Sepsis carruurta: calaamadaha, daaweynta, sawiro

daawo Modern si degdeg ah horumarinta, laakiin inkastoo this, waxaa weli jira dhibaatooyin, kuwaas oo la kaashanayo horumarka sayniska iyo teknoolajiyada cusub aan lagu xallin karin. Mid ka mid ah iyaga ka mid ah - sepsis carruurta. Calaamadaha habkan bahal la ogaado in 0.8% ka mid ah ilmaha dhashay. Laakiin halkan waxa xusid mudan in carruurta dheer buuxa sepsis yeesho in 0.1% ka mid ah xaaladaha, caruurta dhiciska - 1% ee kiisaska. In ilmaha risk aad u badan inta badan ka helay cudurada this - in 30-33% ee kiisaska. Waa maxay calaamadaha sepsis carruurta, sawir ka ah geedi socodka this?

Waa maxay sepsis?

Tani state of Dadka ayaa loo yaqaan tan iyo wakhtiyadii hore. Hippocrates ee wuxuu qoray ku xusan sepsis. Markaasaa eraygii this fahamsan yahay dhiigga oo qurmay. Currently, erayga ku takhasusay "sepsis" tixraac habka bahal ah, kaas oo ku salaysan jawaab systemic bararka in viral infection, fangas ama asal bakteeriyada.

Cunuga waxaa loo qaadi karaan sepsis in dhalmada ah (utero), intrapartum (xilliga dhalmada) iyo umusha muddo (dhalmada ka dib). Ka hor dhalashada cudurka la isugu gudbiyo si ilmaha caloosha ka qof dumar ah. Xilliga dhalmada iyo ummusha ilo cudurka waa hooyada, shaqaalaha caafimaadka, deegaanka.

Sababaha iyo arrimo keeni karo geedi socodka cudurka

Sepsis carruurta, calaamadaha xaaladda this halis ah kici sabab u ingress bakteeriyada, fangaska, fayrusyada iyo protozoa ee jirka. Xaaladaha intooda badan, waxaa jira sepsis bakteeriyada. Waxa uu ogaadaa in 85-90% ee kiisaska. Mararka qaarkood la ogaado isku dhafan ee dhowr wareer ah oo kala duwan. Statistics show in tani ay tahay caadiga ah ee 10-50% ee kiisaska.

Sepsis in carruurta astaamaha way kala gadisan yihiin, taasoo keenta qaar ka mid ah qodobada. Kuwaas waxaa ka mid ah:

• helin daaweeyaa antibiotika;
• isticmaalka daroogada taas oo u horseedi in ay hoos u jawaabta difaaca jirka;
• burburiyaha muddada-dheer ee TPN;
• Hababka faafa ogaanshaha iyo daaweynta;
• dalalka difaaca iyo asalka faalig daran.

dirka sepsis

Iyada oo ku xidhan wakhtiga bilawga calaamadaha caafimaad oo ahaa mid go'doonsan sepsis lagu dhasho oo soo daahay ee dhallaanka. Waayo, nooca u horeeya geedi socodka bahal lagu gartaa dhacdo ee calaamadaha 72 saacadood ee ugu horeeya gudahood dhalashada ka dib. Sida caadiga ah, cudurka sepsis hore dhacdaa utero. Ahmiyada hoose waa cudur lahayn. sepsis soo daahay waxa muujiyay 3 maalmood ka dib. Caabuqa ee noocan ah xaalad aad u daran waxay dhacdaa inta lagu jiro ama ka dib dhalmada. sababaha la fili karo cudurka -... Pneumonia, meningitis, peritonitis iyo kuwa kale, k t waayo, cuduradan waxaa lagu calaamadeeyay faafinta iyo Axdigu ee wareer ah iyo horumarinta.

sepsis ka dambeysa waa fulminant, ba'an iyo subacute. Waxa kale oo jira kala soocidda ah, kaas oo ku salaysan kala-soocidda noocyada on xaaladda halista ah ee odayga ama goobta koowaad ee cudurka:

• sepsis xudunta;
• cerebral;
• sambabada;
• caloosha iyo mindhicirka,
• maqaarka.

sawir clinical

Eebbe nidaamka cudurada la kala duwanaayeen karo. Liiska soo socda waxaa ka mid ah calaamadaha hore iyo kan dambe ee sepsis in ilmaha dhasha:

• xaaladda guud ee daran;
• xad gudub ku ah thermoregulation (dhallaanka dheer dhacdaa qandho, iyo risk - hypothermia horusocod ah);
• isbedelka midabka maqaarka (jirka helo cirro wasakh wasakh ama hadh cirro);
• xad gudub ku ah gobolka functional ah ee nidaamka dhexe ee habdhiska,
• dhiig lama filaan ah;
• si degdeg ah sii kordhaya joonis;
• neefta (ay ka maqan yihiin isbedel bararka sawirka X-ray);
• cillad of mareenka caloosha iyo mindhicirka, beerka size leexasho iyo beeryarada ee qalad ah oo jidka weyn.

In dhallaanka la sepsis iyo calaamadaha sida matag, shuban. Ilmuhu diido naaska, waxaa si degdeg ah miisaanka. Inta badan lagu go'aamiyaa suppuration in xuduntiisa ah, soo bax helay deegaamaynta kala duwan.

ogaanshaha of sepsis

calaamadaha sepsis carruurta (photos cudurka this ma siin sawir buuxa oo cudurka) - ma yihiin mawduucyada kaliya in wax laga qabto. Attention waa in la siiyaa Baadhista xaalad khatar ah - cilmi baaris degdeg ah dhaqanka. Waxaa ka mid ah:

• complete count dhiig la platelets;
• xinjirowga (set oo ah tilmaamayaasha by kaas oo ka mid ah qiimeyn kartaa xinjirowga dhiigga);
• isutagga dhiig iyo Rh-factor;
• chemistry dhiig;
• gobolka acid-saldhig dhiigga (CBS: pH iyo gaasaska dhiigga halbowlaha);
• X-ray thorax viscera;
• electrocardiography;
• microscopy iyo dhaqanka ee wax noolaha (saxarada, kaadida, bafinayo xabka cunaha);
• dhaqamada dhiigga.

calaamadaha sepsis soo baxaya in carruurta laga yaabaa in asalka ah ee cudurrada kale. Sidaas awgeed waa in cudurka kala duwan oo muhiim ah. Sepsis waa in la kala duwanaayeen ka foomamka guud ee cudurrada bakteeriyada. Waxaa cudurka go'aamin doona tallaabooyinka ka hortagga iyo xakameynta, therapy antibiotic gaar ah. Intaas waxaa sii dheer, aad u baahan tahay cudurka kala duwan ee sepsis iyo foomamka guud ee cudurada viral ah. Marka rumayn ay helitaanka si ay u qabtaan therapy fayruska gaar ah.

Ujeeddooyinka iyo hababka lagu daweeyo sepsis

Tani waa xaalad halis ah oo ku dhaca carruurta da'doodu u baahan tahay daaweyn deg deg ah, sababtoo ah waa mid aad u khatar ah oo keeni karta in horumarka waa in la dilaa. Daaweynta in sepsis waxaa lagu fuliyaa mar on laba xadhig. Mid ka mid ah iyaga ka mid ah - waa daaweynta etiotropic. Waxaa ka mid ah Axdigu fayadhowrka iyo therapy bakteeriyada.

jihada xigta ee daaweynta ee sepsis - therapy pathogenetic. Hawshoodu waa in la soo celiyo isbedel homeostasis (oo ay ku jiraan edbinta xaaladda difaaca iyo cudura xubnaha).

daaweynta sababaha

tallaabada ugu muhiimsan ee daaweynta ee sepsis - baxnaanin ah septic diirada. Kaliya in this mahad sida therapy siiyey at xaalad halis ah, waxa uu noqonayaa mid wax ku ool ah. Marka marxaladdan khabiiro ku sameeyeen qalliin - dhigi furitaanka ama dalool oo dheecaan ka mid ah godadka purulent, nekretomiyu iwm ...

Haddii calaamadaha sepsis waxaa lagu arkay carruur xilsaaray therapy antibiotic (si loo ogaado pathogene ah). Doorteen daawada dhakhtarka. In doorashada ee alaabta laga qaado akoonka wakhtiga dhacdo ka mid ah gobolka (ee utero, xilliga dhalmada ama dhalashada ka dib), shuruudaha dhacdo (isbitaalka ama bulshada-Acquired), ee deegaamaynta ah septic diirada. Dhammaan macluumaadka this soo jeedinaya pathogene in uu keeno sepsis ah. Ka dib markii cadeeyo dabiiciga ah ee microflora ee therapy antibiotic waxaa laga beddelo. Haddii loo baahdo, bedelay daroogada kale loo isticmaalaa.

Qaar ka mid ah daawada

Nasiib darro, ma jiraan daroogada gaar ah in la baabi'iyo yaabaa sepsis carruurta, calaamadaha habka cudurka. Si kastaba ha ahaatee, waxaa lagu talinayaa in mudada. Tusaale ahaan, therapy ah bakteeriyada ee sepsis dhalaanka lagu dhasho waxaa laga yaabaa in sida soo socota:

• "Ampicillin" isku dhafan oo aminoglycosides (ama "Amikacin" ama "Gentamycin" ama "Netilmicin");
• cephalosporins jiilka III (ama "ceftriaxone" ama "Cefotaxime") isku dhafan oo aminoglycosides.

In case of sepsis dhalaanka goor tahay mid ka mid ah nidaamyada of therapy bakteeriyada ay la mid tahay (isku-dar ah cephalosporins III jiilka aminoglycosides) dambe. Marka foomka pulmonary waxa lagu qoray "Vancomycin" iyo aminoglycosides. codsatay "Vancomycin" Marka kateetarka sepsis. mudada Alternative - "linezolid".

Isticmaalka fogaado iyo wakiilada antifungal

daweeynta antibiyootikada for dheer halka habka bahal ah. daaweynta noocan oo kale ah dheeraaday oo xoogan ee sepsis carruurta ka cadhaysiinina kartaa dysbacteriosis. Wixii ka hortaga fogaado wada magacaabay la antibiotics ( "Linex", "Bifiform", "Bifidumbacterin") iyo "fluconazole".

door muhiim ah waxaa ciyaaray by quudinta saxda ah. Carruurta yar yar waa in la siiyo caanaha naaska. In ay ka maqan, takhaatiirta carruurta ku talinaynaa isticmaalka isku dar ah oo gaar ah, oo ka kooban bifidobacteria, ama fogaado.

pathogenetic therapy

jihada horyaalka ee daaweynta ee sepsis ka mid ah dhowr cunsur:

• immunotherapy;
• dib u soo celinta ee elektrolytka iyo dheelitirka biyaha, iyo edbinta ee xanuunada dheelitirka acid-saldhig,
• naanin,
• therapy protivoshokovym;
• kabashada functional ah ee nidaamka saameysey iyo xubnaha.

Tallaabooyinka ku jira therapy ah pathogenetic waa sida soo socota.

Qiimeynta waxtarka daawaynta

A weyn oo kaalin ee daaweynta sepsis riwaayadaha antibiotic therapy. Thanks iyada inay, in jidhka la dilay wareer habka bahal ah. Taasi waa sababta khubaro waxaa la qiimeynayo waxtarka daaweynta. Antibiyootiko therapy waxaa loo arkaa wax ku ool ah haddii ka dib 72 saacadood ka bilow of diyaarinta:

• hagaajinaysaa xaaladda guud ee ilmaha;
• heerkulka jidhka caadiga ah ama qiimo jaban;
• hoos tachycardia;
• hoos neefta oo ku qabata;
• caadi qiimaha shaybaarka.

Antibiyootiko therapy waa wax ku ool ah, waxay qaadataa muddo 3 isbuuc ah (ugu yaraan). Kolkaasay ku tidhi baajiyay ku takhasusay. 4-6 toddobaad laga bilaabo daaweynta ka dib markii si buuxda u soo celiyay shaqo ee xubnaha gudaha iyo nidaamyada, doorsoonka baaba'aa.

Gebogebadii, waxa xusid mudan in sepsis (sawiro reer habka bahal ma siin sawir buuxa oo cudurka) - xaalad khatar ah ku dhici karaa ilmahaaga wax dhasha. Inkastoo horumarinta deg deg ah ee daawada, caruurtu waxay sii wadi in ay u dhintaan sepsis. Baadhitaanada tirakoobyada ayaa muujinaya in 1 kun. Dhallaanka dhawaan dhashay 4-5 dhinta cudurkan.