Isivivinyo seMantoux sibhekisela ekuvivinyweni kwe-laboratory. Iyenziwa ezinganeni ngenhloso yokuvimbela nokutholakala ngokushesha kwesifo sofuba . Ake sicabangele ngokuningiliziwe indlela, ukuzikhethela kokuqhuba kwayo, futhi sihlale ekuhloleni kwemiphumela etholakalayo.
Ukwakhiwa kwesampuli seMantoux
Ukwakhiwa kwesampula se-tuberculin kuyinkimbinkimbi. Isisekelo semithi yi-tuberculin. Yenziwa ngxube yenkambiso ye-mycobacteria yehlobo lomuntu nesifuba. Ngaphambi kokuqala, azinakwenziwa ngesikhathi sokunakekelwa okushisayo, bese ehlanzwa yi-ultraviolet futhi enwetshiwe nge-trichloroacetic acid. Isigaba sokugcina sokulungiselela ukwelashwa kwengxube ne-ethyl yotshwala ne-ether. Lezi zakhi zidlala indima yokuvikela.
Ngaphezu kwesisekelo samanje, i-tuberculin, ukuhlolwa kwe-Mantoux kuqukethe:
- usawoti wama-phosphates;
- i-chloride ye-sodium;
- i-phenol;
- stabilizer "Twin-80".
Ukuhlolwa kweMantoux - nini?
Kufanele kuthiwa lesi sampuli sikhombisa impendulo ekusungulweni kwe-tuberculin emzimbeni. Endaweni yomjovo, kugxila ukugxila okuncane. Ngokushesha ubukhulu bayo buhlolwa ngemva kwenqubo. Isivivinyo sokuqala seMantoux senziwa izinyanga ezingu-12 emva kokuzalwa kweziqu. Ukuhlolwa kokuqala, ezinyangeni ezimbili, kuvunyelwe lapho ukugoma kwe-BCG kungenziwanga esibhedlela.
Ngokuvamile, ukubeletha okunzima, izimo ze-fetus azivumeli ukwethulwa komgomo. Ezimweni ezinjalo, ngaphambi kokwakhiwa kwe-BCG, ukuhlolwa kwe-tuberculin kwenziwa kuqala, iMantoux. Ikuvumela ukuba ukhiphe ukutheleleka kwengane ngenduku kaKoch. Emva kwalokhu, isifundo senziwa njalo ngonyaka, 1 isikhathi. Uma ukusabela ekusungulweni kwe-tuberculin kwanda, abazali bomntwana noma abathandekayo bakhe abathintana naye, bathole intonga kaKoch , isampula senziwa izikhathi ezingu-2-3 ngonyaka.
I-Technique yokuhlolwa kwe-Mantoux
I-syringe ekhethekile isetshenziselwa ukwenza lokhu kuhlolwa. Isidakamizwa sijojowe nge-intradermally, sibe sesithathu esiphakathi sendawo yangaphakathi ye-forearm. Ukulungiswa kwangaphambi kokuqala akudingeki, kwenziwa nganoma isiphi isikhathi. Odokotela bazise abazali kusengaphambili ukuthi ingane izohlolwa i-Mantoux, i-algorithm yayo ilandela kanje:
- Uboya bekotini obuthintekile ekuthinteni isifo se-antiseptic endaweni yokuphatha.
- Inaliti iphakanyisiwe phezulu, isikhumba sithulwa kancane.
- Umgodi wesinaliti ufakwa ngokuphelele esikhumbeni, uphakamise kancane uphinde ujove umuthi.
- Emva kwalokho, kuvuvuka ukuvuvukala okuncane, okuyinto eyanyamalala ngemva kwemizuzu embalwa.
- Umthamo wesidakamizwa esampula seMantoux yi-2 TE (amayunithi e-tuberculosis), okuqukethwe ku-0.1 ml.
Imiphumela yokuhlolwa yeMantoux
Emva kokuhlolwa kweMantoux, umphumela uhlolwe ngemva kwamahora angu-72. Endaweni yokujola, kuhlanganiswa i-papule. Usayizi ngokuqondile ubukhulu bayo buwuphawu lokuhlola. Ngaphandle, lokhu kuhlanganiswa kuhlanganiswe, okugqamile ngaphezu kwesikhumba. Kungumphumela wokugcwalisa isikhumba nge-lymphocyte ehlonzwe.
Ngokucindezela kancane phezu kwe-papule, ithola i-hue emhlophe. Amasayizi wesampula ahlolwa ngokusebenzisa umbusi obala, ngokukhanyisa okuhle. Ifakwe ngokuphambene nendawo yangaphambili. Ngokwenza kanjalo, balala ubukhulu betidwa ngokwayo, ungacabangi nge-bezel ebomvu. Kungumphumela wokuphendula komzimba ekufakweni kwe-pathogen, kuyinto evamile. Emva kokuhlolwa kweMantoux, ukuhlolwa komphumela kubantwana kwenziwa kuphela ngodokotela wezingane.
Isivivinyo se-Negative Mantoux
Uma ukuhlolwa kohlolo lweMantoux kwenziwa, odokotela abavamile ukurekhoda umphumela omubi. Lokhu kuthiwa uma ubukhulu be-papule bungaphezulu kuka-1 mm noma abukho ngokuphelele. Ukhomba ukuthi i-agent ye-causative ayingakaze ingene emzimbeni ngaphambili noma ukutheleleka kwenzeke emavikini angu-10 edlule, kungabe kusaba khona. Lo mphumela ungabonisa ukungabi nokugoma kwe-BCG esibhedlela sokubeletha.
Isivivinyo sokungabaza sikaMantoux
Isivivinyo seMantoux, esivamile esichazwe ngezansi, singase sibe nomphumela ongathandabuzeki. Lokhu kushiwo ngosayizi wamapule we-2-4 mm. Futhi, ngokuphendula okunjalo, ukubomvu okuncane kungenzeka. Lokhu kubuye kwenzeke lapho isayithi lokujola lihlangana namanzi. Umphumela ongathandabuzi udinga ukuxilongwa kabusha okwesikhashana, ukuze uthole umphumela onembile.
Isivivinyo esiphezulu seMantoux
Ukuhlolwa kwe-tuberculin kubhekwa njengokuhle uma usayizi we-seal u-5-16 mm. Lo mphumela ubonisa ukutholakala kokuzivikela okusebenzayo ku-agent causative yesifo sofuba. Ukushintsha lokhu kusabela kusiza ukuthi ngabe ingane isulelekile yini. Ngaphezu kwalokho, umphumela omuhle ubonakala ezinganeni ezagonywa nge-BCG. Izinhlobonhlobo ezilandelayo zesampula enhle zihlukaniswa:
- buthakathaka kahle - ngaphezu kwama-5 mm;
- isilinganiso samandla - 10-14 mm;
- ivezwe - 15-16 mm.
Ukusabela kokuqala okuhle ku-tuberculin kungabonisa ukuthi usulele ukutheleleka okuyinhloko. Kodwa-ke, ngisho nemiphumela enjalo ayisetshenziselwa ukuxilongwa - idinga ukubona nokuphindaphinda kwesampula ngesikhathi esifushane. Ezinganeni ezineminyaka engama-2-3 ubudala, ukuhlolwa okuhle kweMantoux kungabhekwa njengesifo sofuba esingemva kwesikhashana, okudinga ukuxilongwa ngokucophelela, okuhlukile.
Ukuxilongwa "kokuphenduka kwe-tuberculin test" - kuyini?
Igama elithi "ukuphenduka kwe-tuberculin test" lisetshenziselwa ukuchaza isimo lapho umphumela omubi wocwaningo uphenduka khona. Kulesi simo, lezi zici ezilandelayo zibonisa, izindlela ezisetshenziswa ekuxilongweni ziyahlukaniswa:
- ukuxilongwa kokuqala kwaba nomphumela ongathandabuzeki noma omuhle;
- ubukhulu be-post-injection papule benyuke ku-17-20 mm;
- Ubukhulu be-papule nesampula esilandelayo bukhulu kuneyaphambilini ngo-6 mm.
Kumele uqaphele ukuthi isampula ngokwayo ayikuvumeli ukuba wenze iziphetho mayelana nesifo esidluliselweyo. Kwezinye izimo, ukwanda kwesikhwama esakhiwe endaweni yomjovo kungumphumela wokuphendula okweqile. Ukukhipha okuhlukile kokutheleleka, odokotela benza ukuxilongwa okwengeziwe ngemuva kwesikhathi. Ngokuvamile, ukugoba kokuhlolwa kwe-tuberculin ezinganeni kubonisa umlando wesifo sofuba ngonyaka odlule.
Izinkinga zokuhlolwa kwe-tuberculin
Isivivinyo se-tuberculin seMantoux yinkqubo lapho amangqamuzana abuthakathaka e-pathogen ayiswa emzimbeni. Ngenxa yalokhu, izinkinga kungenzeka. Isizathu esivamile sokusungulwa kwe-tuberculin ezinganeni kuyindlela yokwelapha. Phakathi kweminye imiphumela emibi, kubalulekile ukuhlukanisa:
- ukushisa komzimba ukuphakama;
- izikhukhula;
- ukubonakala kwesiyezi;
- isicasuli;
- ukuhlanza;
- ukushaya okukhulu endaweni yomjovo;
- ukwephulwa kwenqubo yokuphefumula.
Ukuhlolwa kwe-Mantoux - ukuphikisana
Isivivinyo se-Mantoux kubantu abadala asikwenziwa ngenxa yokungazi kahle. Ngeke kwenzeke njalo izingane. Njenganoma imuphi umuthi, i-tuberculin inezinkomba zokusebenzisa. Uma zikhona, ucwaningo luhlehlisiwe kuze kube phakade. Ukuhlolwa kwe-Mantoux akunakwenzeka lapho:
- iminyaka yengane ingaphansi kwezinyanga ezingu-12;
- Izifo zesikhumba;
- isikhathi sesifo, kungakhathaliseki ukuthi imvelaphi;
- ukuthola ingane emkhakheni wokuhlukanisa;
- ukusabela okweqile ;
- isithuthwane;
- emva kokuhlolwa kwangaphambilini kwakungaphansi kwamasonto amane.
Okunye okunye kwisampula seMantoux
Ngenxa yokuthi isivivinyo seMantoux asikwazi ngaso sonke isikhathi, odokotela basebenzisa izindlela ezihlukile zokuxilonga isifo sofuba. Phakathi kokusebenza okusebenzayo:
- i-immunogram;
- Icala likaSuslov.
Zombili lezi zindlela zihilela ukuthatha isampula yegazi elibizayo ukuze lihlolwe. Ngakho-ke, lapho enza i-immunogram, odokotela banquma ukuthi amangaki amangqamuzana akhiqizwa ukulwa nesifo. Imiphumela ihlola ikhono lomzimba ukulwa ne-pathogen. Ukungahambi kahle akunakwenzeka ukuveza isithombe esiphelele sezimo zokutheleleka, ukucacisa ukuba khona kwesifo okwamanje.
Isivivinyo sikaSuslov sisekelwe ekutadisheni kwesampula segazi lapho i-tuberculin ifakwa khona. Ngemva kwesikhashana, isimo sezimpawu zegazi sihlolwa ngaphansi kwe-microscope. Indlela ayinayo i-100% yenani lokufundisa. Usiza odokotela ukuba bacabange ukuthi kungenzeka yini ukutheleleka ngenduku kaKoch. Ngenxa yalokhu, ngesikhathi sokuqala, kuhlolwa i-Mantoux engayithola lesi sifo.