Kumapeto kwa chaka cha 1995, bungwe la World Health Organization (WHO) linasankha tsiku la 24 March kukhala Tsiku la Padziko Lonse la Matenda a Chifuwa.
1 Kumvetsetsa chifuwa chachikulu
Chifuwa chachikulu (TB) ndi matenda osatha owononga thupi, omwe amatchedwanso "matenda owononga thupi". Ndi matenda osatha owononga thupi omwe amayambitsidwa ndi mycobacterium TB yomwe imalowa m'thupi la munthu. Sichikhudzidwa ndi zaka, jenda, mtundu, ntchito komanso dera. Ziwalo zambiri ndi machitidwe a thupi la munthu zimatha kudwala chifuwa chachikulu, chomwe pakati pawo chifuwa chachikulu ndicho chofala kwambiri.
Chifuwa chachikulu ndi matenda opatsirana osatha omwe amayamba chifukwa cha Mycobacterium tuberculosis, yomwe imalowa m'ziwalo zonse za thupi. Popeza malo ofala kwambiri a matendawa ndi mapapo, nthawi zambiri amatchedwa chifuwa chachikulu.
Matenda opitilira 90% a chifuwa chachikulu amafalikira kudzera m'njira yopumira. Odwala chifuwa chachikulu amadwala chifukwa cha kutsokomola, kuyetsemula, kupanga phokoso lalikulu, zomwe zimapangitsa kuti madontho okhala ndi chifuwa chachikulu (otchedwa madontho ang'onoang'ono) atuluke m'thupi ndi kupumidwa ndi anthu athanzi.
2 Chithandizo cha odwala chifuwa chachikulu
Chithandizo cha mankhwala ndi maziko a chithandizo cha chifuwa chachikulu. Poyerekeza ndi mitundu ina ya matenda oyambitsidwa ndi mabakiteriya, chithandizo cha chifuwa chachikulu chingatenge nthawi yayitali. Pa chifuwa chachikulu cha m'mapapo, mankhwala oletsa chifuwa chachikulu ayenera kumwedwa kwa miyezi yosachepera 6 mpaka 9. Mankhwala enieni ndi nthawi ya chithandizo zimadalira zaka za wodwalayo, thanzi lake lonse, komanso kukana mankhwala.
Odwala akamakana mankhwala oyamba, ayenera kusinthidwa ndi mankhwala achiwiri. Mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza chifuwa chachikulu cha m'mapapo chomwe sichimakana mankhwala ndi monga isoniazid (INH), rifampicin (RFP), ethambutol (EB), pyrazinamide (PZA) ndi streptomycin (SM). Mankhwala asanu awa amatchedwa mankhwala oyamba ndipo amagwira ntchito kwa odwala opitilira 80% omwe angoyamba kumene kutenga matenda a chifuwa chachikulu cha m'mapapo.
3 Mafunso ndi mayankho a chifuwa chachikulu
Q: Kodi chifuwa chachikulu chingachiritsidwe?
A: 90% ya odwala chifuwa chachikulu cha m'mapapo amatha kuchiritsidwa akamalimbikira kumwa mankhwala nthawi zonse ndikumaliza njira yochizira (miyezi 6-9). Kusintha kulikonse kwa chithandizo kuyenera kusankhidwa ndi dokotala. Ngati simutenga mankhwalawo pa nthawi yake ndikumaliza njira yochizira, zingayambitse kukana mankhwala a chifuwa chachikulu. Kukana mankhwala kukachitika, njira yochizira idzatenga nthawi yayitali ndipo ingayambitse kulephera kwa chithandizo.
Q: Kodi odwala chifuwa chachikulu ayenera kusamala ndi chiyani akamalandira chithandizo?
A: Mukapezeka ndi chifuwa chachikulu, muyenera kulandira chithandizo cha chifuwa chachikulu nthawi zonse, tsatirani malangizo a dokotala, tenga mankhwala nthawi yake, fufuzani nthawi zonse ndikulimbitsa chidaliro. 1. Samalani kupuma ndikulimbitsa zakudya; 2. Samalani ukhondo wanu, ndipo phimbani pakamwa ndi mphuno yanu ndi matawulo apepala mukamatsokomola kapena kuyetsemula; 3. Chepetsani kutuluka panja ndikuvala chigoba mukatuluka.
Q: Kodi chifuwa chachikulu chikufalikirabe ngakhale chitachiritsidwa?
A: Pambuyo pa chithandizo chokhazikika, matenda a odwala chifuwa chachikulu cha m'mapapo nthawi zambiri amachepa mofulumira. Pambuyo pa milungu ingapo ya chithandizo, chiwerengero cha mabakiteriya a chifuwa chachikulu m'makoswe chimachepa kwambiri. Odwala ambiri omwe ali ndi chifuwa chachikulu cha m'mapapo chosapatsirana amatsiriza chithandizo chonse motsatira dongosolo la chithandizo lomwe laperekedwa. Akafika pamlingo woyenera, palibe mabakiteriya a chifuwa chachikulu omwe amapezeka m'makoswe, kotero salinso opatsirana.
Q: Kodi chifuwa chachikulu chikufalikirabe ngakhale chitachiritsidwa?
A: Pambuyo pa chithandizo chokhazikika, matenda a odwala chifuwa chachikulu cha m'mapapo nthawi zambiri amachepa mofulumira. Pambuyo pa milungu ingapo ya chithandizo, chiwerengero cha mabakiteriya a chifuwa chachikulu m'makoswe chimachepa kwambiri. Odwala ambiri omwe ali ndi chifuwa chachikulu cha m'mapapo chosapatsirana amatsiriza chithandizo chonse motsatira dongosolo la chithandizo lomwe laperekedwa. Akafika pamlingo woyenera, palibe mabakiteriya a chifuwa chachikulu omwe amapezeka m'makoswe, kotero salinso opatsirana.
Yankho la chifuwa chachikulu
Macro & Micro-Test imapereka zinthu zotsatirazi:
Kuzindikira kwaMTB (Mycobacterium tuberculosis) nucleic acid
1. Kuyambitsa njira yowongolera khalidwe la mkati mwa dongosolo kungathe kuyang'anira bwino njira yoyesera ndikutsimikizira khalidwe la kuyesa.
2. Kukulitsa kwa PCR ndi kafukufuku wa fluorescent zitha kuphatikizidwa.
3. Kuzindikira kwambiri: malire ochepa ozindikira ndi bacteria imodzi pa mL.
Kuzindikira kwaKukana kwa isoniazid mu MTB
1. Kuyambitsa njira yowongolera khalidwe la mkati mwa dongosolo kungathe kuyang'anira bwino njira yoyesera ndikutsimikizira khalidwe la kuyesa.
2. Njira yodzipangira yokha yodzitetezera ku ma amplification inagwiritsidwa ntchito, ndipo njira yophatikiza ukadaulo wa ARMS ndi fluorescent probe inagwiritsidwa ntchito.
3. Kuzindikira kwambiri: malire ocheperako ozindikira ndi mabakiteriya 1000 /mL, ndipo mitundu yosagwirizana yosamva mankhwala yokhala ndi mitundu yosinthika ya 1% kapena kuposerapo imatha kupezeka.
4. Kulondola kwambiri: Palibe kusintha komwe kumachitika chifukwa cha kusintha kwa majini a rpoB komwe kumachitika m'malo anayi (511, 516, 526 ndi 531).
Kuzindikira Kusintha kwa Masinthidwe aKukana kwa MTB ndi Rifampicin
1. Kuyambitsa njira yowongolera khalidwe la mkati mwa dongosolo kungathe kuyang'anira bwino njira yoyesera ndikutsimikizira khalidwe la kuyesa.
2. Njira yoyeretsera melting curve pamodzi ndi closed fluorescent probe yokhala ndi RNA bases idagwiritsidwa ntchito pozindikira in vitro amplification.
3. Kuzindikira kwambiri: malire ocheperako ozindikira ndi mabakiteriya 50 / mL.
4. Kudziwika bwino: palibe kusinthana kwa majini ndi majini a anthu, matenda ena a mycobacteria ndi chibayo; Malo osinthira majini ena a mycobacterium TB omwe sagonjetsedwa ndi mankhwala, monga katG 315G>C\A ndi InhA -15 C>T, adapezeka, ndipo zotsatira zake sizinawonetse kusinthana.
Kuzindikira kwa MTB nucleic acid (EPIA)
1. Kuyambitsa njira yowongolera khalidwe la mkati mwa dongosolo kungathe kuyang'anira bwino njira yoyesera ndikutsimikizira khalidwe la kuyesa.
2. Njira yopezera mphamvu ya enzyme digestion probe yokhazikika yokulitsa kutentha yagwiritsidwa ntchito, ndipo nthawi yozindikira ndi yochepa, ndipo zotsatira zake zitha kupezeka mu mphindi 30.
3. Pogwiritsidwa ntchito ndi chotulutsira zitsanzo cha Macro & Micro-Test ndi chowunikira kutentha kwa nucleic acid chokhazikika cha Macro & Micro-Test, n'chosavuta kugwiritsa ntchito komanso choyenera pazochitika zosiyanasiyana.
4. Kuzindikira kwambiri: malire ocheperako ozindikira ndi 1000Copies/mL.
5. Kudziwika bwino: Palibe njira yolumikizirana ndi mabakiteriya ena a mycobacteria omwe si a chifuwa chachikulu (monga Mycobacterium kansas, Mycobacterium Sukarnica, Mycobacterium marinum, etc.) ndi tizilombo tina (monga Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, etc.).
Nthawi yotumizira: Marichi-22-2024