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2 years ago

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æ'… ÿπ —¢∫â

·π«∑“߇«ªÆ‘∫—μ‘‚√§æ‘… ÿπ—¢∫â“ ©∫—∫ª√—∫ª√ÿß ªï 25552. °“√¥Ÿ·≈√—°…“ºŸâ —¡º— ‚√§2.1 ª∞¡æ¬“∫“≈∫“¥·º≈‚¥¬∑—π∑’-≈â“ß·º≈¥â«¬πÈ”øÕ° ∫ŸàÀ≈“¬Ê §√—Èß ≈â“ß ∫ŸàÕÕ°„ÀâÀ¡¥ ∂â“·º≈≈÷°„Àâ≈â“ß∂÷ß°âπ·º≈Õ¬à“ßπâÕ¬ 15 π“∑’ √–«—ßÕ¬à“„Àâ·º≈È” Àâ“¡„â§√’¡„¥Ê ∑“-‡Á¥·º≈¥â«¬πÈ”¬“à“‡◊ÈÕ §«√„⬓‚æ«’‚¥π‰Õ‚Õ¥’π (povidone iodine) À√◊ÕŒ‘∫‘‡∑π„ππÈ” (hibitane in water) ∂Ⓣ¡à¡’„Àâ„â·Õ≈°ÕŒÕ≈å 70% À√◊Õ∑‘߇®Õ√å‰Õ‚Õ¥’π-‰¡à§«√‡¬Á∫·º≈∑—π∑’ §«√√Õ‰«â 2 - 3 «—𠇫âπ‡ ’¬·μà«à“‡≈◊Õ¥ÕÕ°¡“°À√◊Õ·º≈„À≠৫√‡¬Á∫À≈«¡Ê ·≈–„ à∑àÕ√–∫“¬‰«â2.2 °“√ªÑÕß°—π∫“¥∑–¬—°æ‘®“√≥“„Àâ tetanus toxoid À√◊Õ diphtheria tetanus toxoid (dT) μ“¡ª√–«—μ‘°“√‰¥â√—∫«—§´’πªÑÕß°—π∫“¥∑–¬—°¡“°àÕπ ·≈–æ‘®“√≥“„À⬓ªØ‘’«π–μ“¡§«“¡‡À¡“– ¡ ”À√—∫ tetanus antitoxin„Àâæ‘®“√≥“μ“¡≈—°…≥–∫“¥·º≈‡ªìπ√“¬Ê ‰ª2.3 °“√√—°…“μ“¡Õ“°“√„À⬓·°âª«¥μ“¡§«“¡®”‡ªìπ2.4 °“√μ—¥ ‘π„®„â«—§´’π·≈–Õ‘¡¡Ÿ‚π‚°≈∫ÿ≈‘πªÑÕß°—π‚√§æ‘… ÿπ—¢∫â“„Àâæ‘®“√≥“≈—°…≥–¢Õß —μ«å∑’Ë —¡º— ¥—ßμ“√“ß∑’Ë 2 À“°‡ΩÑ“ —߇°μÕ“°“√ —μ«å§√∫ 10 «—π·≈â«—μ«å¬—ߪ°μ‘¥’„ÀâÀ¬ÿ¥©’¥«—§´’π‰¥â ∑—Èßπ’È®–‡∑à“°—∫‰¥â√—∫«—§´’π 3 §√—Èß ·≈–„Àâ∂◊Õ«à“‡ªìπ°“√‰¥â√—∫«—§´’π·∫∫ªÑÕß°—π‚√§≈à«ßÀπâ“ (pre-exposure immunization)3. °“√„Àâ«—§´’πªÑÕß°—π‚√§æ‘… ÿπ—¢∫â“·°àºŸâ —¡º— ‚√§ (post-exposure immunization)3.1 «—§´’πªÑÕß°—π‚√§æ‘… ÿπ—¢∫â“∑’Ë„â„πªí®®ÿ∫—π (μ“√“ß∑’Ë 4) ‡ªìπ«—§´’π∑’Ë∫√‘ ÿ∑∏‘Ï ¡’§«“¡·√ß(antigenic value) Ÿßμ“√“ß∑’Ë 4 «—§´’πªÑÕß°—π‚√§æ‘… ÿπ—¢∫â“ ”À√—∫§π∑’Ë„â„πª√–‡∑»‰∑¬„πªí®®ÿ∫—πå«—§´’π º≈‘μ®“° «‘∏’°“√∑”„Àâ ‰«√— ∫√‘…—∑ ≈—°…≥–‡◊ÈÕ쓬 ‰μ‡μÕ√å ºŸâº≈‘μº≈‘μ®“°°“√‡≈’Ȭ߇◊ÈÕ ∑”„Àâ‡◊ÈÕ쓬 ¡’‰«√— ‰μ‡μÕ√å Chiron Behringfixed rabies virus (inactivated) ¥â«¬ >10 3 TCLD 50/ml GmbH ‡¬Õ√¡—πæ—π∏ÿFlury LEP-C25 beta-propiolactone (Tissue Culture Õ‘π‡¥’¬„π primary chick 0.025% Infectious Dose)embryo fibroblast·≈– antigeniccells.value >2.5 IU/mlPurified ChickEmbryo CellRabies Vaccine(PCECV)Rabipur˙‡ªìπ«—§´’πºß·Àâßæ√âÕ¡sterile water forinjection ‡¡◊ËÕ≈–≈“¬·≈⫇ªìππÈ”„ ‰¡à¡’ ’¢π“¥ 1 ml14

åååPurified Vero CellRabies Vaccine(PVRV)- VERORAB ˙Purified Vero CellRabies Vaccine(PVRV)- Abhayrab ˙Chromatographically PurifiedVero CellRabies Vaccine(CPRV)- SPEEDA ˙Purified DuckEmbryo CellRabies Vaccine(PDEV)Human DiploidCell RabiesVaccine (HDCV)*** PM = Pitman Moore** ¡’°“√®¥∑–‡∫’¬π„πª√–‡∑»‰∑¬ ·μà‰¡à¡’®”Àπà“¬”π—°‚√§μ‘¥μàÕ∑—Ë«‰ª °√¡§«∫§ÿ¡‚√§«—§´’π º≈‘μ®“° «‘∏’°“√∑”„Àâ ‰«√— ∫√‘…—∑ ≈—°…≥–‡◊ÈÕ쓬 ‰μ‡μÕ√å ºŸâº≈‘μº≈‘μ®“°°“√‡≈’Ȭ߇◊ÈÕ ∑”„Àâ‡◊ÈÕ쓬 ¡’‰«√— ‰μ‡μÕ√å Sanofi Pasteurfixed rabies virus æ—π∏ÿ (inactivated) ¥â«¬ >10 7.5 LMD 50/0.5 ml Ω√—Ë߇»PMWI 138-1503-3M beta-propiolactone ·≈– antigenic GPO - MBP„π Vero cells 0.025% value >2.5 U/0.5ml ª√–‡∑»‰∑¬º≈‘μ®“°°“√‡≈’Ȭ߇◊ÈÕfixed rabies virusæ—π∏ÿå L.Pasteur 2061 15passages „π Vero cellsº≈‘μ®“°°“√‡≈’Ȭ߇◊ÈÕfixed rabies virus æ—π∏ÿL. Pasteur PV2061 „πVero cellsº≈‘μ®“°°“√‡≈’Ȭ߇◊ÈÕfixed rabies virusæ—π∏ÿå PM* „πμ—«ÕàÕπ‰¢à‡ªì¥øí° (embryonatedduck eggs)º≈‘μ®“°°“√‡≈’Ȭ߇◊ÈÕfixed rabies virus æ—π∏ÿPM** 1503-3M„π human diploid cell∑”„Àâ‡◊ÈÕ쓬(inactivated) ¥â«¬beta-propiolactone0.025%∑”„Àâ‡◊ÈÕ쓬(Inactivated) ¥â«¬beta-propiolactone0.025%∑”„Àâ‡◊ÈÕ쓬(inactivated) ¥â«¬beta-propiolactone0.025% ·≈–ºà“π¢∫«π°“√ ∑”„Àâ∫√‘ ÿ∑∏‘ Ϭ‘Ëߢ÷Èπ∑”„Àâ‡◊ÈÕ쓬(inactivated) ¥â«¬beta-propiolactone0.025%¡’‰«√— ‰μ‡μÕ√å 10 6PFU/ml ·≈– antigenicvalue > 2.5IU/0.5 ml¡’‰«√— ‰μ‡μÕ√å10 6 -10 7 LgLD50/ml·≈– antigenic value> 2.5 IU/0.5ml¡’‰«√— ‰μ‡μÕ√å>10 7 MLD 50/1 ml·≈– antigenicvalue >2.5 IU/1 ml¡’‰«√— ‰μ‡μÕ√å>10 7 MLD 50/ml(Minimum LethalDose in mice) ·≈–antigenic value>2.5 IU/mlHumanBiologicalsInstitute(A Division ofIndianImmunologicalLimited (IIL)Õ‘π‡¥’¬Liaoning Cheng DaBiotechnology ®’πBerna, SwissSerum andVaccine InstituteÕ‘π‡¥’¬Sanofi PasteurΩ√—Ë߇»‡ªìπ«—§´’πºß·Àâßæ√âÕ¡πÈ”¬“≈–≈“¬ (solution ofsodium chloride 0.4 %)‡¡◊ËÕ≈–≈“¬·≈⫇ªìππÈ”„‰¡à¡’ ’ ¢π“¥ 0.5 ml‡ªìπ«—§´’πºß·Àâßæ√âÕ¡πÈ”¬“≈–≈“¬ (solutionof sodium chloride 0.9 %)‡¡◊ËÕ≈–≈“¬·≈⫉¥â “√≈–≈“¬¢π“¥ 0.5 ml.«—§´’ππ’È¡’ Thiomersal‡ªìπ “√∂πÕ¡(preservative) º ¡Õ¬Ÿà‡ªìπ«—§´’πºß·Àâßæ√âÕ¡πÈ”¬“∑”≈–≈“¬(sterile water forinfection) ‡¡◊ËÕ≈–≈“¬·≈⫇ªìππÈ”„ ‰¡à¡’ ’¢π“¥ 0.5 ml‡ªìπ«—§´’πºß·Àâßæ√âÕ¡πÈ”¬“≈–≈“¬(sterile water forinjection) 1 ml‡¡◊ËÕ≈–≈“¬·≈â« ®–‡ªìπ“√·¢«πμ–°Õπ ’¢“«¢ÿàπ‡≈Á°πâÕ¬ ‡π◊ËÕß®“°¡’ Thiomersal ´÷Ë߇ªìπ“√∂πÕ¡ (preservative)º ¡Õ¬Ÿà‡ªìπ«—§´’πºß·Àâßæ√âÕ¡ sterile water forinjection ‡¡◊ËÕ≈–≈“¬·≈⫇ªìππÈ”„ ’¡æŸ¢π“¥ 1 ml15

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