Ngubani osemngciphekweni ophezulu weSepsis?

Nangona nabani na enokuba ne-sepsis ukuba unosulelo, la maqela alandelayo asengozini enkulu kwaye afuna ukulumka ngakumbi:

1. Iintsana kunye nabantu abadala: Uphawu oluqhelekileyo lwaba bantu kukungabikho kwenkqubo yomzimba yokuzikhusela ephucukileyo. Inkqubo yomzimba yokuzikhusela yeentsana nabantwana abancinci ayikakhuli ngokupheleleyo, ngelixa inkqubo yomzimba yokuzikhusela yabantu abadala iyehla njengoko bekhula kwaye idla ngokuhamba nezifo ezininzi ezisisiseko, nto leyo eyenza kube nzima kubo ukulwa ngempumelelo nosulelo.
2. Izigulana ezineZifo eziNgapheliyo: Izigulana ezinezifo ezifana nesifo seswekile, umhlaza, isifo sesibindi nezintso, isifo esingapheliyo semiphunga (COPD) okanye i-HIV/AIDS zineendlela zokuzikhusela zomzimba ezibuthathaka kunye nemisebenzi yezitho zomzimba, nto leyo eyenza ukuba usulelo lungabi namandla.
3. Abantu Abangenawo Amandla Okuzikhusela: Aba baquka izigulane ezinomhlaza ezifumana unyango lwe-chemotherapy, abantu abathatha amayeza okunciphisa amandla okuzikhusela emva kokufakelwa amalungu omzimba, kunye nabantu abanezifo ezikhusela umzimba, apho amajoni abo omzimba engakwaziyo ukuphendula ngokufanelekileyo kwiintsholongwane.
4. Izigulana ezineNgxaki Enkulu okanye Utyando Olukhulu: Kwizigulana ezitshileyo kakhulu, ezenzakeleyo kakhulu okanye ezityandwa kakhulu, umqobo wolusu okanye we-mucosal uyatshatyalaliswa, nto leyo enika ithuba lokuba iintsholongwane zingene, kwaye umzimba uxinezelekile kakhulu.
5. Abasebenzisi beZixhobo zonyango ezingenelelayo: Izigulana ezinee-catheters (ezifana nee-catheters zemithambo ephakathi, ii-catheters zomchamo), ezisebenzisa ii-ventilators okanye ezineetyhubhu zokukhupha amanzi emizimbeni yazo, ezi zixhobo zinokuba “ziindlela ezimfutshane” zokuba iintsholongwane zingene emzimbeni womntu.
6. Abantu Abasandula Usulelo okanye Abangeniswe Esibhedlele: Ingakumbi kwizigulane ezine-pneumonia, usulelo lwesisu, usulelo lomchamo okanye usulelo lolusu, ukuba unyango alufikeleli ngexesha okanye alusebenzi, usulelo lunokusasazeka lula luye egazini luze lubangele i-sepsis.

Ungayibhaqa njani i-sepsis? Izinto eziphambili zokufumanisa zidlala indima ephambili

Ukuba abantu abasengozini enkulu bafumanisa iimpawu ezirhanelwayo zosulelo (ezifana nomkhuhlane, ukugodola, ukuphefumla kancinci, ukubetha kwentliziyo ngokukhawuleza, kunye nokudideka), kufuneka bafune uncedo lwezonyango ngokukhawuleza. Ukuxilongwa kwangoko kuxhomekeke kuthotho lovavanyo lweklinikhi kunye novavanyo lwelabhoratri, phakathi kwazo iintlobo ngeentlobo zee-reagents zovavanyo lwe-in vitro diagnostic (IVD) "ziiliso" eziyimfuneko kakhulu koogqirha.

1. Inkcubeko yeentsholongwane (Inkcubeko yegazi) – “Umgangatho wegolide” wokuxilongwa
   • Indlela: Iisampulu zegazi, umchamo, i-sputum, okanye ezinye iindawo ezirhanelwayo zosulelo ziyaqokelelwa zize zibekwe kwiibhotile ezine-culture medium, ezithi emva koko zifakwe kwi-incubator ukukhuthaza ukukhula kwezifo ezibangela iintsholongwane (iibhaktheriya okanye iifungi).
   • Indima: Le "ngumgangatho ogqwesileyo" wokuqinisekisa i-sepsis kunye nokuchonga i-pathogen ebangela isifo. Nje ukuba i-pathogen ikhuliswe, uvavanyo lokuchaphazeleka yi-antimicrobial susceptibility (AST) lunokwenziwa ukukhokela oogqirha ekukhetheni ii-antibiotics ezisebenzayo. Nangona kunjalo, ingxaki yayo ephambili lixesha elifunekayo (ngesiqhelo iiyure ezingama-24-72 ukuze kufunyanwe iziphumo), elingafanelekiyo ekwenzeni izigqibo ezingxamisekileyo zokuqala.
2. Uvavanyo lweBiomarker – “Iinkqubo zeAlarm” ezikhawulezayo
   Ukuze kulungiswe ingxaki yenkcubeko ethatha ixesha elide, kusetyenziswa iindlela ezahlukeneyo zokuchonga ii-biomarker ukuze kufunyaniswe ngokukhawuleza.
   • Uvavanyo lweProcalcitonin (PCT): Okwangoku le yeyona biomarker ibalulekileyo nekhethekileyo enxulunyaniswa ne-sepsis.I-PCTyiproteni ekhoyo kumanqanaba aphantsi kakhulu kubantu abasempilweni, kodwa iveliswa ngobuninzi kwiithishu ezininzi emzimbeni wonke ngexesha losulelo olukhulu lweebhaktheriya.I-PCT Uvavanyo (oludla ngokusebenzisa iindlela ze-immunochromatographic okanye ze-chemiluminescent) lubonelela ngeziphumo zobungakanani kwiiyure ezi-1-2.I-PCTamanqanaba abonisa kakhulu i-bacterial sepsis kwaye angasetyenziselwa ukujonga ukusebenza kakuhle konyango lwee-antibiotics kunye nokubonisa indlela yokuyeka.
   • Uvavanyo lwe-C-reactive protein (CRP): I-CRP yiprotheyini yesigaba esibukhali ekhula ngokukhawuleza xa isabela ekudumbeni okanye usulelo. Nangona inobuthathaka kakhulu, ayichanekanga kangako kuneI-PCTkuba inokunyuka kwiimeko ezahlukeneyo, kuquka usulelo lwentsholongwane kunye nokwenzakala. Idla ngokusetyenziswa kunye nezinye iimpawu.
   • Inani leeSeli zeGazi eliMhlophe (i-WBC) kunye nePesenti yeNeutrophil: Olu lolona vavanyo lusisiseko lwenani elipheleleyo legazi (i-CBC). Izigulane zeSepsis zihlala zibonisa ukwanda okanye ukwehla okukhulu kwi-WBC kunye nepesenti eyonyukileyo yee-neutrophils (utshintsho lwasekhohlo). Nangona kunjalo, ukuchaneka kwayo kuphantsi, kwaye kufuneka itolikwe kunye nezinye izalathisi.
3. Iindlela Zokuxilonga Iimolekyuli – “Amaqhinga” Achanekileyo
   • Indlela: Iindlela ezifana nePolymerase Chain Reaction (PCR) kunye neMetagenomic Next-Generation Sequencing (mNGS). Ezi teknoloji zisebenzisa iiprimer kunye neeprobes ezithile (ezinokubonwa njenge "reagents" eziphambili) ukufumanisa ngokuthe ngqo i-pathogen nucleic acids (i-DNA okanye i-RNA).
   • Indima: Azidingi kukhula kwaye zinokubona ngokukhawuleza iintsholongwane egazini kwiiyure nje ezimbalwa, zide zibone nezinto eziphilayo ezinzima ukuzikhulisa. Ingakumbi xa iinkcubeko zemveli zingalunganga kodwa ukurhanelwa kwezonyango kuhlala kuphezulu, i-mNGS inokubonelela ngeempawu ezibalulekileyo zokuxilonga. Nangona kunjalo, ezi ndlela zibiza kakhulu kwaye aziboneleli ngolwazi lokuba sesichengeni sokuchasana namayeza okubulala iintsholongwane.
4. Uvavanyo lweLactate – Ukulinganisa iNqanaba “leNgxaki”
   • Ukuncipha komthamo wezicubu kunye nokuncipha komthamo we-hypoxia zizinto eziphambili ekusileleni kwamalungu omzimba okubangelwa yi-sepsis. Amanqanaba aphezulu e-lactate luphawu olucacileyo lwe-hypoxia yezicubu. Iikiti zovavanyo lwe-lactate ezikhawulezayo ecaleni kwebhedi zinokulinganisa ngokukhawuleza amazinga e-lactate kwi-plasma (kwimizuzu embalwa). I-Hyperlactatemia (>2 mmol/L) ibonisa kakhulu ukugula okuqatha kunye ne-prognosis embi, kwaye luphawu olubalulekileyo lokuqalisa unyango oluqatha.

Isiphelo

I-Sepsis lugqatso oluchasene nexesha. Abantu abadala, ababuthathaka, abo baneengxaki zempilo ezingaphantsi, kunye nabo baneengxaki ezithile zempilo ngabona bantu baphambili abajoliswa kubo. Kwala maqela asengozini enkulu, naziphi na iimpawu zosulelo kufuneka ziphathwe ngononophelo. Amayeza anamhlanje aseke inkqubo yokuxilonga ngokukhawuleza ngeendlela ezahlukeneyo, kubandakanya iinkcubeko zegazi, uvavanyo lwe-biomarker olufanaI-PCT/I-CRP, ukuxilongwa kweemolekyuli, kunye novavanyo lwe-lactate. Phakathi kwezi, iintlobo ngeentlobo zee-reagents zokufumanisa ezisebenza kakuhle nezinobukrelekrele zezona zinto zibalulekileyo ekulumkiseni kwangethuba, ukuchonga ngokuchanekileyo, kunye nokungenelela ngexesha elifanelekileyo, nto leyo ephucula kakhulu amathuba okusinda kwezigulane. Ukuqonda iingozi, ukujongana neempawu zangethuba, kunye nokuthembela kubuchwepheshe bokufumanisa obuphambili zezona zixhobo zethu zinamandla zokulwa nalo “mbulali ungabonakaliyo.”