Ubani osengozini enkulu ye-Sepsis?

Nakuba noma ubani engase abe ne-sepsis uma enokutheleleka, la maqembu alandelayo asengozini enkulu kakhulu futhi adinga ukuqapha okwengeziwe:

1. Izinsana Nabadala: Isici esivamile salaba bantu amasosha omzimba angathuthukisiwe. Amasosha omzimba ezinsana nabantwana abancane awakakhuli ngokugcwele, kuyilapho amasosha omzimba asebekhulile ehla ngokukhula futhi ngokuvamile ahambisana nezifo eziningi ezicashile, okwenza kube nzima ngabo ukulwa ngokuphumelelayo nezifo.
2. Iziguli Ezinezifo Ezingamahlalakhona: Iziguli ezinezifo ezifana nesifo sikashukela, umdlavuza, isibindi nesifo sezinso, isifo esingamahlalakhona sokuvimbela ipulmonary (COPD) noma i-HIV/AIDS zinezinqubo zokuzivikela zomzimba ezibuthakathaka kanye nemisebenzi yezitho, okwenza izifo zibe maningi amathuba okuba zingalawuleki.
3. Abantu Abangenayo I-Immunocompromised: Lokhu kufaka phakathi iziguli ezinomdlavuza ezilashwa ngamakhemikhali, abantu abathatha ama-immunosuppressants ngemva kokufakelwa kwesitho, kanye nabantu abanezifo ezizimele, lapho amasosha abo omzimba engakwazi ukuphendula ngempumelelo kumagciwane.
4. Iziguli ezine-Trauma Enzima noma Ukuhlinzwa Okukhulu: Ezigulini ezinokusha okukhulu, ukuhlukumezeka okukhulu noma ukuhlinzwa okukhulu, isikhumba noma umgoqo we-mucosal ubhujiswa, uhlinzeka ngesiteshi sokuthi amagciwane ahlasele, futhi umzimba usesimweni sokucindezeleka okukhulu.
5. Abasebenzisi Bamadivaysi Ezokwelapha Ahlaselayo: Iziguli ezinama-catheter (njengama-venous catheter, ama-urinary catheter), zisebenzisa ama-ventilator noma ezinamashubhu okukhipha amanzi emizimbeni yazo, le mishini ingase ibe “izinqamuleli” zokuthi amagciwane angene emzimbeni womuntu.
6. Abantu Abanezifo Zakamuva noma Ukulaliswa Esibhedlela: Ikakhulukazi ezigulini ezinenyumoniya, ukutheleleka kwesisu, ukutheleleka komgudu womchamo noma ukutheleleka kwesikhumba, uma ukwelashwa kungafika ngesikhathi noma kungasebenzi, ukutheleleka kungasakazeka kalula egazini futhi kubangele i-sepsis.

Ungayithola kanjani i-sepsis? Ama-reagents abalulekile adlala indima ebalulekile

Uma abantu abasengozini enkulu beba nezimpawu okusolakala ukuthi zokutheleleka (njengomkhuhlane, ukugodola, ukuphelelwa umoya, ukushaya kwenhliziyo okusheshayo, nokudideka), kufanele bafune usizo lwezokwelapha ngokushesha. Ukuxilongwa kusenesikhathi kuncike ochungechungeni lokuhlolwa komtholampilo kanye nokuhlolwa kwaselabhorethri, phakathi kwayo izinhlobonhlobo ze-in vitro diagnostic (IVD) reagents "amehlo" abalulekile odokotela.

1. I-Microbial Culture (Isiko Legazi) - I-Diagnostic "Gold Standard"
   • Indlela: Amasampula egazi lesiguli, umchamo, isikhwehlela, noma ezinye izindawo okusolakala ukuthi zinegciwane ziyaqoqwa bese zifakwa emabhodleleni aqukethe i-culture medium, abese efukanyelwa ukuze akhuthaze ukukhula kwamagciwane (amagciwane noma isikhunta).
   • Iqhaza: Leli "izinga legolide" lokuqinisekisa i-sepsis nokuhlonza i-pathogen eyimbangela. Uma i-pathogen isikhulile, ukuhlolwa kwe-antimicrobial susceptibility testing (AST) kungenziwa ukuze kuqondiswe odokotela ekukhetheni ama-antibiotic asebenza kakhulu. Kodwa-ke, ukuhlehla kwayo okuyinhloko yisikhathi esidingekayo (imvamisa amahora angama-24-72 ngemiphumela), engahambisani nokuthathwa kwezinqumo eziphuthumayo.
2. Ukuhlolwa kwe-Biomarker - "Izinhlelo ze-alamu" ezisheshayo
   Ukuze kulungiswe inkinga yesiko edla isikhathi, izinhlobonhlobo zama-reagents okuthola ama-biomarker zisetshenziswa kabanzi ukuze kuxilongwe ngokushesha.
   • Ukuhlolwa kwe-Procalcitonin (PCT).: Lokhu okwamanje kuyi-biomarker ebaluleke kakhulu futhi ethize ehlotshaniswa ne-sepsis.I-PCTiphrotheni ekhona emazingeni aphansi kakhulu kubantu abanempilo, kodwa ikhiqizwa ngobuningi ezicutshini eziningi emzimbeni wonke ngesikhathi sokutheleleka okunzima kwebhaktheriya.I-PCT izivivinyo (ngokuvamile kusetshenziswa izindlela ze-immunochromatographic noma ze-chemiluminescent) zinikeza imiphumela yobuningi phakathi kwamahora angu-1-2. IphakanyisiweI-PCTamazinga aphakamisa kakhulu i-sepsis yebhaktheriya futhi angasetshenziswa ukuqapha ukuphumelela kokwelashwa ngama-antibiotic kanye nokuyeka ukuqondisa.
   • Ukuhlolwa kwe-C-reactive protein (CRP).: I-CRP iphrotheni yesigaba esibucayi ekhula ngokushesha ekuphenduleni ukuvuvukala noma ukutheleleka. Nakuba izwela kakhulu, ayicacisi kangakoI-PCTngoba ingakhushulwa ezimweni ezihlukahlukene, kuhlanganise nezifo ezibangelwa amagciwane kanye nokuhlukumezeka. Ivame ukusetshenziswa ngokuhambisana nezinye izimpawu.
   • I-White Blood Cell Count (WBC) kanye Nephesenti Le-Neutrophil: Lokhu ukuhlolwa kwesibalo segazi esiphelele esiyisisekelo (CBC). Iziguli ze-Sepsis zivame ukubonisa ukwanda okuphawulekayo noma ukwehla kwe-WBC kanye nephesenti elikhulayo lama-neutrophils (ukushintsha kwesobunxele). Nokho, ukucaciswa kwayo kuphansi, futhi kufanele kuhunyushwe ngokuhambisana nezinye izinkomba.
3. Amasu Okuxilonga Amangqamuzana - Ukunemba “Ama-Scouts”
   • Indlela: Amasu afana ne-Polymerase Chain Reaction (PCR) kanye ne-Metagenomic Next-Generation Sequencing (mNGS). Lobu buchwepheshe busebenzisa ama-primers athile kanye nama-probes (okungabonakala “njengama-reagents” athuthukile) ukuze kutholwe ngokuqondile i-pathogen nucleic acid (i-DNA noma i-RNA).
   • Iqhaza: Azidingi isiko futhi ziyakwazi ukubona ngokushesha amagciwane egazini emahoreni ambalwa, ngisho nokubona izinto eziphilayo okunzima ukuzijwayeza. Ikakhulukazi lapho amasiko endabuko engemihle kodwa izinsolo zomtholampilo zihlala ziphezulu, i-mNGS inganikeza izinkomba zokuxilonga ezibucayi. Kodwa-ke, lezi zindlela zibiza kakhulu futhi azinikezi ulwazi lokungenwa ngama-antibiotic.
4. Ukuhlola I-Lactate - Ukulinganisa Izinga "Lenhlekelele".
   • I-hypoperfusion yezicubu kanye ne-hypoxia kuphakathi kokungaphumeleli kwesitho esidalwa yi-sepsis. Amazinga e-lactate aphakanyisiwe awuphawu olucacile lwe-tissue hypoxia. Amakhithi okuhlola i-lactate esheshayo aseceleni kombhede angakala ngokushesha ukugxila kwe-lactate ku-plasma (kungakapheli imizuzu). I-Hyperlactatemia (>2 mmol/L) ikhombisa ngokuqinile ukugula okunzima kanye nokubikezela okubi, futhi kuyinkomba ebalulekile yokuqala ukwelashwa okunamandla.

Isiphetho

I-Sepsis umjaho wokulwa nesikhathi. Abantu asebekhulile, ababuthaka, labo abanezimo zezempilo ezicashile, nalabo abanezimo ezithile zempilo yizona okuhloswe ngazo okuyinhloko. Kula maqembu asengozini enkulu, noma yiziphi izimpawu zokutheleleka kufanele ziphathwe ngokuqapha. Imithi yesimanje isungule uhlelo lokuxilonga ngokushesha ngokusebenzisa uhla lwezindlela, okuhlanganisa amasiko egazi, ukuhlolwa kwe-biomarker njengeI-PCT/I-CRP, ukuhlolwa kwamangqamuzana, nokuhlolwa kwe-lactate. Phakathi kwalokhu, ama-reagents okuhlonza asebenza kahle kakhulu futhi azwelayo ayisisekelo sesixwayiso sangaphambi kwesikhathi, ukuhlonza okunembile, nokungenelela okufika ngesikhathi, athuthukisa kakhulu amathuba eziguli okusinda. Ukubona ubungozi, ukubhekana nezimpawu zakuqala, nokuncika kubuchwepheshe bokubona obuthuthukile kuyizikhali zethu ezinamandla kakhulu zokulwa nalo “mbulali ongabonakali.”