Ndani ali pachiwopsezo chachikulu cha Sepsis?

Ngakhale aliyense akhoza kutenga matenda a sepsis ngati ali ndi kachilomboka, magulu otsatirawa ali pachiwopsezo chachikulu ndipo amafunika kusamala kwambiri:

1. Makanda ndi Okalamba: Chizindikiro chofala cha anthuwa ndi chakuti chitetezo cha m'thupi sichikukula bwino. Chitetezo cha m'thupi cha makanda ndi ana aang'ono sichikukula mokwanira, pomwe chitetezo cha m'thupi cha okalamba chimachepa ndi ukalamba ndipo nthawi zambiri chimakhala ndi matenda osiyanasiyana, zomwe zimapangitsa kuti zikhale zovuta kuti athe kulimbana ndi matenda.
2. Odwala Matenda Osatha: Odwala matenda monga matenda a shuga, khansa, matenda a chiwindi ndi impso, matenda osatha obstructive pulmonary disease (COPD) kapena HIV/AIDS ali ndi njira zofooka zodzitetezera thupi komanso ziwalo, zomwe zimapangitsa kuti matenda azitha kufalikira mosavuta.
3. Anthu Osadziteteza Kuthupi: Izi zikuphatikizapo odwala khansa omwe amalandira chithandizo cha chemotherapy, anthu omwe amamwa mankhwala oletsa chitetezo chamthupi atangoikidwa chiwalo china, ndi anthu omwe ali ndi matenda odziteteza okha, omwe chitetezo chawo chamthupi sichingathe kuyankha bwino ku matenda opatsirana.
4. Odwala Ovulala Kwambiri Kapena Opaleshoni Yaikulu: Kwa odwala omwe ali ndi kupsa kwambiri, kuvulala kwambiri kapena opaleshoni yayikulu, chotchinga cha khungu kapena mucous chimawonongeka, zomwe zimapangitsa kuti tizilombo toyambitsa matenda tilowe, ndipo thupi limakhala ndi nkhawa kwambiri.
5. Ogwiritsa Ntchito Zipangizo Zachipatala Zowononga: Odwala omwe ali ndi ma catheter (monga ma catheter apakati pa mitsempha, ma catheter a mkodzo), omwe amagwiritsa ntchito ma ventilator kapena omwe ali ndi machubu otulutsira madzi m'thupi lawo, zidazi zitha kukhala "njira zachidule" kuti tizilombo toyambitsa matenda tilowe m'thupi la munthu.
6. Anthu omwe ali ndi matenda opatsirana posachedwapa kapena omwe agonekedwa m'chipatala: Makamaka kwa odwala omwe ali ndi chibayo, matenda am'mimba, matenda amkodzo kapena matenda a pakhungu, ngati chithandizo sichinachitike nthawi yake kapena sichinagwire ntchito, matendawa amatha kufalikira mosavuta m'magazi ndikuyambitsa sepsis.

Kodi mungazindikire bwanji sepsis? Zinthu zofunika kuzizindikira zimathandiza kwambiri

Ngati anthu omwe ali pachiwopsezo chachikulu akupeza zizindikiro zokayikiridwa kuti ali ndi matenda (monga kutentha thupi, kuzizira, kupuma movutikira, kugunda kwa mtima mofulumira, komanso kusokonezeka), ayenera kupita kuchipatala nthawi yomweyo. Kuzindikira matendawa msanga kumadalira mayeso angapo azachipatala ndi mayeso a labotale, omwe pakati pawo mitundu yosiyanasiyana ya mayeso a in vitro diagnostic (IVD) ndi "maso" ofunikira kwambiri a asing'anga.

1. Chikhalidwe cha Tizilombo Tosaoneka ndi Maso (Chikhalidwe cha Magazi) - "Muyezo wa Golide" Wodziwitsa
   • Njira: Zitsanzo za magazi, mkodzo, makoswe, kapena malo ena omwe akukayikiridwa kuti ali ndi kachilombo zimasonkhanitsidwa ndikuyikidwa m'mabotolo okhala ndi njira yolerera, omwe kenako amaikidwa mu chidebe chosungiramo tizilombo toyambitsa matenda (mabakiteriya kapena bowa).
   • Udindo: Iyi ndiyo "muyezo wabwino kwambiri" wotsimikizira sepsis ndikuzindikira kachilombo kamene kamayambitsa matendawa. Kachilombo kakamera, kuyezetsa kukana maantibayotiki (AST) kumatha kuchitika kuti kutsogolere madokotala posankha maantibayotiki ogwira ntchito bwino. Komabe, vuto lake lalikulu ndi nthawi yomwe imafunika (nthawi zambiri maola 24-72 kuti zotsatira zake zitheke), zomwe sizingathandize kupanga zisankho zadzidzidzi poyamba.
2. Kuyesa kwa Biomarker - "Machitidwe a Alamu" Ofulumira
   Pofuna kubweza vuto la chikhalidwe lomwe limawononga nthawi yambiri, ma reagents osiyanasiyana ozindikira ma biomarker amagwiritsidwa ntchito kwambiri pozindikira mwachangu.
   • Kuyesa kwa Procalcitonin (PCT): Pakadali pano iyi ndi biomarker yofunika kwambiri komanso yeniyeni yokhudzana ndi sepsis.PCTNdi mapuloteni omwe amapezeka pamlingo wochepa kwambiri mwa anthu athanzi, koma amapangidwa mochuluka m'maselo osiyanasiyana m'thupi lonse panthawi ya matenda oopsa a bakiteriya.PCT Kuyesa (nthawi zambiri pogwiritsa ntchito njira za immunochromatographic kapena chemiluminescent) kumapereka zotsatira zochulukirapo mkati mwa maola 1-2.PCTMlingo wa mankhwalawa umasonyeza kwambiri kuti mabakiteriya amayambitsa sepsis ndipo ungagwiritsidwe ntchito poyang'anira momwe mankhwala opha maantibayotiki amagwirira ntchito komanso kutsogolera kuletsa kugwiritsa ntchito mankhwalawa.
   • Kuyesa kwa C-reactive protein (CRP): CRP ndi puloteni yogwira mtima yomwe imawonjezeka mofulumira chifukwa cha kutupa kapena matenda. Ngakhale kuti ndi yovuta kwambiri, si yeniyeni kwambiri kuposaPCTchifukwa imatha kukwera m'mikhalidwe yosiyanasiyana, kuphatikizapo matenda opatsirana ndi mavairasi komanso kuvulala. Nthawi zambiri imagwiritsidwa ntchito limodzi ndi zizindikiro zina.
   • Chiwerengero cha Maselo Oyera a M'magazi (WBC) ndi Neutrophil Peresenti: Iyi ndiye mayeso oyambira kwambiri a kuwerengera magazi kwathunthu (CBC). Odwala Sepsis nthawi zambiri amawonetsa kuwonjezeka kwakukulu kapena kuchepa kwa WBC komanso kuchuluka kwa ma neutrophil (kusintha kumanzere). Komabe, kutsimikizika kwake ndi kochepa, ndipo kuyenera kutanthauziridwa limodzi ndi zizindikiro zina.
3. Njira Zodziwira Mamolekyu - "Asaki" Olondola
   • Njira: Njira monga Polymerase Chain Reaction (PCR) ndi Metagenomic Next-Generation Sequencing (mNGS). Maukadaulo awa amagwiritsa ntchito ma primer ndi ma probes apadera (omwe angawoneke ngati "ma reagents" apamwamba) kuti azindikire mwachindunji ma nucleic acids (DNA kapena RNA).
   • Udindo: Sizifuna kukulitsa ndipo zimatha kuzindikira mwachangu matenda opatsirana m'magazi mkati mwa maola ochepa, ngakhale kuzindikira zamoyo zomwe zimakhala zovuta kuzikulitsa. Makamaka ngati zachikhalidwe zilibe thanzi koma kukayikira kwachipatala kukupitirirabe, mNGS ingapereke zizindikiro zofunika kwambiri zodziwira matenda. Komabe, njirazi ndizokwera mtengo ndipo sizipereka chidziwitso chokhudza kuopsa kwa maantibayotiki.
4. Kuyesa Lactate - Kuyeza Mlingo wa "Vuto"
   • Kuchepa kwa magazi m'thupi ndi kuchepa kwa magazi m'thupi ndizofunikira kwambiri pa kulephera kwa ziwalo chifukwa cha sepsis. Kuchuluka kwa lactate m'thupi ndi chizindikiro chodziwikiratu cha kuchepa kwa magazi m'thupi. Zipangizo zoyesera lactate zomwe zili pafupi ndi bedi zimatha kuyeza kuchuluka kwa lactate m'magazi mwachangu (mkati mwa mphindi zochepa). Hyperlactatemia (>2 mmol/L) imasonyeza kwambiri matenda oopsa komanso chiyembekezo choipa cha matenda, ndipo ndi chizindikiro chofunikira choyambitsa chithandizo chamankhwala mwachangu.

Mapeto

Sepsis ndi mpikisano wotsutsana ndi nthawi. Okalamba, ofooka, omwe ali ndi matenda enaake, komanso omwe ali ndi matenda enaake ndi omwe amafunidwa kwambiri. Kwa magulu omwe ali pachiwopsezo chachikulu, zizindikiro zilizonse za matenda ziyenera kuchiritsidwa mosamala. Mankhwala amakono akhazikitsa njira yodziwira matenda mwachangu kudzera m'njira zosiyanasiyana, kuphatikizapo kuyesa magazi, kuyezetsa zizindikiro mongaPCT/CRP, kuzindikira mamolekyulu, ndi kuyesa lactate. Pakati pa izi, mitundu yosiyanasiyana ya ma reagents odziwika bwino komanso osavuta kuzindikira ndi maziko a chenjezo loyambirira, kuzindikira molondola, komanso kuchitapo kanthu pa nthawi yake, zomwe zimawonjezera mwayi wa odwala wopulumuka. Kuzindikira zoopsa, kuthana ndi zizindikiro zoyambirira, komanso kudalira ukadaulo wapamwamba wozindikira ndi zida zathu zamphamvu kwambiri polimbana ndi "wakupha wosaoneka" uyu.