Ko wai kei te tino mōrearea ki te Sepsis?

Ahakoa ka pāngia te tangata e te mate sepsis mēnā he mate pāwera tō rātou, ko ēnei rōpū e whai ake nei he nui ake te mōrearea, ā, me tino tupato:

1. Ngā Pēpi me ngā Kaumātua: Ko tētahi āhuatanga noa o ēnei tāngata ko te ngoikore o te pūnaha ārai mate. Kāore anō kia tino whanake te pūnaha ārai mate o ngā pēpi me ngā tamariki nohinohi, engari ka heke te pūnaha ārai mate o ngā kaumātua i te pakeketanga, ā, he maha ngā wā ka haere tahi me ngā mate maha, ka uaua ai te whawhai tika ki ngā mate.
2. Ngā Tūroro e pāngia ana e ngā Mate Pūmau: Ko ngā tūroro e pāngia ana e ngā mate pēnei i te mate huka, te mate pukupuku, te mate ate me te mate tākihi, te mate pūkahukahu aukati mau tonu (COPD) me te HIV/AIDS, he ngoikore ake ngā tikanga tiaki tinana me ngā mahi a ngā okana, ā, ka nui ake te tūponotanga ka kore e taea te whakahaere i ngā mate.
3. Ngā Tāngata Kua Whakaitihia te Ārai Mate: Kei roto i ēnei ko ngā tūroro mate pukupuku e whiwhi ana i te chemotherapy, ngā tāngata e tango ana i ngā rongoā ārai mate i muri i te whakawhitinga okana, me ngā tāngata whai mate pūnaha ārai mate, e kore ai e taea e ō rātou pūnaha ārai mate te aro atu ki ngā mate tuku iho.
4. Ngā Tūroro he Whara Nui, he Pokanga Nui rānei: Mō ngā tūroro he nui ngā weranga, he whara nui, he pokanga nui rānei, ka pakaru te kiri, te ārai kiriuhi rānei, ka waiho hei ara mō ngā huaketo ki te whakaeke, ā, kei roto te tinana i te āhua ahotea nui.
5. Ngā Kaiwhakamahi i ngā Taputapu Hauora Urupare: Mō ngā tūroro he catheter (pērā i ngā catheter uaua pokapū, ngā catheter mimi), e whakamahi ana i ngā mīhini manawa, he ngongo waikeri rānei kei roto i ō rātou tinana, ka noho pea ēnei taputapu hei "ara poto" mō ngā huaketo ki te tomo ki te tinana o te tangata.
6. Ngā Tangata kua Pāngia e ngā Mate Pukupuku Tata Nei, kua Noho Hōhipera rānei: Ina koa mō ngā tūroro e pāngia ana e te niumōnia, te mate puku, te mate mimi, te mate kiri rānei, ki te kore e tere te maimoatanga, e kore rānei e whai hua, ka tere te horapa o te mate ki te toto, ka pāngia e te sepsis.

Me pēhea te kite i te sepsis? He mahi nui tā ngā matū kimi matua

Mena ka puta he tohu mate pāwera ki ngā tāngata mōrearea nui (pēnei i te kirika, te makariri, te poto o te manawa, te tere o te ngakau, me te pōhēhē), me rapu tonu rātou i te awhina hauora. Ko te tautuhi wawe i te mate ka whakawhirinaki ki te raupapa o ngā aromatawai haumanu me ngā whakamātautau taiwhanga, i roto i ēnei ko te maha o ngā matū whakamātautau tātaritanga in vitro (IVD) he "kanohi" tino nui o ngā tākuta.

1. Te Ahurea o ngā moroiti (Ahurea Toto) – Te "Paerewa Koura" mō te Tātaritanga
   • Tikanga: Ka kohia ngā tauira o te toto, te mimi, te huware, me ētahi atu wāhi e whakapaetia ana kei reira te mate o te tūroro, ka whakanohoia ki roto i ngā pounamu kei roto he ipu ahurea, kātahi ka whakatōkia hei whakatenatena i te tipu o ngā pathogens (huakita, harore rānei).
   • Tūranga: Koinei te "paerewa koura" mō te whakaū i te sepsis me te tautuhi i te mate pukupuku pūtake. Kia oti te whakatipu i tētahi mate pukupuku, ka taea te whakahaere i te whakamātautau ngoikore ki ngā huakita (AST) hei ārahi i ngā tākuta ki te whiriwhiri i ngā paturopi tino whai hua. Heoi, ko tōna ngoikoretanga matua ko te wā e hiahiatia ana (ko te tikanga he 24-72 hāora mō ngā hua), kāore e pai mō te whakatau ohorere tuatahi.
2. Whakamātautau Tohu Koiora – Ngā "Pūnaha Whakaoho" Tere
   Hei whakaea i te hapa roa o te ahurea, he maha ngā momo matū kimi koiora e whakamahia whānuitia ana hei tautuhi tere i te mate.
   • Te whakamātautau Procalcitonin (PCT)Koinei te tohu koiora tino nui me te tino motuhake e pā ana ki te sepsis i tēnei wā.PCTHe pūmua iti rawa te ūkuikui i roto i ngā tāngata hauora, engari he nui te rahinga e whakaputaina ana i roto i ngā kiko maha puta noa i te tinana i te wā e pangia kinotia ana te tinana e te mate huakita.PCT ka puta ngā hua tauanga i roto i ngā haora 1-2 mā roto i ngā whakamātautau (mā te whakamahi i ngā tikanga immunochromatographic, chemiluminescent rānei).PCTHe tino tohu ngā taumata o te homoni kei te pāngia e te sepsis huakita, ā, ka taea te whakamahi hei aroturuki i te whai huatanga o te rongoā paturopi me te ārahi i te whakamutu.
   • Whakamātautau pūmua C-reactive (CRP): CRP he pūmua wāhanga-whakamataku e tere piki ake ana hei urupare ki te mumura, ki te mate rānei. Ahakoa he tino tairongo, he iti ake te motuhake i tePCTnā te mea ka taea te piki ake i roto i ngā momo āhuatanga, tae atu ki ngā mate huaketo me ngā whara. He maha ngā wā ka whakamahia ngātahitia me ētahi atu tohu.
   • Te Tatau o ngā Pūtau Toto Mā (WBC) me te Ōrau o ngā Neutrophil: Koinei te whakamātautau tatau toto katoa (CBC) tino taketake. He maha ngā wā ka kitea he pikinga nui, he hekenga rānei o te WBC e ngā tūroro Sepsis, me te pikinga o te ōrau o ngā neutrophil (he nekehanga maui). Heoi, he iti tōna motuhaketanga, ā, me whakamāramahia me ētahi atu tohu.
3. Ngā Tikanga Tātaritanga Ngota – Ngā "Kaitirotiro" Tika
   • Tikanga: Ngā tikanga pēnei i te Polymerase Chain Reaction (PCR) me te Metagenomic Next-Generation Sequencing (mNGS). Ka whakamahia e ēnei hangarau ngā paraimere me ngā whakamātautau motuhake (e kitea ana ko ngā "tauhohenga") matatau hei kimi tika i ngā waikawa karihi pathogen (DNA, RNA rānei).
   • Tūranga: Kāore e hiahiatia he ahurea, ā, ka taea te tautuhi tere i ngā mate pāwera i roto i te toto i roto i ngā hāora, tae atu ki te kimi i ngā rauropi uaua ki te whakatipu. Ina koa ka kino ngā ahurea tuku iho engari kei te teitei tonu te whakapae haumanu, ka taea e te mNGS te whakarato i ngā tohu tātaritanga nui. Heoi, he nui ake te utu o ēnei tikanga, ā, kāore e whakarato i ngā mōhiohio e pāngia ana e te pāwera ki ngā paturopi.
4. Whakamātautau Lactate – Te Ine i te Taumata "Raruraru"
   • Ko te ngoikore o te toto me te korenga o te hāora te take matua o te ngoikore o ngā okana i puta mai i te sepsis. Ko te nui o te lactate he tohu mārama mō te korenga o te hāora o te kiko. Ka taea e ngā kete whakamātautau tere lactate i te taha o te moenga te ine tere i ngā kukū lactate plasma (i roto i ngā meneti). Ko te hyperlactatemia (>2 mmol/L) he tohu kaha mō te mate kino me te matapae kino, ā, he tohu nui mō te tīmatanga o te maimoatanga kaha.

Whakamutunga

He whakataetae te Sepsis ki te wā. Ko te hunga kaumātua, te hunga ngoikore, te hunga whai mate hauora, me te hunga whai mate hauora motuhake ngā whāinga matua. Mō ēnei rōpū mōrearea nui, me ata tirotiro i ngā tohu o te mate. Kua whakatūria e te rongoā hou he pūnaha tātaritanga tere mā roto i ngā tikanga maha, tae atu ki ngā ahurea toto, te whakamātautau biomarker pēnei i tePCT/CRP, ngā tātaritanga ngota, me te whakamātautau lactate. I roto i ēnei, he maha ngā momo matū kimi tino whai hua me te tairongo ko ngā pou o te whakatūpato wawe, te tautuhi tika, me te wawaotanga wā, e whakapai ake ana i te tūponotanga o te oranga o ngā tūroro. Ko te mohio ki ngā mōrearea, te aro atu ki ngā tohu wawe, me te whakawhirinaki ki ngā hangarau kimi matatau ko ā mātou patu tino kaha ki tēnei "kaikōhuru ngaro."