Nosocomial chibayo: tizilombo toyambitsa matenda, mankhwala ndi kapewedwe

Nosocomial chibayo - ndi pachimake matenda ndondomeko kunachitika thupi mchikakamizo cha moyo yogwira tizilombo toyambitsa matenda. mbali khalidwe la matenda ndi m'mapapo mwanga airway chotupa khadi ndi kudzikundikira mkati mwa buku lalikulu la madzi. Exudate kenako seeps kudzera ndi likulowerera maselo minofu aimpso.

Kusinthidwa malangizo m'dziko lawo chibayo kuchipatala anapeza

Kuyambira 2014 "Society kupuma" anayambitsa dziko malangizo kuchipatala. Iwo potengera aligorivimu kwa matenda ndi mankhwala zinthu kumene kukayikirana kuti wodwalayo m'kati chibayo nosocomial. malangizo National mwakuchita akatswiri clinicians, ogwira ntchito zaumoyo, anakumana ndi matenda pachimake kupuma.

Mwachidule, ndi aligorivimu tichipeza mfundo zinayi.

1. Kudziwa ngati mukufuna m'chipatala. A zochita zabwino anapangidwa, ngati wodwalayo bwino anafotokoza mavuto kupuma, pali kuchepa minofu perfusion, pachimake kudziletsa poizoni, mkhutu kutsitsimuka, wosakhazikika magazi. Anaikidwa mu chipatala kwambiri kudziwa chizindikiro chimodzi.
2. Kuona chifukwa cha matenda. Kuti tichite zimenezi, wodwalayo Kwalamulidwa maphunziro ambiri a zasayansi zipangizo kwachilengedwenso: chikhalidwe magazi, chikhalidwe kuchokera mtsempha, bakposev sputum, mkulu-liwiro mayeso kudziwa antigenurii bakiteriya chikhalidwe.
3. Kuona nthawi ya mankhwala. Zoperekedwa kuti matenda ndi chiyambi mabakiteriya, koma chifukwa chenicheni si wokhazikitsidwa mankhwala imachitika pa masiku khumi. Pa mavuto osiyanasiyana kapena extrapulmonary cholinga achire Inde mwina mpaka masiku 21.
4. Njira zofunika inpatient kukhala. Mu chikhalidwe lalikulu, odwala afunika kupuma kapena osakhala olanda mpweya wabwino.

Komanso malangizo a dziko Kwalamulidwa zodzitetezera. The yabwino kwambiri ndi katemera ndi fuluwenza ndi pneumococcus, woikidwa makamaka kwa odwala ndi chibayo aakulu ndi anthu zaka akulu gulu.

chibayo makamaka ku dera anapeza

Community-anapeza nosocomial chibayo ndi dzina lina wamba - dera zinazake. Matendawa amayamba ndi matenda a etiology bakiteriya. Njira waukulu matenda - chilengedwe. Chotero, tatsimikiza adzakhala motere: yotupa m'mapapo chotupa khadi akamagwira m'malovu, mmene kukhudzana pamwamba ndi onyamula matenda zaumoyo zoikamo wodwalayo ayi.

Community-yotengedwa ndi nosocomial chibayo chiyambi bakiteriya zambiri matenda odwala ndi chitetezo chokwanira zochepa, pamene thupi sangathe kukana tizilombo toyambitsa matenda (pneumococcus, Haemophilus influenzae, Klebsiella). Iwo kudutsa mu M'mimbamo a m'mapapo kudzera ndime m'mphuno.

Gulu chiopsezo zikuphatikizapo ana a gulu wamng'ono zaka ndi odwala matenda aakulu m'mapapo. Pankhaniyi, nthumwi causative ndi Staphylococcus aureus.

Community-anapeza chibayo nosocomial: mfundo za gulu la matenda

Pofuna kukhala ndi mankhwalawa a chibayo kuti m'kagulu mwa magawo:

• matenda si limodzi ndi kuchepa kwa ntchito zoteteza wa chamoyo;
• matenda kulumikizana ndi maziko a chitetezo chokwanira wotsikirapo;
• matenda akuwuka mu gawo pachimake cha AIDS;
• matenda, anapanga molumikizana ndi matenda ena.

Kawirikawiri, matendawa zikutsimikiziridwa odwala amene ali ndi vuto mu mawonekedwe a chitetezo chokwanira yafupika motsutsa likhale Oncology kapena hematology. Komanso mu gulu chiopsezo, odwala kumwa mankhwala kwa nthawi yaitali mkulu mlingo. Komanso, pali nthawi zina pamene matendawa amapezeka odwala pathologies aakulu m'thupi.

Komanso, gulu osiyana monga mtundu wa chibayo ndi chiyembekezo.

Madokotala dziwani kuti pakadali pano mu njira ya chiyambi cha mtundu uliwonse wa chibayo kukhumba Palinso matupi zakunja kukhudzana ndi zomwe matenda akufotokozera.

chibayo makamaka nosocomial

Mfundo imeneyi ndi kuika za chipatala wodwalayo, pamene kutupa mu gawo m'mapapo kukuonetsedwa pambuyo pa 72 maola pambuyo matenda. Vuto lagona pa mfundo yakuti nosocomial nosocomial chibayo ndi kobvuta ndi chikhalidwe kumene ndipo kawirikawiri itha imfa. Izo ndi bakiteriya amene amakhala mu mpanda wa bungwe la zachipatala, kugonjetsedwa ndi mankhwala ambiri, choncho zovuta kupeza nthawi yoyamba mankhwala zolondola.

Nosocomial Nosocomial chibayo: mfundo za gulu la matenda

mtundu patsogolo chipatala nosocomial chibayo zimagawidwa mu matenda sitepe:

1. siteji oyambirira - mu masiku asanu kupeza m'chipatala anayamba kuwonetsa zizindikiro zoonekeratu matenda.
2. siteji mochedwa - mawonetseredwe a zizindikiro anachedwa ndi masiku opitirira asanu.

Malinga etiology matendawa mitundu itatu:

1. Kukhumba nosocomial chibayo.
2. Postoperative.
3. Othandizira-kugwirizana.

Dziwani kuti gulu zokambidwa ndi mtundu pokhapo titachitapo ndipo nthawi zambiri amapezeka chibayo mu mawonekedwe losanganikirana. Zimenezi, kwambiri kukuwonjezera mkhalidwe wa mtima ndipo kumachepetsa mpata kuchira.

kukhumba

Anapereka mtundu wa matenda ndi ambiri. Pamene kachilombo mamina m'mphuno umalowa mu dipatimenti m'mapapo mwanga, pali autoinfection thupi.

Phula nasopharyngeal - malo abwino kwa tizilombo mabakiteriya chakudya, choncho, kamodzi mu mapapo, ndi tizilombo anayamba mwachangu zikuchulukirachulukira, ndipo zimenezi zimathandiza kuti chitukuko cha chibayo chiyembekezo.

postoperative

Kuperekedwa ndi mtundu wa chibayo amawapeza 18 milandu matenda mwa 100, ndipo imapezeka odwala amene opaleshoni.

Pankhaniyi, nthenda kumachitika chimodzimodzi monga chibayo kukhumba, koma nasopharyngeal madzimadzi anawonjezera ndi secretions chapamimba, amene ndi oopsa chimodzimodzi. Komanso, kodi sunaletse matenda a zida wodwalayo kuchipatala ndi zipangizo. Kudzera chubu kapena matenda catheter mosavuta kufalitsa kwa thirakiti m'munsi kupuma.

Othandizira-kugwirizana

Matenda odwala amene ali nthawi yaitali mawu a yokumba m'mapapo mpweya wabwino. nthawi Safe si maola oposa 72 mu chikhalidwe ichi, mu izi tsiku lililonse likadutsa kumaonjezera ngozi ya kudwala chibayo.

chibayo Nosocomial

Nosocomial chibayo kuchipatala nthawi zambiri kumachitika chifukwa pneumococci. diagnoses oterewa amakhala ku 30 mpaka 50 peresenti ya milandu onse matenda.

Mabakiteriya osachepera mwamakani ndi mauka, Mycoplasma ndi Legionella. Muulamuliro awo, kukhala chibayo si oposa 30% koma osachepera 8%.

Wochepetsetsa amapezeka matenda choukira limakhala la ntchito wolimba: Haemophilus influenzae, Staphylococcus aureus, klebsiella ndi enterobacteria.

Komabe tizilombo toyambitsa matenda ena nosocomial chibayo - mavairasi fuluwenza ndi gulu la A ndi B, parainfluenza, adenovirus, kupuma syncytial HIV.

The tizilombo toyambitsa matenda ambiri nosocomial mtundu chibayo aukali kuti chimayambitsa kubuka mliri, - Mycoplasma ndi Legionella. Mbali yoyamba, nthawi zambiri achinyamata kudwala ndi achinyamata zaka 25. A matenda Legionella kumachitika mwa madzi, mwachitsanzo, mu mtima onse, beseni ndi zina.

Njira diagnostics zamakono

Ngati wodwala ali chibayo, mtundu dera yotengedwa, nthawi zambiri matenda ndi Kupenda thupi. Nthaŵi iliyonse matenda, chifukwa mayiko kuyan'anila alili ndi zizindikiro za matenda Kuyambitsa khadi osiyana kapena mbiri zachipatala.

Phased matenda kunja wodwala motere:

• Pachifuwa X-ray - X-ray diagnostics njira kuti ntchito zifaniziro pa chikhalidwe cha m'mapapo mu ndege angapo. Pamaso pa mdima, wandiweyani mawanga matenda zikutsimikiziridwa. Matendawa kukuonetsedwa kawiri: pachiyambi cha mankhwala ndi pambuyo mankhwala opha tizilombo.

• mayesero Laboratory - wodwalayo ali wofunikila kuti apereke magazi kwa kusanthula ndi mtima wa chiwerengero cha leukocytes, shuga ndi electrolytes.
• Microbiological maphunziro - ikuchitika Khadili madzimadzi pleural ndi ochekenera wa kapepalako m'munsi kupuma limanenedwa ndi kukhalapo kwa antigens mu mkodzo.

Zotsatira za njira izi matenda chikukwanira matenda okhazikika ndi chithandizo dongosolo chitukuko.

Ayamikira zochizira odwala

malangizo kuchipatala zochizira chibayo nosocomial ali monga momwe kupereka mankhwala yotakata-sipekitiramu.

Atalandira zotsatira kafukufuku mu yamtunduwu a dokotala kusintha mankhwala poyamba anali ndi akapolo zosavuta. maziko ndi mtundu wa tizilombo toyambitsa matenda.

Mfundo ya chithandizo cha odwala ndi chibayo nosocomial

Chithandizo cha chibayo nosocomial tichipeza mu kusankha mankhwala oyenera, chakudya ake, njira ya utsogoleli ndi mlingo. Limachita yekha ndi dokotala nawo. Ndi mbali ya mankhwala ndi mankhwala a m'mapapo thirakiti remediation (kuchotsa madzimadzi anasonkhanitsa).

Mfundo yofunika ndi kupeza wodwala mu mkhalidwe zolimbitsa thupi. Muyenera kuchita Zochita kupuma ndi zolimbitsa yaing'ono mu mawonekedwe a KUKHALA akuluakulu. Odwala amene ali mu chikhalidwe kwambiri, kuthandiza anamwino. Iwo zikugwira kusintha nthawi zonse malo a mtima, kulola madzi si stagnate mu malo amodzi.

Popewa matenda kobwereza chikanathandiza kupewa chibayo nosocomial, omwe anafotokoza mwatsatanetsatane dokotala.

mankhwala opha tizilombo

Chithandizo umalimbana kulimbana mabakiteriya, ali mitundu iwiri: dala ndi chala chachikulu. Poyamba, odwala onse ankachitira empirically kulemba ndi chinatsogolera yoikidwiratu pambuyo kudziŵa wothandizila causative.

Zinthu zofunika kwambiri achire ndi:

1. Akutukuka moyenera mankhwala mankhwala.
2. Yafupika ntchito antimicrobials.

Sankhani mankhwala antibacterial ndi mlingo awo akhoza dokotala yekha, kudzikonda m'malo mankhwala ndi zosayenela.

The Mapa apeze

Malinga anasankha mankhwala zolondola, kukula kwa matenda ndi boma ambiri zotsatira wodwalayo mankhwala akhale motere: kuchira, kuwongolera pang'ono, chithandizo kulephera, muyambirenso, ndi imfa.

Mu chibayo nosocomial Mwina imfa ndi apamwamba kuposa mu mawonekedwe a anthu kuthi.

zodzitetezera

Kupewa chibayo nosocomial ankaimira miyeso zovuta mankhwala ndi AIDS:

• chithandizo yake ya matenda okhudzana;
• zoletsedwa ndi malamulo ndiponso mfundo za ukhondo;
• kulandira nthumwi immunomodulatory;
• katemera.

Nkofunika akulitse alili - kuteteza muyambirenso - kuti kuyan'ana malamulo a losavuta: wokhazikika ukhondo wa M'mimbamo m'kamwa, kutsokomola mpaka kudzikundikira madzimadzi, masewera olimbitsa thupi.