Leej twg yog tus pheej hmoo rau Sepsis?

Txawm hais tias leej twg tuaj yeem txhim kho sepsis yog tias lawv muaj tus kab mob, cov pab pawg hauv qab no muaj kev pheej hmoo siab dua thiab yuav tsum tau ceev faj ntxiv:

1. Cov me nyuam mos thiab cov neeg laus: Ib tug yam ntxwv ntawm cov tib neeg no yog ib qho kev tiv thaiv kab mob tsis zoo. Lub cev tiv thaiv kab mob ntawm cov me nyuam mos thiab cov menyuam yaus tseem tsis tau tsim kho tag nrho, thaum lub cev tiv thaiv kab mob ntawm cov neeg laus poob qis nrog lub hnub nyoog thiab feem ntau nrog ntau yam kab mob hauv qab, ua rau lawv nyuaj rau kev tiv thaiv kab mob.
2. Cov neeg mob uas muaj kab mob ntev: Cov neeg mob uas muaj kab mob xws li ntshav qab zib, mob qog noj ntshav, kab mob siab thiab lub raum, kab mob obstructive pulmonary disease (COPD) lossis HIV / AIDS muaj zog tiv thaiv lub cev thiab kev ua haujlwm ntawm lub cev, ua rau cov kab mob kis tau los ntawm kev tswj hwm.
3. Immunocompromised Individuals: Cov no suav nrog cov neeg mob qog noj ntshav uas tau txais tshuaj kho mob, cov neeg siv tshuaj tiv thaiv kab mob tom qab hloov lub cev, thiab cov neeg muaj kab mob autoimmune, uas lawv lub cev tiv thaiv kab mob tsis tuaj yeem teb tau zoo rau cov kab mob.
4. Cov neeg mob uas muaj mob hnyav lossis phais loj: Rau cov neeg mob uas muaj qhov kub hnyiab, kev raug mob hnyav lossis kev phais loj, cov tawv nqaij lossis cov mucosal barrier raug rhuav tshem, muab txoj hauv kev rau cov kab mob nkag mus, thiab lub cev muaj kev ntxhov siab.
5. Cov Neeg Siv Khoom Siv Kho Mob: Cov neeg mob uas muaj cov catheters (xws li lub hauv paus venous catheters, urinary catheters), siv lub tshuab ua pa los yog muaj cov kav dej hauv lawv lub cev, cov cuab yeej no yuav dhau los ua "qhov luv" rau cov kab mob nkag mus rau tib neeg lub cev.
6. Cov neeg uas muaj kab mob tsis ntev los no los yog mus pw hauv tsev kho mob: tshwj xeeb tshaj yog rau cov neeg mob ntsws ntsws, mob plab, kab mob hauv lub cev lossis kab mob ntawm daim tawv nqaij, yog tias kev kho tsis tau raws sijhawm lossis tsis ua haujlwm, tus kab mob kis tau yooj yim mus rau cov ntshav thiab ua rau mob sepsis.

Yuav ua li cas thiaj kuaj tau sepsis? Qhov tseem ceeb tshawb nrhiav reagents ua lub luag haujlwm tseem ceeb

Yog tias cov tib neeg muaj kev pheej hmoo siab tsim cov tsos mob ntawm tus kab mob (xws li ua npaws, ua daus no, ua tsis taus pa, lub plawv dhia ceev, thiab tsis meej pem), lawv yuav tsum nrhiav kev kho mob tam sim ntawd. Kev kuaj mob ntxov yog nyob ntawm ntau qhov kev soj ntsuam kuaj mob thiab kev kuaj sim, ntawm cov uas muaj ntau yam hauv vitro diagnostic (IVD) cov tshuaj tiv thaiv kab mob yog qhov tseem ceeb "qhov muag" ntawm cov kws kho mob.

1. Microbial Culture (Blood Culture) - Kev kuaj mob "Gold Standard"
   • Txoj kev: Cov qauv ntawm tus neeg mob cov ntshav, tso zis, hnoos qeev, lossis lwm qhov chaw uas xav tias muaj kab mob raug sau thiab muab tso rau hauv lub raj mis uas muaj kab lis kev cai nruab nrab, uas tom qab ntawd incubated los txhawb kev loj hlob ntawm cov kab mob (cov kab mob los yog fungi).
   • Lub luag haujlwm: Qhov no yog "tus qauv kub" rau kev lees paub sepsis thiab txheeb xyuas cov kab mob ua rau muaj kab mob. Thaum cov kab mob kis tau kab mob, kev sim tshuaj tiv thaiv kab mob tiv thaiv kab mob (AST) tuaj yeem ua tau los qhia cov kws kho mob hauv kev xaiv cov tshuaj tua kab mob zoo tshaj plaws. Txawm li cas los xij, nws qhov teeb meem tseem ceeb yog lub sijhawm xav tau (feem ntau 24-72 teev rau cov txiaj ntsig), uas tsis tsim nyog rau kev txiav txim siab thaum muaj xwm txheej ceev.
2. Biomarker Test - Ceev "Tswb Systems"
   Txhawm rau ua kom lub sijhawm ua haujlwm tsis zoo ntawm kab lis kev cai, ntau yam biomarker nrhiav kom pom cov tshuaj reagents tau dav siv rau kev kuaj mob sai.
   • Procalcitonin (PCT) kuaj: Qhov no yog tam sim no tseem ceeb tshaj plaws thiab tshwj xeeb biomarker cuam tshuam nrog sepsis.PCTyog ib qho protein ntau nyob rau hauv cov tib neeg noj qab nyob zoo, tab sis yog tsim nyob rau hauv ntau qhov ntau ntawm cov ntaub so ntswg thoob plaws hauv lub cev thaum muaj kab mob loj heev.PCT kev soj ntsuam (feem ntau yog siv cov txheej txheem immunochromatographic lossis chemiluminescent) muab cov txiaj ntsig ntau hauv 1-2 teev. Ua kom siabPCTCov theem yog qhov qhia tau zoo ntawm cov kab mob sepsis thiab tuaj yeem siv los saib xyuas cov txiaj ntsig ntawm kev kho tshuaj tua kab mob thiab qhia kev txiav tawm.
   • Kev kuaj C-reactive protein (CRP).: CRP yog ib qho mob hnyav-theem protein uas nce sai sai hauv kev teb rau qhov mob lossis kis kab mob. Txawm tias muaj kev nkag siab zoo, nws yog qhov tshwj xeeb tsawg duaPCTvim tias nws tuaj yeem nce siab hauv ntau yam mob, suav nrog kev kis kab mob thiab kev raug mob. Nws yog feem ntau siv ua ke nrog lwm cov cim.
   • Cov Ntshav Dawb suav (WBC) thiab Neutrophil Feem Xyuam: Qhov no yog qhov kev kuaj ntshav ntau tshaj plaws (CBC). Cov neeg mob Sepsis feem ntau pom muaj qhov nce lossis txo qis hauv WBC thiab feem pua ​​​​ntawm cov neutrophils (kev hloov pauv sab laug). Txawm li cas los xij, nws qhov tshwj xeeb yog qhov tsawg, thiab nws yuav tsum tau txhais nrog rau lwm cov ntsuas.
3. Molecular Diagnostic Techniques - Precision "Scouts"
   • Method: Cov txheej txheem xws li Polymerase Chain Reaction (PCR) thiab Metagenomic Next-Generation Sequencing (mNGS). Cov thev naus laus zis no siv cov primers tshwj xeeb thiab kev sojntsuam (uas tuaj yeem pom tias yog "reagents") ncaj qha mus kuaj cov kab mob nucleic acids (DNA lossis RNA).
   • Lub luag haujlwm: Lawv tsis xav tau kab lis kev cai thiab tuaj yeem txheeb xyuas cov kab mob hauv cov ntshav sai sai, txawm tias kuaj cov kab mob uas nyuaj rau kab lis kev cai. Tshwj xeeb tshaj yog thaum cov kab lis kev cai ib txwm muaj qhov tsis zoo tab sis qhov kev ua xyem xyav kho mob tseem siab, mNGS tuaj yeem muab cov ntsiab lus tseem ceeb rau kev kuaj mob. Txawm li cas los xij, cov txheej txheem no kim dua thiab tsis muab cov ntaub ntawv tiv thaiv kab mob.
4. Lactate Testing – Ntsuas qhov “Crisis” Level
   • Cov ntaub so ntswg hypoperfusion thiab hypoxia yog lub hauv paus rau sepsis-induced organ tsis ua hauj lwm. Cov qib lactate nce siab yog qhov pom tseeb ntawm cov ntaub so ntswg hypoxia. Cov khoom siv kuaj lactate ceev ceev hauv txaj tuaj yeem ntsuas cov ntshav plasma lactate concentrations sai sai (hauv feeb). Hyperlactatemia (> 2 mmol / L) qhia tau hais tias muaj mob hnyav thiab tsis zoo, thiab yog ib qho tseem ceeb rau kev pib kho mob hnyav.

Xaus

Sepsis yog kev sib tw nrog lub sijhawm. Cov neeg laus, cov neeg tsis muaj zog, cov uas muaj mob hauv qab, thiab cov uas muaj mob tshwj xeeb yog lub hom phiaj tseem ceeb. Rau cov pab pawg muaj kev pheej hmoo siab no, txhua yam cim ntawm tus kab mob yuav tsum tau kho nrog ceev faj. Cov tshuaj niaj hnub no tau tsim kom muaj kev kuaj mob sai sai los ntawm ntau txoj hauv kev, suav nrog ntshav kab lis kev cai, kuaj biomarker xws liPCT/CRP, molecular diagnostics, thiab lactate kuaj. Ntawm cov no, ntau yam kev ua haujlwm tau zoo thiab muaj txiaj ntsig zoo tshaj plaws yog cov hauv paus ntawm kev ceeb toom ntxov, kev txheeb xyuas tseeb, thiab kev cuam tshuam raws sijhawm, txhim kho cov neeg mob txoj kev muaj sia nyob. Paub txog qhov txaus ntshai, hais txog cov tsos mob thaum ntxov, thiab tso siab rau cov thev naus laus zis tshawb pom yog peb cov riam phom muaj zog tshaj plaws tiv thaiv "tus neeg tua tsis pom."