Ubani Osengozini Enkulu Yokuthola I-Sepsis?

Nakuba noma ubani engaba ne-sepsis uma enesifo, amaqembu alandelayo asengozini enkulu kakhulu futhi adinga ukuqaphela okwengeziwe:

1. Izinsana kanye nabantu asebekhulile: Isici esivamile salaba bantu ukuthi amasosha omzimba awathuthuki kahle. Amasosha omzimba ezinsana nezingane ezincane awakathuthuki ngokugcwele, kuyilapho amasosha omzimba asebekhulile ewohloka ngokuguga futhi avame ukuhambisana nezifo eziningi eziyisisekelo, okwenza kube nzima ngabo ukulwa nokutheleleka ngempumelelo.
2. Iziguli Ezinezifo Ezingamahlalakhona: Iziguli ezinezifo ezifana nesifo sikashukela, umdlavuza, isifo sesibindi nezinso, isifo samaphaphu esingapheli (i-COPD) noma i-HIV/AIDS zinezindlela zokuzivikela zomzimba ezibuthakathaka kanye nemisebenzi yezitho zomzimba, okwenza izifo zibe lula kakhulu ukuzilawula.
3. Abantu Abane-Autoimmune Conspromised: Lokhu kufaka phakathi iziguli ezinomdlavuza ezithola ukwelashwa ngamakhemikhali, abantu abathatha imithi yokucindezela amasosha omzimba ngemva kokufakelwa isitho, kanye nabantu abanezifo ezizimele, lapho amasosha omzimba abo engakwazi ukusabela kahle ezifweni ezibangelwa amagciwane.
4. Iziguli Ezinokulimala Okukhulu Noma Ukuhlinzwa Okukhulu: Ezigulini ezinokusha okukhulu, ukulimala okukhulu noma ukuhlinzwa okukhulu, isikhumba noma isithiyo se-mucosal siyabhujiswa, okunikeza umzila wokungena kwamagciwane, futhi umzimba usesimweni sokucindezeleka okukhulu.
5. Abasebenzisi Bemishini Yezokwelapha Ehlaselayo: Iziguli ezine-catheter (njenge-catheter yemithambo ephakathi, ama-catheter omchamo), ezisebenzisa ama-ventilator noma ezinamapayipi okukhipha amanzi emizimbeni yazo, la madivayisi angaba “izinqamuleli” zokuthi amagciwane angene emzimbeni womuntu.
6. Abantu Abanezifo Zamuva Noma Abalaliswe Esibhedlela: Ikakhulukazi ezigulini ezine-pneumonia, ukutheleleka kwesisu, ukutheleleka komgudu womchamo noma ukutheleleka kwesikhumba, uma ukwelashwa kungafiki ngesikhathi noma kungasebenzi kahle, ukutheleleka kungasakazeka kalula egazini futhi kubangele i-sepsis.

Ungayithola kanjani i-sepsis? Ama-reagent okuthola abalulekile adlala indima ebalulekile

Uma abantu abasengozini enkulu beba nezimpawu zokutheleleka okusolwayo (njengomkhuhlane, ukubanda, ukuphelelwa umoya, ukushaya kwenhliziyo okusheshayo, kanye nokudideka), kufanele bafune usizo lwezokwelapha ngokushesha. Ukuxilongwa kusenesikhathi kuncike ochungechungeni lokuhlolwa kwezokwelapha kanye nokuhlolwa kwelebhu, phakathi kwazo izinhlobo ezahlukene ze-reagents zokuhlola i-in vitro diagnostic (IVD) ziyi-"amehlo" abalulekile odokotela.

1. Isiko Lamagciwane (Isiko Legazi) – “Izinga Legolide” Lokuhlola
   • Indlela: Amasampula egazi lesiguli, umchamo, isikhwehlela, noma ezinye izindawo okusolwa ukuthi zinokutheleleka ayaqoqwa bese efakwa emabhodleleni aqukethe indawo yokukhulisa, abese efakwa ukuze kukhuthazwe ukukhula kwamagciwane (amagciwane noma isikhunta).
   • Indima: Lena "indinganiso yegolide" yokuqinisekisa i-sepsis nokuhlonza i-pathogen ebangela. Uma i-pathogen isitshaliwe, ukuhlolwa kokuzwela kwamagciwane (i-AST) kungenziwa ukuze kuqondiswe odokotela ekukhetheni ama-antibiotic asebenza kahle kakhulu. Kodwa-ke, inkinga yayo eyinhloko isikhathi esidingekayo (ngokuvamile amahora angama-24-72 ukuthola imiphumela), okungasizi ukwenza izinqumo eziphuthumayo zokuqala.
2. Ukuhlolwa Kwe-Biomarker – “Izinhlelo Ze-Alarm” Ezisheshayo
   Ukuze kulungiswe inkinga yokukhuliswa kwesifo edla isikhathi, kusetshenziswa ama-reagent ahlukahlukene okuthola ama-biomarker ukuze kutholakale ngokushesha ukuxilongwa okusizayo.
   • Ukuhlolwa kwe-Procalcitonin (PCT): Okwamanje lena yi-biomarker ebaluleke kakhulu neqondile ehlotshaniswa ne-sepsis.I-PCTiyiprotheni etholakala emazingeni aphansi kakhulu kubantu abanempilo, kodwa ikhiqizwa ngobuningi ezicutshini eziningi emzimbeni wonke ngesikhathi sokutheleleka okukhulu ngamagciwane.I-PCT Ukuhlolwa (ngokuvamile kusetshenziswa izindlela ze-immunochromatographic noma ze-chemiluminescent) kunikeza imiphumela yobuningi zingakapheli amahora angu-1-2.I-PCTamazinga abonisa kakhulu i-bacterial sepsis futhi angasetshenziswa ukuqapha ukusebenza kahle kokwelashwa ngama-antibiotic kanye nokuqondisa ukuyeka.
   • Ukuhlolwa kwe-C-reactive protein (CRP): I-CRP iyiprotheni yesigaba esibukhali ekhula ngokushesha ngenxa yokuvuvukala noma ukutheleleka. Nakuba ibucayi kakhulu, ayiqondile kangako kune-I-PCTngoba ingakhuphuka ezimweni ezahlukahlukene, okuhlanganisa ukutheleleka ngegciwane kanye nokulimala. Ivame ukusetshenziswa kanye nezinye izimpawu.
   • Inani Lamaseli Amhlophe Egazi (i-WBC) kanye ne-Neutrophil Percentage: Lolu vivinyo oluyisisekelo kakhulu lokubalwa kwegazi okuphelele (i-CBC). Iziguli ze-Sepsis zivame ukukhombisa ukwanda noma ukwehla okukhulu kwe-WBC kanye nephesenti elikhuphukile lama-neutrophil (ukushintsha kwesobunxele). Kodwa-ke, ukucaca kwayo kuphansi, futhi kumele kuhunyushwe kanye nezinye izinkomba.
3. Amasu Okuhlola Ama-Molecular - "Ama-Scout" Aqondile
   • Indlela: Amasu afana ne-Polymerase Chain Reaction (PCR) kanye ne-Metagenomic Next-Generation Sequencing (mNGS). Lobu buchwepheshe busebenzisa ama-primer nama-probe athile (angabonakala “njenge-reagents” ethuthukisiwe) ukuthola ngqo ama-nucleic acid e-pathogen (i-DNA noma i-RNA).
   • Indima: Azidingi ukukhuliswa futhi zingabona ngokushesha amagciwane egazini zingakapheli amahora, ngisho nokuthola izinto eziphilayo okunzima ukuzikhuliswa. Ikakhulukazi uma amasiko endabuko engemihle kodwa ukusola kwezokwelapha kuhlala kuphezulu, i-mNGS inganikeza izinkomba ezibalulekile zokuxilonga. Kodwa-ke, lezi zindlela zibiza kakhulu futhi azinikezi ulwazi lokuthambekela kuma-antibiotic.
4. Ukuhlolwa kwe-Lactate - Ukulinganisa Izinga "Lenkinga"
   • Ukuncipha komthamo wezicubu kanye nokwehla komthamo wezicubu kuyimbangela yokwehluleka kwezitho okubangelwa yi-sepsis. Amazinga aphezulu e-lactate ayisibonakaliso esicacile se-hypoxia yezicubu. Ama-kit okuhlola i-lactate esheshayo eceleni kombhede angalinganisa ngokushesha amazinga e-lactate egazini (kungakapheli imizuzu). I-Hyperlactatemia (>2 mmol/L) ikhombisa kakhulu ukugula okubi kanye nokubikezela okubi, futhi iyisibonakaliso esibalulekile sokuqala ukwelashwa okujulile.

Isiphetho

I-Sepsis iwumjaho obhekene nesikhathi. Asebekhulile, ababuthakathaka, labo abanezimo zezokwelapha ezingaphansi, kanye nalabo abanezimo zezokwelapha ezithile yibo abahlaselwa kakhulu. Kula maqembu asengozini enkulu, noma yiziphi izimpawu zokutheleleka kufanele ziphathwe ngokucophelela. Imithi yesimanje isungule uhlelo lokuxilonga ngokushesha ngezindlela ezahlukahlukene, okuhlanganisa ukuhlukaniswa kwegazi, ukuhlolwa kwe-biomarker okufanaI-PCT/I-CRP, ukuxilongwa kwama-molecule, kanye nokuhlolwa kwe-lactate. Phakathi kwalokhu, izinhlobo ezahlukene ze-reagents zokuthola ezisebenza kahle kakhulu futhi ezibucayi ziyizisekelo zesixwayiso sokuqala, ukuhlonza okunembile, kanye nokungenelela ngesikhathi esifanele, okuthuthukisa kakhulu amathuba okusinda kweziguli. Ukuqaphela izingozi, ukubhekana nezimpawu zakuqala, kanye nokuthembela kubuchwepheshe bokuthola obuthuthukisiwe kuyizikhali zethu ezinamandla kakhulu ngokumelene nalo “mbulali ongabonakali.”