Gusuzuma byihuse indwara zandurira mu maraso

Indwara yamaraso (BSI) bivuga syndrome de sisitemu yo guterwa no guterwa na mikorobe itandukanye itera indwara hamwe nuburozi bwabo mumaraso.

Inzira yindwara ikunze kurangwa no gukora no kurekura abunzi batera umuriro, bigatera urukurikirane rwibimenyetso byindwara nkumuriro mwinshi, gukonja, tachycardia guhumeka neza, guhubuka no guhindura imitekerereze, kandi mubihe bikomeye, guhungabana, DIC nibindi byinshi -kunanirwa kwinzego, hamwe numubare munini wimpfu. yaguze HA) sepsis na septique yibibazo, bingana na 40% byimanza naho hafi 20% byimanza za ICU. Kandi ifitanye isano rya bugufi no guhanura nabi, cyane cyane idafite imiti igabanya ubukana ku gihe no kurwanya indwara.

Gutondekanya kwandura kwamaraso ukurikije urugero rwanduye

Indwara ya bagiteri

Kubaho kwa bagiteri cyangwa ibihumyo mumaraso.

Septicemia

Indwara ya syndrome yatewe no gutera za bagiteri zitera indwara n'uburozi bwabo mu maraso, ni indwara ikomeye ya sisitemu.

Pyohemia

Imikorere idahwitse yubuzima iterwa no kutagabanya uko umubiri wakira kwandura.

Muby’ubuvuzi bukomeye ni indwara ebyiri zikurikira.

Indwara zidasanzwe za Catheter zifitanye isano n'amaraso

Indwara ziva mu maraso zifitanye isano na catheteri zatewe mu mitsi y'amaraso (urugero, catheteri ya periferique, catheters yo hagati, catteri ya arterial, catheteri ya dialyse, nibindi).

Indwara idasanzwe yanduza

Nindwara yandura iterwa no kwimuka kwa virusi kuri endocardium na valve yumutima, kandi irangwa no kwibumbira mu binyabuzima bitagira ingano mu buryo bwo kwangiza indwara, ndetse no kwanduza indwara ya metastasis cyangwa sepsis bitewe no kumeneka kw'ibinyabuzima.

Ingaruka zo kwandura amaraso：

Indwara yamaraso isobanurwa nkumurwayi ufite umuco mwiza wamaraso nibimenyetso byubwandu bwa sisitemu. Indwara ziva mu maraso zirashobora kuba iya kabiri ahandi zandurira nko kwandura ibihaha, kwandura mu nda, cyangwa kwandura kwambere. Byagaragaye ko 40% by'abarwayi bafite septis cyangwa se septique bahitanwa n'indwara zandurira mu maraso [4]. Bivugwa ko miliyoni 47-50 zanduye sepsis zibaho ku isi buri mwaka, bigatuma hapfa abantu barenga miliyoni 11, ugereranyije ugereranyije n’urupfu 1 buri masegonda 2.8.

Uburyo buboneka bwo gusuzuma indwara zanduza amaraso

01 PCT

Iyo kwandura sisitemu hamwe no gutwika ibintu bibaye, ururenda rwa calcitoninogene PCT rwiyongera vuba mugihe cyo kwinjiza uburozi bwa bagiteri na cytokine ikongora, kandi urwego rwa serumu PCT rugaragaza imiterere yindwara kandi nikimenyetso cyiza cyo guhanura.

0.2 Ingirabuzimafatizo nibintu bifatika

Molekile zifata ingirabuzimafatizo (CAM) zigira uruhare muburyo butandukanye bwa physiopathologique, nko gukingira indwara no gukongoka, kandi bigira uruhare runini mukurwanya kwandura no kwandura bikomeye. Harimo IL-6, IL-8, TNF-a, VCAM-1, nibindi.

03 Endotoxin, Ikizamini G.

Gram-negative bacteria yinjira mumaraso kugirango irekure endotoxine irashobora gutera endotoxemia; (1)

04 Ibinyabuzima bya molekuline

ADN cyangwa RNA yarekuwe mumaraso na mikorobe irageragezwa, cyangwa nyuma yumuco mwiza wamaraso.

05 umuco wamaraso

Indwara ya bagiteri cyangwa ibihumyo mumico yamaraso ni "zahabu".

Umuco w'amaraso ni bumwe mu buryo bworoshye, bwuzuye kandi bukoreshwa cyane mu kumenya indwara zandurira mu maraso kandi ni yo mpamvu itera indwara yo kwemeza indwara zandurira mu mubiri. Kumenya hakiri kare umuco wamaraso hamwe nubuvuzi bwa mikorobe hakiri kare kandi bukwiye ningamba zambere zigomba gufatwa muguhashya kwandura amaraso.

Umuco w'amaraso nicyo gipimo cya zahabu mugupima indwara zandurira mu maraso, zishobora gutandukanya neza indwara zanduza, zifatanije no kumenya ibisubizo by’ibiyobyabwenge kandi bigatanga gahunda nziza yo kuvura. Icyakora, ikibazo cyigihe kirekire cyo gutanga raporo kumuco wamaraso cyagize ingaruka kumasuzuma no kuvurwa mugihe cyamavuriro, kandi byavuzwe ko umubare wimpfu zabarwayi batavuwe na antibiyotike mugihe kandi cyiza wiyongera 7,6% kumasaha nyuma yamasaha 6 ya hypotension ya mbere.

Kubwibyo, umuco wamaraso muri iki gihe no kumenya imiti y’ibiyobyabwenge ku barwayi bakekwaho kwandura amaraso ahanini bakoresha uburyo bwo gutanga raporo mu byiciro bitatu, aribyo: gutanga raporo y'ibanze (gutanga raporo y'agaciro gakomeye, ibisubizo bisebanya), gutanga raporo ya kabiri (kumenyekanisha byihuse cyangwa / no kumva neza ibiyobyabwenge gutanga raporo) no gutanga raporo ya gatatu (raporo yanyuma, harimo izina rito, igihe cyiza cyo gutabaza hamwe nibisubizo bisanzwe byo gupima ibiyobyabwenge) [7]. Raporo y'ibanze igomba kumenyeshwa ivuriro bitarenze 1 h ya raporo nziza yamaraso; raporo ya kaminuza irasabwa kurangizwa vuba bishoboka (muri rusange muri 48-72 h kuri bagiteri) bitewe na laboratoire.