卡介苗接种适应症

卡介苗接种适应症 卡介苗接种适应症、禁忌症及注意事项 卡介苗接种后可有局部反应和淋巴结反应两种。 (1)局部反应:皮内法或皮上划痕法的接种，局部在3周左右可出现红肿硬结，中间逐渐软化形成白色小脓疱，脓疱自行穿破结痂，痂落后留下一个小疤痕。它的局部反应一般持续2个月左右。 (2)淋巴结反应:卡介苗接种后，菌苗可通过淋巴系统而达全身，所以接种处附近的淋巴结可以稍有肿大，如腋下、锁骨上下或颈部，若反应强烈可见脓肿或破溃，应及时就医。 卡介苗接种的禁忌症是:?新生儿有发热、腹泻、呕吐;早产、难产有产伤者;患有脓疱疮及湿疹时均不宜接种。?儿童发热，37.5?以上者;各种急性传染病时及恢复不到2个月;严重心、肾、肝疾病者;有皮肤病、过敏性哮喘、荨麻疹或预防接种有过敏反应者;其他预防接种不满两周者(牛痘接种除外，但应错开接种部位)。 检验卡介苗是否接种成功，应在卡介苗接种后2,3个月再作结核菌素试验，如由阴性转为阳性，示接种成功。 接种卡介苗后，免疫力可维持数年，日久免疫力可减弱，因此需要复种。在初种后，宜每隔3,4年复种1次(当结核菌素试验转为阴性时)。近有趋势延长到每隔6,7年复种1次，一般在成年后不需复种。卡介苗接种常用的方法有3种:即皮内法、皮上划痕法和内服法。 yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder (1)皮内法:即皮内注射法。注射部位在左上臂三角肌下端外缘，注射后应起一皮丘。结核菌素试验阴性者，所用菌苗每毫升含介苗0.5mg或0.75mg，用0 .1ml做皮内注射用，严禁注入皮下。此法阳转率高且稳定。 (2)皮上划痕法:皮上划痕所用卡介苗是乳白色混悬液，每1ml内含菌量50,75mg。在左上臂三角肌下端外缘，用酒精消毒皮肤，待干后，滴2,3滴摇匀的菌苗液，用消毒的针划一“井”字，各长1,1 5cm，间隙0.5cm，以出现红痕为宜，涂匀菌苗，使其渗入皮内，菌苗干后才可穿衣服。此法操作简单，易于普及和推广，局部反应轻，淋巴结反应较少。 (3)口服法:只限于出生后2个月以内的婴儿。 以上3种方法，以皮内法和口服法阳转率较高，皮上划痕法阳转率较低。 卡介苗接种注意事项: 1、承担接种的单位，应有业务领导分工负责，组织由防疫(痨)医生、内科(儿、妇产科)医生、护土组成的接种技术指导小组。主要负责对接种人员进行、技术指导、检查督促、反应处理、统计报表以及效果考核等有关事宜。凡接种人员必须经专门培训考核合格后方可参加接种。 yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder 2、接种工作开始前，必须向家长、教师等作好宣传工作。凡接种对象的姓名、性别、年龄、住址、健康状况、家长姓名等一一询问、登记，填好卡介苗接种登记表。 3、工作现场有组织、有秩序，防止忙乱中将结素或菌液溅入眼内，注射针头误伤他人或自己等事故。操作中要严格执行无菌技术和操作规程。尤其要防止误将卡介苗作结核菌素使用及将皮内卡介苗误入皮下或肌肉。 4、注射前必须先核对安瓿上的品名、浓度、有效期和批号，检查安瓿有无破裂，菌液有无混浊、沉淀。卡介苗容易发生沉淀，使用时要充分摇匀，吸入注射器后菌苗也应随时摇匀，如有摇不散凝块，异物或安瓿有裂缝及过期者均不可使用。卡介苗安瓿打开后超过一小时(夏天半小时)尚未用完的应废弃。 5、结素与液体卡介苗都必须保存在2~10?冷暗处，可用冰箱、冰瓶或适当方法冷藏，但菌苗与冰块要用塑料纸隔开，不可直接与冰接触或泡在冰水中。并应有专人负责保存，结素和卡介菌分开存放，不能与其它药物混放。 6、接种应在光线充足的室内进行，但不能在日光直射下进行操作，同时也应避免日光直接照射到存有卡介苗的安瓿或注射器上。 yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder 7、打开安瓿前要先用小砂轮割锯安瓿颈部，然后用消毒干棉球包住，轻扳颈部打开安瓿，要防止误将玻璃掉入安瓿或误入眼内及其它部位。 8、注射器和针头要严密消毒，最好用高压消毒(如煮沸消毒，在抽取菌液前应先把针管内的水排出)。每注射一人更换一个针头，接种时针头和注射器一定要固定牢，以防菌液溢出。 9、接种后必须把用过的安瓿，废弃的菌苗，棉球等集中存放，及时进行深埋或焚烧，作妥善处理，切勿随地乱丢。 10、卡介苗接种和结核菌素试验所用过的兰芯注射器、针头用毕后，要先用清水抽洗针筒及针头多遍(不可用热水洗，以免因结核菌素或卡介苗内的蛋白质凝固在针管壁上或堵塞针孔)，再经高压或煮沸消毒后方可再使用。结核菌素和卡介苗所用注射器与针头应各自专用，并应有专人负责，分开存放。 卡介苗本身含有蜡质，有较强的吸附力，必须经过特殊处理方能洗净、故卡介苗所用1毫升兰芯注射器及针头必须专用，不能作它用，也不得用其它型号注射器、针头代用。特殊情况下，结核菌素和卡介苗所用注射器与针头需互用时，必须经专门严格清洗，消毒处理后方可使用。 yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder 11、皮内卡介苗接种反应及处理，见卡介苗接种手册有关部 分。 12、在接种工作中若发生异常反应或差错事故，应及时查明 原因，积极妥善处理，及时逐级上报。接种工作完毕后，要 将资料及时整理。接规定要求统计上报。 yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder