Usulelo ekukhulelweni: Umothuko woSeptic

Umxholo

• Ziintoni Iimpawu Zomothuko we-Septic?
• Yintoni ebangela umothuko we-Septic?
• Uhlaselwa njani nge-Septic kuhlala kuchongwa?
• Umothuko we-Septic kufuneka uphathwe njani?
• Ukujikeleza kwegazi
• Amayeza okubulala iintsholongwane
• Unonophelo oluxhasayo
• Unyango lotyando
• Imbonakalo

Yintoni uSotic Septic?

Ukutshitshiswa kwe-Septic sisifo esibi kunye nesistim. Oku kuthetha ukuba ichaphazela umzimba uphela. Kubangelwa xa iibhaktheriya zingena kwigazi lakho kwaye zihlala zenzeka emva koxinzelelo okanye uqhaqho.

Xa abasetyhini abakhulelweyo beqala ukothuka okubangelwa sisifo septic, ihlala iyingxaki yenye yezi meko zilandelayo:

• isisu sokukhupha isisu (ukuphuphuma kwesisu okunxulunyaniswa nosulelo lwe-uterine)
• usulelo olukhulu lwezintso
• usulelo lwesisu
• usulelo lwe-sac amniotic
• usulelo lwesibeleko

Ziintoni Iimpawu Zomothuko we-Septic?

Ukutshatyalaliswa kwe-Septic kwenzeka ngenxa ye-sepsis enamandla. I-Sepsis, ekwabizwa ngokuba "yityhefu yegazi," ibhekisa kwiingxaki ezibangelwa kukusuleleka kwegazi kokuqala. Ukutshatyalaliswa kwe-Septic yimiphumo emibi ye-sepsis engalawulwayo. Zombini zineempawu ezifanayo, ezinje ngoxinzelelo lwegazi oluphantsi kakhulu. Nangona kunjalo, i-sepsis inokubangela utshintsho kwimeko yakho yengqondo (ukothuka) kunye nokonakala komzimba ngokubanzi.

Ukutshatyalaliswa kwe-Septic kubangela iimpawu kunye neempawu zesistim, kuquka:

• ukungazinzi nokudideka
• ukukhawuleza kwentliziyo kunye noxinzelelo lwegazi (hypotension)
• Umkhuhlane we-103˚F okanye ngaphezulu
• ubushushu bomzimba obuphantsi (hypothermia)
• Ulusu olufudumeleyo nolugudileyo ngenxa yokonyuka kwemithambo yegazi (vasodilation)
• ulusu olupholileyo kunye nolusu
• ukubetha kwentliziyo ngendlela engaqhelekanga
• ukuluhlaza kolusu lwakho (i-jaundice)
• ukuncipha kokuchama
• ukopha okuzenzekelayo kwilungu lakho langasese okanye kumchamo

Unokufumana neempawu ezinxulumene nendawo ephambili yosulelo. Kubasetyhini abakhulelweyo, ezi zimpawu zihlala zibandakanya:

• Ukukhutshwa kwesibeleko ngombala
• ukuthamba kwesibeleko
• iintlungu kunye nokuthamba kwisisu sakho kunye neplanga (indawo phakathi kweembambo kunye nomlenze)

Enye ingxaki eqhelekileyo sisifo sabantu abadala sokuphefumla (ARDS). Iimpawu zibandakanya:

• ukuqhawukelwa ngumphefumlo
• ukuphefumla ngokukhawuleza kunye nokusebenza
• ukukhohlela
• ukuxinana kwemiphunga

I-ARDS sesinye sezizathu eziphambili zokufa kweemeko ze-sepsis ezinzima.

Yintoni ebangela umothuko we-Septic?

Iibhaktheriya eziqhelekileyo ezijongene ne-sepsis yi-aerobic gram-negative bacilli (i-bacteria-shaped-bacteria), ngokukodwa:

• Escherichia coli (E. coli)
• UKlebsiella pneumoniae
• Iproteus iintlobo

Ezi bhaktheriya zineembumba ezimbini, ezenza ukuba zinganyangeki ngakumbi kwiintsholongwane.

Xa bengena kwigazi lakho, banokubangela umonakalo kumalungu akho abalulekileyo.

Kwabasetyhini abakhulelweyo, ukothuka okubangelwa sisifo septic kunokubangelwa:

• usulelo ngexesha lomsebenzi kunye nokuhanjiswa
• amacandelo ase-cearean
• ukukrala kwemiphunga
• buthathaka amajoni omzimba
• umkhuhlane (umkhuhlane)
• ukukhupha izisu
• ukuphuma kwesisu

Uhlaselwa njani nge-Septic kuhlala kuchongwa?

Iimpawu ezinxulunyaniswa nothuko lwe-septic ziyafana kakhulu neempawu zezinye iimeko ezinzima kakhulu. Ugqirha wakho uya kuqhuba uvavanyo olusempilweni, kwaye baya kuthi baodole iimvavanyo zaselebhu.

Ugqirha wakho unokusebenzisa uvavanyo lwegazi ukukhangela:

• ubungqina bosulelo
• iingxaki zokunqanda igazi
• iingxaki zesibindi okanye zezintso
• ukungalingani kwe-electrolyte

Ugqirha wakho unokuyalela i-x-ray yesifuba ukufumanisa ukuba unayo i-ARDS okanye inyumoniya. Izikena ze-CT, ii-MRIs, kunye nee-ultrasound zinokunceda ekuchongeni indawo yosulelo ephambili. Unokufuna kwakhona ukubeka esweni i-electrocardiographic ukubona iintliziyo ezingaqhelekanga kunye neempawu zokulimala kwentliziyo yakho.

Umothuko we-Septic kufuneka uphathwe njani?

Zintathu iinjongo eziphambili kunyango lokothuka.

Ukujikeleza kwegazi

Injongo yakho yokuqala yogqirha kukulungisa iingxaki ngokujikeleza kwegazi lakho. Banokusebenzisa i-catheter enkulu efakwa ngaphakathi ukukunika ulwelo. Baza kujonga ukubetha kwentliziyo yakho, uxinzelelo lwegazi, kunye nemveliso yomchamo ukuqinisekisa ukuba ufumana izixa ezifanelekileyo zala manzi.

Ugqirha wakho unokufaka i-catheter yentliziyo elungileyo njengesinye isixhobo sokubeka esweni ukuba ukufakwa kokuqala kolwelo akubuyisi ukujikeleza kwegazi okufanelekileyo. Unokufumana iDopamine. Eli chiza liphucula ukusebenza kwentliziyo kwaye lonyusa ukuhamba kwegazi kumalungu aphambili.

Amayeza okubulala iintsholongwane

Injongo yesibini yonyango kukunika i-antibiotics ekujoliswe kuyo ngokubhekiselele kubhaktheriya. Usulelo lwezifo zangasese, unyango olusebenzayo ludibaniso:

• penicillin (PenVK) okanye ampicillin (Principen), kunye
• clindamycin (Cleocin) okanye metronidazole (Flagyl), kunye
• gentamicin (Garamycin) okanye aztreonam (Azactam).

Ngenye indlela, imipenem-cilastatin (Primaxin) okanye i-meropenem (Merrem) inokunikwa njengechiza elinye.

Unonophelo oluxhasayo

Injongo yesithathu ephambili yonyango kukubonelela ngenkxaso. Amayeza anciphisa umkhuhlane kunye nengubo yokupholisa aya kunceda ukugcina iqondo lakho lobushushu lisondele ngokwesiqhelo kangangoko. Ugqirha wakho kufuneka akhawuleze achonge imiba ngokujiya kwegazi kwaye aqale unyango ngokufakwa kweeplatelets zegazi kunye nezinto ezijiyayo.

Okokugqibela, ugqirha wakho uya kukunika ioksijini eyongezelelweyo kwaye akuqwalasele ngokusondeleyo kubungqina be-ARDS. Isimo sakho seoksijini siya kujongwa ngononophelo kunye ne-oximeter yentliziyo okanye i-catheter yomthambo ojikelezayo. Ukuba ukusilela kokuphefumla kuyabonakala, uya kubekwa kwinkqubo yokuxhasa ioksijini.

Unyango lotyando

Unokufuna utyando. Unyango olusetyenziswayo lungasetyenziselwa ukukhupha ubofu obuqokelelwe kwibala lakho, okanye ukususa amalungu asulelekileyo e-pelvic.

Ukuba unesistim somzimba sokucinezela, unokumiselwa ukunyuswa kweeseli ezimhlophe zegazi. Olunye ukhetho lonyango lwe-antisera (anti-toxin) olujolise kwintsholongwane yesiqhelo ebangela ukothuka kwe-septic. Olu nyango lubonakala luthembisa kuphando oluthile, kodwa luhlala luvavanyo.

Imbonakalo

Ukutshatyalaliswa kwe-Septic isifo esibi, kodwa kubalulekile ukuqonda ukuba yimeko enqabileyo ekukhulelweni. Ngapha koko, I-Obstetrics kunye neGynecologyIjenali iqikelela ukuba ukuya kuthi ga kwiipesenti eziyi-0.01 zazo zonke izinto ezithunyelwayo zibangela ukothuka. Abasetyhini abanononophelo olwaneleyo lokukhulelwa abanakufane bakhulise i-sepsis kwaye babangele ukothuka. Ukuba ufumana naziphi na iimpawu ezingaqhelekanga, kubalulekile ukubiza ugqirha wakho ngokukhawuleza ukukhusela nayiphi na ingozi ebanzi.