Ingabe kufanele ngiphuze ama-antibiotics umkhuhlane kanye nomkhuhlane?

Noma yimuphi uchwepheshe wezokwelapha oneziqu unolwazi oluqinile lweqiniso lokuthi ukwelapha ngama-antibiotic emkhuhlane kanye nomkhuhlane akusho lutho. Odokotela bendawo nodokotela abasebenza ezibhedlela bayakwazi lokhu. Kodwa-ke, ama-antibiotic anqunyelwe, futhi ngokuvamile akwenza njengesinyathelo sokuvimbela. Phela isiguli esiye kudokotela silindele ukwelashwa kuye.

Uma ubuza udokotela ukuthi uphuze yini i-antibiotic yomkhuhlane kanye nemikhuhlane, impendulo izoba yimbi ngokungananazi. Konke ukwelashwa kwe-ARVI kwehla kuphela ekuphuzeni amanzi amaningi, ukuphumula kombhede, ukuthatha amavithamini, ukudla okunomsoco, ukuhlanza ikhala, ukugubha, ukuhogela kanye nokwelashwa okuphawulekayo. Imithi elwa namagciwane ayidingeki, kodwa ngokuvamile isiguli ngokwaso siyaphikelela kubo, sibuza ngokoqobo udokotela ukuba athole isikhathi.

Emisebenzini yezingane, izidakamizwa ezilwa namagciwane zivame ukubekwa ngenhloso yokuqinisekisa kabusha, ukuze inkinga yebhaktheriya ingenzeki ngokumelene nesizinda sokutheleleka ngegciwane. Ngakho-ke, udokotela utusa umuthi osebenzayo kubazali, awubize ngokuthi “imithi elwa namagciwane” yezingane, ukuze bazivikele emibuzweni engadingekile. Nokho, izinkinga zingagwenywa ngokumane unikeze umntwana isiphuzo ngesikhathi, ukumanzisa umoya awuphefumulayo, ukugeza ikhala lakhe nokusebenzisa ezinye izindlela zokwelapha izimpawu. Umzimba, ngokusekelwa okwanele okunjalo, uzobhekana nesifo ngokwawo.

Umbuzo ungokwemvelo ukuthi kungani udokotela wezingane esabeka umuthi wokulwa namagciwane womkhuhlane kanye ne-SARS. Iqiniso liwukuthi ingozi yezinkinga zomkhuhlane kanye nomkhuhlane ezinganeni zasenkulisa empeleni iphezulu kakhulu. Ukuzivikela kwabo komzimba akuphelele, futhi impilo yabo ivame ukucekelwa phansi ukungondleki, izimo ezimbi zemvelo, njll. Ngakho-ke, uma inkinga iqala, udokotela kuphela ozoba necala. Nguye ozosolwa ngokungafaneleki, ngisho ukushushiswa nokulahlekelwa umsebenzi akulaleki. Yilokhu okuholela odokotela bezingane abaningi ukuthi batuse ama-antibiotic ezimeni lapho bengase banikezwe khona.

Isibonakaliso sokuqokwa kwama-antibiotics ukungezwa kokutheleleka kwebhaktheriya, okuyinkinga yomkhuhlane kanye nemikhuhlane. Lokhu kwenzeka lapho umzimba ungakwazi ukulwa negciwane ngokwawo.

Kungakhathaliseki ukuthi kungenzeka yini ukuqonda ngaphansi kokuhlaziywa, yimaphi ama-antibiotic adingekayo?

Yiqiniso, kungenzeka ukuqonda kusukela ekuhlaziyweni ukuthi ukwelashwa kwe-antibacterial kuyadingeka.

Nokho, ayenziwa kuzo zonke izimo:

• Ukuqoqwa komchamo noma isikhwehlela sesiko kuwukuhlolwa okubizayo, lapho ama-polyclinics efuna ukulondoloza isabelomali esitholakalayo;

• Ngokuvamile, i-smear ithathwa emgodini wekhala kanye ne-pharynx ngomphimbo obuhlungu. I-swab ithathwa ngenduku ye-Lefler, okuyimbangela yokuthuthukiswa kwe-diphtheria. Futhi, odokotela bangadlulisela isiguli ukuthi sithathe i-swab emathanjeni ukuze bathole isiko lebhaktheriya uma isiguli sihlaselwe yi-tonsillitis engapheli. Okunye ukuhlaziya okuvamile isiko lomchamo elikhethiwe lama-pathologies wesistimu yomchamo;

• Ukwanda kwe-ESR kanye nezinga le-leukocyte, kanye nokushintshwa kwefomula ye-leukocyte ngakwesobunxele, kuwuphawu olungaqondile lokuthi ukuvuvukala kwamagciwane kwenzeka emzimbeni. Lesi sithombe ungasibona ngokuhlolwa kwegazi kwasemtholampilo.

Ukuqonda kanjani ngenhlalakahle ukuthi izinkinga ziye zavela?

Ngezinye izikhathi ungakwazi ngisho nokuqonda ukuthi inkinga yebhaktheriya ivele ngokwakho.

Lokhu kuzoboniswa yizimpawu ezilandelayo:

• Imfihlo ehlukaniswa nezitho ze-ENT noma emehlweni iba namafu, ibe phuzi noma ibe luhlaza. Ngokuvamile, ukukhishwa kufanele kube obala;

• Okokuqala kuba ngcono, bese izinga lokushisa liyakhuphuka futhi. Ukugxuma kwesibili ekushiseni komzimba akufanele kunganakwa;

• Uma amabhaktheriya ehlasela isimiso somchamo, khona-ke umchamo uba namafu, i-sediment ingatholakala kuwo;

• Uma ukutheleleka kwebhaktheriya kuthinte amathumbu, khona-ke amafinyila noma ubomvu kuzoba khona esitokisini. Ngezinye izikhathi ngisho nokungcola kwegazi kutholakala, kuye ngokuthi isifo singakanani.

Ngokuqondene nokutheleleka kwegciwane lokuphefumula okunamandla, ukungezwa kwe-bacterial flora kungasolwa ngezimpawu ezilandelayo:

• Ngokumelene nesizinda somkhuhlane osuvele utholwe, kwakukhona izinga lokushisa lomzimba elikhulayo, elaqala ukwehla ngosuku lwe-3-4, kodwa laphinde lagxumela emazingeni aphezulu. Ngokuvamile lokhu kwenzeka ngosuku lwe-5-6 lokugula, futhi isimo sempilo jikelele siphinde siwohloke kakhulu. Ukukhwehlela kuba namandla, ukuphefumula kwenzeka, ubuhlungu esifubeni buvela. Ngokuvamile, lesi simo sibonisa ukuthuthukiswa kwe-pneumonia. Bheka futhi: izimpawu ze-pneumonia;

• I-Diphtheria kanye ne-tonsillitis nazo ziyizinkinga ezivamile ze-SARS. Ungasola ukuqala kwabo ngomphimbo obuhlungu, okwenzeka ngokumelene nesizinda sokushisa komzimba okwandisiwe, ungqimba lwamafomu e-plaque kumathoni. Ngezinye izikhathi kunezinguquko kuma-lymph nodes - akhula ngosayizi futhi abe buhlungu;

• Ukukhishwa endlebeni kanye nokubonakala kobuhlungu okwandayo lapho i-tragus icindezelwa yizibonakaliso ze-otitis media, evame ukukhula ezinganeni ezincane;

• Uma ubuhlungu butholakala endaweni yasebunzini, endaweni yobuso, izwi liba ngamakhala futhi i-rhinitis ibonakala, khona-ke i-sinusitis noma i-sinusitis kufanele ikhishwe. Isibonakaliso esinjalo njengokwanda kobuhlungu lapho ikhanda libheke phambili futhi ukulahlekelwa iphunga kungaqinisekisa ukusola.

Uma kusolwa inkinga yebhaktheriya, kungenzeka ngenxa yezimpawu zesifo kanye nokuwohloka kwenhlalakahle, khona-ke uchwepheshe kuphela ongakhetha i-ejenti ethile ye-antibacterial.

Lokhu kuthonywa yizici eziningi, okuhlanganisa:

• Indawo yokuvuvukala;

• Iminyaka yesiguli;

• Umlando wezokwelapha;

• Ukungabekezelelani komuntu ngamunye ekhambi elithile;

• Ukumelana ne-pathogen emithini elwa namagciwane.

Lapho ama-antibiotics engaboniswanga umkhuhlane noma i-SARS engaxakile?

• I-Rhinitis ene-purulent-mucous discharge, ehlala isikhathi esingaphansi kwamaviki ama-2;

• I-Viral conjunctivitis;

• I-tonsillitis yemvelaphi yegciwane;

• i-rhinopharyngitis;

• I-tracheitis kanye ne-bronchitis emnene ngaphandle kokushisa komzimba okuphezulu;

• Ukuthuthukiswa kwe-herpetic infection;

• Ukuvuvukala kwe-larynx.

Kunini lapho kungenzeka khona ukusebenzisa ama-antibiotics ezifweni ezingelula zokuphefumula ezibukhali?

• Uma kukhona ukuphazamiseka ekusebenzeni kokuzivikela komzimba, njengoba kuboniswa izimpawu ezithile. Lezi yizimo ezifana nesandulela ngculazi, umdlavuza, izinga lokushisa lomzimba elihlala liphakeme (ukushisa kwe-subfebrile), izifo ezibangelwa amagciwane ezenzeka izikhathi ezingaphezu kwezinhlanu ngonyaka, ukuphazamiseka kokuzalwa esimisweni sokuzivikela komzimba.

• Izifo zesistimu ye-hematopoietic: i-aplastic anemia, i-agranulocytosis.

• Uma sikhuluma ngengane kuze kube yizinyanga eziyisithupha, khona-ke uzonconywa ukuthi athathe ama-antibiotics ngokumelene nesizinda sama-rickets, ngesisindo somzimba esinganele kanye nokukhubazeka okuhlukahlukene.

Izinkomba zokuqokwa kwama-antibiotics

Izimpawu zokuqokwa kwama-antibiotic yilezi:

• I-Angina, imvelo yebhaktheriya eye yaqinisekiswa izivivinyo zaselabhorethri. Imvamisa, ukwelashwa kwenziwa ngokusetshenziswa kwezidakamizwa ezivela eqenjini lama-macrolides noma ama-penicillin. Bheka futhi: ama-antibiotic e-angina kumuntu omdala;

• I-bronchitis esigabeni esibi, i-laryngotracheitis, ukuphindaphinda kwe-bronchitis engapheli, i-bronchiectasis idinga ukuthatha ama-antibiotics eqenjini le-macrolide, isibonelo, i-Macropen. Ukukhipha inyumoniya, i-x-ray yesifuba iyadingeka ukuze kuqinisekiswe inyumoniya;

• Ukuthatha izidakamizwa ezilwa namagciwane, ukuvakashela udokotela ohlinzayo kanye ne-hematologist kudinga isifo esifana ne-purulent lymphadenitis;

• Ukubonisana kwe-otolaryngologist mayelana nokukhetha kwezidakamizwa eqenjini le-cephalosporins noma i-macrolides kuyodingeka ezigulini ezine-otitis media ezitholwe esigabeni esibi. Udokotela we-ENT uphinde aphathe izifo ezifana ne-sinusitis, i-etmoiditis, i-sinusitis, edinga ukuqokwa kwe-antibiotic eyanele. Kungenzeka ukuqinisekisa inkinga enjalo ngokuhlolwa kwe-X-ray;

• Ukwelashwa ngama-penicillin kuboniswa inyumoniya. Ngesikhathi esifanayo, ukulawulwa okuqinile kokwelashwa nokuqinisekiswa kokuxilongwa ngosizo lwesithombe se-X-ray kuyimpoqo.

Okubonisa kakhulu mayelana nemithi enganele yama-antibacterial agents kuwucwaningo olwenziwa komunye wemitholampilo yezingane. Ngakho-ke, ukuhlaziya amarekhodi ezokwelapha zezingane ezingu-420 zasenkulisa ubudala kwembula ukuthi i-89% yazo yayine-ARVI noma izifo zokuphefumula ezinzima, i-16% yayine-bronchitis eyingozi, i-3% ye-otitis media, i-1% inyumoniya nezinye izifo. Ngesikhathi esifanayo, ukwelashwa ngama-antibiotic kwanqunywa kuma-80% amacala okutheleleka ngegciwane, kanye ne-bronchitis ne-pneumonia ku-100% yamacala.

Odokotela bezingane batholakale beqaphela ukuthi izifo ezibangelwa amagciwane azikwazi ukwelashwa ngama-antibiotics, kodwa zinikeza ama-antibiotics ngezizathu ezifana nalezi:

• Umhlahlandlela wokufaka;

• Izingane ezingaphansi kweminyaka engu-3;

• Isidingo sokuvimbela izinkinga;

• Ukungabi nesifiso sokuvakashela izingane ekhaya.

Ngesikhathi esifanayo, ama-antibiotics anconywa ukuba athathwe izinsuku ezingu-5 futhi ngemithamo emincane, futhi lokhu kuyingozi mayelana nokuthuthukiswa kokumelana namagciwane. Ngaphezu kwalokho, ayikho imiphumela yokuhlolwa, ngakho-ke akwaziwa ukuthi iyiphi i-pathogen eyabangela lesi sifo.

Phakathi naleso sikhathi, ku-90% wamacala, amagciwane ayeyimbangela ye-malaise. Ngokuqondene nezifo ezibangelwa amagciwane, zazivame ukucasulwa yi-pneumococci (40%), i-Haemophilus influenzae (15%), i-staphylococci kanye ne-mycotic organisms (10%). Ama-microorganisms afana ne-mycoplasmas ne-chlamydia ayengavamile ukuba nomthelela ekuthuthukiseni lesi sifo.

Ungathatha noma yimiphi imithi elwa namagciwane kuphela ngemva kokubonisana nodokotela. Udokotela kuphela ongakwazi ukunquma ngokufanelekile ukufaneleka kokuqokwa kwabo ngemuva kokuqoqa i-anamnesis, ecabangela iminyaka yesiguli kanye nobukhulu be-pathology.

Ungasebenzisa ama-antibacterial agents alandelayo:

• Amalungiselelo ochungechunge lwe-penicillin. Ama-penicillin e-semi-synthetic anconywa lapho kungekho ukungezwani komzimba kuwo. Ingageza i-Amoxicillin neFlemoxin Solutab. Uma lesi sifo sinzima, khona-ke ochwepheshe batusa ukuthatha ama-penicillin avikelwe, isibonelo, i-Amoxiclav, i-Augmentin, i-Flemoclav, i-Ecoclave. Kulawa malungiselelo, i-amoxicillin yengezwa nge-clavulanic acid;

• ama-antibiotic e-macrolide esetshenziselwa ukwelapha inyumoniya kanye nezifo zokuphefumula ezibangelwa i-chlamydia kanye ne-mycoplasmas. Lena i-Azithromycin (Zetamax, Sumamed, Zitrolid, Hemomycin, Azitrox, Zi-factor). Nge-bronchitis, ukuqokwa kwe-Macropen kungenzeka;

• Izidakamizwa ze-cephalosporin kungenzeka ukuthi ubeke i-Cefixime (i-Lupin, i-Suprax, i-Pantsef, i-Ixim), i-Cefuroxime (i-Zinnat, i-Aksetin, i-Zinacef), njll.;

• Kusukela ochungechungeni lwe-fluoroquinolone ukunquma izidakamizwa Levofloxacin (Floracid, Glevo, Hailefloks, Tavanik, Flexid) kanye Moxifloxacin (Moksimak, Pleviloks, Aveloks). Izingane kuleli qembu lezidakamizwa azikaze zibekwe ngenxa yokuthi uhlaka lwamathambo abo asakhiwa. Ngaphezu kwalokho, i-fluoroquinolones yizidakamizwa ezisetshenziswa ezimweni ezinzima kakhulu, futhi zimelela indawo yokugcina lapho i-bacterial flora yengane esekhulile ingeke imelane nayo.

Iziphetho eziyinhloko

• Ukusebenzisa izidakamizwa ze-antibacterial for umkhuhlane ovela kwi-viral akukona nje okungenangqondo, kodwa futhi kuyingozi. Ziyadingeka ukwelapha ukutheleleka ngebhaktheriya.

• Imithi elwa namagciwane inohlu olubanzi lwemiphumela emibi: ingathinta kabi ukusebenza kwesibindi nezinso, ingavusa ukukhula kwe-allergies, ibe nomphumela ocindezelayo kumasosha omzimba, futhi iphazamise i-microflora evamile emzimbeni.

• Ngezinhloso ze-prophylactic, ukusetshenziswa kwezidakamizwa ezilwa namagciwane akwamukelekile. Kubalulekile ukuqapha isimo sesiguli futhi unikeze ama-antibiotic kuphela uma kwenzeka ngempela inkinga ye-antibacterial.

• Umuthi we-antibacterial awusebenzi uma izinga lokushisa lomzimba linganciphi emva kwezinsuku ezi-3 kusukela ekuqaleni kokuphathwa kwawo. Kulokhu, ithuluzi kufanele lishintshwe.

• Lapho umuntu ephuza kaningi ama-antibiotics, amagciwane azokhula ngokushesha ukumelana nawo. Kamuva, lokhu kuzodinga ukuqokwa kwezidakamizwa ezimbi kakhulu ezinomphumela omubi hhayi kuphela kuma-pathogenic agents, kodwa nasemzimbeni wesiguli uqobo.