ÌÈÍÈÑÒÅÐÑÒÂÎ ÇÄÐÀÂÎÎÕÐÀÍÅÍÈß ÐÑÔÑÐ

 

ÏÈÑÜÌÎ

îò 20 ôåâðàëÿ 1979 ã. N 06Á/7À-342

 

Ãëàâíîå ñàíèòàðíî-ýïèäåìèîëîãè÷åñêîå óïðàâëåíèå íàïðàâëÿåò äëÿ ðóêîâîäñòâà â ðàáîòå Ìåòîäè÷åñêèå ðåêîìåíäàöèè ïî ñáîðó, õðàíåíèþ è òðàíñïîðòèðîâêå ìàòåðèàëà îò áîëüíûõ äëÿ áàêòåðèîëîãè÷åñêîé äèàãíîñòèêè èíôåêöèîííûõ çàáîëåâàíèé.

 

Íà÷àëüíèê Ãëàâíîãî

ñàíèòàðíî-ýïèäåìèîëîãè÷åñêîãî

óïðàâëåíèÿ

Í.Ñ.ÒÈÒÊÎÂ


 

ÌÅÒÎÄÈ×ÅÑÊÈÅ ÐÅÊÎÌÅÍÄÀÖÈÈ

ÏÎ ÑÁÎÐÓ, ÕÐÀÍÅÍÈÞ È ÒÐÀÍÑÏÎÐÒÈÐÎÂÊÅ

ÌÀÒÅÐÈÀËÀ ÎÒ ÁÎËÜÍÛÕ ÄËß ÁÀÊÒÅÐÈÎËÎÃÈ×ÅÑÊÎÉ

ÄÈÀÃÍÎÑÒÈÊÈ ÈÍÔÅÊÖÈÎÍÍÛÕ ÇÀÁÎËÅÂÀÍÈÉ <*>

 

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<*> Ðåêîìåíäàöèè ñîñòàâëåíû ñîòðóäíèêàìè Ëåíèíãðàäñêîé, Ìîñêîâñêîé îáëàñòíûõ ñàíèòàðíî-ýïèäåìèîëîãè÷åñêèõ ñòàíöèé, Ðåñïóáëèêàíñêîé ñàíèòàðíî-ýïèäåìèîëîãè÷åñêîé ñòàíöèåé. Îäîáðåíû Ëàáîðàòîðíûì ñîâåòîì ïðè Ãëàâíîì ñàíèòàðíî-ýïèäåìèîëîãè÷åñêîì óïðàâëåíèè Ìèíçäðàâà ÐÑÔÑÐ.

 

┌────────────────────┬────────────┬──────────┬───────────────┬────────────┬───────────────────────────┬──────────────────────────┐

│Èññëåäóåìûé ìàòåðèàë│Ñðîêè âçÿòèÿ│Êîëè÷åñòâî  Åìêîñòü äëÿ  Êîíñåðâàíò  Ñïîñîá çàáîðà ìàòåðèàëà  │ Âðåìÿ è ñïîñîá äîñòàâêè 

                                │ìàòåðèàëà │ñáîðà ìàòåðèàëà│                                       ìàòåðèàëà â ëàáîðàòîðèþ 

├────────────────────┴────────────┴──────────┴───────────────┴────────────┴───────────────────────────┴──────────────────────────┤

             ÁÐÞØÍÎÉ ÒÈÔ, ÏÀÐÀÒÈÔ À è Á, ÄÐÓÃÈÅ ÑÀËÜÌÎÍÅËËÅÇÛ                                                                   

                                                                                                                               

│Êðîâü íà            │1. Ïåðâûå   │15 - 20 ìë│Ñòåðèëüíàÿ     │Ñðåäà Ðàïïî-│Øïðèöåì èç ëîêòåâîé âåíû   │Ñîáðàííûé ìàòåðèàë äîñòàâ-│

ãåìîêóëüòóðó        │äíè áîëåçíè │          │ïðîáèðêà èëè   │ïîðò, æåë÷-                           ëÿåòñÿ â ëàáîðàòîðèþ áåç 

                    │2. Íà ïîçä- │5 - 10 ìë │ôëàêîí         íûé áóëüîí è│                           │ïðîìåäëåíèÿ, ëèøü â èñêëþ-│

                    │íèõ ñðîêàõ                           │äð. â ñîîò-                           ÷èòåëüíûõ ñëó÷àÿõ äîïóñ- 

                    │(2 - 3                               │íîøåíèè 1:10│                           │êàåòñÿ õðàíåíèå ìàòåðèàëà │

                    │íåäåëè)                                                                     │íå áîëåå ñóòîê â õîëîäèëü-│

                                                                                                íèêå ïðè òåìïåðàòóðå ïëþñ │

                                                                                                │2 - 4 ãðàäóñà            

                                                                                                                         

│Äëÿ ñåðîëîãè÷åñêèõ  │1. Íà 1-é - │5 - 8 ìë. │Ñòåðèëüíàÿ     │-           │Øïðèöåì èç ëîêòåâîé âåíû. Ó│Ïðè òðàíñïîðòèðîâêå      

│èññëåäîâàíèé (ïàðíûå│3-é äåíü    │Ó äåòåé - │ïðîáèðêà                   │ìàëåíüêèõ äåòåé - èç ñîñó- │ñëåäèòü, ÷òîáû æèäêîñòü íå│

│ñûâîðîòêè)          │2. Íà 7-é - │0,5 - 1,0 │                           äîâ ïàëüöà èëè ìî÷êè óõà   │ñìà÷èâàëà âàòíûå ïðîáêè, è│

                    │14-é äåíü   │ìë                                                              │ïðåäîõðàíÿòü ñîáðàííûé   

                                                                                                │ìàòåðèàë îò çàìåðçàíèÿ.  

                                                                                                │Äîñòàâêà ìàòåðèàëà ïðîèç- │

                                                                                                │âîäèòñÿ â æåñòÿíûõ êîíòåé-│

                                                                                               íåðàõ, ïåíàëàõ, áèêñàõ è 

                                                                                                │äðóãîé òàðå, èñêëþ÷àþùåé 

                                                                                                │ïîâðåæäåíèÿ ïðîáèðîê     

                                                                                                                         

│Èñïðàæíåíèÿ         │Ïðè ïîäîçðå-│Èñïðàæíå- │Ñòåðèëüíàÿ ïðî-│Ãëèöåðèíîâàÿ│Ïðè åñòåñòâåííîé äåôåêàöèè │Ìàòåðèàë ñîïðîâîæäàåòñÿ  

                    íèè íà ñàëü-íèÿ äîëæíû│áèðêà èëè áàíêà│ñìåñü,      │èç ñóäíà, ãîðøêà, ïåëåíêè -│ñïåöèàëüíûì íàïðàâëåíèåì, │

                    ìîíåëëåçíóþñîñòàâëÿòü│ñ êîíñåðâàíòîì │áóôåðíûé    │ñòåðèëüíûì äåðåâÿííûì      │â êîòîðîì óêàçûâàåòñÿ    

                    │èíôåêöèþ - ñ│1/3 îáúåìà│               │ðàñòâîð ôîñ-│øïàòåëåì, ñòåðèëüíîé       │íàçâàíèå ó÷ðåæäåíèÿ,     

                    │ïåðâûõ ÷àñîâ│êîíñåðâàí-               ôîðíîêèñëûõ │ñòåêëÿííîé èëè äåðåâÿííîé  │íàïðàâëÿþùåãî ìàòåðèàë,  

                    çàáîëåâàíèÿ,│òà                       │ñîëåé       │ïàëî÷êîé. Ïðè íàëè÷èè â    ôàìèëèÿ, èìÿ, îò÷åñòâî,  

                    │ïðè òèôî-   │(1 - 2 ã) │               │(pH - 8,0), │èñïðàæíåíèÿõ ãíîÿ è ñëèçè  │âîçðàñò è àäðåñ îáñëåäóå- │

                    ïàðàòèôàõ - │                         │ñåëåíèòîâàÿ │(íî íå êðîâè) âêëþ÷èòü èõ â│ìîãî, äàòà çàáîëåâàíèÿ,  

                    │ñ êîíöà 2-é │                         │ñðåäà îáîãà-│ïîñåâíîé ìàòåðèàë          │äèàãíîç èëè ýïèäåìèîëîãè- │

                    │íåäåëè äî                            ùåíèÿ 5 - 6 │íåïîñðåäñòâåííî èç ïðÿìîé  ÷åñêîå ïîêàçàíèå ê       

                    │íà÷àëà ëå÷å-                         │ìë          │êèøêè âàòíûì òàìïîíîì,     │ïðîâåäåíèþ àíàëèçà. Äàòà è│

                    íèÿ, íå                                          êîòîðûé ìîíòèðóåòñÿ íà     │òî÷íîå âðåìÿ çàáîðà      

                    │ðàíåå äâóõ                                       │ñòåðæåíü èç äåðåâà èëè     │ìàòåðèàëà è ôàìèëèÿ ëèöà, │

                    │äíåé ïîñëå                                       │àëþìèíèåâîé ïðîâîëîêè      ïðîèçâîäèâøåãî çàáîð.   

                    │îêîí÷àíèÿ                                        │ñå÷åíèåì 3 - 4 ìì, äëèíîé  │ëàáîðàòîðèè îáÿçàòåëüíî  

                    │ëå÷åíèÿ                                          │200 ìì è âûñîòîé âàòíîé    │ðåãèñòðèðóåòñÿ òî÷íîå    

                                                                     │÷àñòè íå ìåíåå 50 - 60 ìì  │âðåìÿ äîñòàâêè ìàòåðèàëà 

                                                                                                                          

│Ìî÷à                │Ó áîëüíûõ,  │20 - 30 ìë│Ñòåðèëüíûå     │Íå          │Åñòåñòâåííûì ïóòåì ïîñëå   │Òàê æå                   

                    │íà÷èíàÿ ñ             │áóòûëêè, áàíêè,│èñïîëüçóåòñÿ│òùàòåëüíîãî òóàëåòà ñ                                

                    │êîíöà ïåðâîé│          │ôëàêîíû                    │ñîáëþäåíèåì âñåõ                                    

                    │íåäåëè çàáî-                                     │íåîáõîäèìûõ óñëîâèé,                                

                    ëåâàíèÿ, è ó│                                     èñêëþ÷àþùèõ âíåñåíèå                                

                    ðåêîíâàëåñ-                                     │ïîñòîðîííåé ìèêðîôëîðû                              

                    │öåíòîâ                                                                                               

                                                                                                                         

│Æåë÷ü (äóîäåíàëüíîå │Ó áîëüíûõ â │Ðàçäåëüíî │Ñòåðèëüíûå     │-           │Ïóòåì çîíäèðîâàíèÿ ïðè     │Òàê æå                   

│ñîäåðæèìîå)         │ïåðèîä      │ïîðöèè À, │ïðîáèðêè                   │ïîìîùè äóîäåíàëüíîãî çîíäà │                         

                    ðåêîíâàëåñ- │Á è Ñ                                │ïîëó÷àþò òðè ïîðöèè æåë÷è                           

                    öåíöèè                                           │(À, Á è Ñ)                                          

                                                                                                                         

│Ðâîòíûå ìàññû,      │ ïåðâûå    │Îò 50 äî  │Ñòåðèëüíûå áàí-│-           │-                          │Òàê æå                   

│ïðîìûâíûå âîäû      │÷àñû çàáîëå-│150       êè, øèðîêîãîð- │                                                                

│æåëóäêà             âàíèÿ, â              ëûå ôëàêîíû                                                                   

                    │ïåðâûå äíè                                                                                           

                    │çàáîëåâàíèÿ │                                                                                         

                    │è äàæå íà                                                                                            

                    │7-é - 8-é                                                                                            

                    │äåíü                                                                                                 

                                                                                                                         

│Ãíîé è ýêññóäàò     │ òå÷åíèå   Íåîãðàíè- │Ñòåðèëüíàÿ     │-           │Ñòåðèëüíûì òàìïîíîì,       │Òàê æå                   

│âîñïàëèòåëüíûõ      │âñåãî       ÷åííîå    │ïîñóäà (áàíêè, │            │øïàòåëåì                                            

│î÷àãîâ              │çàáîëåâàíèÿ │          │÷àøêè Ïåòðè)                                                                   

                                                                                                                         

Ïàòîìîðôîëîãè÷åñêîå            │5 - 10 ìë │               │-           │Ñòåðèëüíûì èíñòðóìåíòîì,   │Òàê æå                   

│èññëåäîâàíèå - îðãà-│            │2 - 5 ã                              │èñêëþ÷àÿ âíåøíåå                                    

íû òðóïà (êðîâü èç              │10 ìë                                │çàãðÿçíåíèå. Êðîâü èç                               

│ñåðäöà, ïå÷åíü,                                                      │ñåðäöà è æåë÷ü èç æåë÷íîãî │                         

│ñåëåçåíêà, ïî÷êè,                                                    │ïóçûðÿ áåðóò ñòåðèëüíîé                             

│êîñòíûé ìîçã,                                                        │ïàñòåðîâñêîé ïèïåòêîé,                              

ìåçåíòåðèàëüíûå óçëû│                                                 │ïðåäâàðèòåëüíî îáæèãàÿ                              

│êèøå÷íèêà, îòðåçêè                                                   │ìåñòî ââåäåíèÿ ïèïåòêè                              

òîíêîãî è òîëñòîãî                                                   │ðàñêàëåííûì ñêàëüïåëåì.                             

│êèøå÷íèêà ñ                                                          │Îòðåçêè êèøå÷íèêà âûðåçàþò │                         

│ñîäåðæèìûì)                                                          │ìåæäó äâóìÿ ëèãàòóðàìè.                              

                                                                     │Êóñî÷êè ïàðåíõèìàòîçíûõ                             

                                                                     │îðãàíîâ - ñòåðèëüíûìè                                

                                                                     │íîæíèöàìè, ñêàëüïåëåì                               

                                                                                                                               

                                ÄÈÇÅÍÒÅÐÈß                                                                                      

                                                                                                                               

│Èñïðàæíåíèÿ         │Ñ ïåðâîãî   Èñïðàæíå- │Ñòåðèëüíûå ïðî-│Ãëèöåðèíîâàÿ│Ïðè åñòåñòâåííîé äåôåêàöèè │Òàê æå                    

                    │äíÿ çàáîëå-íèÿ äîëæíû│áèðêè èëè áàíêè│ñìåñü,      │èç ñóäíà, ãîðøêà, ïåëåíêè -│                         

                    âàíèÿ äî    ñîñòàâëÿòü│ñ êîíñåðâàíòîì │áóôåðíûé    │ñòåðèëüíûì äåðåâÿííûì øïà- │                          

                    │íà÷àëà ëå÷å-│1/3 îáúåìà│               │ðàñòâîð ôîñ-òåëåì, ñòåðèëüíîé ñòåêëÿí- │                         

                    íèÿ, íå     êîíñåðâàí-               ôîðíîêèñëûõ │íîé èëè äåðåâÿííîé ïàëî÷-                            

                    │ðàíåå äâóõ  │òà                       │ñîëåé       │êîé. Ïðè íàëè÷èè â èñïðàæ- │                         

                    │äíåé ïîñëå  │(1 - 2 ã) │               │(pH - 8,0), │íåíèÿõ ãíîÿ è ñëèçè (íî íå │                         

                    │îêîí÷àíèÿ                            ñåëåíèòîâàÿ │êðîâè) âêëþ÷èòü èõ â ïîñåâ-│                         

                    │ëå÷åíèÿ                              │ñðåäà       íîé ìàòåðèàë íåïîñðåäñòâåí-│                         

                                                         îáîãàùåíèÿ  │íî èç ïðÿìîé êèøêè âàòíûì                           

                                                         │5 - 6 ìë    │òàìïîíîì                                            

                                                                                                                         

│Ñåðîëîãè÷åñêîå      │1. Íà 1-é - │5 - 8 ìë. │Ñòåðèëüíàÿ     │-           │Øïðèöåì èç ëîêòåâîé âåíû. Ó│Òàê æå                   

│èññëåäîâàíèå êðîâè  │3-é äåíü    │Ó äåòåé - │ïðîáèðêà                   │ìàëåíüêèõ äåòåé - èç                                

│(ÐÀ è ÐÏÃÀ â        │2. Íà 7-é - │0,5 - 1,0 │                           │ñîñóäîâ ïàëüöà, ïÿòêè èëè                           

│äèíàìèêå)           │14-é äåíü   │ìë                                   │ìî÷êè óõà                                           

                                                                                                                         

Ïàòîìîðôîëîãè÷åñêîå            │10 ñì     │Ñòåðèëüíàÿ     │-           │Ñòåðèëüíûì èíñòðóìåíòîì,   │Òàê æå                   

│èññëåäîâàíèå - îðãà-│            │2 - 5 ã   │ïîñóäà (áàíêè, │            │èñêëþ÷àÿ âíåøíèå çàãðÿçíå- │                         

íû òðóïà (êèøå÷íèê, │                      │÷àøêè Ïåòðè)               íèÿ.                                                

ìåçåíòåðèàëüíûå                                                      │Îòðåçêè êèøå÷íèêà âûðåçàþò │                         

│æåëåçû, ïàðåíõèìà-                                                   │ìåæäó äâóìÿ ëèãàòóðàìè.                             

òîçíûå îðãàíû)                                                       │Êóñî÷êè ïàðåíõèìàòîçíûõ                             

                                                                     │îðãàíîâ - ñòåðèëüíûìè                               

                                                                     │íîæíèöàìè, ñêàëüïåëåì                               

                                                                                                                               

       ÏÐÎ×ÈÅ ÊÈØÅ×ÍÛÅ ÈÍÔÅÊÖÈÈ (ÝÍÒÅÐÈÒÛ, ÃÀÑÒÐÎÝÍÒÅÐÈÒÛ, ÊÎËÈÒÛ),                                                            

                        ÒÎÌ ×ÈÑËÅ ÂÛÇÛÂÀÅÌÛÅ ÝÏÊÏ                                                                              

                                                                                                                                    

│Ïðè ÿâëåíèÿõ êèøå÷- │Ñ ïåðâîãî   │1 - 2 ã   │Ñòåðèëüíûå ïðî-│Ãëèöåðèíîâàÿ│Ïðè åñòåñòâåííîé äåôåêàöèè │Òàê æå                    

│íîé äèñôóíêöèè -    │äíÿ çàáîëå- │Îò 50,0 äî│áèðêè èëè áàíêè│ñìåñü,      │èç ñóäíà, ãîðøêà, ïåëåíêè -│                         

│èñïðàæíåíèÿ, ïðè    âàíèÿ äî    │150,0     │ñ êîíñåðâàíòîì │áóôåðíûé    │ñòåðèëüíûì äåðåâÿííûì                                

│ïîÿâëåíèè ðâîòû -   │íà÷àëà ëå÷å-          │Ñòåðèëüíàÿ     │ðàñòâîð ôîñ-│øïàòåëåì, ñòåðèëüíîé                                

│ðâîòíûå ìàññû,      íèÿ.  òå÷å-          │øèðîêîãîðëàÿ   ôîðíîêèñëûõ │ñòåêëÿííîé èëè äåðåâÿííîé                           

│ïðîìûâíûå âîäû      íèå âñåãî             │ïîñóäà         │ñîëåé       │ïàëî÷êîé. Ïðè íàëè÷èè â                             

│æåëóäêà             │ïåðèîäà                              │(pH - 8,0), │èñïðàæíåíèÿõ ãíîÿ è ñëèçè                           

                    │çàáîëåâàíèÿ │                         ñåëåíèòîâàÿ │(íî íå êðîâè) âêëþ÷èòü èõ â│                         

                                                         │ñðåäà       │ïîñåâíîé ìàòåðèàë                                   

                                                         │îáîãàùåíèÿ  │íåïîñðåäñòâåííî èç ïðÿìîé                           

                                                         │5 - 6 ìë    │êèøêè âàòíûì òàìïîíîì                               

                                                                                                                         

│Ïðè ïîðàæåíèè       │Ó áîëüíûõ è │20 - 30 ìë│Ñòåðèëüíûå     │Íå          │Åñòåñòâåííûì ïóòåì ïîñëå   │Òàê æå                   

│ìî÷åâîãî ïóçûðÿ -   ðåêîíâàëåñ-          │áàíêè, áóòûëêè,│èñïîëüçóåòñÿ│òùàòåëüíîãî òóàëåòà ñ ñî-                           

│ìî÷à                │öåíòîâ                │ôëàêîíû                    áëþäåíèåì âñåõ íåîáõîäèìûõ │                         

                                                                     │óñëîâèé, èñêëþ÷àþùèõ âíåñå-│                         

                                                                     íèå ïîñòîðîííåé ìèêðîôëîðû │                         

                                                                                                                         

│Ïðè ïîðàæåíèè       │Ó áîëüíûõ â │Ðàçäåëüíî │Ñòåðèëüíûå     │-           │Ïóòåì çîíäèðîâàíèÿ ïðè     │Òàê æå                   

│æåë÷íîãî ïóçûðÿ -   │ïåðèîä      │ïîðöèè À, │ïðîáèðêè                   │ïîìîùè äóîäåíàëüíîãî çîíäà │                         

│äóîäåíàëüíîå        ðåêîíâàëåñ- │Á è Ñ                                │ïîëó÷àþò òðè ïîðöèè æåë÷è                           

│ñîäåðæèìîå (æåë÷ü)  öåíöèè                                           │(À, Á è Ñ)                                          

                                                                                                                         

│Ïðè ïîäîçðåíèè íà   │ òå÷åíèå   │5 - 10 ìë │Ñòåðèëüíûå     │Ñðåäà Ðàïïî-│Øïðèöåì èç ëîêòåâîé âåíû   │Òàê æå                   

│êîëèáàöèëëÿðíûé     │âñåãî                 │ïðîáèðêè,      │ïîðò, æåë÷- │                                                    

│ñåïñèñ - êðîâü      │çàáîëåâàíèÿ │          │ôëàêîíû        íûé áóëüîí è│                                                    

                                                         │äð. â ñîîò- │                                                    

                                                         íîøåíèè 1:10│                                                    

                                                                                                                         

Ïàòîìîðôîëîãè÷åñêîå            │10 ñì     │Ñòåðèëüíàÿ     │-           │Ñòåðèëüíûì èíñòðóìåíòîì,                            

│èññëåäîâàíèå - îðãà-│            │5 - 10 ìë │ïîñóäà (áàíêè, │            │èñêëþ÷àÿ âíåøíåå                                    

íû òðóïà (ñîäåðæèìîå│            │2 - 5 ã   │÷àøêè Ïåòðè)               │çàãðÿçíåíèå.                                        

│òîíêîãî êèøå÷íèêà,                                                   │Êðîâü èç ñåðäöà áåðóò                               

│êðîâü èç ñåðäöà,                                                     ñòåðèëüíîé ïàñòåðîâñêîé                             

│êóñî÷êè îðãàíîâ                                                      │ïèïåòêîé, ïðåäâàðèòåëüíî                            

│ïå÷åíè, ñåëåçåíêè,                                                   │îáæèãàÿ ìåñòî ââåäåíèÿ                              

│ëåãêîãî, ïî÷åê,                                                      │ïèïåòêè ðàñêàëåííûì ñêàëü- │                         

│ëèìôàòè÷åñêèå óçëû                                                   ïåëåì. Îòðåçêè êèøå÷íèêà                            

│êèøå÷íèêà)                                                           │âûðåçàþò ìåæäó äâóìÿ ëèãà- │                         

                                                                     │òóðàìè. Êóñî÷êè ïàðåíõèìà- │                          

                                                                     òîçíûõ îðãàíîâ - ñòåðèëüíû-│                         

                                                                     │ìè íîæíèöàìè, ñêàëüïåëåì                             

                                                                                                                               

                         ÌÅÍÈÍÃÎÊÎÊÊÎÂÀß ÈÍÔÅÊÖÈß                                                                               

                                                                                                                               

│Ñïèííîìîçãîâàÿ      │Ïðè ïîñòóï- │2 - 5 ìë  │2 ñóõèå        │Íå          │Çàáîð ïðîâîäèòñÿ ñ ñîáëþäå-│Íå äîïóñêàåòñÿ õðàíåíèå. 

│æèäêîñòü            ëåíèè                 │ñòåðèëüíûå     èñïîëüçóåòñÿ│íèåì âñåõ ïðàâèë àñåïòèêè  │Äîñòàâêà â ëàáîðàòîðèþ   

                    │áîëüíîãî â            │ïðîáèðêè                   │(çàáîð ïðîâîäèòü â ìàñêå-  │ïðîèçâîäèòñÿ íåìåäëåííî, â│

                    │ñòàöèîíàð                                        ðåñïèðàòîðå, íå êàñàòüñÿ   │óñëîâèÿõ, ïðåäóïðåæäàþùèõ │

                                                                     │ðóêàìè êðàåâ êàíþëè, èãëû, │îõëàæäåíèå.              

                                                                     │êðàåâ ïðîáèðîê, íå ïåðåëè- │Åñëè ïóíêòèðîâàíèå       

                                                                     âàòü æèäêîñòü ÷åðåç êðàé).ïðîâîäèòñÿ âå÷åðîì èëè   

                                                                     │Ïåðâóþ ïîðöèþ ëèêâîðà      │íî÷üþ, ïðîáèðêè ñ        

                                                                     │(îêîëî 1 ìë) ïîìåùàþò â    │ìàòåðèàëîì ìîæíî ñîõðàíÿòü│

                                                                     │ñóõóþ ïðîáèðêó (äëÿ        │äî íà÷àëà ðàáîòû         

                                                                     │êëèíè÷åñêîãî èññëåäîâàíèÿ).ëàáîðàòîðèè â òåðìîñòàòå 

                                                                     │Âåñü îñòàëüíîé ëèêâîð      │ïðè òåìïåðàòóðå 37°      

                                                                     │ïîìåùàþò âî âòîðóþ ïðîáèðêó│                         

                                                                                                                         

│Êðîâü               │Ñ ìîìåíòà   │5 - 10 ìë │Ôëàêîí ñ 50 ìë │-           │Êðîâü çàáèðàþò èç âåíû ñ   │Äîñòàâêà â ëàáîðàòîðèþ   

                    │çàáîëåâàíèÿ │äëÿ ãåìî- │ïîëóæèäêîãî                │ñîáëþäåíèåì âñåõ ïðàâèë    │íåìåäëåííî, â óñëîâèÿõ,  

                                │êóëüòóðû  àãàðà                      │àñåïòèêè âî ôëàêîí ñ       ïðåäóïðåæäàþùèõ îõëàæäåíèå│

                                          │2 ïðåäìåòíûõ               │ïîëóæèäêèì àãàðîì. Êàïëþ                            

                                          │ñòåêëà                     │êðîâè íàíîñÿò íà ïðåäìåòíîå                         

                                                                     │ñòåêëî è ñ ïîìîùüþ âòîðîãî │                         

                                                                     │ñòåêëà äåëàþò ìàçîê (àíàëî-│                         

                                                                     ãè÷íî ìàçêó äëÿ ïîäñ÷åòà                            

                                                                     │ôîðìåííûõ ýëåìåíòîâ êðîâè).│                         

                                                                     │Íà äðóãîì ïðåäìåòíîì ñòåêëå│                         

                                                                     │äåëàþò äâà îòïå÷àòêà (òîëñ-│                         

                                                                     òûå êàïëè) è, íå ðàñòèðàÿ, │                         

                                                                     │ïîäñóøèâàþò íà âîçäóõå.                             

                                                                     │Ðåêîìåíäàöèè 1 Âñåñîþçíîé                           

                                                                     │íàó÷íî-ïðàêòè÷åñêîé êîíôå- │                         

                                                                     ðåíöèè ïî ìåíèíãîêîêêîâûì                           

                                                                     │èíôåêöèÿì. Êàóíàñ, 1973.                            

                                                                     Îïóáëèêîâàíû â ñáîðíèêå                             

                                                                     │ìàòåðèàëîâ êîíôåðåíöèè.                             

                                                                     │Êàóíàñ, 1973 ã.                                     

                                                                                                                         

│Íîñîãëîòî÷íàÿ ñëèçü │Ïðè îáðàùå- │-         │Âàòíûé òàìïîí, │Íå          │Çàáîð íîñîãëîòî÷íîé ñëèçè  │Òðàíñïîðòèðîâêà íåçàñåÿí- │

                    íèè ê âðà÷ó.│          │âìîíòèðîâàííûé │èñïîëüçóåòñÿ│ïðîâîäÿò íàòîùàê èëè íå    íûõ òàìïîíîâ íå äîïóñêàåò-│

                    │Ñ öåëüþ               │â ïðîáèðêó, ïðè            │ðàíåå 3 - 4 ÷àñîâ ïîñëå    ñÿ. Ñîáðàííûé ìàòåðèàë   

                    │êîíòðîëÿ              │âçÿòèè ìàòåðè-            │ïðèåìà ïèùè èëè ïèòüÿ.     │çàñåâàþò ó ïîñòåëè áîëüíî-│

                    │ëå÷åíèÿ               àëà èçãèáàåòñÿ │            │Øïàòåëåì, íàõîäÿùèìñÿ â    ãî íà òåïëûå ÷àøêè ñî ñâå-│

                    │ïîñëå èñ÷åç-          │ïîä óãëîì â                │ëåâîé ðóêå, ôèêñèðóþò      æåïðèãîòîâëåííîé ïèòàòåëü-│

                    íîâåíèÿ êëè-│          │110 - 120°                 │êîðåíü ÿçûêà, îäíîâðåìåííî │íîé ñðåäîé ïóòåì òùàòåëü- │

                    íè÷åñêèõ                                         │òàìïîí (â ïðàâîé ðóêå) ïî  íîãî âòèðàíèÿ ìàòåðèàëà â

                    │ÿâëåíèé è íå│                                     │øïàòåëþ çàâîäÿò ïîä ìÿãêîå │ïîâåðõíîñòü ñðåäû. Òàìïîí │

                    │ðàíåå ÷åì                                        │íåáî â íîñîãëîòêó,         │ïîâîðà÷èâàþò âñåìè ñòîðî- │

                    │÷åðåç òðîå                                       │ïîâîðà÷èâàþò êîíöîì ââåðõ è│íàìè. Ìàòåðèàë îò îäíîãî 

                    │ñóòîê ïîñëå │                                     äåëàþò äâà øòðèõà ñâåðõó   │ëèöà çàñåâàþò íà ñåêòîð  

                    │îêîí÷àíèÿ                                        │âíèç. Íàäàâëèâàíèå øïàòåëåì│(1/4 - 1/6) ÷àøêè ñ ðèñòî-│

                    │ëå÷åíèÿ                                          │íà êîðåíü ÿçûêà è çàáîð    ìèöèíîâîé ñðåäîé, çàòåì íà

                    │àíòèáèîòèêà-                                     │ìàòåðèàëà òàìïîíîì äîëæíû  │1/2 - 1 ÷àøêó ñ ñûâîðîòî÷-│

                    │ìè. Ìàòåðèàë│                                     │áûòü îäíîâðåìåííûìè.       íûì àãàðîì. Ïðè îòñóòñòâèè│

                    │çàáèðàþò                                         │Òàìïîí èçâëåêàþò ïî        ðèñòîìèöèíà ìàòåðèàë îò  

                    │äâóêðàòíî ñ                                     │øïàòåëþ, íå êàñàÿñü çóáîâ, │îäíîãî ëèöà ìîæíî çàñåÿòü │

                    │èíòåðâàëîì â│                                     │ñëèçèñòîé ùåê, ÿçûêà       │íà äâå ÷àøêè ñ ñûâîðîòî÷- │

                    │1 - 2 äíÿ                                                                   íûì àãàðîì. Çàñåÿííûå    

                                                                                                │÷àøêè òðàíñïîðòèðóþòñÿ â 

                                                                                                │ëàáîðàòîðèþ íåìåäëåííî, â

                                                                                                óñëîâèÿõ, ïðåäóïðåæäàþùèõ │

                                                                                                │îõëàæäåíèå               

                                                                                                                         

│Òðóïíûé ìàòåðèàë    │Ïðîèçâîäèòü │-         │Ñòåðèëüíûå áàí-│-           │Êóñî÷êè òêàíåé è îðãàíîâ ñ │Ìàòåðèàë äîñòàâëÿþò â    

│(êðîâü, êóñî÷êè     │èññëåäîâàíèå│          êè ñ ïðèòåðòûìè│            │ïîìîùüþ ñòåðèëüíîãî ïèíöåòà│ëàáîðàòîðèþ â óñëîâèÿõ,  

│îðãàíîâ, ãíîé ñ     òðóïíîãî              │ïðîáêàìè, ñóõèå│            │ïîìåùàþò â áàíêè. Êðîâü,   èñêëþ÷àþùèõ îõëàæäåíèå   

│ìîçãîâûõ îáîëî÷åê)  │ìàòåðèàëà             │ñòåðèëüíûå ïðî-            │ãíîé îòáèðàþò ñ ïîìîùüþ                             

                    │èìååò ñìûñë │          │áèðêè, ïðîáèðêè│            ñòåðèëüíûõ ñòåêëÿííûõ òðó- │                         

                    │òîëüêî â              │ñ âìîíòèðîâàí-            │áîê è ïîìåùàþò â ïðîáèðêè; │                         

                    │ïåðâûå ÷àñû │          íûìè â íèõ âàò-            │äëÿ ýòèõ æå öåëåé ìîæíî èñ-│                         

                    │ïîñëå ñìåð-          íûìè òàìïîíàìè │            │ïîëüçîâàòü âàòíûå òàìïîíû, │                         

                    òè, ïîêà íå │                                     │âìîíòèðîâàííûå â ïðîáèðêè                           

                    │ïðîèçîøëî                                                                                            

                    │îñòûâàíèå                                                                                             

                    │òðóïà                                                                                                

                                                                                                                                

                            ÊÎÊËÞØ È ÏÀÐÀÊÎÊËÞØ                                                                                

                                                                                                                                

│Íîñîãëîòî÷íàÿ ñëèçü │Ïðè ïåðâè÷- │-         │Âàòíûé òàìïîí, │Ìîæíî ïðèìå-│Çàáîð ìàòåðèàëà            │Ìàòåðèàë, çàáðàííûé ñóõèì │

                    │íîì îáðàùå-          │âìîíòèðîâàííûé │íÿòü òàìïîí,│ïðîèçâîäèòñÿ íàòîùàê èëè íå│çàäíåãëîòî÷íûì òàìïîíîì, 

                    íèè ê âðà÷ó │          │â ïðîáèðêó, ïðè│óâëàæíåííûé │ðàíåå 3 - 4 ÷àñîâ ïîñëå    │äîëæåí áûòü íåìåäëåííî   

                    │ïî ïîâîäó             │âçÿòèè ìàòåðè- │ôîñôàòíûì   │ïðèåìà ïèùè èëè ïèòüÿ.     │çàñåÿí íà ÷àøêè ñ ïèòà-  

                    │êàøëÿ - äî            àëà èçãèáàåòñÿ │áóôåðîì ñ   │Òåõíèêà çàáîðà ìàòåðèàëà   │òåëüíîé ñðåäîé. Òðàíñïîð- │

                    │íà÷àëà ëå÷å-          │ïîä óãëîì â    │óãëåì <*>.  │ñóõèì è âëàæíûì òàìïîíàìè  òèðîâêà òàìïîíà íå äîïóñ- │

                    íèÿòå÷å-│          │110 - 120°     │Òàêîé òàìïîí│îäèíàêîâà. Øïàòåëåì,       │êàåòñÿ.                  

                    íèå 10 - 14 │                         │ìîæåò áûòü  │íàõîäÿùèìñÿ â ïðàâîé ðóêå, │Ìàòåðèàë ñ îäíîãî òàìïîíà │

                    │äíåé îò                              èñïîëüçîâàí │ôèêñèðóþò êîðåíü ÿçûêà,    │çàñåâàþò ïîñëåäîâàòåëüíî â│

                    │íà÷àëà çàáî-                         │â òå÷åíèå   │îäíîâðåìåííî òàìïîí (â     │äâå ÷àøêè Ïåòðè ñî ñïåöè- │

                    ëåâàíèÿ).                            │2 - 3 äíåé  │ïðàâîé ðóêå) ïî øïàòåëþ    àëüíîé ïèòàòåëüíîé ñðåäîé,│

                    │Ìàòåðèàë                             │ñî äíÿ      │çàâîäÿò çà êîðåíü ÿçûêà,   │òùàòåëüíî âòèðàÿ åãî ñíà- │

                    │çàáèðàþò                             │ïîëó÷åíèÿ â │ïîâîðà÷èâàþò êîíöîì âíèç è │÷àëà ïî ïåðèôåðèè ÷àøêè, 

                    │äâàæäû - äâà│                         │ëàáîðàòîðèè │äåëàþò äâà øòðèõà ïî çàäíåé│çàòåì â öåíòðå (ìàêñèìàëü-│

                    │äíÿ ïîäðÿä                           │(ïðè óñëîâèè│ñòåíêå ãëîòêè. Òàìïîí      │íî èñïîëüçóÿ âñþ ïîâåðõ- 

                    │èëè ÷åðåç                            │õðàíåíèÿ ïðè│èçâëåêàþò èç ïîëîñòè ðòà,  íîñòü ïèòàòåëüíîé ñðåäû). │

                    │äåíü                                 òåìïåðàòóðå │íå êàñàÿñü ñëèçèñòîé ÿçûêà,│Ñòåêëÿííûì øïàòåëåì òùà- 

                                                         │ïëþñ        │ùåê, ìèíäàëèí. Ìåòîä çàáîðà│òåëüíî ðàñòèðàþò ìàòåðèàë │

                                                         │4 - 6 °Ñ).  │ìàòåðèàëà êàøëåâûìè ïëàñ-  │â öåíòðå ÷àøêè.          

                                                         │Ìåòîä àïðî- │òèíêàìè èñïîëüçóþò òîëüêî â│ ñëó÷àå ïðèìåíåíèÿ óâëàæ-│

                                                         áèðîâàí â   │ñëó÷àå ñïàçìàòè÷åñêîãî êàø-íåííîãî òàìïîíà ïîñëåäíèé │

                                                         │ëàáîðàòîðèè │ëÿ è ïðèìåíÿþò ïàðàëëåëüíî │äîëæåí áûòü äîñòàâëåí â  

                                                         Ìîñêîâñêîé  │ñ ìåòîäîì àêòèâíîãî çàáîðà │ëàáîðàòîðèþ íå ïîçäíåå 3 -│

                                                         îáëàñòíîé   │òàìïîíîì. Ó äåòåé ïåðâîãî  │4 ÷àñîâ ñ ìîìåíòà âçÿòèÿ 

                                                         │ÑÝÑ         │ãîäà æèçíè âñåãäà ñëåäóåò  │ìàòåðèàëà. ×àøêè ñ ïîñåâà-│

                                                                     │ïîëüçîâàòüñÿ çàäíåãëîòî÷íûì│ìè äîñòàâëÿþòñÿ â ëàáîðà- │

                                                                     │òàìïîíîì                   │òîðèþ â óñëîâèÿõ, èñêëþ÷à-│

                                                                                               þùèõ îõëàæäåíèå          

                                                                                                                               

                                 ÄÈÔÒÅÐÈß                                                                                      

                                                                                                                               

│Ñëèçü è ïëåíêè èç   │Íåìåäëåííî  │-         │Ñòåðèëüíûå     │Íà ñëó÷àé   │Ñëèçü èç çåâà è íîñà çàáè- │Òàìïîíû ñ ìàòåðèàëîì     

│çåâà (ñ îáåèõ       │ïðè ïåðâîì            │ïðîáèðêè ñ     òðàíñïîðòè-ðàþò îòäåëüíûìè òàìïîíàìè, │äîëæíû áûòü äîñòàâëåíû â 

│ìèíäàëèí) è íîñà.   ïîäîçðåíèè            âìîíòèðîâàííûìè│ðîâêè íà    │âìîíòèðîâàííûìè â ðàçíûå   │ëàáîðàòîðèþ íå ïîçäíåå 2 -│

│Ïðè äèôòåðèè ðåäêèõ │íà çàáîëåâà-          │â íèõ ñóõèìè   │äàëüíèå     │ïðîáèðêè è ïðîìàðêèðîâàí-  │3 ÷àñîâ ñ ìîìåíòà çàáîðà â│

│ëîêàëèçàöèé (ãëàç,  íèå äèôòå-            │âàòíûìè        │ðàññòîÿíèÿ  íûìè "çåâ - íîñ". Ìàòåðèàë │óñëîâèÿõ, ïðåäîõðàíÿþùèõ 

│óõî, ðàíà, êîæà,    ðèéíîé ýòèî-│          │òàìïîíàìè      ïðèìåíÿþò   │áåðóò íàòîùàê èëè íå ðàíåå │îò ïåðåîõëàæäåíèÿ.        

│âëàãàëèùå) çàáèðàþò │ëîãèè                                │òàêèå æå    │÷åì ÷åðåç 2 ÷àñà ïîñëå åäû.│Óâëàæíåííûå òàìïîíû      

│ìàòåðèàë ñ                                               │òàìïîíû, íî │Ïîñëå ïðîâåäåííîãî êóðñà   │ðåêîìåíäóåòñÿ èñïîëüçîâàòü│

│ïîðàæåííûõ ó÷àñòêîâ │                                     │óâëàæíåííûå │ëå÷åíèÿ àíòèáèîòèêàìè ìàçêè│ïðè òðàíñïîðòèðîâêå íà   

│è îäíîâðåìåííî èç                                        │5-ïðîöåíòíûì│ñëåäóåò áðàòü íå ðàíåå ÷åì │äàëüíèå ðàññòîÿíèÿ       

│çåâà è íîñà                                              │ðàñòâîðîì   │÷åðåç 3 äíÿ ïîñëå îêîí÷àíèÿ│                         

                                                         │ãëèöåðèíà   │ëå÷åíèÿ. Çàáîð ìàòåðèàëà èç                          

                                                         │èëè ïðîáèðêè│çåâà ïðîâîäèòñÿ îäíèì                               

                                                         │ñî ñðåäîé   │òàìïîíîì ñ îáåèõ ìèíäàëèí                           

                                                         │îáîãàùåíèÿ.ïóòåì ëåãêîãî íàäàâëèâàíèÿ │                         

                                                         │Òàìïîí â    │íà íèõ ïðè îáÿçàòåëüíîé                             

                                                         ïîñëåäíåì   │ôèêñàöèè ÿçûêà øïàòåëåì.                            

                                                         ñëó÷àå      │Òàìïîí íå äîëæåí êàñàòüñÿ                           

                                                         │ìîíòèðóåòñÿ │ÿçûêà, ñëèçèñòîé ùåê è                              

                                                         │âûøå ñðåäû  │çóáîâ. Ïðè íàëè÷èè íàëåòîâ │                         

                                                         │îáîãàùåíèÿ, │ìàòåðèàë çàáèðàþò íà ãðàíè-│                         

                                                         │ïîñëå çàáîðà│öå ïîðàæåííûõ è çäîðîâûõ                            

                                                         │ìàòåðèàëà   │òêàíåé, ñðûâàòü ïëåíêè íå                           

                                                         ïîãðóæàåòñÿ │ðåêîìåíäóåòñÿ. Äðóãèì òàì- │                         

                                                         │â íåå       ïîíîì çàáèðàþò ìàòåðèàë èç                         

                                                                    │íîñà, ââîäÿ òàìïîí â íîñî- │                         

                                                                     │âûå õîäû íà ãëóáèíó 1 -                             

                                                                     │1,5 ñì                                              

└────────────────────┴────────────┴──────────┴───────────────┴────────────┴───────────────────────────┴──────────────────────────┘

 

--------------------------------

<*> Ðåöåïò îïóáëèêîâàí â æóðíàëå "Ëàáîðàòîðíîå äåëî", N 11, 1973.

 

 

 


 
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