Ukuxilongwa okusheshayo kwezifo ezithinta igazi

I-Bloodstream infection (BSI) ibhekisela ku-systemic inflammatory reaction syndrome ebangelwa ukuhlasela kwama-microorganisms ahlukahlukene e-pathogenic kanye nobuthi bawo egazini.

Inkambo yalesi sifo ivame ukubonakala ngokusebenza nokukhululwa kwabalamuli abavuvukalayo, okubangela uchungechunge lwezimpawu zomtholampilo ezifana nokushisa okuphezulu, ukugodola, ukuphefumula kwe-tachycardia, ukuqubuka nokushintsha isimo sengqondo, futhi ezimweni ezimbi kakhulu, ukushaqeka, i-DIC kanye ne-multi -ukwehluleka kwezitho zomzimba, nezinga eliphezulu lokufa. ithole i-HA) i-sepsis kanye nezimo ze-septic shock, ezibalelwa ku-40% wamacala kanye namacala acishe abe ngu-20% e-ICU atholwe. Futhi kuhlotshaniswa kakhulu nokubikezela okubi, ikakhulukazi ngaphandle kokwelashwa okufika ngesikhathi kwe-antimicrobial kanye nokulawulwa okugxile kokutheleleka .

Ukuhlukaniswa kwezifo ezithinta igazi ngokwezinga lokutheleleka

I-bacterium

Ukuba khona kwamagciwane noma isikhunta egazini.

I-Septicemia

I-Clinical syndrome ebangelwa ukuhlasela kwamabhaktheriya e-pathogenic kanye nobuthi bawo egazini, kuyisifo esibi kakhulu sesistimu..

I-Pyohemia

Ukungasebenzi kahle kwezitho ezisongela ukuphila okubangelwa ukungasebenzi kahle kokusabela komzimba ekuthelelekeni.

Okukhathaza kakhulu umtholampilo yizifo ezimbili ezilandelayo ezihambisanayo.

Ukutheleleka okukhethekile okuhambisana ne-Catheter yegazi

Izifo ze-bloodstream ezihambisana nama-catheter afakwe emithanjeni yegazi (isb., i-peripheral venous catheter, i-central venous catheter, i-arterial catheter, i-dialysis catheter, njll.).

I-Special Infective endocarditis

Kuyisifo esithathelwanayo esibangelwa ukufuduka kwamagciwane ku-endocardium kanye nama-valve enhliziyo, futhi kubonakala ngokubunjwa kwezinto eziphilayo ezingafuneki kuma-valve njengendlela yokulimala kwe-pathological, kanye ne-embolic infection metastasis noma i-sepsis ngenxa yokuchithwa kwezinto eziphilayo ezingafuneki.

Izingozi zokutheleleka ngegazi:

Ukutheleleka ngegazi kuchazwa njengesiguli esinomkhuba omuhle wegazi kanye nezimpawu zokutheleleka kwesistimu. Ukutheleleka nge-Bloodstream kungaba okwesibili kwezinye izingosi zokutheleleka ezifana nezifo zamaphaphu, izifo zesisu, noma izifo eziyinhloko. Kubikwa ukuthi ama-40% eziguli ezine-sepsis noma ukushaqeka kwe-septic abangelwa izifo zegazi [4]. Kulinganiselwa ukuthi izigidi ezingu-47-50 ze-sepsis zenzeka emhlabeni wonke unyaka ngamunye, okubangela ukufa kwabantu abangaphezu kwezigidi ezingu-11, kanti isilinganiso sokufa komuntu oyedwa njalo ngemizuzwana engu-2.8 [5].

Izindlela zokuxilonga ezitholakalayo zokutheleleka ngegazi

01 PCT

Lapho ukutheleleka kwesistimu kanye nokusabela kokuvuvukala kwenzeka, ukugcinwa kwe-calcitoninogen PCT kwanda ngokushesha ngaphansi kokugqugquzelwa kokungeniswa kobuthi bebhaktheriya kanye nama-cytokines avuthayo, futhi izinga le-PCT ye-serum libonisa isimo esibucayi sesifo futhi kuyinkomba enhle yokubikezela.

0.2 Amaseli nezinto zokunamathela

Ama-molecule e-Cell adhesion (CAM) ahileleke ochungechungeni lwezinqubo ze-physiopathological, ezifana nokuphendula kwamasosha omzimba kanye nokusabela kokuvuvukala, futhi adlala indima ebalulekile ekulweni nokutheleleka kanye nokutheleleka okukhulu. Lokhu kufaka phakathi i-IL-6, IL-8, TNF-a, VCAM-1, njll.

03 I-Endotoxin, ukuhlolwa kwe-G

Amagciwane ane-Gram-negative angena egazini ukuze akhulule i-endotoxin angabangela i-endotoxemia; (1,3) -β-D-glucan ingenye yezakhiwo eziyinhloko zodonga lwamaseli esikhunta futhi yanda kakhulu ekuthelelekeni kwefungal.

04 I-Molecular Biology

I-DNA noma i-RNA ekhishelwe egazini ngama-microorganisms ihlolwe, noma ngemva kwesiko legazi elihle.

05 isiko legazi

Amagciwane noma isikhunta emasikweni egazi "yizinga legolide".

Isiko legazi ingenye yezindlela ezilula, ezinembile futhi ezivame ukusetshenziswa kakhulu zokuthola izifo ezithinta igazi futhi iyisisekelo se-pathogenic sokuqinisekisa ukutheleleka kwegazi emzimbeni. Ukutholwa kusenesikhathi kwesiko legazi kanye nokwelashwa kwamagciwane kusenesikhathi futhi okufanele yizinyathelo eziyinhloko okufanele zithathwe ukuze kulawuleke izifo ezithinta igazi.

Isiko legazi liyindinganiso eyigolide yokuxilonga ukutheleleka ngegazi, okungahlukanisa ngokunembile igciwane elithelelanayo, kuhlanganiswe nokuhlonzwa kwemiphumela yokuzwela kwezidakamizwa futhi kunikeze isu lokwelapha elilungile nelinembile. Kodwa-ke, inkinga yesikhathi eside sokubika okuhle kwesiko legazi ibilokhu ithinta ukuxilongwa nokwelashwa okufika ngesikhathi, futhi kuye kwabikwa ukuthi izinga lokufa kweziguli ezingalashwa ngesikhathi nangempumelelo likhuphuka ngo-7.6% ngehora ngemuva kwamahora ayisi-6. i-hypotension yokuqala.

Ngakho-ke, isiko legazi lamanje kanye nokuhlonza ukuzwela kwezidakamizwa ezigulini ezisolakala ukuthi zinezifo ezithinta igazi ngokuvamile zisebenzisa inqubo yokubika enezigaba ezintathu, okungukuthi: ukubika okuyinhloko (ukubika ukubaluleka okubalulekile, imiphumela ye-smear), ukubika kwesibili (ukuhlonza ngokushesha noma/kanye nokuzwela okuqondile kwezidakamizwa. ukubika) kanye nokubika kwezemfundo ephakeme (ukubika kokugcina, okuhlanganisa igama lobunzima, isikhathi se-alamu esivumayo kanye nemiphumela yokuhlola evamile yokuzwela izidakamizwa) [7]. Umbiko oyinhloko kufanele ubikwe esikhungweni sezempilo kungakapheli ihora eli-1 lombiko webhodlela legazi elihle; umbiko wesikhungo semfundo ephakeme kuhle ukuba uqedwe ngokushesha (ngokuvamile phakathi kwamahora angu-48-72 kumagciwane) kuye ngesimo selabhorethri.