Pneumonia Nosocomial: wareer ah, daaweynta iyo ka hortaga

pneumonia Nosocomial - waa hab degdeg ah faafa dhaca jidhka ku sarkhaansan yihiin nolol firfircoon oo bakteeriyada pathogenic. Tilmaamo sifo cudurka waa kaarka pulmonary marinka hawada nabar leh raasamaal gudaha ee mugga weyn oo cabitaan ah. Exudate danbe iyada oo loo marayo gobolka Oodweyne iyo guskiisa unugyada nudaha kelyaha.

Updated xeerarka qaranka ee pneumonia isbitaalka-helay

Laga bilaabo 2014 "Society Respiratory" dunida soo bandhigay in tilmaamo caafimaad. Waxay ku salaysan yihiin isku geynta ah ogaanshaha iyo daawaynta xaaladaha ay jirto shaki ah in bukaanka soconayo pneumonia nosocomial. tilmaamaha Qaranka ee ay khubarada, rugaha caafimaadka, shaqaalaha daryeelka caafimaadka, wajahay cudurka ba'an ee neef-mareenka.

Si kooban, isku geynta ka kooban yahay afar dhibcood.

1. Go'aanso haddii aad u baahan tahay in isbitaal. Go'aan wanaagsan laga sameeyey, haddii bukaanku si cad u muujiyay in neefsigu, waxaa jira perfusion ah unugyada hoos u dhac, ba'an is-sumowga, miyir oo yaraada, cadaadis dhiig oo aan degganayn. Si aad in lagu meeleeyaa isbitaalka arrin la go'aaminayo ugu yaraan hal calaamad.
2. Go'aaminta sababta cudurka. Si arrintan loo sameeyo, bukaanka waxaa qoray tiro ka mid ah cilmiga shaybaarka qalabka noolaha: dhaqanka dhiig, dhaqanka ka, xaako bakposev, imtixaanka xididka-xawaaraha sare ah si loo ogaado nooca antigenurii bakteeriyada.
3. Go'aaminta muddada daawaynta. Waase in uu cudurku waa soo jeedo bakteeriyada, laakiin sababta dhabta ah aan la aasaasay, therapy waxaa sameeyay in ka badan toban maalmood. At dhibaatooyin kala duwan ama koorso-daweynta diiradda sambabada laga yaabaa in ilaa 21 cisho.
4. Tallaabooyinka loo baahan yahay joogista bukaan-jiifka. In xaalad halis ah, bukaanada u baahan Neefta ama hawo non-invasive.

Sidoo kale xeerarka qaranka qoray tallaabooyin ka hortag ah. Kuwa ugu waxtar badan yahay tallaalka hargabka iyo pneumococcus, magacaabay inta badan bukaanka qaba pneumonia chronic iyo Insiba da'da ka weyn.

pneumonia Gaar ahaan bulshada helay

pneumonia nosocomial Community-helay waa magaca kale ee caadiga ah - bulshada helay. Cudurku waxaa keena jeermiska cudurka of etiology bakteeriyada. wadada ugu muhiimsan ee cudurka - deegaanka. Iyadoo la raacayo, go'aan ka soo noqon doonaa sida soo socota: card nabar sambabada bararka helay dhibco, kuna waari dhexdeeda xiriir kor ku xusan la sidayaal caabuq in daryeel caafimaad oo goobaha bukaan ma ahaa.

Community-helay iyo pneumonia nosocomial asal ahaan bakteeriyada sida caadiga ah cudurka bukaanka qaba difaac hoos, marka jidhku waa in ay iska caabin wareer ah (pneumococcus, Haemophilus influenzae, Klebsiella) awoodin. Waxay dhex galay saabka of sambabada iyada oo meelihii sanka.

kooxda halista waxaa ka mid ah carruurta oo ka tirsan kooxda da'da yar iyo dadka qaba cudurada sanbabada chronic. Xaaladdan oo kale, wakiilka sababaya waa Staphylococcus aureus.

Community-helay pneumonia nosocomial: mabaadii'da kala soocidda cudurka

Si loo horumariyo daaweynta saxda ah ee pneumonia loo kala saaro by-beegyada uu:

• cudur aan la Ulasocto hoos ka mid ah hawlaha ilaaliya ee u shaqeeyo;
• Cudurka inuu soo baxo ka dhanka ah asalka ah oo ah difaaca jirka hoos u,
• cudurka timi in marxaladda ba'an ee AIDS;
• cudurka, aasaasay in lala cudurada kale.

Sida caadiga ah, cudurka waxa la xaqiijiyay in bukaanka qaba dhibaato qaab difaac la tixraacayo ee kansarka ama Dhiigga hoos. Sidoo kale kooxda halista ah, bukaanka qaadanaya steroids ah qiyaasta sare waqti dheer. Sidoo kale, waxaa jira marar marka cudurka ku dhacaa bukaanka qaba heley difaaca chronic.

Intaa waxaa dheer, category gooni ah waxaa ka mid ah noocan ah pneumonia waa rajo gelin.

Dhakhaatiirta la soco in markan in hab ay asal ahaan ka mid ah nooc kasta oo ka mid ah pneumonia rajo gelin darteed waxaa jira jidhadhka shisheeye xiriir la kaas oo cudurka uu yeesho.

pneumonia Gaar ahaan nosocomial

Aragtidani waxa la saarayaa xaaladda caafimaad ee bukaanka, marka caabuq qaybta sambabada ayaa lagu muujiyay dib markii ku saabsan 72 saacadood ka dib markii cudurka. Khatarta ugu been in xaqiiqda ah in pneumonia nosocomial nosocomial ah mid qasan by dabiiciga ah ee koorsada iyo inta uu dhammaanayo dhimasho. Waxaa keena bakteeriyo ku nool derbiyada hay'adda caafimaadka, adkaysi u daawooyinka ugu, sidaas darteed waxaa aad u adag in la helo markii ugu horeysay antibiotic saxda ah.

Nosocomial Nosocomial pneumonia: mabaadii'da kala soocidda cudurka

nooca Mudnaanta ee isbitaalka pneumonia nosocomial waxa lagu tilmaamay in tallaabo cudurka:

1. stage Early - in shantii maalmood ee ugu horreeya helo bukaanka ah ee isbitaalka bilaabaan si ay u muujiyaan calaamadaha muuqda ee cudurka.
2. Marxaladda dambe - muujinta calaamadaha waa raagay in ka badan shan maalmood.

Iyada oo ku xidhan etiology cudurka jira saddex nooc:

1. Aspiration pneumonia nosocomial.
2. Postoperative.
3. Hawo-la xidhiidha.

Waxaa xusid mudan in soocidda soo bandhigay nooca ay tahay shuruud, iyo xaaladaha inta ugu badan ayaa lagu ogaadaa pneumonia qaab isku dhafan. Tani, markeeda, aad buu u sii xumaysaa xaaladda bukaanka iyo yaraynaysaa fursadaha soo kabashada.

Doonidba

foomka soo bandhigay cudurka waa kuwa ugu badan. Marka xab sanka infekshanka qaba marka waaxda pulmonary, waxaa jirka autoinfection.

ilaa dhuunta Liquid - meel fiican cunto bakteeriyada pathogenic, sidaa darteed, mar sambabada, sheyga bilaabaan inay si firfircoon badanayaan, oo wax ka tarta horumarinta pneumonia rajo gelin.

postoperative

Soo bandhigay nooca pneumonia waxaa lagu gartaa in 18 xaaladood caafimaad oo ka mid ah 100, waana la helay oo keliya ee bukaan kuwaas oo maray qaliin.

Xaaladdan oo kale, cudurka dhacdaa si la mid ah sida in pneumonia rajo gelin darteed, oo kaliya in ay dheecaanka dhuunta lagu daray iyo dheecaanka gastric, taas oo aan ka yarayn waa khatar. Sidoo kale, ha meesha kama saarayo cudurka oo ah alaabta caafimaadka bukaan-socodka iyo qalabka. Tuubo ama caabuq kateetarka si fudud ku faafi karaa mareenka hoose.

Hawo-xiriira

Ogaadaa in bukaannada ku jira waqti dheer marka la eego of hawo sambabada aan dabiici ahayn. muddo Safe ma aha in ka badan 72 saacadood ee gobolka this, ee soo socda iyada oo maalin kasta marayay wuxuu kordhiyaa khatarta ah ee soo koraya pneumonia.

pneumonia Nosocomial

isbitaalka pneumonia Nosocomial badanaa keena PNEUMOKOCKER. cudurka noocan oo kale ah waa 30 ilaa 50 boqolkiiba dhammaan xaaladaha caafimaad.

Bakteeriyada dagaal ugu yaraan waa Chlamydia, Mycoplasma iyo Legionella. Under saameynta ay, horumarinta pneumonia aan ka badnayn 30% balse ma ka yar tahay 8%.

disorder ugu yaraan tahay in laga helo kacay tixraacayo dhaqdhaqaaqa xorta ah, Haemophilus influenzae, Staphylococcus aureus, Klebsiella oo enterobacteria.

Weli wareer kale ee pneumonia nosocomial - fayraska hargabku waa class A iyo B, parainfluenza, adenovirus, virus syncytial neefsashada.

The wareer ah ugu badan ee pneumonia nosocomial nooca dagaal badan in ku siin karaan kor u dillaacay cudurka faafa, - Mycoplasma iyo Legionella. Xaaladda hore, inta badan dhallinyarada xanuunsan iyo dhalinyarada waaweyn ee ilaa 25 sano. cudurka Legionella A dhacdaa biyaha, tus marayo, in maskaxda dadweynaha, berkeddii weysada iyo kale.

Hababka casriga Baadhista xanuunada

Haddii bukaanka uu pneumonia, nooca bulshada-urursaday, waxaa inta badan laga helay by baaritaan jireed. In kiis kasta oo bukaan ah, sahlaansashada la socodka xaaladda bukaanka iyo calaamadaha cudurka bilowdo card gaar ah ama taariikhdaada caafimaad.

Joojinayaa cudurka bukaan-waa sida soo socota:

• Laab X-ray - Habka Baadhista X-ray in mashaariic images ku saabsan xaaladda sambabada in dhowr diyaaradood. In joogitaanka mugdi ah, dhibco cufan cudurka waxaa la xaqiijiyay. Cilad lagu muujiyay laba jeer: bilowga ah ee daaweynta iyo ka dib therapy antibiotic.

• imtixaanada Laboratory - bukaanka waxaa looga baahan yahay in ay ku deeqdo dhiigga, waayo, falanqaynta iyo go'aaminta tirada guud ee leukocytes, glucose iyo electrolytes.
• waxbarashada microbiological - fuliyay falanqayn dheecaanka pleural iyo midab ah ee neef-mareenka hoose waxaa lagu qeexaa by joogitaanka cudur kaadida.

Natiijada ka mid ah hababka ogaanshaha waa ku filan ogaanshaha kama dambaysta ah iyo horumarinta qorshaha daaweynta.

Talooyin ku saabsan daaweynta bukaanka

tilmaamaha Clinical lagu daaweyn jiray pneumonia nosocomial waa sida arrin dejinaya antibiotics ballaaran spectrum.

Kadib markii ay natiijo baadhitaan ah ee kartida shaqo ee dhakhtarka in la beddelo daroogada waxaa markii hore soo rogay ku ool ah. salaysan waa qaab sheyga pathogenic.

The mabaadiida daaweynta bukaannada qaba pneumonia nosocomial

Daaweynta pneumonia nosocomial ka kooban tahay in xulashada antibiotic habboon ee, ay mudada, wadada ka mid ah maamulka iyo qiyaasta. Waxaa ka hadlaya oo kaliya dhakhtarka xaadirka ah. Sidoo kale waa qayb muhiim ah oo therapy waa daaweynta dhaqancelinta mareenka (saarista dheecaan ururtay).

Ujeedadu waxay muhiim u tahay in la helo qof bukaan ah oo ku jira xaalad ah dhaqdhaqaaqa jirka. Waa in aad qabtaan jimicsiyo neefsasho iyo jimicsi yar oo ah qaab fadhiyaan-ups. Bukaanka ku jira xaalad halis ah, u caawiyaan kalkaaliyayaasha. Waxay ku hawlan yihiin isbeddel joogto ah oo meel ka mid ah bukaanka, jidaynayey dareeraha ma dooran boosas hal meel.

Looga hortago cudurada soo noqnoqda caawin lahaa ka hortagga pneumonia nosocomial, kaas oo faah faahsan u sharax dhakhtarka.

therapy antibiotic

Daaweynta loogu talagalay bakteeriyada la dagaallanka, waxay leedahay laba nooc: ula kac ah iyo suulka. Marka hore, bukaanka oo dhan waxaa lagu daaweeyaa siman nooca iyo si toos ah u magacaabay ka dib markii la go'aaminayo wakiilka sababaya.

The xaaladaha ugu muhiimsan ee dib u soo kabashada waa:

1. Horumarinta daaweynta antibiotic habboon.
2. isticmaalka hoos antimicrobials.

Soo qaado daawooyinka bakteeriyada iyo qiyaasta karaa dhakhtar oo keliya, daroogada is-bedel aan la aqbali karin.

Saadaasha rayshada

Iyada oo ku xidhan daroogada sax ah loo doortay, adkaanta cudurka iyo gobolka guud ee natiijada bukaan daaweynta waxaa laga yaabaa in sida soo socota: kabashada, xoogaa horumar ah, daaweynta failure, soo noqoshada, iyo dhimasho.

In pneumonia nosocomial jaaniska dhimashada waa ka sii badan qaab bulshada helay.

tallaabooyinka ka hortagga

Ka hortagga pneumonia nosocomial wakiil tallaabooyin caafimaad iyo epidemioligal kakan:

• daaweynta waqtigii cudurada la xiriira;
• waafaqsan xeerarka iyo heerarka faya-dhowrka;
• qaata wakiilada immunomodulatory;
• tallaalka.

Waa arrin aad u muhiim ah in hagaajinta xaaladda bukaanka - si looga hortago soo noqoshada - si ay ula socdaan dhaqmayo sharciyada fudud: fayadhowrka joogtada ah ee saabka afka, qufaco dheecaan, dhaqdhaqaaqa jirka.