Ndiani Ari Panjodzi Yakanyanya yeSepsis?

Kunyange hazvo munhu wese achigona kuwana sepsis kana aine hutachiona, mapoka anotevera ari panjodzi yakakura uye anoda kungwarira zvakanyanya:

1. Vacheche Nevakwegura: Chinhu chinowanzoonekwa nevanhu ava isimba rekudzivirira muviri risina kukura zvakakwana. Masisitimu ekudzivirira muviri evacheche nevana vadiki haasati akura zvakakwana, nepo masisitimu ekudzivirira muviri evakwegura achiderera nekukura uye anowanzo perekedzwa nezvirwere zvakawanda, zvichiita kuti zvivaomere kurwisa hutachiona zvinobudirira.
2. Varwere Vane Zvirwere Zvisingaperi: Varwere vane zvirwere zvakaita sechirwere cheshuga, kenza, chirwere chechiropa neitsvo, chirwere chemapapu chinovhara mapapu (COPD) kana HIV/AIDS vane nzira dzisina simba dzekudzivirira muviri uye mashandiro enhengo dzemuviri, zvichiita kuti hutachiona huve nyore kudzora.
3. Vanhu Vasina Simba Remuviri Rinorema: Izvi zvinosanganisira varwere vegomarara vari kurapwa nechemotherapy, vanhu vanotora mishonga inodzvinyirira immune system mushure mekuisirwa nhengo yemuviri, uye vanhu vane zvirwere zve autoimmune, umo masoja avo emuviri asingakwanise kupindura zvinobudirira kuzvirwere zvinotapukira.
4. Varwere Vane Kukuvara Kwakanyanya Kana Kuvhiyiwa Kwakakura: Kune varwere vane kutsva kwakanyanya, kukuvara kwakanyanya kana kuvhiyiwa kwakakura, ganda kana mucous membrane zvinoparadzwa, zvichiita kuti pave nenzira yekuti utachiona hupinde, uye muviri unenge uri mumamiriro ekushushikana kwakanyanya.
5. Vanoshandisa Midziyo Yekurapa Inorwisa: Varwere vane macatheter (akadai semacatheter epakati petsinga, macatheter emuweti), vachishandisa maventilator kana kuti vane machubhu ekubuditsa mvura mumiviri yavo, michina iyi inogona kuva "nzira dzepfupi" dzekuti utachiona hupinde mumuviri wemunhu.
6. Vanhu Vane Utachiona Hwazvino Kana Kupinda Muchipatara: Kunyanya kune varwere vane pneumonia, hutachiona hwemudumbu, hutachiona hweweti kana hutachiona hweganda, kana kurapwa kusingaitwe nenguva kana kuti kusingashande, hutachiona hunogona kupararira nyore nyore kuenda kuropa uye kukonzera sepsis.

Nzira yekuona sepsis? Zvinhu zvakakosha zvinobata basa guru

Kana vanhu vane njodzi huru vakaratidza zviratidzo zvinofungidzirwa zvehutachiona (zvakadai sefivha, dzihwa, kufema zvishoma nezvishoma, kurova kwemoyo nekukurumidza, uye kuvhiringidzika), vanofanira kutsvaga rubatsiro rwechiremba nekukasika. Kuongororwa kwekutanga kunoenderana nekuongororwa kwekiriniki uye bvunzo dzemurabhoritari, pakati padzo, mishonga yakasiyana-siyana yekuongorora in vitro diagnostic (IVD) ndiyo "maziso" akakosha evanachiremba.

1. Tsika dzeMabhakitiriya (Tsika dzeRopa) - "Muyero weGoridhe" wekuongorora
   • Maitiro: Mienzaniso yeropa remurwere, weti, sputum, kana dzimwe nzvimbo dzinofungidzirwa kuti dzine hutachiona dzinounganidzwa dzoiswa mumabhodhoro ane nzira yekukudziridza, ayo anobva achengetedzwa kuti akurudzire kukura kwezvirwere (mabhakitiriya kana fungi).
   • Basa: Uyu ndiwo "muyero wepamusoro" wekusimbisa sepsis uye kuziva chirwere chinokonzera. Kana chirwere changorimwa, bvunzo dzekudzivirira utachiona (AST) dzinogona kuitwa kuti dzitungamirire vanachiremba mukusarudza mishonga inorwisa utachiona inoshanda zvakanyanya. Zvisinei, dambudziko rayo guru inguva inodiwa (kazhinji maawa 24-72 kuti pave nemhedzisiro), izvo zvisingakodzeri kuita sarudzo dzekutanga dzekukurumidzira.
2. Kuedzwa kweBiomarker - "Masisitimu eAlarm" Anokurumidza
   Kuti vagadzirise dambudziko iri rinotora nguva yakareba, ma reagents akasiyana-siyana ekuona zviratidzo zve biomarker anoshandiswa zvakanyanya pakuongorora nekukurumidza.
   • Kuongororwa kweProcalcitonin (PCT): Iyi ndiyo biomarker inonyanya kukosha uye chaiyo inobatanidzwa ne sepsis parizvino.PCTipuroteni inowanikwa zvishoma muvanhu vane hutano hwakanaka, asi inogadzirwa yakawanda munyama dzakawanda mumuviri wese panguva yehutachiona hwakakomba hwebhakitiriya.PCT bvunzo (dzinowanzo shandiswa nzira dze immunochromatographic kana chemiluminescent) dzinopa mhedzisiro yakawanda mukati memaawa 1-2.PCTmazinga anonyanya kuratidza kuti kune bhakitiriya rinouraya utachiona uye anogona kushandiswa kutarisa kushanda kwemishonga inorwisa mabhakitiriya uye gwara rekuti mishonga iyi irege kushandiswa.
   • Kuongororwa kweC-reactive protein (CRP): CRP ipuroteni ye "acute-phase" inowedzera nekukurumidza kana munhu azvimba kana hutachiona. Kunyangwe ichinyanya kubatwa nechirwere, haina kunyanya kutaurwa nezvayo panePCTnekuti inogona kukwidziridzwa mumamiriro akasiyana-siyana, kusanganisira hutachiona hwehutachiona uye kukuvara. Inowanzo shandiswa pamwe chete nezvimwe zviratidzo.
   • Kuwanda kweMasero Machena Eropa (WBC) neNeutrophil Percentage: Iyi ndiyo bvunzo inonyanya kuverengwa ropa rose (CBC). Varwere vane Sepsis vanowanzoratidza kuwedzera kana kudzikira kukuru kweWBC uye kuwedzera kwehuwandu hwemasero eropa (kuruboshwe). Zvisinei, hunhu hwayo hwakaderera, uye inofanira kutsanangurwa pamwe chete nezvimwe zviratidzo.
3. Maitiro Ekuongorora Mamorekuru - "Vasori" Vakanyatsojeka
   • Nzira: Matekiniki akadai sePolymerase Chain Reaction (PCR) uye Metagenomic Next-Generation Sequencing (mNGS). Matekiniki aya anoshandisa ma primer nema probes chaiwo (anogona kuonekwa se "reagents" yepamusoro) kuti aone zvakananga pathogen nucleic acids (DNA kana RNA).
   • Basa: Hazvidi kuti pave nekuongororwa kwezvirwere uye zvinogona kukurumidza kuona utachiona muropa mukati memaawa mashoma, kunyangwe kuona tupukanana twakaoma kuratidzwa. Kunyanya kana tsika dzechivanhu dzisina kunaka asi fungidziro yekiriniki ichiri yakakwira, mNGS inogona kupa zviratidzo zvakakosha zvekuongororwa. Zvisinei, nzira idzi dzinodhura zvakanyanya uye hadzipe ruzivo rwekubatwa nehutachiona hwemabhakitiriya.
4. Kuongororwa kweLactate - Kuyera "Dambudziko"
   • Kupera simba kweropa mumuviri uye kushaya simba remuviri ndizvo zvinonyanya kukonzera kutadza kushanda zvakanaka kwenhengo dzemuviri nekuda kwe sepsis. Kuwedzera kwehuwandu hwe lactate muropa chiratidzo chekushaya simba kwemuviri mumuviri. Zvishandiso zvekuongorora lactate zvinokurumidza kuyera huwandu hwe lactate muropa (mukati memaminitsi). Hyperlactatemia (>2 mmol/L) inoratidza chirwere chakakomba uye fungidziro yakaipa, uye chiratidzo chakakosha chekutanga kurapwa kwakasimba.

Mhedziso

Sepsis inhangemutange inopesana nenguva. Vakwegura, vasina simba, avo vane zvirwere zvisina kusimba, uye avo vane zvirwere zvakasiyana ndivo vanonyanya kurwiswa. Kune mapoka aya ane njodzi huru, chero zviratidzo zvehutachiona zvinofanirwa kurapwa nekungwarira. Mishonga yemazuva ano yakagadzira nzira yekuongorora nekukurumidza kuburikidza nenzira dzakasiyana-siyana, kusanganisira kuongorora ropa, kuongororwa kwe biomarker sengePCT/CRP, kuongorora mamorekuru, uye kuyedzwa kwe lactate. Pakati peizvi, mhando dzakasiyana dze reagents dzinoshanda zvakanyanya uye dzinonzwisisika dzekuongorora chirwere ndidzo dzinokosha pakuyambira pakutanga, kuziva chirwere nemazvo, uye kupindira panguva yakakodzera, zvichivandudza zvikuru mikana yevarwere yekupona. Kuziva njodzi, kugadzirisa zviratidzo zvepakutanga, uye kuvimba nehunyanzvi hwepamusoro hwekuongorora chirwere ndizvo zvombo zvedu zvine simba pakurwisa "muurayi asingaoneki" uyu.