Hōʻike ʻili PPD

ʻO ka hoʻāʻo ʻili PPD kahi ala i hoʻohana ʻia e ʻike pono ʻole i ka maʻi ʻaʻai hamo (latent) tuberculosis (TB). Kū ʻo PPD no ka derivative protein i hoʻomaʻemaʻe ʻia.

Pono ʻoe i ʻelua mau kipa ʻana i kāu keʻena ʻoihana olakino no kēia hōʻike.

I ka kipa mua, e hoʻomaʻemaʻe ka mea hāʻawi i kahi o kou ʻili, ʻo ka maʻa mau o loko o kou lima. E kiʻi ʻoe i kahi pana liʻiliʻi (injection) i loaʻa iā PPD. Hoʻokomo mālie ʻia ke kui kele ma lalo o ka papa luna o ka ʻili, e hoʻokumu ana i kahi puʻupuʻu (welt). Hele pinepine kēia puʻupuʻu i kekahi mau hola e like me ka lawe ʻia o ka mea.

Ma hope o 48 a 72 mau hola, pono ʻoe e hoʻi i ke keʻena o kāu mea hāʻawi. E nānā kāu mea hāʻawi i ka wahi e ʻike ai inā ua nui kāu hopena i ka hōʻike.

ʻAʻohe hoʻomākaukau kūikawā no kēia hōʻike.

E haʻi i kāu mea hāʻawi inā ua loaʻa iā ʻoe kahi hōʻoia maikaʻi o ka ʻaoʻao PPD maikaʻi. Inā pēlā, ʻaʻole pono ʻoe e hana hou i kahi hōʻike PPD, koe wale nō ma lalo o nā ʻano maʻamau.

E haʻi i kāu mea hāʻawi inā loaʻa ʻoe i kahi maʻi olakino a i ʻole inā ʻoe e lawe i kekahi mau lāʻau, e like me nā steroid, hiki ke hoʻopili i kāu ʻōnaehana pale. Hiki i kēia mau hanana ke alakaʻi i nā hopena hōʻike pololei ʻole.

E haʻi i kāu mea hāʻawi inā ua loaʻa iā ʻoe ka lāʻau lapaʻau BCG a inā pēlā, ke loaʻa iā ʻoe. (Hāʻawi wale ʻia kēia lāʻau lapaʻau ma waho o ʻAmelika Hui Pū ʻIa.

E ʻike ʻoe i kahi ʻōkole pokole ke hoʻokomo ʻia o ka nila ma lalo pono o ka ʻili.

Hana ʻia kēia hōʻike e ʻike inā ua launa pū ʻoe me nā koʻohune i kumu i ka TB.

He maʻi maʻalahi ka maʻi TB (contagious). Hoʻopili pinepine ia i nā ake māmā. Hiki ke hoʻomau ʻole ka bacteria (dormant) i loko o nā ake māmā no nā makahiki he nui. Kapa ʻia kēia kūlana he latent TB.

ʻO ka hapa nui o ka poʻe maʻAmelika Hui Pū ʻIa i loaʻa i nā maʻi bacteria ʻaʻohe o lākou hōʻailona a hōʻailona paha o ka TB hana.

Pono paha ʻoe i kēia hōʻoia inā:

• Ua puni paha i kekahi me ka TB
• Hana i ka mālama olakino
• Loaʻa i kahi ʻōnaehana pale nāwaliwali, ma muli o kekahi mau lāʻau a i ʻole nā ​​maʻi (e like me ka maʻi ʻaʻai a i ʻole HIV / AIDS)

ʻO kahi hopena maikaʻi ʻole ʻo ia hoʻi ʻaʻole ʻoe i loaʻa i nā maʻi bacteria e kumu ai ka TB.

Me kahi hopena maikaʻi ʻole, ʻaʻole pehu ka ʻili kahi i loaʻa ai iā ʻoe ka hōʻoia PPD, a liʻiliʻi paha ka ʻōhū. ʻOkoʻa kēia ana no nā keiki, nā poʻe me ka maʻi HIV, a me nā pūʻulu kūlana kiʻekiʻe ʻē aʻe.

ʻO ka hōʻike ʻili PPD ʻaʻole ia kahi hōʻike kānana maikaʻi loa. Pākuʻi ʻole ʻia kekahi mau kānaka i ka bacteria. Eia kekahi, ʻo nā maʻi a lāʻau paha e hoʻonāwaliwali ai i ka ʻōnaehana pale e hoʻonā i kahi hopena maikaʻi ʻole.

ʻO kahi hopena maʻamau (maikaʻi) hopena ʻoe i hoʻopili ʻia me nā maʻi bacteria e hoʻokumu i ka TB. Pono ʻoe i ka lāʻau e hoʻohaʻahaʻa i ka makaʻu o ka maʻi e hoʻi mai ana (reactivation o ka maʻi). ʻO ka hōʻoia ʻili maikaʻi ʻaʻole ia he manaʻo he maʻi nui ko kekahi kanaka no ka TB. Pono e hana hou i nā hoʻokolohua e nānā inā loaʻa ka maʻi ʻeleu.

Kuhi ʻia kahi hopena liʻiliʻi (5 mm o ka pehu paʻa ma ka pūnaewele) he maikaʻi i ka poʻe:

• ʻO wai ka maʻi HIV / AIDS
• ʻO wai ka mea i loaʻa i kahi transplant organ
• ʻO wai ka mea i pale i ka ʻōnaehana pale pale a i ʻole ke lawe nei i ka steroid therapy (ma kahi o 15 mg o prednisone i kēlā me kēia lā no 1 mahina)
• ʻO wai i launa pū me kahi kanaka i loaʻa i ka TB ikaika
• ʻO wai ka mea e loli i ka x-ray umauma e like me ka TB i hala

ʻO nā hopena nui (ʻoi aku a i ʻole like o 10 mm) i manaʻo ʻia he maikaʻi i:

• ʻO ka poʻe me kahi hōʻike maikaʻi ʻole i ʻike ʻia i nā makahiki 2 i hala
• ʻO ka poʻe me ka maʻi kō, a me nā kōpaʻa ʻole, a i ʻole nā ​​kūlana ʻē aʻe e hoʻonui ai i ko lākou manawa kūpono i ka loaʻa ʻana o ka maʻi TB
• Nā limahana mālama ola
• Nā mea hoʻohana lāʻau hoʻowawā
• ʻO nā malihini i neʻe mai kahi ʻāina me ka helu TB kiʻekiʻe i nā makahiki he 5 i hala
• Nā keiki ma lalo o ka makahiki 4
• Nā pēpē, keiki, a ʻōpio paha i hōʻike ʻia i nā mākua pilikia nui
• ʻO nā haumāna a me nā limahana o kekahi mau nohona hui, e like me nā hale paʻahao, nā hale hānai, a me nā hale noho ʻole

I ka poʻe me ka ʻike ʻole ʻia o ka makaʻu o ka TB, 15 mm a ʻoi aku paha o ka naue ʻana o ka paʻa ma ka pūnaewele e hōʻike i kahi hopena maikaʻi.

ʻO ka poʻe i hānau ʻia ma waho o ʻAmelika Hui Pū ʻIa i loaʻa kahi lāʻau āpau i kapa ʻia ʻo BCG e loaʻa paha kahi hopena hōʻoia maikaʻi ʻole.

Aia kahi makaʻu liʻiliʻi loa no ka ʻulaʻula nui a me ka pehu ʻana o ka lima i ka poʻe i loaʻa kahi hōʻike PPD maikaʻi ma mua a me nā mea e loaʻa hou ka hoʻāʻo. ʻO ka mea maʻamau, ʻaʻole pono e hoʻāʻo hou ka poʻe i loaʻa kahi hōʻike maikaʻi i ka wā i hala. Hiki ke hana i kēia hopena i kekahi mau poʻe i hoʻokolokolo ʻole ʻia ma mua.

Hoʻomaʻamaʻa i ka derivative protein; Hōʻoia ʻili TB; Hōʻike ʻili Tuberculin; Hōʻike Mantoux

• Tuberculosis i ka akemāmā
• Hōʻike ʻili PPD maikaʻi
• Hōʻike ʻili PPD

Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 249.

ʻO Woods GL. ʻO Mycobacteria. I: McPherson RA, Pincus MR, hua. ʻO kā Henry's Clinical Diagnosis a me Management e nā Laboratory Methods. 23rd Ed. Piladelapia, PA: Elsevier; 2017: chap 61.