Matenda kugwirizana ndi chithandizo: zoyimira ndi gulu

Matenda kugwirizana ndi chithandizo, zonse anakumana kuchita matenda. Ndipo sindikuwatsutsa madokotala, iwo akuyesera kuchita zonse zimene tingathe kuti akuchedwa isanayambike mavuto amenewa. Mwatsoka, kupewa anthu ochepa mungathe.

tanthauzo

Kuti kupatula mu lingaliro la "kugwirizana ndi chithandizo cha mankhwala, kachirombo"? Tanthauzo limati motere: ndi zizindikiro za matenda ndi tizilombo tating'onoting'ono chikhalidwe, amene ankachitika odwala pambuyo chithandizo kuchipatala kapena kuchipatala maulendowo mankhwala kapena mwa mwezi kuchokera kumaliseche kwa kuchipatala.

dzina lina gulu la matenda - matenda nosocomial, kapena matenda nosocomial. Akukhulupirira kuti matenda anadza kuchokera kwa wodwala ku chipatala, pamene zizindikiro choyamba anaonekera palibe kale kuposa masiku awiri chiphaso cha. Kuvomerezedwa chikhalidwe - kupanda mawonetseredwe wodwala matenda zisanayambe Kusinthaku bungwe lina la zachipatala.

matenda Hospital ayenera siyanitsa iatrogenic ndi osiyanasiyana, kuyambira ali ofanana zokwanira kusokonezedwa. Akuti iatrogenic matenda amene anaonekera chifukwa vuto la ogwira ntchito kuchipatala mu njira ya mankhwala kapena matenda. Osadziwika limapezekanso pa anthu kuposa chitetezo cha m'thupi sangathe kuletsa mu cheke mabakiteriya osiyanasiyana.

kuwanda

Epidemiology matenda kugwirizana ndi makonzedwe a chithandizo, kuweruza ndi ziwerengero Center kwa Control Disease (CDC) ndi zokhumudwitsa. Mu United States wa munthu ndi milandu miliyoni theka pachaka, oposa theka anafa. Ku Ulaya, chithunzi ndi twente-faifi sauzande, Russia - zikwi makumi atatu. Koma ngati kanjedza otsika salankhula za khalidwe chithandizo, ndi osauka khalidwe la kafukufuku zowerengera.

Matenda nosocomial ali mfundo yake ya kafalitsidwe, amene kusiyanitsa kumatenda ena a mtundu umenewu. kusiyana ndi limagwirira ndi zinthu za HIV, ndi kulunjika kwa matenda a AIDS, udindo wa achipatala kukhalabe ndi kuwonjezera chiwerengero cha milandu. Komanso, matenda awa ndi ovuta kuchiza chifukwa tizilombo kuti moyo mu chipatala, ndi kusamva mankhwala.

etiology

Tizilombo toyambitsa matenda kugwirizana ndi zaumoyo sizachilendo padziko lonse. Pakali pano, pali wothandizira tating'onoting'ono oposa mazana awiri kuti angathe kuyambitsa matenda nosocomial. Pamaso pa nyengo ya mankhwala iwo anali anaerobic Bacillus, streptococci ndi staphylococci. Tsopano anakhazikitsa kuti chifukwa cha matenda akhoza kukhala rotavirus, cytomegalovirus, chiwindi mavairasi, ndipo ngakhale HIV.

Kukhala nthawi yaitali pa gawo la kuchipatala, bakiteriya ali pansi kusankha zamoyo ndi masinthidwe, chifukwa cha zomwe pali kugonjetsedwa mitundu, amene osiyanasiyana disinfectants, ndi mankhwala kvartsevanie. Mu aliyense kuchipatala, dipatimenti ndipo ngakhale opaleshoni moyo wawo "wapadera" mabakiteriya.

Magwero ndi njira za kufala

Mawu akuti "matenda kugwirizana ndi zaumoyo" zikutanthauza pamaso pa atatu AIDS ndondomeko zinsomba:

- gwero;

- kufala njira;

- atengeke munthu.

magwero HAI tigulitse odwala amene m'chipatala kwa nthawi yaitali ndi zoipa microflora ake, komanso ogwira ntchito zaumoyo, tsiku kukhudzana ndi mabakiteriya chomwecho. Alendo wosamalira ndi banja kusewera mu kufala kwa matenda nosocomial udindo sekondale.

Kufala limagwirira kungakhale chilichonse: fecal-m'kamwa, airborne, pini kapena transmissive. Choka zinthu ndi zida, zipangizo kupuma ndipo makope, zofunda ndi kabudula, bedi, kuvala ndi chuma suture, ziwalo, ngalande ndi zinthu yonyowa. Zikuphatikizapo Muzikonza mipope ndi limalephera, limalephera, njira kulowetsedwa, madzi oyera, njira antiseptic, madzi Miphika kwa maluwa, condensate mu dongosolo mpweya kuyeretsa ndi zina zotero.

anthu okhudzidwa

Matenda kugwirizana ndi chithandizo, odwala amayambira ku anthu ndi chitetezo wofooka. Ndithudi, odwala onse amakhala osiyana, yafupika ntchito zoteteza za thupi, koma pali anthu amene ali osatetezeka. Njirazi ndi monga:

- anthu okalamba;

- makanda msanga ndi ana;

- Odwala ndi khansara, autoimmune, matenda awo sagwirizana;

- odwala amene akhala akukonza ntchito nthawi yaitali;

- anthu amene anali kukhala m'dera zachilengedwe oipa.

Chipatso chimadalira Mosakayika kudwala pamene m'chipatala, kotero muyenera kusamalira bwino kwa ogwira ntchito zachipatala.

Gawo

ndi mitundu ya matenda kugwirizana ndi zaumoyo chiyani? Izi zidalira pa, pa maziko zimene m'kagulu. Mwachitsanzo, ngati inu kutenga njira, ndiye kumasula: aerosol, zakudya, kukhudzana-banja, zipangizo, posttranstplantatsionnye, matenda pambuyo jekeseni, magazi, ntchito, ndiponso kayendetsedwe ena endoscopic. Ndi nthenda yotaya, komanso matenda ena, matenda nosocomial ndi pachimake, subacute ndi aakulu komanso kwambiri, odziletsa ndi wofatsa mitundu.

kusiyana wina wopangidwa pakati pa madigiri osiyana cha kuwanda, amene angapange matenda kugwirizana ndi chithandizo cha kuchipatala. Gawo akuyamba ndi Zikavuta:

- zowombetsa mkota form: bacteremia, septicemia, pyosepticemia, bakiteriya mantha.

- m'madera mawonekedwe.

- Matenda a khungu ndi subcutaneous mafuta.

- wotsika kupuma matenda.

- Owona Zamano mawonekedwe.

- Matenda a dongosolo m'mimba.

- matenda a dongosolo la uchembere wabwino ndi mkodzo.

- Matenda a minofu ndi mafupa dongosolo.

- matenda ya ubongo.

- Matenda a dongosolo mtima.

Chifukwa kufala kwa

Kupewa matenda kugwirizana ndi chithandizo, umalimbana kuchepetsa odwala wonse. Koma mwatsoka, ndi chibwenzi, malangizo onse sizithandiza. Chifukwa chachikulu ichi - mu zikamera wa zomera Mipikisano kugonjetsedwa.

Kwenikweni, ndi chifukwa bakiteriya mutate, kusintha katundu wawo chifukwa cha ntchito zopanda chilungamo cha mankhwala ndi disinfectants. Awa ndi makhalidwe abwino kwa chilengedwe microflora multiresistant sekondale.

kukana chachikulu - ndi luso lachibadwa a mtundu umenewu mabakiteriya kukana wothandizila aukali. Chizolowezi madokotala chifukwa chilichonse kuti mankhwala opha tizilombo kumabweretsa chakuti mphamvu ya mankhwala yafupika, ndi mabakiteriya akukhala kusamva mankhwala. Koma osati madokotala ndi mlandu. Mu Russia, anthu ntchito paokha kusankha antibacterials, koma satsatira malangizo ntchito.

mfundo Fleming

Pali mfundo zitatu Fleming analimbikitsa ndi World Health Organization.

Mfundo yoyamba - mankhwala antimicrobials kokha pamene nthumwi opatsirana amakhudzidwa iwo. Izi kuchepetsa kugwiritsa ntchito antibayotiki, madokotala nthawi zonse khalidwe tilinazo maphunziro a zomera kwa mankhwala, mankhwala patsogolo ndi yopapatiza, mbali sipekitiramu wa kanthu.

The chachiwiri mfundo Fleming ananena kuti pofuna kuti ndende ogwira mtima a mankhwala chotupa cha. ulamuliro Izi kuchepetsa mankhwala ntchito timitu ndi mankhwala analamula kuti zolinga njira. Komanso, adzakhala ndi mpata kuletsa mankhwala mwakamodzi, osati pang'onopang'ono, komanso kusintha mlingo ndi mankhwala potengera zofufuza wodwala mbewu madzi kwachilengedwenso kamodzi pa masiku asanu ndi awiri.

Mfundo yachitatu - kufunika mankhwala opha mu mlingo ndi awerengazo mu njira kuchepetsa mavuto obwera. Izi ntchito mankhwala rationally kwambiri.

mapangidwe mabakiteriya

Matenda kugwirizana ndi chithandizo sangaonekerenso popanda mabakiteriya onyamula, otchedwa "ziro mtima", limene lidzakhala wosaoneka magwero a matenda ena.

Bacteriocarrier - mtundu wa matenda limapezeka pamene pakati pa khamu ndi tiziromboti anakhazikitsa bwino odwala popanda mawonetseredwe matenda. zochita Immunological kupitiriza zidzachitika pa nthawi yomweyo. Ngati bakiteriya ndi unachitikira mu mawonekedwe zobisika odwala asanu, chingasinthe katundu wake ndipo amtopola.

zochita njira Pankhaniyi ndi:

- zonse matenda Kupenda azaumoyo;

- bacteriological Kupenda achipatala;

- kudziwika oyambirira ndi mankhwala a sing'anga ndi kachilombo;

- Daily ulamuliro wa boma la thanzi mankhwala.

Oopsa matenda ndiponso zochizira

Matenda kugwirizana ndi chithandizo (IHS) azaonekera osati pambuyo wodwala Wakhale nthawi mankhwalawa kuchipatala, koma pambuyo angapo njira yodziwira ndi achire zimene zimachititsa zakhudzana zomera kuchipatala. Izi limakhudzanso kuikidwa magazi, jakisoni, opaleshoni ziwalo Thirani ndipo zimakhala. Mwa kuwatsitsimula ndi intubation, inhalation mankhwala, zipangizo thandizo moyo, atakhala catheters. Komanso, matenda angayambe pambuyo hemodialysis chithandizo, inhalations ndi spa mankhwala.

Gawo ndi Spaulding

Matenda kugwirizana ndi chithandizo, akhoza kudzera zipangizo zachipatala. Choncho Spaulding anawagawa m'magulu atatu, kutenga monga chizindikiro cha mtundu angathe kutenga zomera chipatala.

Woyamba gulu - yovuta. Zikuphatikizapo opaleshoni zida, catheters, amadzala, masingano, ndi jekeseni madzimadzi.

Gulu lachiwiri - polukriticheskie: endoscopic ndi inhalation zida, zida ndi mankhwala, thumbo thermometers.

Gulu lachitatu, motero, noncritical. Ndi zinthu zina: chotengera, kuthamanga kwa magazi oyang'anira, ndodo, mbale, linens, axillary thermometers.

kupewa

Kupewa matenda kugwirizana ndi chithandizo, zochokera Health Organization World malangizo kupewa matenda nosocomial. Mu kupewa wabwino pazikhalanso nthawi zitatu:

- minimization matenda kuchokera kunja chipatala;

- osati matenda ndi kanthu pa mayunitsi mliri ndondomeko;

- kuchotsa kupatulapo kupitirira matenda m'chipatala.

Chifukwa chaichi pali odwala kutchinjiriza ndi matenda aakulu opatsirana mu mabokosi wapadera ndi athandizira osiyana ndi linanena bungwe, amene salankhula ndi zina chipinda cha. Komanso, aliyense chipinda, ndipo panopa anagwira ambiri sanitization zipangizo ndi pamalo. Pafupipafupi zonsezi zimatengera kufunika: mu Dipatimenti mkati mankhwala - kawirikawiri opaleshoni, motero, m'pamenenso.

chithandizo

Matenda kugwirizana ndi chithandizo, ngakhale movutikira, koma amenable kwa mankhwala. Choncho, dokotala n'kukulemberani yeniyeni antimicrobial wothandizira a sipekitiramu yopapatiza kanthu, limene lakonzedwa mtundu enieni a tizilomboto. Koma mwambo umenewu si zotheka, chifukwa mbewu microflora ndi kusanthula tilinazo amatenga masabata, ndi wodwala ayenera kulandira chithandizo msanga. Choncho, dokotala ali woika empiric mankhwala zochokera apeza. Kusankha mankhwala zimadalira kudziwa dokotala zimene Flora uli dipatimenti.

Pofuna kuti tizilombo toyambitsa matenda ananyamuka mankhwala kukana, m'pofunika kutsatira kasinthasintha wa mankhwala, ndiye, kusintha lililonse miyezi iwiri kapena itatu. Izi zingathandize kuchepetsa kukana ndi bwino zakambidwa chithandizo.