Eli nqaku liza kuchaza ngokufutshane ukuba zeziphi iintlobo zovavanyo ooGqirha abazisebenzisayo ukuxilonga i-allergies.
Uvavanyo lwePlick Prick (SPT)
Uvavanyo lwe-Skin Prick (SPT) lolona hlobo luxhaphakileyo lovavanyo olusetyenziswa ngugqirha ukuxilonga utywala. Uvavanyo lwesikhumba lunokuba yeyona ndlela ichanekileyo kwaye ingabizi kakhulu yokuqinisekisa iiallergen. I-SPT luvavanyo olulula, olukhuselekileyo nolukhawulezayo, olunika iziphumo ngaphakathi kwemizuzu eyi-15-20.
Ngesiqhelo, oogqirha okanye abongikazi benza uVavanyo lwe-Skin Prick kwingalo yangaphakathi, kodwa kwezinye iimeko, banokulwenza kwelinye ilungu lomzimba, elifana nomqolo (Abantwana/abantwana abancinci). Ugqirha ukhetha i-allergens yovavanyo emva kokukuxilonga. Kuphela zi-3 okanye ezi-4 okanye ukuya kuthi ga kwi-25 ye-allergenics inokuvavanywa.
Okokuqala, ugqirha okanye umongikazi ubeka ithontsi elincinci le-allergen enokwenzeka esikhumbeni. Emva koko baya kuhlaba ulusu lwakho nge-lancet ngethontsi. Ukuba unovelwano kwi-substance, uya kuphuhlisa impendulo ye-aleji yendawo, ngendlela yokudumba (i-bump / wheal) ubomvu, kunye nokurhawuzelela kwindawo yovavanyo phakathi kwemizuzu eyi-15. Ngokuqhelekileyo, okukhona isondo lilikhulu, kokukhona kunokwenzeka ukuba ube nokwaliwayo kwi-allergen. I-SPT inokuqhutywa kuwo onke amaqela eminyaka, kubandakanywa neentsana.
Kubalulekile ukwazi:
- Iziphumo ezincumisayo zovavanyo lolusu azizichongi ngokwabo ukuba ziyaliwa.
- Uvavanyo oluqinisekileyo lolusu aluxeli kwangaphambili ubukrakra bokubangelwa kukwalana komzimba.
- Uvavanyo lwesikhumba olune-negative luthetha ukuba awulalisi. Nangona kunjalo, ukusabela okungalunganga kunokuthi kwenzeke ngenxa yezinye izizathu, umzekelo; ukuba isigulane sithatha i-antihistamines okanye amayeza athintela umphumo we-histamine.
Ukuze oogqirha bakwazi ukuxilonga i-allergies, isigulane kufuneka siyeke ukuthatha antihistamines kunye namanye amayeza athile phambi kovavanyo. Ngaphezu koko, izigulane kufuneka ziyeke ukuthatha i-antihistamines esebenza ixesha elide (ezo zingabangeli ubuthongo) kwi-1 iveki; kunye ne-antihistamines esebenza ixesha elifutshane kwiiyure ezingama-48 ngaphambili. Imixube emininzi yokukhohlela ine-antihistamine; ngoko ke nceda uxelele ugqirha wakho nawaphi na amayeza osele uwathathile.
Uvavanyo lweLusu lwangaphakathi
Olunye uhlobo lovavanyo oludla ngokusetyenziswa ngoogqirha ukuxilonga i-allergies yinto ebizwa ngokuba yi-intradermal skin test. Uvavanyo lubandakanya ukutofa inani elincinci le-allergen esikhumbeni, kunye nesirinji kunye nenaliti. Ukufundwa kwenziwa emva kwemizuzu eyi-10-15 yokuvavanya i-wheal kunye nobomvu. Oogqirha banokulusebenzisa olu vavanyo ukuba iziphumo zovavanyo lwe-skin prick zi-negative kodwa basakrokrela ukuba awuhambisani nezinto ezithile. Ugqirha wakho unokusebenzisa olu vavanyo ukuxilonga ichiza okanye i-allergy yetyhefu. Uvavanyo lwesikhumba alukho 100%. Ezinye izigulana zineziphumo ezilungileyo ngezinto abazinyamezelayo ngaphandle kweempawu. Kule meko, sithi baxhotyiswa nje kodwa abalalisi. Ngeli xesha, kukho imiqondiso embalwa kakhulu yokuvavanya ulusu lwe-intradermal kwi-allergies yokutya.
Uvavanyo lweParkler Patch okanye uVavanyo lwee-Epicutaneous
Ukuxilonga i-allergies usebenzisa i-Allergy Patch Test, ugqirha okanye umongikazi ubeka amabala anezinto ezahlukeneyo (amayeza, izithako zokuthambisa, isinyithi, imichiza yerabha, ukutya,) eluswini lomqolo. Uvavanyo lumisela ukuba yeyiphi i-allergen enokubangela ukudibana kwe-dermatitis. Ugqirha okanye umongikazi ususa amabala emva kweeyure ezingama-48, kodwa ukufundwa kokugqibela kwenziwa emva kweeyure ezingama-72-96. Ukuba uziva ungenwe yinto ethile, kufuneka ube nerhashalala yendawo. Inani lamabala axhomekeke kwizinto ezikrokrelekayo ugqirha wakho afuna ukuziphanda. Yazisa ugqirha wakho ngawo onke amayeza owafumanayo. I-systemic corticosteroids okanye i-immunomodulators inokutshintsha iziphumo zovavanyo. Ukuhlamba kunye nokubila kunokuhambisa amabala, ngoko qaphela.
Uvavanyo lweGazi
I-Serum iyonke i-IgE
Wonke umntu une-Immunoglobulin E (IgE), i-antibody ebandakanyekayo kwi-classical reactions. Olu vavanyo lulinganisa yonke i-IgE egazini. Uvavanyo aluloncedo kakhulu ekuxilongeni i-allergies, kuba inani lezinye iimeko libangela amanqanaba aphezulu e-IgE njengosulelo oluthile lwentsholongwane, ibhaktheriya okanye usulelo lwentsholongwane, izifo zolusu, izifo ezibulalayo, ukungunda,…. Abanye abantu abane-IgE ephezulu abayi kukhula kukwaliwa; Abanye abantu abanamanqanaba aqhelekileyo banokude baqalise ukwaliwa. Amanqanaba e-IgE akadibanisi nokungadibani nokutya. I-Serum iyonke i-IgE ayithethi ukuba isigulana asidibani nento ethile. Kuyimfuneko ukulinganisa i-IgE ethile.
I-IgE ethile
Kuhlalutyo lwegazi ugqirha wakho unokulinganisa i-serum iyonke ye-IgE, kodwa unokulinganisa i-IgE ethile. I-Specific IgE yi-IgE ejoliswe kwi-allergen ethile (umz. I-pollen yengca, inkuku yasendlwini okanye ukutya okufana ne-peanut okanye ipenicillin). Ukuba unemeko yolusu okanye uthatha iyeza eliphazamisana novavanyo lwesikhumba, iimvavanyo zegazi ezinokuthi zisetyenziswe. Zisenokusetyenziselwa abantwana abangakunyamezeliyo ukuvavanywa kolusu. Ugqirha wakho uya kuthatha isampuli yegazi kwaye ayithumele elabhoratri. Ilebhu yongeza i-allergen kwisampulu yakho yegazi kwaye emva koko ilinganise inani le-antibodies egazini lakho elivelisayo ukuze lihlasele izinto ezinokuthi zenzeke.
Abanye abantu bane-IgE ethile, kodwa bayakwazi ukunyamezela into ethile - umzekelo, bane-IgE echasene ne-peanut kodwa bayakwazi ukutya amandongomane ngaphandle kokusabela. Baziva beziva, kodwa hayi aleji. Abanye abantu bane-IgE ethile kwaye basabela kwi-substance. Ziyaliwa, hayi nje ukuva. Ngokuqhelekileyo, ukuba phezulu amanqanaba e-IgE ethile kokukhona kuqatsela iimpawu zokwaliwa. Kukho iinkampani ezininzi eziye zavelisa iindlela zokulinganisa i-IgE ethile, kwaye ngamanye amaxesha olu hlalutyo lunokufumana amagama afana ne-RAST, CAP, ELISA okanye abanye. Alukho uvavanyo olunokuthi lubonise ukuba kuqatha kangakanani na ukwaliwa komnye umntu.
Uvavanyo loMngeni wokutya
Olu vavanyo ludla ngokwenziwa ngamayeza anokubakho okanye ukungezwani nokutya. Ngamanye amaxesha, nasemva kokwenza uvavanyo lwesikhumba kunye novavanyo lwegazi, i-allergist ayikwazi ukunika ukuxilongwa okuqinisekileyo. Kule meko, ugqirha wakho uya kucebisa uvavanyo lomngeni lokutya ngomlomo (OFC), uvavanyo oluchaneke kakhulu lokuxilonga kukwaliwa kokutya. Ngexesha lomngeni wokutya, i-allergist ikunika ukutya okukrokrelwayo kwiidosi ezilinganisiweyo, ukuqala ngeemali ezincinci kakhulu ezingenakwenzeka ukuba ziqalise iimpawu. Ukulandela idosi nganye, ujongwa ixesha elithile kuzo naziphi na iimpawu zokusabela. Ukuba akukho zimpawu, uya kufumana ngokuthe ngcembe iidosi ezinkulu. Ukuba ubonisa naziphi na iimpawu zokusabela, umngeni wokutya uya kuyekwa.
Ngale rejimeni, uninzi lweziphumo zincinci, njengokugungxulwa okanye ukugquma, kwaye ukusabela okubukhali akuqhelekanga. Ukuba kuyimfuneko, uya kunikwa amayeza, ngokuqhelekileyo i-antihistamines, ukukhulula iimpawu. Ukuba ngaba awunazimpawu, ukwaliwa kokutya kunokukhutshwa ngaphandle. Ukuba uvavanyo luqinisekisa ukuba unokwaliwa kokutya, ugqirha wakho uya kukunika ulwazi malunga neendlela zokuthintela ukutya kunye/okanye amisele amayeza afanelekileyo. Olu vavanyo lunamandla okubangela ukusabela okunzulu. Umceli mngeni kufuneka uqhutywe kwiziko lezonyango elinezixhobo kunye nabasebenzi ukujongana neziphumo ezinokuthi zibe yingozi ebomini. Iqela lezonyango liya kuqwalasela isigulana iimpawu ukuya kuthi ga kwiiyure ezininzi emva komngeni. Phambi kovavanyo lomngeni wokutya, izigulane kufuneka zikuphephe ukutya okukrokrelekayo kangangeeveki ezi-2 ubuncinane. Iyeza eliqhelekileyo le-antihistamine nalo liyarhoxiswa.
Zintathu iintlobo zemiceli mngeni yokutya ngomlomo:
Imfama ephindwe kabini, uMceli mngeni woLawulo lokutya (DBPCFC)
I-Double-Blind, i-Placebo-Controlled Food Challenge "ngumgangatho wegolide" wokuxilonga ukutya kokutya. Isigulana sifumana iidosi ezonyukayo zento ekurhaneleka ukuba imelene nokutya okanye indawo ye-placebo. Ukungaboni kabini kuthetha ukuba i-allergen kunye ne-placebo zikhangeleka ngokufanayo, wena okanye ugqirha wakho uya kukwazi ukuba yeyiphi oyifumanayo. Le nkqubo iqinisekisa ukuba iziphumo zovavanyo ziyinjongo egqibeleleyo.
Umceli mngeni wokutya oNgaboniyo
Kolu vavanyo, i-allergist iyazi ukuba ufumana i-allergen, kodwa awunayo.
Umceli mngeni wokutya okuvulekileyo
Bobabini wena kunye nogqirha wakho uyazi ukuba okanye awufumani i-allergen. Xa umngeni kwiintsana kunye nabantwana abancinci akukho mfuneko yokufihla ukutya. Umngeni ovulekileyo yinkqubo esemgangathweni kula maqela eminyaka.
Uvavanyo lwezinambuzane
Oogqirha basebenzisa i-Insect Sting Test kwizigulana ezingadibaniyo nenyosi okanye ityhefu yoonomeva, ukujonga ukuba ngaba unyango luphumelele. Ukuba inyosi okanye unomeva uyakuhlaba, oko kunokukucaphukisa kwaye kube buhlungu. Unokubona iqhuma elibomvu elirhawuzelayo okanye elidumbileyo. Nangona kunjalo, ukuba awuhambisani netyhefu ekulunyweni kwesinambuzane, unokuba nokusabela okunzulu okufana ne-hives, ukudumba, okanye ubunzima bokuphefumla. Ugonyo lwe-Immunotherapy / allergy lusetyenziselwa ukutshintsha indlela yendalo yezifo ezibangelwa yi-allergies. Kwimeko yokwaliwa nokulunywa kwezinambuzane, oogqirha basebenzisa izitofu zokugonya ukunyamezela inyosi okanye ityhefu yoonomeva, ukuze isigulana sibe nokusabela kwendawo kuphela, kwindawo yokulunywa, njengabo bantu bangenayo i-allergies.
Ngesiqhelo, oogqirha banika izigulane zabo izitofu zokugonya ezingevaniyo iminyaka emithathu ukuya kwemihlanu. Emva kweli xesha, ugqirha unokucebisa ukuba kwenziwe uvavanyo lokuhlaba isinambuzane ukwazi ukuba isigulana siyanyamezela na. Ukwenza oku, ugqirha ubamba inyosi okanye unomeva engalweni yesigulane de inambuzane ihlabe isigulane. Emva koko, isigulane sijongwa ukubona ukuba iimpawu zibonakala. Ngokuxhomekeke kuhlobo kunye nobukhulu beempawu, umntu unokuvavanya indlela esebenza ngayo i-immunotherapy kwaye agqibe ekubeni aqhubeke okanye ayiyeke.
Ulwamvila lomlilo
Ubungqongqo be imbovane yomlilo ulwamvila luyahluka kumntu nomntu. Isiganeko esiqhelekileyo sokuhlaba iimbovane zomlilo siquka iimbovane zomlilo ezininzi ezihlabayo. Oku kungenxa yokuba xa imbovane yomlilo iphazanyiswa amakhulu ukuya kumawaka eembovane ezivuthayo ziyasabela. Ukongezelela, imbovane nganye inokuhlaba ngokuphindaphindiweyo. Phantse bonke abantu abalunywa ziimbovane zomlilo baba norhawuzelo, indawo yokuhlala kwindawo ehlabayo, edla ngokuphela kwisithuba semizuzu engama-30 ukuya kuma-60. Oku kulandelwa yiblister encinci kwiiyure ezine. Oku kudla ngokubonakala ngathi kuzaliswa zizinto ezifana nobubovu ngeeyure ezisibhozo ukuya kwezingama-24. Nangona kunjalo, into ebonwayo zizihlunu ezifile ngokwenene, kwaye i-blister inamathuba amancinci okuba yosuleleke ngaphandle kokuba ivuliwe. Xa ziphilisiwe, ezi zilonda zinokushiya amanxeba.
Unyango lwentuthwane yomlilo lujolise ekuthinteleni usulelo lwesibini lwebhaktheriya, olunokuthi lwenzeke ukuba i-pustule ikrwelwe okanye yaphukile. Unyango lwexesha elide lokwaliwa kwembovane yomlilo lubizwa ngokuba yi-whole-body extract immunotherapy equlethe umzimba wonke wembovane, hayi nje ubuthi, njengoko kunjalo nakwezinye izinambuzane ezihlabayo. Yinkqubo esebenza kakhulu, enokuthi ithintele ukuchasana nokuchasana nomlilo kwiimbovane.
