Nosocomial ciwon huhu: pathogens, magani da kuma rigakafin

Nosocomial ciwon huhu - shi ne wani m dauke da kwayar cutar aiwatar da ke faruwa a cikin jiki a ƙarƙashin rinjayar aiki rai na pathogenic kwayoyin. Halayyar siffofin da cuta ne da na huhu airway rauni katin da ciki jari na wani manyan girma na ruwa. Exudate baya seeps ta hanyar da yake shiga Kwayoyin a koda nama.

Updated kasa jagororin for asibiti-samu ciwon huhu

An fara daga 2014 "numfashi Society" ya gabatar da duniya zuwa asibiti jagororin. Suna dogara ne a kan wani algorithm ga ganewar asali da kuma far a yanayi inda akwai tuhuma da cewa haƙuri progresses nosocomial ciwon huhu. National jagororin ci gaba da masana, clinicians, ma'aikatan kiwon lafiya, da fuskantar da m na numfashi kamuwa da cuta.

A takaice, da algorithm kunshi maki hudu.

1. Ƙayyade idan kana bukatar arin. A tabbatacce yanke shawara aka sanya, idan haƙuri a fili bayyana numfashi wuya, akwai wani karu nama perfusion, m kai-da guba, illa sani, m jini. Da za a sanya a cikin asibiti quite kayyade akalla daya alama.
2. Kayyade cikin hanyar cutar. Don yin wannan, da haƙuri da aka wajabta a yawan awon nazarin halittu da kayayyakin: jini al'adu, da al'adu daga jijiyar, bakposev sputum, high-gudun gwajin domin sanin antigenurii kwayan yanayi.
3. Kayyade lokacin kiranka na magani. Bayar da cewa cutar ne na kwayan asalin, amma ainihin dalilin da ba a kafa, an gudanar far kan kwana goma. A daban-daban da rikitarwa ko extrapulmonary mayar da hankali warkewa Hakika iya zama har zuwa kwanaki 21.
4. Matakan dole inpatient tsaya. A tsanani yanayin, marasa lafiya a bukatar numfasawa ko ba masu cin zali iska.

Har ila yau a cikin kasa jagororin wajabta m matakan. A mafi inganci shi ne alurar riga kafi da mura da kuma pneumococcus, nada yafi ga marasa lafiya da na kullum ciwon huhu da kuma mutane mazan shekaru kungiyar.

Musamman al'umma-samu ciwon huhu

Community-samu nosocomial ciwon huhu ne da wani na kowa sunan - al'umma-samu. A cuta ne ya sa ta kamuwa da cuta daga kwayan etiology. Babban hanya kamuwa da cuta - yanayi. Haka kuma, ya tabbatar da dalilin zai zama kamar haka: kumburi huhu rauni katin samu ta hanyar droplets, a cikinsa sama lamba tare da yan dako na kamuwa da cuta a harkokin kiwon lafiya da saitunan haƙuri ba.

Community-tsiwirwirinsu, da nosocomial ciwon huhu na kwayan asalin yawanci kamu a marasa lafiya tare da rage rigakafi, lokacin da jiki ba zai iya yin tsayayya da pathogens (pneumococcus, Haemophilus influenzae, Klebsiella). Sun shiga a cikin rami daga cikin huhu ta hanyar hanci Tsarki.

A hadarin kungiyar hada da yara na ƙaramin shekaru kungiyar da kuma marasa lafiya da na kullum huhu cututtuka. A wannan yanayin, da causative wakili ne staphylococcus aureus.

Community-samu nosocomial ciwon huhu: ka'idodinta rarrabuwa na cuta

Domin ci gaba da ta dace lura da ciwon huhu zuwa rarraba da sigogi:

• cutar da aka ba tare da rage daga cikin m ayyuka da kwayoyin.
• cuta ya fito fili kan bango na rage yawan rigakafi.
• cutar tasowa a cikin m mataki na AIDS.
• cuta, kafa a tare da sauran cututtuka.

Yawancin lokaci, ganewar asali aka tabbatar a cikin marasa lafiya da suke da wata matsala a cikin nau'i na rage rigakafi kan backdrop na Oncology ko Hematology. Har ila yau a cikin hadarin kungiyar, marasa lafiya shan steroids na dogon lokaci high sashi. Har ila yau, akwai sau lokacin da cutar ta auku a cikin marasa lafiya da na kullum rigakafi pathologies.

Bugu da kari, mai raba category hada da irin wannan ciwon huhu ne tsammãni.

Doctors lura cewa a wannan lokaci a cikin ginshikai na asali na wani irin na tsammãni ciwon huhu akwai waje jikinsu a lamba tare da cutar tasowa.

Musamman nosocomial ciwon huhu

Wannan ra'ayi ne ya sa likita yanayin da haƙuri, idan kumburi a cikin huhu sashe ne da aka nuna bayan game da 72 hours bayan kamuwa da cuta. A hatsari ya ta'allaka ne da cewa nosocomial nosocomial ciwon huhu da wahala da yanayin da shakka da kuma sau da yawa ƙare a mutuwa. Yana yana lalacewa ta hanyar kwayoyin da cewa rayuwa a cikin ganuwar da likita ma'aikata, resistant zuwa mafi magunguna, don haka yana da matukar wuya a samu da farko lokacin da daidai da kwayoyin.

Nosocomial Nosocomial ciwon huhu: ka'idodinta rarrabuwa na cuta

Fifiko irin asibiti nosocomial ciwon huhu ne classified a da kamuwa da cuta mataki:

1. Farkon mataki - a farkon kwanaki biyar na gano wani haƙuri a wani asibiti a fara nuna shakka akwai ayoyi da cuta.
2. Late mataki - bayyanuwar cututtuka an jinkirta ta fiye da kwanaki biyar.

Dangane da etiology da cutar ne iri uku:

1. Tsammãni nosocomial ciwon huhu.
2. Postoperative.
3. Ventilator-hade.

Shi ne ya kamata a lura da cewa rarrabuwa gabatar da irin ne matukar, kuma a mafi yawan lokuta suna kamu da ciwon huhu, a gauraye form. Wannan, bi da bi, ƙwarai aggravates da yanayin haƙuri kuma rage chances na dawo.

muradinta

Gabatar nau'i na cutar ne ya fi kowa. Lokacin da kamuwa da hanci gamsai samun shiga cikin huhu sashen, akwai autoinfection jiki.

Liquid nasopharyngeal - wani manufa wuri domin pathogenic kwayoyin abinci, don haka, sau daya a cikin huhu, da kwayoyin fara rayayye radiyo, da kuma cewa taimaka wa ci gaban da muradinta na ciwon huhu.

postoperative

Gabatar da irin ciwon huhu da aka cuta a 18 na asibiti lokuta daga 100, kuma an samu kawai a marasa lafiya da suke yi halartar tiyata.

A wannan yanayin, da kamuwa da cuta yakan faru a cikin wannan hanya kamar yadda a tsammãni ciwon huhu, kawai don nasopharyngeal ruwa da aka kara da ciki secretions, wanda shi ne babu kasa mai hadarin gaske. Har ila yau, ba sarauta daga kamuwa da haƙuri da likita kida da na'urorin. Ta tube ko catheter kamuwa da cuta iya yada wa ƙananan numfashi fili.

Ventilator-hade

Bincikar lafiya a marasa lafiya da suke lokaci mai tsawo a cikin sharuddan na wucin gadi huhu iska. Safe lokaci ba fiye da 72 hours a cikin wannan jiha, a cikin wadannan da kowane wucewa rana na kara hadarin tasowa ciwon huhu.

Nosocomial ciwon huhu

Nosocomial ciwon huhu asibiti sau da yawa ya sa ta pneumococci. Irin wannan diagnoses ne daga 30 zuwa 50 bisa dari na duka na asibiti lokuta.

A kalla m kwayoyin ne Chlamydia, wato Mycoplasma da Legionella. Su rinjayi, masu tasowa, ciwon huhu ba fiye da 30% amma ba kasa da 8%.

Kalla ila za a samu cuta ya tashi gāba da backdrop na ƙwazo aiki: Haemophilus influenzae, staphylococcus aureus, klebsiella da enterobacteria.

Har yanzu wasu pathogens na nosocomial ciwon huhu - mura ƙwayoyin cuta ne aji A da B, parainfluenza, adenovirus, na numfashi syncytial cutar.

Mafi na kowa pathogens na nosocomial ciwon huhu m irin da za su iya bayar da Yunƙurin zuwa annoba annobar cutar, - Mycoplasma da Legionella. A cikin farko case, sau da yawa m matasa da matasa har zuwa shekaru 25. A Legionella kamuwa da cuta na faruwa ne ta ruwa, msl, a cikin jama'a hankali, da daron da sauran.

Hanyar na zamani bincikowa

Idan wani haƙuri yana da ciwon huhu, al'umma-samu irin, shi ne sau da yawa kamu da jiki jarrabawa. A kowane asibiti hali, domin saukaka sa idanu haƙuri da yanayin da kuma bayyanar cututtuka da cutar fara up raba katin ko likita tarihi.

Phased fitar da-haƙuri ganewar asali ne kamar haka:

• Chest X-ray - X-ray bincikowa Hanyar cewa ayyukan da take images a kan yanayin da huhu da dama jirage. A gaban da duhu, m spots ganewar asali aka tabbatar. Ganewar asali da aka nuna sau biyu: a farkon magani da kuma bayan kwayoyin far.

• Laboratory gwaje-gwaje - haƙuri ake bukata su bada gudumawar jini domin bincike da kuma tabbatar da dalilin da total number of leukocytes, glucose da kuma Wutan.
• Microbiological nazarin - za'ayi wani bincike na cikin pleural ruwa da kuma canza launi da ƙananan numfashi fili aka bayyana ta wurin antigens a cikin fitsari.

A sakamakon wadannan bincike hanyoyin ishe tabbatacce ganewar asali da kuma lura da shirin ci gaba.

Yabo don lura da marasa lafiya

Jagorancin Asibitoci, domin lura da nosocomial ciwon huhu ne a matsayin wani al'amari na danganci maganin rigakafi m-bakan.

Bayan karbar binciken sakamakon a iyawa da likitan canza da miyagun ƙwayoyi da aka asali hõre ta a fi dacewa. Dalili shi ne nau'i na pathogenic kwayoyin.

Ka'idojin lura da marasa lafiya da nosocomial ciwon huhu

Jiyya na nosocomial ciwon huhu kunshi a zabi dace kwayoyin, ta regimen, da hanya na gwamnati da kuma sashi. Yana hulda kawai tare da halartar likita. Haka ma, wani ɓangare daga cikin far ne lura da numfashi fili remediation (kau na tara ruwa).

Lamari ne mai muhimmanci a sami wani haƙuri a Jihar jiki aiki. Ya kamata ka yi numfashi darussan da kuma kananan motsa jiki a cikin nau'i na zauna-rubucen. Marasa lafiya suke a tsanani yanayin, taimaka da jinya. Suna tsunduma a wani yau da kullum da canji na matsayi na haƙuri, da barin ruwa ba stagnate a wuri guda.

Hana maimaita cuta zai taimaka rigakafin nosocomial ciwon huhu, wanda bayyana a cikin daki-daki, ga likita.

kwayoyin far

Jiyya da nufin magance kwayoyin cuta, yana da iri biyu: m da yatsa. Da farko, dukan marasa lafiya suna bi empirically rubuta da kuma directed nada bayan kayyade causative wakili.

A mafi muhimmanci da yanayi na a dawo da su ne:

1. Developing dace kwayoyin magani.
2. Rage amfani da antimicrobials.

Pick antibacterial kwayoyi da kuma su sashi iya kawai likita, kai-maye kwayoyi ne unacceptable.

Kintacen dawo da

Dangane da zabi daidai da kwayoyi, mai tsanani da cuta da kuma janar jihar na haƙuri sakamako na magani iya zama kamar haka: dawo da, wani kadan kyautata, magani rashin cin nasara, da komowa, da kuma mutuwa.

A nosocomial ciwon huhu yiwuwar mutuwa ne da ya fi yadda a cikin al'umma da-samu form.

m matakan

Rigakafin nosocomial ciwon huhu wakilta hadaddun likita da ANNOBA matakan:

• dace lura da alaka cututtuka.
• yarda da dokoki da kuma matsayin da kiwon lafiya;
• samun immunomodulatory jamiái.
• alurar riga kafi.

Yana da muhimmanci sosai a inganta haƙuri da yanayin - to a hana sake komowa - don saka idanu da kiyaye sauki sharudda: na yau da kullum dubagari da na baka rami, tari up ruwa jari, jiki aiki.