Несмотря на свою эффективность, антибиотики вызывают много вопросов. Большая часть педиатров не рекомендуют их применять в детском возрасте, но при некоторых заболеваниях без них просто не обойтись. Бывают ситуации, когда у ребенка после укола антибиотика появляется шишка. Это вызывает беспокойство у родителей. В таком случае обязательна консультация у врача, который определит причину образования и тактику лечения. Но не стоит сильно переживать, если уплотнение безболезненно и не доставляет ребенку дискомфорта.
Преимущества уколов
Наиболее подходящими лекарственными формами для введения антибиотиков детям являются суспензии или разводимые порошки. Их используют для внутреннего и наружного применения, а также для инъекций, т.е. уколов. Также такой способ введения лекарств называется парентеральным. Главное преимущество уколов заключается в том, что они подходят для детей любого возраста, начиная с рождения. Далеко не каждый малыш может проглотить капсулы и таблетки, поэтому нужно искать подходящие альтернативы.
Другие важные особенности антибактериальных средств в форме уколов:
- Не требуют участия пациента: ребенок может находиться без сознания, в тяжелом состоянии или просто занят игрушками;
- Высокая способность к усвоению. Больше 90% лекарства доходит до места его действия в организме ребенка. К тому же, инъекционные формы антибиотиков дают эффект быстрее, чем оральное применение. Это крайне важно в чрезвычайных ситуациях, когда нет времени ждать.
- Так как при парентеральном введении антибиотики минуют желудочно-кишечный тракт, то они абсолютно безопасны при заболеваниях органов пищеварения и печени.
- Не требуют ограничения питания во время терапии, потому что употребляемая пища никак на это не влияет.
- Попадая в организм, антибиотик быстро разносится через кровь прямо в очаг скопления бактерий.
- Лекарство практически не раздражает желудок, микрофлора кишечника нарушается только при приеме очень сильных антибиотиков.
Стоит отметить, что иногда пациенты после прививки обнаруживают уплотнение под кожей. Эта шишка может быть связана с неправильным введением препарата внутрь мышцы или с самим лекарством. Существуют антибиотики, которые колют еженедельно и даже ежемесячно. Одной инъекции достаточно, чтобы активные компоненты проникли глубоко в организм и воздействовали непосредственно на причину болезни. Из-за своего сильного действия, антибиотики в первые дни после укола накапливаются, образуя шишку. В этом нет ничего страшного, потому что такое образование рассосется само. Если появления бугорка обусловлено другими причинами, то нужно разобраться в этом более подробно.
Правила проведения внутривенной инъекции
Перед процедурой нужно тщательно вымыть руки, насухо вытереть полотенцем и обработать обеззараживающим средством. Сверху надеваются стерильные перчатки и обрабатываются бинтом, смоченным в спирте. Затем проверяется срок годности препарата и его название, чтобы не возникла ошибка при введении.
Многие антибиотики для парентерального применения выпускают в виде кристаллического порошка. Его нужно развести с помощью стерильных растворителей. Наиболее часто используется новокаин, который не только обезболивает, но и задерживает в организме пенициллины. В свою очередь, антибиотики дозируют в ЕД – единицах действия. Для детей достаточно 1 мл. растворителя на 200 000 ЕД лекарства. Это разведение 1:1 (малые дозы антибиотика).
Затем указанный объем препарата вкалывают внутривенно или внутримышечно. Чаще всего делают укол в вену локтевого сгиба, а при необходимости и в другие места, например вены на внешней стороне ладони. На ногах никогда не делают инъекции, потому что существует риск образования тромба и воспаления стенок вен.
Перед тем, как вводить препарат, немного выше места укола затягивают жгут, который сдавливает вены. Также нужно проверить пульс на запястье и убедиться, что артериальная кровь циркулирует нормально. Если вена выступает слабо и в нее трудно попасть, пациент должен несколько раз сжать и разжать кулак.
Если процедура была проведена неверно, есть большая вероятность появления таких осложнений:
- попадание внутрь кровеносных сосудов некоторого количества воздуха, развитие воздушной эмболии;
- гематома в результате повреждения сосудов;
- тромбоз из-за частых инъекций в одну и ту же вену.
Основной список современных антибиотиков
Как таковых «детских» антибиотиков не существует. В детском и взрослом возрасте назначают одинаковые антибактериальные средства, но есть определенные формы выпуска, которые наиболее подходят для малышей (например, суспензии).
Самые популярные лекарства, назначаемые детям:
- Амоксициллин – гранулы для приготовления суспензии. Лекарство относится к пенициллинам широкого спектра действия. Разрешено даже новорожденным. Лечение длиться до 2-х недель.
- Аугментин – порошок для оральной суспензии. Совмещает антибиотики пенициллинового ряда и ингибиторы бета-лактамазы. Дают детям с 3-х месяцев.
- Цефуроксим – порошок для приготовления раствора для инъекций. Обладает высокой активностью в отношении большинства бактерий. Допустим в любом возрасте.
- Амоксиклав. Имеет множество лекарственных форм: таблетки, порошок для приготовления суспензии и порошок для внутривенной инфузии. Состоит из пенициллина и клавулановой кислоты. Длительность терапии составляет от 5 до 14 дней.
- Экоклав – таблетки в пленочной оболочке и сухое вещество для суспензии. По фармакологическому действию похож на Амоксиклав.
- Флемоксин Солютаб – противомикробные таблетки для системного применения. Разрешены с рождения. Как побочные эффекты, были отмечены расстройства кишечника и изменение вкуса.
- Сумамед – желатиновые капсулы, которые относятся к макролидным антибиотикам. Препарат подавляет синтез белков в болезнетворных микроорганизмах. Следует применять детям с массой тела ≥45 кг.
- Макропен – гранулы для оральной суспензии. Во флакон с гранулами добавить100 мл кипяченой воды. Емкость встряхнуть. Употреблять перед приемом пищи. Для детей дозировка рассчитывается по формуле 20-40 мг*кг массы тела.
- Зиннат – таблетки, покрытые оболочкой. Угнетают синтез клеточной оболочки бактерий. Предназначены для лечения инфекций у взрослых и детей старше 3-х месяцев.
- Супракс – таблетки, устраняющие инфекционно-воспалительные заболевания. В такой форме разрешены от 12 лет, а для детей меньшего возраста рекомендуется прием суспензии для точного дозирования.
- Кларитромицин – таблетки в пленочной оболочке. Для детей от 12 лет.
Прием антибиотиков должен осуществлять под контролем врача. Несоблюдение рекомендаций специалиста и инструкции к препарату приводит к серьезным последствиям и ухудшению здоровья.
Методы лечения постинъекционных уплотнений
Нередко родители жалуются, что у их детей после укола антибиотика появляется подкожное уплотнение. В медицинской практике оно получило название инфильтрат. Причины постинъекционных шишек могут скрываться в следующем:
- неправильная длина иглы (например, для людей с лишним весом и толстым жировым слоем не подойдут иглы стандартного размера);
- напряжение мышц во время укола;
- повреждение нервных волокон (человек ощущает «стреляющую» боль, онемение);
- введение масляных субстанций, которые долго рассасываются;
- аллергия на компоненты антибиотика;
- быстрое введение антибиотика, приводящее к его скоплению под кожей.
Последняя причина – не опасна для здоровья. Со временем от шишки не останется и следа. Поводом для беспокойства является нагноение, отечность, увеличение температуры и общее ухудшение самочувствия. В таком случае необходимо заняться лечением шишки.
Если уплотнение не болезненно, а только выглядит некрасиво, достаточно медикаментозной терапии. Подойдут гели и мази для внешнего применения с гепарином или троксерутином. С их помощью уменьшаются отеки тканей, разжижается кровь и снимается воспаление. Есть много препаратов на выбор:
- Мазь Траумель – оказывает противовоспалительное и противоэкссудативное действие, активизирует защитные силы организма.
- Мазь Вишневского – антибактериальное средство, ускоряющее процессы регенерации тканей. Прикладывают на шишку на пару часов. За это время мазь вытягивает гнойный экссудат и лечит нарывы.
- Гель Лиотон – снимает отек и помогает при осложнениях неправильных инъекций.
- Гель Троксевазин – относится к ангиопротекторам и капилляростабилизирующим лекарствам.
- Мазь арники – не обладает ярко выраженным эффектом, но ускоряет рассасывание гематом.
- Йод – используют для рисования сеточки на месте шишки. У детей полоски должны быть очень тонкими, чтобы не появились ожоги на коже. Процедуры проводятся 1 раз в 2 дня, после каждой из них место смазывается детским кремом. Если в организме ребенка избыток этого элемента, то такое лечение негативно повлияет на работу щитовидной железы. Помогает только в первые дни появления проблемы.
- Сульфат магния – расслабляет мускулатуру и нормализует метаболизм. В растворе смачивают салфетку и прикладывают к уплотнению перед сном. Можно зафиксировать бинтом или лейкопластырем. Наутро снять.
Важно! Накожный раствор Димексид не включен в этот список, потому что имеет множество противопоказаний и побочных эффектов. Вреда для организма будет намного больше, чем пользы, если нарушить хотя бы одно из указаний. Для детей это лекарство точно не подходит.
Еще один действенный способ – физиотерапевтические процедуры. Их делают в салоне квалифицированные специалисты. Однако, все оборудование легко приобрести и можно заниматься лечением самостоятельно. Для пациентов с постинъекционными шишками полезны:
- массажи с помощью электрических массажеров;
- обеззараживающие процедуры;
- электрофорез с гидрокортизоном (кортикостероид для применения в дерматологии);
- рефлектор Минина, или «синяя лампа»;
- ультразвуковая терапия;
- УВЧ-терапия.
Стоит отметить, что многие специалисты не рекомендуют делать прогревающие процедуры. Так может появиться воспаление или изменение структуры шишки (ее утолщение и окаменение). Это только ухудшит ситуацию, и вместо рассасывания, уплотнение станет твердым и будет доставлять еще больше неудобств.
Народные методы лечения
Рецепты народной медицины также используют для лечения постинъекционных уплотнений. Желательно их совмещать с традиционными методами лечения, чтобы достичь желаемого эффекта в короткое время. Важно: перед применением лекарственных трав нужно узнать, нет ли на них аллергии.
Обратить внимание нужно на такие народные рецепты:
- Компрессы на спирту. Ускоряют исчезновение шишки. Нужно применять с особой осторожностью в течение 2-3 часов, чтобы не повредить кожу. Спиртовой ожог проявляется в виде шелушения. Чтобы не допустить это, после каждой процедуры уплотнение смазывают кремом. Также можно добавить растертый аспирин в соотношении 1 таблетка на 2 л жидкости.
- Свежий лист капусты прикладывают к шишке, предварительно размягчив его. Менять лист на новый нужно 3-4 раза в сутки. Есть другой вариант – разогреть в кипятке капустный лист и намазать жидким медом. Способ использования тот же. Чтобы было удобно передвигаться, его можно примотать пленкой, а ночью поверх надеть теплую пижаму. Нужно постоянно находиться в тепле и не перемерзать.
- Марлевую ткань пропитывают соком алоэ. Затем прикладывают к больному месту и фиксируют с помощью лейкопластыря. Также с соком смешивают мед и растирают инфильтрат.
Важно! Если уплотнение не проходит долгое время, то от народной медицины стоит отказаться. На запущенных стадиях уплотнение вылечить еще труднее, поэтому не нужно рисковать здоровьем.
Обычная пищевая пленка – альтернатива сложным рецептам. Благодаря ней тепло от тела человека сохраняется и согревает припухлость. Не требует фиксации, поэтому можно расслабиться. Прогревать место уколов можно не только после появления инфильтрата, но и для их профилактики. Это повысит биодоступность антибиотика.
Таким образом, шишка после укола антибиотика не является серьезным осложнением. От нее можно избавиться с помощью медикаментов и физиопроцедур. Но без консультации врача не обойтись: в случае нарыва и воспаления нужен комплексный подход к лечению.
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Капустный лист приложи, йодом не надо бы грудничку делать… Только правильно его приложи и результат на лицо!
Как лечить шишки от уколов:
1. Аккуратно массируйте место укола, чтобы улучшить местное кровообращение и ускорить рассасывание инфильтрата.
2. Самое простое и всем известное средство – йодная сетка. Рисуйте сеточку ватной палочкой, смоченной в растворе йода. Необходимо делать эту процедуру 2-3 раза в день.
3. Следующее по популярности средство – прикладывание на ночь сочного капустного листа или листа алоэ (нужно разрезать лист и приложить сочной стороной). Известен этот способ еще от наших бабушек, он действительно эффективен, и многие медики рекомендуют его для лечения воспалительных постинъекционных инфильтратов.
4. Компресс с «димексидом», разведенным с водкой в соотношении 1:4. Предварительно желательно смазать кожу противовоспалительным кремом. Несмотря на свой неприятный специфический запах, «димексид» является очень эффективным средством и, к тому же, стоит недорого, что тоже немаловажно.
5. Местное использование препаратов троксерутина или гепариновой мази. Она снимет воспаление и обезболит зону с шишкой. Предлагаются также эффективные и удобные в использовании гели, также изготовленные на основе гепарина.
6. Отлично зарекомендовала себя в лечении воспалительных процессов, какими и являются «шишки» от уколов, гомеопатическая мазь на основе трав «Траумель С». Благодаря своему уникальному составу эта мазь в кратчайшие сроки способна устранить шишки после уколов на ягодицах. Аналогичным действием обладают и другие гомеопатические мази на основе арники.
Перечисленные выше народные советы и лекарственные средства при своевременном начале лечения помогут избавиться от «шишек» от уколов и избежать неприятных осложнений.
И, напоследок, хочется сказать, пожалуйста, доверьтесь рекомендациям квалифицированных врачей и используйте проверенные временем средства. Не стоит выискивать в интернете и тестировать на себе сомнительные советы приложить к «шишке» кусок сала или компресс из мочи. Если только в качестве шутки! Будьте здоровы!
Вакцинация для малыша — серьёзное испытание. Организм ребёнка ещё не окреп настолько, чтобы дать отпор внешнему «врагу» – инфекции. Большинство маленьких пациентов показывает постинъекционные реакции: кто-то в большей степени, кто-то в меньшей.
Шишка после прививки АКДС — частый случай. Родители наслышаны о такой «неприятности» и опасаются её появления. Но так ли опасна шишка, может быть для беспокойства нет причин?
Осталось уплотнение после прививки АКДС у ребенка на ножке: норма или осложнение?
АКДС — сложная прививка, имеющая в составе анатоксины (ослабленные яды бактерий) столбняка и дифтерии и «мёртвые» коклюшные микробы.
То есть по сути, это токсоидный препарат. В организм одновременно поступают сразу 3 вида антигенов от различных инфекций. Для неокрепшей иммунной системы малыша — это непростое испытание, и организм начинает действовать. Что же происходит после введения укола в ножку ребёнка?
Иммунитет «отвечает» на появление патогенных микроорганизмов выработкой защитных телец – лимфоцитов. Начинается своего рода борьба – сложная химико-биологическая реакция, призванная победить инфекционные элементы и сформировать длительную защиту от них – иммунитет.
А внешне это противостояние выражается в уплотнении места вакцинации, называемое «шишкой». И здесь следует чётко различать обычный ожидаемый «ответ» организма на введённые вирусы и серьёзные осложнения после укола. Реакция на АКДС диагностируется у каждого 10-го ребёнка.
В основном это происходит на 2-ом и 3-ем прививании, что нормально. Так иммунная система «откликается» на внедрение враждебных патогенов. Следует быть готовым к подобной реакции.
Покраснение и незначительное уплотнение (до 2-х см) считаются нормой для такого рода вакцины. Как не спутать обычную симптоматику с возможным осложнением?
Следует знать, что общая реакция на введение любого инактивированного препарата (каким является и АКДС) быстро появляется (в первый день) и проходит через 3-е суток. К этому моменту малыш уже должен чувствовать себя нормально. Если негативная симптоматика затягивается – следует искать причину.
Если после прививки АКДС у ребенка шишка в месте укола, что делать?
Но вот укол сделан, и шишка всё-таки появилась. Как поступить? Важно знать, что уплотнения имеют различную природу. Например, инфильтрата не стоит пугаться. Он появляется потому, что введённому препарату нужно некоторое время, чтобы рассосаться.
Лечение здесь не нужно. Врачи советуют наносить на шишечку (если она безболезненна) йодную сетку. Такой простой приём поможет уплотнению быстрее исчезнуть.
Можно погреть место укола, например, солевыми или электрическими грелками. Но без консультации педиатра этого делать не стоит. Иногда тепло может навредить. Если шишка не более 2-3 см в диаметре и динамики её роста не наблюдается – беспокоиться нет оснований.
А вот абсцесс (скопление гнойной жидкой массы в уплотнении) — процесс болезненный. Кожа в месте прокола краснеет, малышу больно её задевать. Это ситуация требует врачебной помощи. Если вакцинация прошла корректно, то уплотнение пройдёт самостоятельно через день-другой.
В этом случае рассасывание суспензии будет длительным, а значит, уплотнение долго не пройдёт.
Если размер шишечки в норме, и температура у малыша обычная, значит, это местная реакция, и лечение не требуется. Наденьте на ребёнка свободную одежду, чтобы он случайно не расчесал инфильтрат.
Если малыш всё же пытается это сделать, аккуратно погладьте уплотнение своей рукой. Успокойте кроху, дав ему попить. Чтобы избежать возможной аллергии после вакцинации, не давайте ребёнку витамин D, если до прививания он его принимал.
Лучше заменить препарат таблетированным Кальция глюконатом. В постпрививочный период не стоить давать ребёнку Супрастин, поскольку он сушит дыхательные пути, повышая риск проникновения микробов. Замените препарат на Фенистил или Зиртек.
Известный врач Е.Комаровский уверен, что уплотнение после укола – обычная реакция. Она ребёнку не опасна. Популярный педиатр считает, что не следует лечить шишку специально.
Нужно лишь следить, чтобы малыш не расчёсывал место инъекции, и наблюдать за самочувствием ребёнка. Если всё проходит нормально, уплотнение исчезнет через несколько дней. Следует знать, что иногда процесс может длиться неделями и даже месяцами.
Можно ли мазать покраснение на ножке Гепариновой мазью?
Мазь с гепарином – популярное противоотёчное средство. Она часто используется при постинъекционных уплотнениях. Состав наносят тонким слоем на место прокола и накрывают стерильной салфеткой.
Срок жизни такого компресса – несколько часов. После нанесения средства малыш может забеспокоиться, возможно, так он реагирует на небольшое покалывание, вызываемое мазью. Но это обычная реакция кожи на препарат.
Помимо этого, Гепариновая мазь может вызвать и небольшое покраснение в местах нанесения на кожу. Это тоже нормально, не следует путать такую реакцию с аллергией.
Какие делать компрессы, чтобы большой инфильтрат рассасывался?
Чтобы помочь шишке быстрее исчезнуть, родители могут воспользоваться следующими препаратами, снимающими отёчность:
- Эскузан (мазь). Помогает активизировать кровообращение в месте инъекции, позволяя уплотнению быстрее пройти. Применять раз в день. Лучше перед сном;
- Троксевазин. Его состав из активных компонентов помогает шишке быстрее рассасываться;
- Фенистил (гель) придёт на помощь, если малыша беспокоит зуд в месте прививания. Но намазывать средство следует не на место прокола, а вокруг него. Фенистил быстро снимает болевые ощущения, и малыш успокаивается;
- Зодак и Тавегил. Помогут избавиться от уплотнения при склонности малыша к аллергии.
Не торопитесь вылечить уплотнение самостоятельно. Помните, что нельзя мазать шишку мазью Вишневского (без врачебного назначения) и тем более давить на неё, пытаясь удалить содержимое. Результат может быть обратным – уплотнение наполнится гноем, спровоцировав абсцесс.
По этой же причине не стоит и греть шишку самостоятельно, даже если она кажется вам слишком большой и болезненной. В этой ситуации следует проконсультироваться у педиатра.
Быстрому рассасыванию инфильтрата поможет йодная сеточка. Она носится на уплотнение, а когда полностью исчезнет, рисуется вновь. Выручит и марлевый компресс, смоченный в растворе магнезии. Его лучше накладывать на отёк пред сном.
Среди натуральных средств, которыми можно воспользоваться для уменьшения инфильтрата, следует отметить:
- содовый компресс. Пропорция: 1 ст.л. соды на 1/2 стакана тёплой воды. Пропитанную содом марлю (или хлопковую ткань) привязать к уплотнению и ждать полного высыхания;
- лист свежей капусты. Его следует слегка отбить молоточком, чтобы выступил сок. Прикладывать к отёчному месту до высыхания (примерно на 2-3 часа);
- компресс из сырого картофеля. Клубни мелко перетереть. Сформировать лепёшку и обернуть её в марлю. Такая повязка хорошо снимает отёки.
Если вакцинация прошла корректно, уплотнение пройдёт быстро. Родители должны знать, что шишка может появиться не только при первой инъекции АКДС, но и после 2-й и 3-й вакцинации. Это нормально.
Беспокоиться стоит лишь в случае, если после прививки у малыша наблюдаются следующие проявления:
- уплотнение долго не спадает или даже увеличивается (более 6-8 см в диаметре);
- высокая (сверх 38,5 градусов) температура;
- в уплотнении прощупывается гной, выступающий в месте прокола;
- тошнота и плохой аппетит;
- инфильтрат «горячий» и болезненный.
Такая симптоматика — признак абсцесса. И в этом случае нужна диагностика мягких тканей.
Что делать, если шишка на бедре долго не проходит?
Шишка обычно образовывается после 2 или 3 прививания. Она постепенно проходит, но не окончательно. Спустя 6-9 месяцев на месте инъекции остаётся безболезненное уплотнение (3-4 см).
Медики утверждают, что уплотнение ничем не грозит малышу и советуют продолжать назначенную врачом местную терапию.
Но если шишка не проходит больше года, то в этой ситуации она вряд ли самостоятельно исчезнет. Скорее всего, у пациента была гематома, в которой со временем отложился кальций. Такое образование подлежит хирургическому удалению.
В любом случае проблема должна решаться совместно с педиатром. Только специалист может правильно оценить выраженность реакции и дать профессиональный совет. Зачастую нужно просто набраться терпения и лечить уплотнение теми средствами, которые посоветует врач.
Видео по теме
Что делать, если на месте введения вакцины образовалось уплотнение? Ответы в видео:
Шишка после прививания АКДС — одно из наиболее распространённых реакций. В большинстве случаев она в лечении не нуждается. Если ребёнок пришёл на процедуру здоровым, и сама вакцинация проведена правильно, то уплотнение после укола — нормальное явление.
Так организм ребёнка борется с инфекцией. Ситуация представляет опасность только в случае нагноения инфильтрата, что может произойти при некорректном проведении постановки укола и требует срочного оперирования.
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