Cututtukan Septic: menene menene, alamomi, dalilai da kuma yadda ake yin magani

Wadatacce

• Babban bayyanar cututtuka
• Yadda za a tabbatar da ganewar asali
• Dalilin bugun jini
• Wanene yafi yawan hadari
• Yadda ake yin maganin
• 1. Amfani da maganin kashe kwayoyin cuta
• 2. Ruwa a jijiya
• 3. Magungunan hawan jini
• 4. Karin jini
• 5. Amfani da sinadarin corticosteroids
• 6. Maganin Hemodialysis

An bayyana girgizar jini a matsayin babban matsala na sepsis, wanda koda tare da ingantaccen magani tare da maye gurbin ruwa da maye gurbin kwayoyin, mutumin yana ci gaba da samun ƙananan jini da matakan lactate sama da 2 mmol / L. Waɗannan sigogi ana kimanta su akai-akai a asibiti don bincika haɓakar mai haƙuri, amsawa ga jiyya da kuma buƙatar yin wasu hanyoyin.

Bala'in girgizar jini ana ɗaukarta a matsayin ƙalubale, saboda lokacin da mai haƙuri ya kai wannan matakin na cutar, ya rigaya ya zama mai rauni, banda wannan kuma akwai mai saurin kamuwa da ƙwayoyin cuta da kuma mafi rinjaye na abubuwa masu guba waɗanda ƙananan ƙwayoyin cuta ke samarwa.

Saboda raguwar hawan jini, ya zama ruwan dare ga mutanen da ke cikin tabin hankali su ma suna da matsala mai yawa a zagawar jini, wanda ke haifar da karancin iskar oxygen don isa ga gabobi masu mahimmanci kamar kwakwalwa, zuciya da koda. Wannan yana haifar da wasu, takamaiman takamaiman alamomi da alamomin girgizar ruwa na bayyana, kamar raguwar fitowar fitsari da canje-canje a yanayin tunani.

Ana yin maganin bugun juji a cikin Sashin Kulawa na Musamman (ICU), ta amfani da kwayoyi da magungunan kashe ƙwayoyi don daidaita ayyukan zuciya da na koda da kuma kawar da ƙananan ƙwayoyin cuta da ke haifar da kamuwa da cutar, ban da sa ido kan matsi da matakan lactate.

Babban bayyanar cututtuka

Yayinda ake ɗaukar damuwa na septic a matsayin rikitarwa na sepsis, alamomi da alamomin da mai haƙuri ya gabatar iri ɗaya ne, tare da zazzaɓi mai ɗorewa da ci gaba da bugun zuciya. Bugu da kari, idan akwai yanayin tabin hankali shima zai yiwu a kiyaye:

• Lowananan ƙananan jini, tare da matsin lamba na jini (MAP) ƙasa da ko daidai da 65 mmHg;
• Inara cikin ƙididdigar yaduwar lactate, tare da ƙididdiga sama da 2.0 mmol / L;
• Saurin numfashi a yunƙurin ƙara adadin iskar oxygen mai zagayawa;
• Zazzabi ya tashi sama da na al'ada ko ya wuce gona da iri;
• Rateara yawan bugun zuciya;
• Lessarancin yin fitsari;
• Rashin sani ko rikicewar hankali;

Alamomin bugun juji sun bayyana lokacin da kwayar halittar ta isa jini kuma ta fitar da guba, wanda ke karfafa garkuwar jiki don samarwa da kuma sakin cytokines da masu shiga tsakani don yakar wannan kamuwa da cutar. Idan mai haƙuri bai amsa ga magani ba ko yawan guba na ƙananan ƙwayoyin cuta yana da girma sosai, yana yiwuwa mai haƙuri zai ci gaba da ɓarkewar jijiya mai tsanani sannan kuma girgiza septic.

Saboda yawan gubobi, ana iya samun canje-canje a yawan iskar oxygen da ke kaiwa ga gabobin, wanda kan haifar da gazawar sassan jiki da sanya rayuwar mutum cikin hadari.

Yadda za a tabbatar da ganewar asali

Ganewar cutar ta juzu'i ana yinsa ne ta hanyar gwajin mutum da gwaje-gwajensa. A ka’ida, ana yin gwajin jini don gano ko an canza adadin kwayar jinin (kwayoyin jini ja, leukocytes da platelets), idan akwai matsala game da aikin koda, menene yawan iskar oxygen a cikin jini kuma idan a can shine duk wani canji a adadin wutan lantarki wanda yake cikin jini. Sauran gwaje-gwajen da likita zai iya yin oda suna da alaƙa da gano ƙananan ƙwayoyin cuta da ke haifar da damuwa.

Sanarwar ta zama tabbatacciya ga girgizar cikinji lokacin da, ban da alamomin alamomin alamomin alamomin sipsis, an gano haɓakar haɓakar lactate da naci na ƙwanƙwasa jini koda bayan jiyya.

Dalilin bugun jini

Abin da ya faru na gigicewa na da alaƙa da juriya na ƙananan ƙwayoyin cuta ga magani, ban da tsarin garkuwar jikin mutum. Bugu da kari, kasancewar masu bincike da catheters masu dauke da cutar, wadanda sune naurorin likitanci wadanda suke mu'amala kai tsaye da mutumin da aka kwantar da su, hakanan zai iya taimakawa girgizar cikin gida, saboda kananan kwayoyin na iya yaduwa cikin sauki a cikin jini, yaduwa da sakin gubobi wadanda zasu kawo karshen matsalar aikin kwayar halitta da samar da iskar oxygen ga kyallen takarda.

Don haka, duk wani kamuwa da cuta na iya haifar da sepsis ko septic shock kuma galibi ana haifar da shi ne:

• Kwayar cuta, kamarStaphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Streptococcus sp., Neisseria meningitidis, da sauransu;
• Ƙwayar cuta, kamar su mura H1N1, H5N1, kwayar cutar zazzabin rawaya ko kwayar cutar dengue, da sauransu;
• Naman gwari, galibi na jinsiCandida sp.

Cututtukan cututtukan da ke haifar da girgizar jini na iya bayyana a ko'ina a jiki, kuma wasu daga cikin mafi yawan sune cututtukan huhu, cututtukan urinary, meningitis, erysipelas, cellulitis mai yaduwa, kamuwa da raunuka na tiyata ko gurɓatar catheters.

Wanene yafi yawan hadari

Mutanen da suka kamu da kamuwa da cuta mai tsanani kuma suka kamu da tabin hankali sune waɗanda ke kwance a asibiti, musamman a cikin ICU, saboda sune wuraren da ƙananan ƙwayoyin cuta zasu iya samun ƙarfin juriya ga maganin rigakafi, inda akwai gabatarwar bincike da catheters ko gwaje-gwaje, wanda na iya zama tushen kamuwa da cuta, haka kuma saboda ƙarancin garkuwar jikin mara lafiya na iya lalacewa saboda wasu cututtuka.

Bugu da kari, samun cututtukan da ke ci gaba kamar su ciwon suga, ciwan zuciya, bargon aplasia, gazawar koda, da kuma yin amfani da magungunan rigakafi irin su chemotherapy, corticosteroids, antibiotics ko radiotherapy na iya sa mutane su zama masu saurin kamuwa da cutar sepsis da septic shock, saboda yana iya lalatawa aikin tsarin rigakafi.

Yadda ake yin maganin

Dole ne a yi maganin ƙwaƙwalwar ƙwaƙwalwar ajiya a cikin ICU (Unungiyar Kulawa Mai )wazo) da nufin kawar da wakilin da ke haifar da sepsis kuma, ta wannan hanyar, don magance tashin hankali. Bugu da kari, ana nuna amfani da kwayoyi masu saurin illa don daidaita karfin jini, ban da maye gurbin ruwa don kara yawan jini kuma, sakamakon haka, ya fi dacewa da jigilar oxygen zuwa kyallen takarda.

1. Amfani da maganin kashe kwayoyin cuta

Idan an tabbatar da tabin hankali, yakamata a fara maganin rigakafi, koda kuwa har yanzu ba a san mai da hankali ba. Wannan saboda kwayoyin halittar dake haifar da kamuwa da cutar ana kawar da ita da wuri-wuri, yana rage karfin garkuwar jiki.

Ana yin jiyya tare da amfani da ƙwayoyin cuta (maganin rigakafi) bisa ga ƙananan ƙwayoyin cuta da aka gano. Nemi ƙarin game da gwajin wanda zai taimaka maka gano mafi kyawun maganin rigakafi.

2. Ruwa a jijiya

A cikin jiji daɗin damuwa, yaduwar jini yana da matukar illa, wanda ke sa oxygenation na kwayar ta wahala. Yin manyan allurai na magani a jijiya, kimanin 30 ml akan kilogiram, ana ba da shawarar azaman hanya don taimakawa ci gaba da karɓar jini da karɓar amsa ga magunguna.

3. Magungunan hawan jini

Saboda raguwar hawan jini, wanda ba a warware shi kawai tare da shayarwa a cikin jijiya, yawanci ya zama dole a yi amfani da kwayoyi don hawan jini, da ake kira vasopressors don cimma matsakaicin matsin lamba na aƙalla 65 mmHg.

Wasu misalan waɗannan kwayoyi sune Noradrenaline, Vasopressin, Dopamine da Adrenaline, waɗanda kwayoyi ne waɗanda dole ne ayi amfani dasu tare da kula da asibiti na kusa don guje wa ƙarin rikitarwa. Wani zabi shine amfani da magunguna wanda ke kara karfin bugun zuciya, kamar su Dobutamine.

4. Karin jini

Zai iya zama dole ga marasa lafiyar da ke da alamun rashin isasshen jini da kuma waɗanda ke da karancin jini tare da haemoglobin ƙasa da 7mg / dl. Duba manyan alamomin karin jini.

5. Amfani da sinadarin corticosteroids

Magungunan Corticosteroid, kamar su Hydrocortisone, ana iya nuna su a matsayin hanya don rage ƙonewa, duk da haka, akwai fa'idodi kawai idan har raɗaɗɗen juji ya ɓarke, ma'ana, a cikin yanayin da ba zai yiwu a inganta hawan jini ba koda tare da shayarwa da amfani da magunguna.

6. Maganin Hemodialysis

Hemodialysis ba koyaushe ake nuna shi ba, duk da haka, yana iya zama mafita a cikin mawuyacin yanayi inda saurin cire yawan electrolytes, acidity a cikin jini ko lokacin da aka tsaya a aikin koda.