Ni nde uri mu kaga gakomeye ko kurwara indwara ya Sepsis?

Nubwo umuntu wese ashobora kurwara sepsis aramutse arwaye, amatsinda akurikira ari mu kaga gakomeye kandi akeneye kwitonda cyane:

1. Impinja n'abageze mu zabukuru: Ikintu kiranga aba bantu ni ubudahangarwa bw'umubiri budatera imbere neza. Ubudahangarwa bw'umubiri bw'impinja n'abana bato ntiburatera imbere neza, mu gihe ubudahangarwa bw'umubiri bw'abageze mu zabukuru bugenda bugabanuka uko imyaka igenda ishira kandi akenshi bugaherekezwa n'indwara nyinshi, bigatuma bigorana kurwanya indwara neza.
2. Abarwayi barwaye indwara zidakira: Abarwayi barwaye indwara nka diyabete, kanseri, indwara y'umwijima n'impyiko, indwara idakira yo mu bihaha (COPD) cyangwa VIH/SIDA bafite uburyo bwo kwirinda bw'umubiri budakora neza n'imikorere y'ingingo, bigatuma indwara zishobora kugabanuka cyane.
3. Abantu bafite ubudahangarwa bw'umubiri budafite ubushobozi bwo guhangana n'ingaruka z'umubiri: Muri abo harimo abarwayi ba kanseri bahabwa imiti igabanya ubukana bw'umubiri nyuma yo guterwa urugingo, n'abantu bafite indwara ziterwa n'ubudahangarwa bw'umubiri, aho ubudahangarwa bw'umubiri bwabo budashobora guhangana n'udukoko.
4. Abarwayi bafite Ihungabana rikomeye cyangwa Kubagwa Gukomeye: Ku barwayi bafite ubushye bwinshi, ibikomere bikomeye cyangwa kubagwa bikomeye, uruhu cyangwa ururenda rw'imitsi birangirika, bigatuma indwara zitera indwara zinjira, kandi umubiri uba uri mu mimerere yo guhangayika cyane.
5. Abakoresha ibikoresho by’ubuvuzi byinjira mu mubiri: Abarwayi bafite catheters (nk'imitsi yo hagati, catheters z’inkari), bakoresha imashini zihumeka cyangwa zifite imiyoboro y’amazi mu mubiri wabo, ibi bikoresho bishobora kuba "inzira z'uburinzi" kugira ngo indwara zigere mu mubiri w'umuntu.
6. Abantu baherutse kwandura cyangwa bashyizwe mu bitaro: Cyane cyane ku barwayi barwaye umusonga, indwara zo mu nda, indwara zo mu nzira y'inkari cyangwa indwara z'uruhu, iyo ubuvuzi budakozwe ku gihe cyangwa budafite ingaruka nziza, ubwandu bushobora gukwirakwira mu maraso byoroshye bigatera sepsis.

Ni gute wamenya sepsis? Ibikoresho by'ingenzi byo gupima bigira uruhare runini

Iyo abantu bafite ibyago byinshi bagaragaje ibimenyetso bikekwaho byo kwandura (nk'umuriro, ubukonje, guhumeka nabi, gutera k'umutima cyane, no kwitiranya), bagomba kwihutira gushaka abaganga. Gusuzuma hakiri kare bishingiye ku isuzuma ry'ubuvuzi n'ibizamini bya laboratwari, muri byo harimo ibikoresho bitandukanye byo gusuzuma indwara mu buryo bwa "in vitro diagnostic" (IVD) ari byo "maso" y'ingenzi y'abaganga.

1. Umuco wa mikorobe (Umuco w'amaraso) – “Igipimo cya zahabu” cyo gusuzuma
   • Uburyo: Ingero z'amaraso y'umurwayi, inkari, amatembabuzi, cyangwa ahandi hantu hakekwa ko yanduye zirakusanywa zigashyirwa mu macupa arimo uburyo bwo gukwirakwiza udukoko, hanyuma zigashyirwa mu buryo bwo gutera udukoko kugira ngo zitere indwara zitera indwara (bagiteri cyangwa ibihumyo) kwiyongera.
   • Uruhare: Iki ni cyo "gipimo ngenderwaho" cyo kwemeza sepsis no kumenya indwara itera indwara. Iyo indwara imaze guterwa, hashobora gukorwa ibizamini byo kwandura udukoko (AST) kugira ngo abaganga bahitemo imiti ivura udukoko ikora neza. Ariko, ikibazo cyayo nyamukuru ni igihe gisabwa (ubusanzwe amasaha 24-72 kugira ngo haboneke ibisubizo), ibyo bikaba bidafasha mu gufata ibyemezo byihutirwa.
2. Isuzuma ry'ibimenyetso by'umubiri - "Sisitemu z'itangazo" zihuse
   Kugira ngo habeho ikosa ryatewe n’imikurire ritwara igihe kinini, hari uburyo butandukanye bwo gusuzuma ibimenyetso by’indwara bwakoreshejwe cyane mu gusuzuma vuba.
   • Gupima Procalcitonin (PCT): Iki ni cyo gipimo cy'ingenzi kandi cyihariye gifitanye isano n'indwara ya sepsis.PCTni poroteyine iboneka ku rugero rwo hasi cyane ku bantu bazima, ariko ikorwa ku bwinshi mu ngingo nyinshi mu mubiri wose mu gihe cy'ubwandu bukomeye bwa bagiteri.PCT ibizamini (ubusanzwe hakoreshejwe uburyo bwa immunochromatographic cyangwa chemiluminescent) bitanga ibisubizo by'ingano mu masaha 1-2.PCTurugero rwerekana cyane ko hari indwara ya bagiteri yitwa sepsis, kandi ishobora gukoreshwa mu kugenzura uburyo imiti ivura antibiyotike ikora neza no mu rwego rwo guhagarika kuyivura.
   • Gupima poroteyine ya C-reactive (CRP): CRP ni poroteyine yo mu cyiciro cya acute yiyongera vuba bitewe n'ububyimbirwe cyangwa ubwandu. Nubwo iterwa n'ububabare bwinshi, ntabwo igaragara cyane kurushaPCTkuko ishobora kwiyongera mu bihe bitandukanye, harimo kwandura virusi n'ihungabana. Akenshi ikoreshwa hamwe n'ibindi bimenyetso.
   • Umubare w’uturemangingo tw’amaraso (WBC) n’ijanisha rya Neutrophil: Iki ni cyo gipimo cy’ibanze cy’ijanisha ry’amaraso yuzuye (CBC). Abarwayi ba Sepsis bakunze kugaragaza ukwiyongera cyangwa kugabanuka gukomeye kwa WBC n’ijanisha ryiyongera rya neutrophil (guhinduka ibumoso). Ariko, umwihariko wayo ni muto, kandi igomba gusobanurwa hamwe n’ibindi bimenyetso.
3. Uburyo bwo Gusuzuma Ibinyabutabire - "Abaskuti" b'Ubwiza
   • Uburyo: Ubuhanga nka Polymerase Chain Reaction (PCR) na Metagenomic Next-Generation Sequencing (mNGS). Ubu buryo bukoresha primers na probes (zishobora kubonwa nk' "ibice bigezweho") kugira ngo hamenyekane neza aside nucleic za pathogen (DNA cyangwa RNA).
   • Uruhare: Ntibisaba ko habaho ubuvuzi kandi bishobora kumenya vuba indwara zanduza mu maraso mu masaha make, ndetse no kumenya udukoko tugoye kuvura. Cyane cyane iyo imigenzo gakondo idahwitse ariko inkeke y’ubuvuzi igakomeza kuba myinshi, mNGS ishobora gutanga ibimenyetso by’ingenzi byo gusuzuma indwara. Ariko, ubu buryo burahenze cyane kandi ntibutanga amakuru ajyanye n’uburyo imiti yica udukoko ishobora kwanduzanya.
4. Gupima Lactate - Gupima urwego rw' "ibibazo"
   • Kugabanuka k'umuvuduko w'amaraso mu mubiri no kugabanuka k'amaraso mu mubiri ni ingenzi mu gutuma ingingo zinanirwa gukora neza bitewe na sepsis. Kuzamuka k'umuvuduko wa lactate ni ikimenyetso cyerekana ko ingingo zidafite amazi mu mubiri. Ibikoresho byo gupima lactate vuba ku buriri bishobora gupima vuba ingano ya lactate mu maraso (mu minota mike). Hyperlactatemia (>2 mmol/L) igaragaza indwara ikomeye n'uko umuntu arwaye indwara mbi, kandi ni ikimenyetso cy'ingenzi cyo gutangiza ubuvuzi bukomeye.

Umwanzuro

Sepsis ni irushanwa rihanganye n'igihe. Abageze mu za bukuru, abanyantege nke, abafite ibibazo by’uburwayi byihariye, n’abafite ibibazo byihariye by’ubuzima ni bo bibasirwa cyane. Kuri abo bantu bafite ibyago byinshi byo kwandura, ibimenyetso byose by’ubwandu bigomba kuvurwa witonze. Ubuvuzi bwa none bwashyizeho uburyo bwihuse bwo gusuzuma indwara binyuze mu buryo butandukanye, burimo gupima amaraso, gupima ibipimo by’indwara nkaPCT/CRP, gusuzuma molekile, no gupima lactate. Muri ibyo, uburyo butandukanye bwo kumenya indwara bukora neza kandi bwihuse ni bwo buryo bw'ingenzi bwo kuburira hakiri kare, kumenya neza, no gutabara ku gihe, bikongera cyane amahirwe y'abarwayi yo kubaho. Kumenya ingaruka, gukemura ibimenyetso hakiri kare, no kwishingikiriza ku ikoranabuhanga rigezweho ryo kumenya indwara ni byo ntwaro zikomeye dufite zo kurwanya uyu "mwicanyi utagaragara."