Ntshav lom (sepsis) yog ib qho txheej txheem ntawm kev kis kab mob hauv lub cev nrog cov kab mob los ntawm cov kab mob los ntawm cov hlab ntsha. Peb yuav tham txog yuav ua li cas tus mob no txhim kho, nws yuav tshwm sim thiab yuav kho li cas, tom qab hauv tsab xov xwm.
Cas ua rau sepsis
Ntau yam kab mob tuaj yeem ua rau muaj kev mob sepsis: kab mob, kab mob, fungi, thiab cov tsos mob ntawm nws tshwm sim yuav nyob ntawm seb lawv tau nkag mus rau hauv cov hlab ntsha. Tab sis qhov pib ntawm tus txheej txheem kis tus kab mob, raws li txoj cai, tau yooj yim los ntawm cov txheej txheem ntawm qee yam xwm txheej:
- hauv lub cev yuav tsum muaj lub ntsiab lus tseem ceeb ntawm kev kis kab mob cuam tshuam nrog cov hlab ntshav lossis lymphatic system;
- kab mob rov nkag mus rau hauv cov ntshav;
- muaj ib qho kev mob siab rau kev kis kab mob, uas tom qab muab cov kab mob.
Thiab yog vim li cas tseem ceeb uas ua rau ntshav sepsis, qhov tshwm sim ntawm qhov peb xav txog hauv kab lus, yog lub cev tsis muaj zog lossis muaj cov kab mob uas ua rau nws nyuaj siab: kev ua haujlwm ntau, ntshav poob,kab mob oncological, HIV, kab mob ntshav, thiab lwm yam. Kev noj tshuaj tiv thaiv kab mob lossis cytostatics tuaj yeem ua lub luag haujlwm tseem ceeb hauv qhov no.
Ntev npaum li cas sepsis kav
Ib qho ntawm cov yam ntxwv ntawm cov kab mob piav qhia yog nws lub peev xwm khiav ntawm xob laim. Hom kab mob sepsis no, hu ua mob hnyav tshaj plaws hauv cov tshuaj, pib sai, ib txhij cuam tshuam rau lub cev thiab lub cev. Hauv qhov no, kev tuag tshwm sim hauv 1-2 hnub.
Ntxiv rau qhov hais txog kev kho mob ntawm cov kab mob pathology, muaj qhov mob hnyav, subacute thiab rov tshwm sim sepsis. Lawv txawv ntawm ib leeg nyob rau hauv cov nqe lus ntawm kev kis tus kab mob (los ntawm ib hlis mus rau rau lub hlis), thiab hom tom kawg kuj yog ib tug nthwv dej zoo li chav kawm, thaum lub sij hawm exacerbations yuav hloov los ntawm ib txwm noj qab haus huv. Tshwj xeeb ntev yog qhov mob sepsis, uas tuaj yeem kav ntev txog ib xyoos lossis ntau dua.
ntshav sepsis: cov tsos mob
Cov tsos mob ntawm cov ntshav lom, raws li tau hais tseg, nyob ntawm ntau yam: daim ntawv ntawm tus kab mob, nws cov chav kawm, qhov chaw ntawm qhov chaw ntawm tus kab mob thawj zaug thiab muaj qhov thib ob.
Tab sis qhov yooj yim, qhov pathology no tshwm sim los ntawm kev dhia hauv lub cev kub, nce mus txog 39-40 ° C, uas tau hloov los ntawm nws qhov normalization. Tus neeg mob yws yws ntawm qhov txias txias, lub sijhawm uas tsis ua npaws yog hloov los ntawm kev hnov tsw ntawm cua sov thiab tawm hws hnyav. Kuj:
- qhov pib ntawm tus kab mob tuaj yeem nrog lub xeev ntawm kev zoo siab, euphoria hauv tus neeg mob, tom qab ntawd tig mus rau qhov tsis txaus siab thiab qaug zog;
- tus neeg mob daim tawv nqaij daj ntseg,icteric tone;
- lub plawv dhia mus txog 150 neeg ntaus ib feeb, ntshav siab poob, ua tsis taus pa tshwm;
- daim tawv nqaij tuaj yeem tsim pob pob liab liab los yog cov pob txha petechial - uas yog ib qho cim ntawm kev txhim kho hemorrhagic syndrome;
- herpes tuaj yeem tshwm sim ntawm daim di ncauj;
- qhov muag sclera liab, thiab qhov ncauj mucosa los ntshav.
Raws li koj tuaj yeem pom, qhov pib ntawm cov ntshav sepsis ua rau muaj ntau yam tshwm sim, tab sis cov cim tseem ceeb ntawm nws qhov tsos tseem suav tias yog kub taub hau, ua daus no thiab tawm hws ntau.
Kev mob ntshav sepsis
Ua tiav kev qaug cawv nrog cov txiaj ntsig ntawm cov haujlwm tseem ceeb ntawm cov kab mob tsis zoo, ua rau cov tsos mob tau teev tseg, thaum muaj ntshav lom tshwm sim vim qhov tseeb tias cov tshuaj lom tam sim ntawd kis thoob plaws hauv lub cev thiab cov ntaub so ntswg, nkag mus rau hauv cov mucous daim nyias nyias thiab txawm tias. pob txha thiab pob qij txha. Thiab tag nrho cov no, vim li ntawd, ua rau muaj qhov tseeb tias tus kab mob nws tus kheej thiab qhov tshwm sim nrog cov ntshav sepsis chain tus neeg mob mus pw hauv tsev kho mob ntev.
Cov teeb meem loj tshaj plaws ntawm tus kab mob tuaj yeem yog septic shock, uas tuaj yeem tshwm sim txhua lub sijhawm thaum nws kawm. Qhov txaus ntshai sib npaug yog o ntawm lub raum (paranephritis) lossis zais zis (cystitis), tsim cov kab noj hniav purulent nyob rau hauv ntau yam kabmob (piv txwv li, abscesses hauv lub ntsws lossis lub hlwb), kev loj hlob ntawm purulent meningitis, plawv tsis ua haujlwm, lossis DIC (intravascular coagulation).).
Yog tsis muaj kev kho mob kom raug, sepsis tuaj yeem ua rau tuag tausExodus.
kab mob daim ntawv
Kev kho cov ntshav sepsis yog ua nyob ntawm seb cov microbes nkag mus rau hauv cov ntshav li cas thiab qhov chaw tseem ceeb ntawm kev kis kab mob nyob. Hauv cov tshuaj, ntau hom pathology yog qhov txawv.
- Percutaneous sepsis. Nws tshwm sim thaum kis tau los ntawm cov tawv nqaij me me hauv daim ntawv ntawm khawb lossis boils.
- Obstetric thiab gynecological. Nws cuam tshuam rau cov poj niam tom qab yug menyuam lossis rho menyuam.
- Tonsillar. Nws yog qhov tshwm sim ntawm kev mob hnyav ntawm tus kab mob angina.
- Otogenic. Cov kab mob kis tau los ntawm pob ntseg kab noj hniav (piv txwv li, los ntawm purulent otitis media).
- Odontogenic. Qhov tshwm sim ntawm kev kis kab mob ntawm qhov ncauj hauv qhov mob hnyav ntawm cov pos hniav thiab cov hniav.
- Cryptogenic sepsis. Hauv qhov no, peb tab tom tham txog qhov ua kom pom tseeb ntawm qhov mob purulent.
Kev kuaj ntshav lom
Yuav kom txiav txim siab seb yuav kho cov ntshav sepsis li cas, nws yuav tsum tsim kom muaj qhov chaw kis kab mob thiab hom kab mob uas nkag mus rau hauv cov hlab ntsha.
Rau qhov no, kuaj ntshav, uas yog coj los ntawm cov leeg sib txawv, thiab kev cog qoob loo ntawm cov kab mob sib cais hauv cov khoom noj nruab nrab. Nyob rau tib lub sijhawm, lawv qhov rhiab heev rau cov tshuaj tua kab mob yog txiav txim siab.
Thaum mob hnyav, kev tshuaj xyuas qhia tau ua tiav, thaum lub sijhawm cov khoom siv caj ces ntawm cov kab mob cais tawm hauv cov ntshav, yog li tom qab 1.5 teev nws tuaj yeem txheeb xyuas 25 hom kab mob lossis cov fungi uas ua rau mob sepsis.
kho li cassepsis
Lub hauv paus ntsiab lus ntawm kev kho ntshav lom yog nyob ntawm kev tshawb nrhiav thiab tshem tawm foci ntawm tus kab mob. Lawv txoj kev kho kom rov zoo yog ua los ntawm kev qhib dav thiab ceev faj necrectomy. Tsis tas li ntawd, lub qhov txhab raug kho nrog tsawg zaus ultrasound, tshuaj tua kab mob (Dioxidin, Dimexidine, thiab lwm yam), surfactants (Chlorhexine), thiab proteolytic enzymes (Trypsin, Profezim, thiab lwm yam).
Qhov siab tshaj plaws ntawm cov tshuaj tua kab mob raug xaiv rau tus neeg mob, nyob ntawm seb cov kab mob uas tau txheeb xyuas, piv txwv li, hauv staphylococcal sepsis, Fuzidin thiab Refampicin yog siv. Qhov nce hauv kev tiv thaiv yog txhawb los ntawm kev kho cov tshuaj vitamin thiab cov tshuaj immunostimulating, thiab cov enzymes txhoj puab heev yog suppressed los ntawm kev qhia txog inhibitors "Kontrykal" los yog "Gordox"
Kev tshem tawm yog ua los ntawm kev siv ntau ntawm cov neeg ua haujlwm protein ntau thiab cov kua dej tso rau hauv cov ntshav.
Txhawm rau tshem tawm qhov tshwm sim ntawm hypovolemia (qhov txo qis hauv cov ntshav), qhov kev nyiam yog muab rau kev npaj "Polidez", "Polyglumasol", thiab lwm yam. ua ke nrog cov tshuaj antiplatelet Xanthinol nicotinate los yog Dipyridamole.
Ib txoj hauv kev kho mob kuj yog kev hloov ntshav rau sepsis lossis hloov ntshav ("Polyglukin", "Reogluman", thiab lwm yam). Kev kho cov ntshav laser kuj muab cov txiaj ntsig zoo, thiab hauv cov xwm txheej hnyav, plasmapheresis thiab lub raum khoom siv tau siv.
tiv thaiv kab mob Sepsis
txhawm rau tiv thaiv qhov tshwm sim ntawm cov ntshav sepsis, ntau txoj cai yuav tsum tau ua, uas, txawm tias lawv tsis tuaj yeemtag nrho kev pov hwm tawm tsam cov lus piav qhia txaus ntshai, tab sis yuav txo qis qhov ua tau ntawm nws txoj kev loj hlob.
- Txhua qhov txhab yuav tsum tau kho nrog tshuaj tua kab mob.
- Purulent foci ntawm qhov mob yuav tsum raug cuam tshuam rau kev phais raws sijhawm.
- Ua tib zoo ua raws li tus kws kho mob cov lus qhia tom qab raug mob.
Thiab, tau kawg, txhawm rau txhim kho lub cev tiv thaiv kab mob - tom qab tag nrho, tsuas yog nws muaj peev xwm tiv thaiv tus kab mob los ntawm kev pib. Noj qab nyob zoo!
