ngezinsuku ezihlukene.
- Ezokuphepha: umuthi wokugoma akusebenziAyinawo amagciwane aphilayo futhi ayikwazi ukudala ukutheleleka. Ukusabela okunamandla (okungaguquki) kukhona akuvamile kakhulu.
- I-contraindication eyinhloko: esethule anaphylaxis kumthamo wangaphambilini noma engxenyeni ethile yomuthi wokugoma. Uma kwenzeka kuba nemfiva ebabazekayo, ngokuvamile kuyakhethwa hlehlisa ukugoma kuze kube yilapho ukululama.
- Ungagonywa kuphi: ngokuvamile ku umtholampilo (umbelethisi noma umhlengikazi), ku esibhedlela uma kukhona ukungena ngesikhathi sokukhulelwa, noma kumadivayisi we ukugoma kwangasese Uma kusebenza. Amalungiselelo athile angahluka kuye ngendawo.
- Umlando wokugoma noma ukugula: ukuthola imithamo ebuntwaneni noma ukuba ne-pertussis ayiqedi izincomo zokugoma ekukhulelweni kwamanje.
Izinyathelo ezengeziwe zokuvikela ingane: imvelo kanye nemikhuba yenhlanzeko
Abantu abahlala nayo futhi bayinakekele ingane (umama, ubaba, izingane zakwabo, ogogo nomkhulu, abanakekeli) yibona abangakwazi ngokuyinhloko dlulisa ukukhwehlela ngenxa yokukhwehlela kanye nokuthimula. Ngaphezu kokugoma kwabesifazane abakhulelwe kanye noku nidoKubalulekile ukuqinisa imikhuba yenhlanzeko ukuxhumana nosana olusanda kuzalwa:
- Vala umlomo nekhala ngesicubu esilahlwayo lapho ukhwehlela noma uthimula.
- Beka izicubu ezisetshenzisiwe ngqo kudoti.
- Uma singekho izicubu, khwehlela noma thimula ungene indololondo noma ingxenye engaphezulu yengalo, ingabi sezandleni.
- Geza izandla ngensipho namanzi njalo (okungenani imizuzwana engama-20) noma usebenzise isisombululo se-hydroalcohol uma amanzi nensipho kungekho.
- Gwema ifayela le- ukuba seduze wengane enabantu abagulayo, ngisho noma unina noma ingane igonyiwe.
Kubaluleke kakhulu ukuthi umntwana osanda kuzalwa athole ezabo umthamo wokuqala kusukela ekhalendeni lezingane kuya ku- izinyanga ezimbili ubudalafuthi uqhubeke nemithamo ye-booster ngokweshejuli emisiwe.
Ulwazi olutholakalayo nolwazi oluqoqiwe lubonisa ukuthi inhlanganisela ye ukugonywa komama engxenyeni yesithathu, ukugonywa kwemvelo kanye nemikhuba ye Ukuhlanzeka kokuphefumula Inciphisa kakhulu ingozi ye-pertussis enzima ezinyangeni ezimbalwa zokuqala. Uma unemibuzo mayelana nenkomba, isikhathi esiqondile, noma ukuhambisana neminye imithi yokugoma noma imithi yokwelapha, Inhlanzeko ingahlola udaba lwakho futhi iluxazulule ngendlela yomuntu siqu.