Ukuxilongwa okusheshayo kwezifo zegazi

Ukutheleleka kwegazi (BSI) kubhekisa kwisifo sokuphendula sokuvuvukala sokuvuvukala okubangelwa ukuhanjiswa kwama-microgenic ama-microgenic ahlukahlukene nobuthi babo egazini.

Inkambo yalesi sifo ivame ukuvezwa ngokwenza kusebenze futhi ikhishwe ama-medrator wokuvuvukala, okwenza uchungechunge lwezimpawu zomtholampilo ezinjenge-free fever, ama-chills, ukushesha kwengqondo, futhi ezimweni ezinzima, futhi ezimweni eziningi zokuhluleka kwezindawo zokufa kwabantu. Amacala we-HA atholakele) we-SEPSIS kanye ne-Septic Shock, accounting ngamaphesenti angama-40 amacala kanye nama-20% amacala atholakele e-ICU. Futhi kuhlotshaniswa kakhulu ne-degnogthosis empofu, ikakhulukazi ngaphandle kwezokwelapha eziphilayo eziphilayo kanye nokulawulwa kokugcwele ukutheleleka.

Ukuhlukaniswa kwezifo zegazi ngokusho kwezinga lokutheleleka

Bactereyiaemia

Ukuba khona kwamagciwane noma isikhunta egazini.

I-septicemia

Isifo somtholampilo esibangelwa ukuhlasela kwamagciwane e-pathogenic kanye nobuthi babo egazini, ukufunwa kabi okuhlelekile.

Pyohemia

Ukusongela okusongela impilo ukudonsa okubangelwa ukudonsa kwempendulo yomzimba ekuthelelekeni.

Ukukhathazeka okukhulu emtholampilo yizifo ezimbili ezihambisana nazo.

Izifo ezikhethekile ze-catheter ezihlobene nokutheleleka kwegazi

Ukutheleleka kwegazi okuhlotshaniswa nama-catheters afakwe emithanjeni yegazi (isib., Ama-peripheral venous catheters, ama-careters asezingeni eliphakathi, ama-catheters ama-arterial, ama-dialysis cacheters, njll.).

Endocarditis ekhethekile endocarditis

Kuyisifo esithathelwanayo esidalwa ukufuduka kwama-pathogen kuya kuma-endocardium nasezinhliziyo, futhi kubonakaliswa ukwakheka kwezinto ezivuselelwayo kuma-valves njengendlela yokulimala kwe-pathological, kanye ne-sepsis ngenxa yokuchitheka komzimba okuqabulayo.

Izingozi zokutheleleka kwegazi:

Ukutheleleka kwegazi kuchazwa njengesiguli esinesiko elifanele legazi nezimpawu zokutheleleka okuhleliwe. Ukutheleleka kwegazi kungaba sesibili kwamanye amasayithi wokutheleleka njengokutheleleka kwamaphaphu, izifo zesisu, noma ukutheleleka okuyisisekelo. Kubikwe ukuthi ama-40% weziguli ezine-Sepsis noma ukwethuka kwe-septic kubangelwa ukutheleleka kwegazi [4]. Kulinganiselwa ukuthi amacala angama-47-50 wezigidi ezi-sepsis ezenzeka emhlabeni wonke unyaka ngamunye, ebangela ukushona kwabantu abangaphezu kwezigidi eziyi-11, ngesilinganiso sokufa cishe okungu-1 imizuzwana engu-2,0.

Amasu wokuxilonga atholakalayo wokutheleleka kwegazi

01 pct

Lapho ukutheleleka okuhleliwe nokusabela kokuvuvukala kwenzeka, imfihlo yeCalcitoninogen PCT inyuka ngokushesha ngaphansi kokukhuthaza amagciwane nobuthi bokuvuvukala, futhi izinga leSerum PCT libonisa isimo esibucayi salesi sifo futhi siyisibonakaliso esihle sokuqanjwa kwe-prognosis.

Amaseli angu-0,2 nezinto zokunamathela

Ama-molecule e-cell adhesion (i-cam) abandakanyeka ezinhlelweni zezinqubo ze-physiopathagical, njengokuphendula ukuzivikela nokuphendula kokuvuvukala, futhi adlale indima ebalulekile ekuthelelekeni ekuthelelekeni nasekuthelelekeni kakhulu. Lokhu kufaka i-IL-6, iL-8, TNF-A, VCAM-1, njll.

03 endotoxin, g vivinya

Amagciwane angenamikhawulo egramu angena egazini ukukhulula endotoxin kungadala i-endotoxemia; (1,3) -β-D-Glucan ingenye yezinhlaka eziphambili zodonga lweseli fungal futhi lenyuswe kakhulu ekuthelelekeni fungal.

04 Biolekkale Biology

I-DNA noma i-RNA ekhishwe egazini ngama-microorganisms ihlolwe, noma ngemuva kwesiko elithile legazi.

Isiko legazi 05

Amagciwane noma isikhunta emasikweni egazi yi "Gold Standard".

Isiko legazi kungenye yezindlela ezilula, ezinembile kakhulu futhi ezisetshenziswa kakhulu zokuthola ukutheleleka kwegazi futhi yisisekelo se-pathogenic sokuqinisekisa ukutheleleka kwegazi emzimbeni. Ukutholwa kusenesikhathi kwesiko legazi kanye nokwelashwa kwe-antimicrobial kanye ne-antimicrobial izindlela eziyinhloko okufanele kuthathwe ukulawula ukutheleleka kwegazi.

Isiko legazi liyindinganiso yegolide yokuxilongwa ukutheleleka kwegazi, okungahlukanisa ngokunembile i-pathogen ethelelekayo, hlanganisa nokukhonjwa kwemiphumela yokuzwela izidakamizwa futhi unikeze uhlelo lokwelashwa olufanele nolunembile. Kodwa-ke, inkinga yokubika okude kwesiko legazi ibilokhu ithinta ukuxilongwa nokwelashwa kwegazi okufika ngesikhathi, futhi kubikwe ukuthi izinga lokufa kweziguli elingaphathwa ngama-antibiotic afike ngesikhathi futhi aphumelelayo likhuphuka ngo-7.6% ngehora ngehora eli-6 le-hypotension yokuqala.

Ngakho-ke, isiko lamanje legazi nokukhonjwa kokuzwela kwezidakamizwa ezigulini ezisolwa ngokutheleleka kwegazi okusolwa ngokuthe xaxa zisebenzisa inqubo yokubika ezintathu (ukubikwa okuphezulu (ukubikwa okuphezulu, okubandakanya igama lesibili (ukubikwa kokugcina, kufaka phakathi imiphumela yokuhlola izidakamizwa) [7]. Umbiko oyinhloko kufanele ubikwe emtholampilo ngaphakathi kwe-1 h yombiko omuhle we-vial vial; Umbiko webanga eliphakeme kungakuhle ukuthi ugcwaliswe ngokushesha okukhulu (ngokuvamile ngaphakathi kwama-48-72 h kuma-bacterium) kuya ngesimo selebhu.