Ngubani oseMngciphekweni oMkhulu weSepsis?

Ngelixa nabani na enokuphuhlisa i-sepsis ukuba unosulelo, la maqela alandelayo asemngciphekweni omkhulu kakhulu kwaye afuna isilumkiso esingaphezulu:

1. Iintsana nabantu abadala: Uphawu oluqhelekileyo kwaba bantu kukungaphuhliswa kakuhle kwamajoni omzimba. Amajoni okuzikhusela kwiintsana kunye nabantwana abancinci akakakhuli ngokupheleleyo, ngelixa amajoni omzimba asebekhulile ehla ngokuguga kwaye ahlala ehamba kunye nezifo ezininzi eziphantsi, okwenza kube nzima kubo ukulwa ngokufanelekileyo nezifo.
2. Izigulane ezinezifo ezingapheliyo: Izigulane ezinezifo ezifana nesifo seswekile, umhlaza, isibindi kunye nesifo sezintso, isifo esingapheliyo se-pulmonary disease (COPD) okanye i-HIV / AIDS baneendlela zokukhusela umzimba ezibuthathaka kunye nemisebenzi yamalungu, okwenza usulelo lukwazi ukuphuma kulawulo.
3. I-Immunocompromised Individuals: Ezi ziquka izigulane zomhlaza ezifumana i-chemotherapy, abantu abathatha i-immunosuppressants emva kokutshintshwa kwelungu, kunye nabantu abanezifo ezizimelayo, apho amajoni abo omzimba angakwazi ukuphendula ngokufanelekileyo kwii-pathogens.
4. Izigulane ezine-Trauma enzima okanye uTyando oluKhulu: Kwizigulane ezinokutshisa okukhulu, ukuxhwaleka okukhulu okanye utyando olukhulu, ulusu okanye umqobo we-mucosal utshabalaliswa, ukubonelela umjelo we-pathogens ukuhlasela, kwaye umzimba ukwimeko yoxinzelelo oluphezulu.
5. Abasebenzisi beZixhobo zoNyango eziHlangeneyo: Izigulane ezine-catheters (ezifana ne-catheter ye-venous central, i-catheter ye-urinary), usebenzisa i-ventilators okanye i-tubes ye-drainage emizimbeni yabo, ezi zixhobo zinokuba "iindlela ezimfutshane" ze-pathogens ukungena emzimbeni womntu.
6. Abantu abanesifo samva nje okanye ukulaliswa esibhedlele: Ngokukodwa kwizigulane ezinenyumoniya, usulelo lwesisu, usulelo lwe-urinary tract okanye usulelo lwesikhumba, ukuba unyango alufikanga okanye lungasebenzi, usulelo lunokusasaza ngokulula egazini kwaye lubangele i-sepsis.

Indlela yokufumanisa i-sepsis? Ii-reagents eziphambili zokubona zidlala indima engundoqo

Ukuba abantu abasemngciphekweni omkhulu baba neempawu ezirhanelekayo zosulelo (ezifana nomkhuhlane, ukugodola, ukuphefumla nzima, ukubetha kwentliziyo ngokukhawuleza, nokubhideka), kufuneka bafune unyango ngokukhawuleza. Ukuxilongwa kwangethuba kuxhomekeke kuthotho lovavanyo lweklinikhi kunye novavanyo lwaselabhoratri, phakathi kwazo iintlobo ngeentlobo ze-in vitro diagnostic (IVD) ii-reagents zovavanyo “ngamehlo” ayimfuneko koogqirha.

1. INkcubeko yeMicrobial (iNkcubeko yeGazi) - Uxilongo "Umgangatho weGold"
   • Indlela: Iisampulu zegazi lesigulana, umchamo, isikhohlela, okanye ezinye iindawo ekurhaneleka ukuba zosuleleko ziyaqokelelwa zize zifakwe kwiibhotile ezinesixhobo sokukhuliswa, ezithi ke zifukanyiswe ukukhuthaza ukukhula kweentsholongwane (iintsholongwane okanye umngundo).
   • Indima: Lo "ngumgangatho wegolide" wokuqinisekisa i-sepsis kunye nokuchonga i-causative pathogen. Emva kokuba i-pathogen ikhuliswe, uvavanyo lwe-antimicrobial susceptibility test (AST) lunokwenziwa ukukhokela oogqirha ekukhetheni awona mayeza asebenzayo. Nangona kunjalo, i-drawback yayo ephambili yithuba elifunekayo (ngokuqhelekileyo iiyure ezingama-24-72 kwiziphumo), ezingahambelani nesigqibo sokuqala esiphuthumayo.
2. Uvavanyo lweBiomarker-“Iinkqubo zeAlarm” eziKhawulezayo
   Ukuze kulungiswe isiphene esichitha ixesha lenkcubeko, iintlobo ngeentlobo ze-biomarker zokufumanisa i-reagents zisetyenziselwa ukuxilongwa ngokukhawuleza kokuncedisa.
   • Uvavanyo lweProcalcitonin (PCT).: Oku okwangoku yeyona nto ibalulekileyo kunye ne-biomarker ethile ehambelana ne-sepsis.PCTyiprotheyini ekhoyo kumanqanaba aphantsi kakhulu kubantu abasempilweni, kodwa iveliswa ngobuninzi kwiithishu ezininzi kuwo wonke umzimba ngexesha losulelo olubi lwebhaktiriya.PCT iimvavanyo (ngokuqhelekileyo zisebenzisa i-immunochromatographic okanye iindlela ze-chemiluminescent) zibonelela ngeziphumo zobuninzi kwiiyure ze-1-2. UnyusiwePCTamanqanaba aphakamisa kakhulu i-sepsis yebhaktiriya kwaye ingasetyenziselwa ukubeka iliso ekusebenzeni konyango lwe-antibiotic kunye nokuyeka ukukhokela.
   • Uvavanyo lweprotheyini esebenzayo (CRP).: CRP yiprotheni yesigaba esibukhali esonyuka ngokukhawuleza ekuphenduleni ukuvuvukala okanye usulelo. Ngelixa olunobuntununtunu kakhulu, ayicacisi kangako kunePCTkuba inokunyuswa kwiimeko ezahlukeneyo, kubandakanywa nosulelo lwentsholongwane kunye nokwenzakala. Ihlala isetyenziswa ngokubambisana nabanye abamakishi.
   • Ubalo lweeseli zeGazi eziMhlophe (WBC) kunye nePesenti yeNeutrophil: Olu lolona vavanyo lusisiseko olupheleleyo lwegazi (CBC). Izigulane ze-Sepsis zihlala zibonisa ukwanda okukhulu okanye ukuncipha kwe-WBC kunye nepesenti eyongeziweyo ye-neutrophils (i-shift shift). Nangona kunjalo, ukuchaneka kwayo kuphantsi, kwaye kufuneka itolikwe kunye nezinye izikhombisi.
3. Iindlela zokuxilonga zeMolekyuli-Ukuchaneka “iiScouts”
   • Indlela: Ubuchwephesha obufana nePolymerase Chain Reaction (PCR) kunye neMetagenomic Next-Generation Sequencing (mNGS). Ezi teknoloji zisebenzisa ii-primers ezithile kunye neeprobes (ezinokuthi zibonwe njenge "reagents" eziphambili) ukufumanisa ngokuthe ngqo i-pathogen nucleic acids (DNA okanye i-RNA).
   • Indima: Azifuni isiko kwaye ziyakwazi ukuzibona ngokukhawuleza iintsholongwane egazini kwiiyure nje ezimbalwa, nokuba zibhaqe nezinto ekunzima ukuzikhulisa. Ngokukodwa xa iinkcubeko zemveli zingalunganga kodwa ukukrokra kwezonyango kuhlala kuphezulu, i-mNGS inokubonelela ngeempawu zoxilongo ezibalulekileyo. Nangona kunjalo, ezi ndlela zibiza kakhulu kwaye aziboneleli ngolwazi lokungenwa ngamayeza okubulala iintsholongwane.
4. Uvavanyo lweLactate - Ukulinganisa iNqanaba "leNgxaki".
   • I-tissue hypoperfusion kunye ne-hypoxia zingundoqo kwi-sepsis-induced organ failure. Amanqanaba e-lactate aphakanyisiweyo luphawu olucacileyo lwe-tissue hypoxia. Izixhobo zokuvavanya i-lactate esecaleni kwebhedi zinokulinganisa ngokukhawuleza ukuxinana kwe-lactate yeplasma (kwimizuzu nje). I-Hyperlactatemia (> 2 mmol / L) ibonisa ngokucacileyo ukugula okunzima kunye ne-prognosis embi, kwaye isalathisi esibalulekileyo sokuqalisa unyango olunzulu.

Ukuqukumbela

I-Sepsis lugqatso oluchasene nexesha. Abantu abadala, ababuthathaka, abo baneemeko zonyango eziphantsi, kunye nabo baneemeko ezithile zonyango zizinto ekujoliswe kuzo eziphambili. Kula maqela asemngciphekweni omkhulu, naziphi na iimpawu zosulelo kufuneka ziphathwe ngononophelo. Iyeza lanamhlanje liseke inkqubo yokuxilonga ngokukhawuleza ngeendlela ezininzi, kubandakanywa neenkcubeko zegazi, uvavanyo lwe-biomarker njengePCT/CRP, ukuxilongwa kweemolekyuli, kunye novavanyo lwe-lactate. Phakathi kwezi, iintlobo ngeentlobo ze-reagents zokubona ezisebenza kakuhle kakhulu kwaye zinovakalelo zisisiseko sesilumkiso sokuqala, ukuchongwa ngokuchanekileyo, kunye nokungenelela kwangethuba, ukuphucula kakhulu amathuba okuphila kwezigulane. Ukuqaphela imingcipheko, ukujongana neempawu zokuqala, kunye nokuxhomekeka kubuchwephesha bokubona obuphambili zezona zixhobo zinamandla ngokuchasene nalo “mbulali ungabonakaliyo.”