Ndiani ari Panjodzi Yakanyanya yeSepsis?

Nepo chero munhu anogona kuita sepsis kana aine hutachiona, mapoka anotevera ari panjodzi yakanyanya uye anoda kuchenjerera:

1. Vacheche uye Vakweguru: Chimiro chakafanana chevanhu ava immune system isina kuvandudzwa. Mishonga yekudzivirira yevacheche nevana vaduku haisati yanyatsogadziriswa, asi masimba ezvirwere zvevakwegura anoderera nezera uye anowanzoperekedzwa nezvirwere zvakawanda, zvichiita kuti zvive zvakaoma kuti vabudirire kurwisa zvirwere.
2. Varwere vane Zvirwere Zvisingaperi: Varwere vane zvirwere zvakadai seshuga, kenza, chiropa uye chirwere cheitsvo, chirwere chisingaperi chemapapu (COPD) kana HIV / AIDS vane maitiro asina simba ekudzivirira muviri uye nhengo dzenhengo, zvichiita kuti zvirwere zviwedzere kubuda kunze kwekutonga.
3. Immunocompromised Individuals: Izvi zvinosanganisira varwere vekenza vari kurapwa chemotherapy, vanhu vanotora immunosuppressants mushure mekuisirwa nhengo, uye vanhu vane autoimmune zvirwere, umo immune system yavo isingakwanisi kupindura zvinobudirira kune hutachiona.
4. Varwere Vane Kushungurudzika Kwakanyanya kana Kuvhiyiwa Kwakakura: Kune varwere vane kupisa kwakanyanya, kukuvadzwa kwakanyanya kana kuvhiyiwa kukuru, ganda kana mucosal barriers inoparadzwa, ichipa chiteshi chekuti hutachiona hupinde, uye muviri uri mukushushikana kwakanyanya.
5. Vashandisi veInvasive Medical Devices: Varwere vane catheter (sepakati venous catheter, urinary catheters), vachishandisa mavheiri kana kuve nemachubhu emvura mumiviri yavo, zvishandiso izvi zvinogona kuita "mapfupi" ekuti hutachiona hupinde mumuviri wemunhu.
6. Vanhu vane Zvichangoburwa Zvirwere kana Kuchipatara: Kunyanya kune varwere vane pneumonia, hutachiona hwemudumbu, hutachiona hwehutachiwana kana hutachiona hweganda, kana kurapwa kusiri panguva kana kusashanda, hutachiona hunogona kupararira muropa nyore uye hunokonzera sepsis.

Nzira yekuziva sei sepsis? Makiyi ekuona reagents anoita basa repakati

Kana vanhu vari panjodzi huru vakaita zviratidzo zvinofungidzirwa zveutachiona (zvakadai sefivha, kupindwa nechando, kutadza kufema zvakanaka, kurova kwemwoyo nekukurumidza, uye kuvhiringika), vanofanira kutsvaga kurapwa nekukurumidza. Kuongororwa kwepakutanga kunoenderana neakatevedzana ekuongororwa kwekiriniki uye bvunzo dzemurabhoritari, pakati peiyo akasiyana in vitro diagnostic (IVD) bvunzo reagents ndiwo akakosha "meso" evarapi.

1. Microbial Tsika (Tsika yeRopa) - Iyo Diagnostic "Gold Standard"
   • Nzira: Mienzaniso yeropa remurwere, weti, sputum, kana dzimwe nzvimbo dzinofungidzirwa kuti dzine hutachiona dzinounganidzwa uye dzinoiswa mumabhodhoro ane tsika yemagariro, iyo inozoiswa incubated kukurudzira kukura kwehutachiona (bacteria kana fungi).
   • Basa: Iyi ndiyo "yegoridhe chiyero" yekusimbisa sepsis uye kuona iyo causative pathogen. Kana pathogen yagadzirwa, antimicrobial susceptibility test (AST) inogona kuitwa kutungamira vanachiremba mukusarudza mishonga inoshanda zvakanyanya. Nekudaro, dhizaini yayo huru inguva inodiwa (kazhinji 24-72 maawa emhedzisiro), izvo zvisingaenderane nekutanga kuita sarudzo yechimbichimbi.
2. Biomarker Testing - Inokurumidza "Alarm Systems"
   Kuti ugadzirise kukanganisa kunotora nguva kwetsika, akasiyana siyana ekuona biomarker reagents anoshandiswa zvakanyanya kukurumidza kuongororwa kwekubatsira.
   • Procalcitonin (PCT) kuongororwa: Iyi parizvino ndiyo inonyanya kukosha uye yakasarudzika biomarker yakabatana ne sepsis.PCTipuroteni inowanikwa pamazinga akaderera zvikuru muvanhu vane utano hwakanaka, asi inogadzirwa muhuwandu hwakawanda mumatishu akawanda mukati memuviri wese panguva yakaoma yehutachiona hwehutachiona.PCT assays (kazhinji kushandisa immunochromatographic kana chemiluminescent nzira) inopa huwandu hwemhedzisiro mukati meawa 1-2. YakasimudzwaPCTmazinga anonyanya kuratidza bhakitiriya sepsis uye anogona kushandiswa kutarisa kushanda kwemishonga inorwisa mabhakitiriya uye kutungamira kurega.
   • C-reactive protein (CRP) kuongororwa: CRP is acute-phase protein inokurumidza kuwedzera mukupindura kuzvimba kana kutapukira. Nepo inonzwa zvakanyanya, haina kujeka panePCTnokuti inogona kukwidziridzwa mumamiriro ezvinhu akasiyana-siyana, kusanganisira zvirwere zvehutachiona uye kushungurudzika. Inowanzoshandiswa pamwe chete nezvimwe zviratidzo.
   • White Blood Cell Count (WBC) uye Neutrophil Percentage: Iyi ndiyo inonyanya kukosha yakakwana yakakwana yeropa bvunzo (CBC). Varwere veSepsis vanowanzoratidza kuwedzera kukuru kana kuderera muWBC uye kuwedzera kwezana yeutrophils (kuchinja kwekuruboshwe). Nekudaro, iyo chaiyo yakaderera, uye inofanirwa kududzirwa pamwe chete nezvimwe zviratidzo.
3. Molecular Diagnostic Techniques - Precision "Scouts"
   • Nzira: Maitiro akadai sePolymerase Chain Reaction (PCR) uye Metagenomic Inotevera-Generation Sequencing (mNGS). Aya matekinoroji anoshandisa chaiwo maprimers uye probes (ayo anogona kuonekwa seyepamusoro "reagents") kuona zvakananga pathogen nucleic acids (DNA kana RNA).
   • Basa: Izvo hazvidi tsika uye zvinogona kukurumidza kuona utachiona muropa mukati memaawa mashoma, kunyange kuona zvipenyu zvakaoma kutsika. Kunyanya kana tsika dzechinyakare dzisina kunaka asi kunyumwa kwekiriniki kunoramba kwakakwira, mNGS inogona kupa zvakakosha zvekuongorora. Zvisinei, nzira idzi dzinodhura uye hadzipi ruzivo rwekubatwa nemishonga inorwisa mabhakitiriya.
4. Lactate Testing - Kuyera "Dambudziko" Level
   • Tissue hypoperfusion uye hypoxia zviri pakati pesepsis-induced organ kukundikana. Yakakwira lactate mazinga chiratidzo chakajeka chetishu hypoxia. Bedside yekukurumidza lactate test kits inogona kukurumidza kuyera plasma lactate concentrations (mukati memaminitsi). Hyperlactatemia (> 2 mmol / L) inonyatsoratidza kurwara kwakanyanya uye kusava nemafungiro asina kunaka, uye chiratidzo chakakosha chekutanga kurapwa kwakanyanya.

Mhedziso

Sepsis nhangemutange inopesana nenguva. Vakwegura, vasina simba, avo vane mamiriro ekurapa, uye avo vane mamiriro ekurapa chaiwo ndivo vavariro huru. Kune aya mapoka ane njodzi huru, chero zviratidzo zvehutachiona zvinofanira kurapwa nekuchenjerera. Mishonga yemazuva ano yakagadzira chirongwa chekukurumidza kuongororwa kuburikidza nemhando dzakasiyana-siyana, kusanganisira tsika dzeropa, kuongorora biomarker zvakadaiPCT/CRP, molecular diagnostics, uye kuongorora lactate. Pakati peizvi, zvakasiyana-siyana zvinonyanya kushanda uye zvinonzwisisika zvekuona reagents ndiyo nheyo dzekutanga yambiro, kunyatsozivikanwa, uye kupindira panguva yakakodzera, inovandudza zvikuru mikana yevarwere yekupona. Kuziva njodzi, kugadzirisa zviratidzo zvekutanga, uye kuvimba nehunyanzvi hwekuona tekinoroji ndizvo zvombo zvedu zvine simba kurwisa "muurayi asingaoneki."