Kakā Nosocomial: tukumate, maimoatanga me te ārai

kakā Nosocomial - ko te tukanga hopuhopu whakapeka puta i roto i te tinana i raro i te mana o te ora kaha o huakita pathogenic. āhuatanga āhuatanga o te mate ko te kāri lesion airway pūkahukahu ki whakaeminga ā o te rōrahi nui o te wai. Exudate muri seeps i roto i, me te ô pūtau i roto i te kiko tākihi.

aratohu motu whakahōutia hoki kakā hōhipera-riro

Tīmata i 2014 "Society Respiratory" whakaurua te ao ki aratohu haumanu. E hāngai ana ratou i runga i te hātepe papatono mō te tātaritanga me te therapy i roto i ngā āhuatanga i reira i reira ko te māharahara e kauneke te manawanui kakā nosocomial. aratohu motu whakawhanakehia e te tohunga, kaihaumanu, kaimahi tiaki hauora, fehangahangai ki te mate romahā whakapeka.

Nounou, Kei te hātepe o wha ngā.

1. Whakatau ki te hiahia koe i hohipera. Kei te hanga te whakatau pai, ki te mārama faaite te manawanui mamae romahā, i reira te mea he kiko perfusion heke, whakapeka whaiaro-paihana, mahara waimaero, te pēhanga toto iu. Hei kia whakanohoia i roto i te hōhipera whakatau rawa i te iti rawa kia kotahi tohumate.
2. Whakatau i te take o te mate. Ki te mahi i tenei, whakaritea te manawanui ko te maha o rangahau taiwhanga o ngā rauemi koiora: ahurea toto, ki te ahurea i te rua, bakposev sputum, nui-tere test whakatau natura kitakita antigenurii.
3. Whakatau i te roanga o te maimoatanga. Engari e ko te mate o te take mai kitakita, engari e kore e te te mau take whakapumautia, whakahaere therapy te i runga i nga ra kotahi tekau. I ngā pōauautanga extrapulmonary akoranga whakaora arotahi ranei kia ki runga ki te 21 nga ra.
4. Measures tūroro noho noho e tika ana. I roto i te huru nui, tūroro i roto i te hiahia o te respiration ventilation kore-urutomo ranei.

i roto i te aratohu motu hoki whakaritea āraihia. Ko te whai hua tino he werohanga ki rewharewha me te pneumococcus, whakaritea te nuinga mō ngā tūroro ki kakā ma'i me te tangata pakeke rōpū pakeke.

kakā Rawa hapori-riro

Ko tetahi atu ingoa noa kakā nosocomial Hapori-riro - riro-hapori. meinga ana te mate e mate o etiology kitakita. Ko te ara matua o te mate - taiao. Nä, ko te faaotiraa e kia e whai ake: inflammatory kāri pūkahukahu lesion whiwhi e rūrūtia, ai kore ko te whakapā runga ake ki kawe o mate i roto i te tiaki hauora tautuhinga manawanui.

Hapori-riro, me te kakā nosocomial o te take mai kitakita te tikanga pāngia i roto i te tūroro ki te wātea i te mate iti, ka taea ki te pato'ii te tukumate (pneumococcus, rewharewha kukuti, Klebsiella) te tinana ko. tomo ratou ki roto ki te kōhao o te pūkahukahu i roto i te mau irava nasal.

Ko te rōpū mōrearea ngā tamariki a muri rōpū pakeke me tūroro ki ma'i mate pūkahukahu. I roto i tenei take, te kaihoko pūtake ko Staphylococcus pene.

Hapori-riro kakā nosocomial: te mau parau tumu o te whakarōpū o mate

I roto i te tikanga ki te whakawhanake i te maimoatanga tika o te kakā ki te whakarōpū i ngā tawhā:

• e kore te mate tahi e heke o te mahi tiaki o te kaiao;
• mate ki te puta ki te papamuri o te wātea i te mate iti;
• mate puta i roto i te wā whakapeka o AIDS;
• mate, i hanga i roto i te taha ki te tahi atu mate.

Ko te tikanga, whakapumautia te tātaritanga i roto i tūroro e whai he raruraru i roto i te puka o te wātea i te mate heke ki te puipuitua o matepukupuku hematology ranei. Ano i roto i te rōpū mōrea, tūroro tango steroids mo te inenga tiketike wa roa. Ano, i reira he wā ka puta te mate i roto i te tūroro ki pathologies ārai ma'i.

I tua atu, ngā te kāwai motuhake tenei momo o te kakā he wawata.

Doctors mōhio e i tenei wāhi i roto i te huarahi o te takenga mai o te ahua tetahi o wawata kakā i reira he tinana ke i roto i whakapā ki ai whakawhanake te mate.

kakā Rawa nosocomial

hoatu ana tēnei ariā te huru hauora o te manawanui, ka whakaaturia mumura i roto i te wāhanga pūkahukahu te i muri i pā ana ki 72 haora i muri i mate. takoto te ati i roto i te meka i faingataa nosocomial kakā nosocomial e te āhua o te akoranga, me te maha mutu i roto i te mate. Kei te meinga te reira e huakita e ora i roto i nga taiepa o te whare hauora, ātete ki te nuinga o rongoā, na ko reira tino uaua ki te kitea te wa tuatahi te rongoā paturopi tika.

Nosocomial Nosocomial kakā: te mau parau tumu o te whakarōpū o mate

whakarōpūtia momo matua o hōhipera kakā nosocomial te i roto i te taahiraa mate:

1. atamira Early - i roto i te ra tuatahi e rima o te kimi i te manawanui i roto i te hōhipera timata ki te whakaatu tohu kitea o te mate.
2. atamira Late - roa te faaiteraa o tohu e ra neke atu i rima.

Tei runga i te etiology o te mate e toru ngā momo:

1. Wawata kakā nosocomial.
2. Postoperative.
3. Ventilator-whai pānga.

E tano ia tapao e te whakarōpū te aroaro e te momo he herenga, me i roto i te nuinga o te wā e pāngia kakā i roto i te puka whakauru. Tenei, i roto i te tahuri, nui aggravates te huru o te manawanui, me te whakaiti i nga tūponotanga o te ora.

wawata

Ko puka Vauvauhia o te mate te noa tino. A, no te riro nga hūpē nasal pangia ki te tari pūkahukahu, i reira te tinana autoinfection.

nasopharyngeal wai - he wahi pai mo te kai huakita pathogenic, na, kotahi i roto i nga pūkahukahu, timata nga microorganisms ki proliferate kaha, me e whai wāhi ana ki te whanaketanga o te wawata kakā.

postoperative

Vauvauhia e te momo o te kakā pāngia te i roto i te 18 take haumanu i roto o te 100, a ka kitea anake i roto i tūroro hunga i pehia pokanga.

I roto i tenei take, puta te mate i roto i te ara ano e rite ana i roto i te wawata kakā, anake ki te tāpiri inu nasopharyngeal me secretions pekitīlia, i te mea kahore iti mōrearea. Ano, e kore e whakahaere tikanga i roto i mate o mea hauora o te manawanui me ngā pūrere. Na roto i te ngongo pū tōngāmimi mate ranei ngāwari e taea horahia ki te wahi romahā raro.

Ventilator-whai pānga

Pāngia i roto i tūroro e ko te roa te wa i roto i ngā o te ventilation pūkahukahu horihori. e kore te mea neke atu i te 72 haora i roto i tenei āhua wā Haumaru, i roto i te whai ki ia ra e haere faarahi te mōrea o te whakawhanake kakā.

kakā Nosocomial

hōhipera kakā Nosocomial maha meinga e te pneumococci. Taua momo tātaritanga kei i te 30 ki te 50 ōrau o te wā haumanu katoa.

Ko te iti rawa huakita pukuriri ko Chlamydia, Mycoplasma ko Legionella. I raro i to ratou mana, e kore neke atu i te 30%, engari e kore te mea iti iho i te 8% whakawhanake kakā.

whakatika iti rawa pea ki te e kitea whakararuraru, ki te puipuitua o mahi maia: rewharewha kukuti, Staphylococcus pene, Klebsiella me enterobacteria.

Tonu atu tukumate o kakā nosocomial - wheori rewharewha ko te te piha haapiiraa, a B, parainfluenza, adenovirus, huaketo syncytial romahā.

Ko te tukumate tino noa o nosocomial kakā momo kaitaua e taea hoatu ara ki urutā urutā, - Mycoplasma ko Legionella. I roto i te take tuatahi, he maha taiohi kino, me te kuao pakeke ake ki te 25 tau. puta te mate Legionella roto i te wai, hei tauira, i roto i te hinengaro tūmatanui, te takotoranga wai me ētahi atu.

Methods o tātaritanga hou

Ki te he kakā, momo riro-hapori i te manawanui, te maha pāngia reira i te whakamātautau tinana. I roto i ia take haumanu, mo te haratau o te aroturuki huru o te manawanui, me te tohu o te mate tīmata ake te kāri motuhake hītori hauora ranei.

Poua ki te tātaritanga i roto i-manawanui ko e whai ake:

• Aaka X-ray - tikanga tātaritanga X-ray e kokiri nga whakapakoko i runga i te huru o te pūkahukahu i te maha rererangi. I roto i te aroaro o te pouri, whakapumautia wahi mātotoru tātaritanga te. whakaaturia tātaritanga te rua: i te timatanga o te maimoatanga me te i muri i te therapy paturopi.

• whakamātautau Laboratory - e hiahiatia te manawanui e ki te koha toto mo te tātari me te faaotiraa o te katoa maha o leukocytes, te kūhuka i me electrolytes.
• rangahau Microbiological - kawea i roto i te tātaritanga o te inu pleural me te tae o te wahi romahā raro tautuhia e te aroaro o antigens i te mimi.

Ko nga hua o enei ngā tukanga tātaritanga he rawaka mō te tātaritanga kua äta me te whanaketanga mahere maimoatanga.

Tūtohutanga mo te maimoatanga o te tūroro

aratohu Haumanu mo te maimoatanga o te kakā nosocomial e rite te mea o e tuhituhia paturopi whanui-hihinga.

I muri i te fariiraa i te hua rangahau i roto i te mātau o te rata ki te huri i te tarukino i utaina tuatahi i runga i atu tōtika. Ko te pūtake ko te ahua o microorganisms pathogenic.

Ko te mau parau tumu o te maimoatanga o te tūroro ki te kakā nosocomial

Maimoatanga o te kakā nosocomial ngā i roto i te kōwhiri i te rongoā paturopi tika, tona talena, te ara o te whakahaere, me te inenga. E tuatapaparaa te reira anake ki te rata haere. Ko te hoki te reira i te wāhi o te therapy ko te maimoatanga o te remediation wahi romahā (tango o wai putu).

Ko te wāhi nui, ko te ki te kitea he manawanui i roto i te āhua o te mahi tinana. kia mahi koe mahi manawa me te mahi iti i roto i te puka o te noho tū. Tūroro e te hunga i roto i te huru taumaha, te āwhina i te nēhi. E whai wāhi ana ratou i roto i te huringa auau o tūranga o te manawanui, tuku e kore e te wai e nuu i roto i te wahi kotahi.

Kore ai te mate recurrent e tauturu i te ārai o te kakā nosocomial, e whakaahua i roto i te taipitopito te rata.

therapy paturopi

Treatment e hāngai ana tohe huakita, e rua ngā momo: āta, me te koromatua. I te tīmatanga, kua tukinotia tūroro katoa empirically patopato a aratakiia whakaritea i muri i te whakatau i te kaihoko pūtake.

Ko te tikanga tino nui mo te whakaora e:

1. Whakawhanake maimoatanga rongoā paturopi tika.
2. whakamahi iti o antimicrobials.

Tangohia taero antibacterial me taea ratou inenga rata anake, he Kāore taero whaiaro whakakapinga-.

Ko te matapae mō te whakaora

Tei runga i te raau taero tika tīpakohia, pakeke o te mate, me te āhua whānui o te putanga manawanui o te maimoatanga kia rite whai: whakaora, he whakapai ake iti, kore maimoatanga, matahoki, me te mate.

I roto i te kakā nosocomial he nui ki runga ake i roto i te puka whiwhi-hapori te tūponotanga o te mate.

āraihia

Prevention o kakā nosocomial kanohi mehua matatini hauora me te tahumaero:

• maimoatanga wā o mate e pā ana;
• tautukunga ki nga ture, me ngā paerewa o te akuaku;
• te fariiraa i āpiha immunomodulatory;
• werohanga.

He mea tino nui i roto i te whakapai ake huru o te manawanui - ki te ārai matahoki - ki te aroturuki i te haapa'oraa o ture ohie: rerenga parukore auau o te kōhao-waha, maremare ake whakaeminga inu, mahi tinana.