Zvirwere chokuita kurapwa: mhando uye kupatsanura

Zvirwere chokuita mishonga, aigara vasangana mu yokuora tsika. Uye regai kupomera vanachiremba, vari kuedza kuita zvose zvinobvira kunonoka kutanga yematambudziko izvi. Zvinosuruvarisa nzvenga vanhu vashoma chaizvo zvingaitwa.

tsananguro

Kuti bhizimisi iri pfungwa "chokuita mishonga, chirwere"? Definition inoti sezvinotevera: vari chero zviratidzo chirwere microbial hunhu, yaiitwa pakati varwere pashure kurapwa muchipatara kana kuchipatara kunoona kuti kurapwa, kana mukati mwedzi pashure zvinoerera kubva kuchipatara.

Rimwe zita boka iri zvirwere - nosocomial zvirwere, kana nosocomial zvirwere. Zvinofungidzirwa kuti utachiona vaibva murwere muchipatara, kana zviratidzo zvokutanga akazviratidza hapana yapfuura pane mazuva maviri kubva risiti. Fanira mamiriro - kushaya nokushivirira kuratidzirwa chirwere ichi asati placement mu sangano kuchipatara.

Hospital chirwere anofanira kusiyaniswa kubva iatrogenic uye mikana, sezvo vari yakafanana zvokuti kuvhiringidzwa. Vaiona iatrogenic chirwere, iyo yakabuda nokuda mhaka navanachiremba mukufamba kurapwa kana nechirwere. Mikana mune vanhu kudarika zvirwere haasi kukwanisa kurega dzaserera mikana utachiona.

Kupararira

Epidemiology kutapukirwa chokuita urongwa mishonga, kutonga nezvinooneka inofungidzirwa Center for Disease Control (CDC) zvinoshamisa. MuUnited States mumwe uye imwe nyaya miriyoni nechidimbu pagore, pane hafu akafa zvakawanda. MuEurope, nhamba-makumi maviri nezvishanu, Russia - zviuru makumi matatu. Asi nhamba yakaderera vakadaro havasi kutaura pamusoro unhu kuchishandiswa, uye varombo unhu Statistical tsvakurudzo.

For nosocomial Zvirwere ine zvarinotaura pamusoro kupararira, izvo kusiyanisa kubva nezvimwe zvirwere izvi mhando. misiyano ava mashandiro uye zvikonzero zviri Kupfuudzwa, ari specificity ari chirwere, basa vomuchipatara kuramba uye kuwedzera mhosva. Uyewo, Zvirwere izvi zvakaoma kurapa nokuti tusingaoneki kuti kurarama utano Zvivako, muri nemishonga.

etiology

Utachiona chokuita dzoutano yakatekeshera munyika yose. To musi, kune vanopfuura mazana maviri microbial yomuchipatara kuti anogona kukonzera nosocomial zvirwere. Pamberi yaitonga inorwisa mabhakitiriya vakanga anaerobic bacillus, streptococci uye staphylococci. Zvinonzi ikozvino yakasimbiswa kuti mhaka chirwere zvinogona rotavirus, cytomegalovirus, hepatitis nemavhairasi, uye kunyange HIV.

Kuva kwenguva refu iri munharaunda muchipatara, microorganism iri pasi dzinongoitika kusarudzwa uye kunotouraya, somugumisiro iyo pane nemishonga utachiona, izvo transcend mishonga yokuuraya utachiona, uye mishonga inorwisa mabhakitiriya kvartsevanie. In mumwe nomumwe chipatara, dhipatimendi uye kunyange anodawo vanogara utachiona dzavo "nemamwe".

Sources uye zvigadziriswe pakati hutachiwana

Shoko rokuti "chirwere chokuita kutarisira utano" zvinoreva kuvapo vatatu hove huru epidemiological muitiro:

- mabviro;

- kufamba nzira;

- muvamwe munhu.

Hai mabhuku titengese varwere vari muchipatara kwenguva yakareba uye utachiona microflora yaro, uyewo nevashandi vezveutano, zuva kuonana chete utachiona. Vanoshanyira zuva kutarisirwa uye mhuri kutamba mukupararira nosocomial utachiona yechipiri basa.

Kupfuudzwa mashandiro vanomboita chero: fecal-nemumuromo, kuenda neherikoputa, mbambo kana transmissive. Kutamisirwa zvikonzero vari zvokushandisa, Namano kuti afemeruke uye kufamba kweropa, zvekufuga uye andapeni, mubhedha, kupfekedza uye suture zvinhu, chakagadzirwa maoko nemakumbo, abudise uye nyoro zvinhu. Izvi zvinosanganisira faucets uye rinosakara, rinosakara, aizomupa zvinogadzirisa, mvura Yakanatswa, akambozvishandisa kuuraya utachiona zvinogadzirisa, mvura tumabhodhoro netumidziyo kuti maruva, condensate mudenga rokutsvaira maitiro uye zvichingodaro.

mapoka njodzi

Zvirwere chokuita mishonga, varwere kazhinji dzinoitika vanhu vane simba zvirwere. Chokwadi, zvose varwere pakawanda, akaderedza kudzivirira mashandiro anoita muviri asi pane vanhu vari vakawanda muvamwe. Idzi dzinosanganisira:

- Vanhu vakwegura;

- vakurumidze vacheche uye vachangoberekwa;

- Varwere nekenza, autoimmune, sema zvirwere;

- varwere vanenge inini-refu akavhiyiwa;

- Vanhu vaigara zvakatipoteredza venga ndima.

Dzakanyorwa contingent chinowanzoitika kupfuura kurwara paaiva muchipatara, saka ivo vanofanira rakawedzera kutarisirwa kubva zvokurapa mudonzvo.

kupatsanura

Ndezvipi mhando kutapukirwa chokuita utano? Zvose zvinoenderana, chii chinoita kuti patsanura navo. Somuenzaniso, kana iwe utore panzira, ipapo kusunungura: aerosol, muviri, kuonana-mhuri, maturusi posttranstplantatsionnye, chirwere pashure majekiseni, kuwedzerwa ropa, kushandiswa, uye zvimwe endoscopic dzokuvhiya. Aibuda, uyewo vamwe zvirwere, nosocomial utachiona vari chakasimba, subacute uye chisingaperi, uyewo chakakomba, mwero uye munyoro siyana.

Chimwe mutsauko yakaitwa pakati akasiyana madhigirii kwokupararira, izvo zvinogona kuita Zvirwere chokuita kurapwa. Kupatsanura runotanga zvikuru zviitiko:

- Generalized chimiro: bacteremia, septicemia, pyosepticemia, kwemabhakitiriya kuvhunduka.

- vemunyika chimiro.

- Zvirwere ganda uye subcutaneous mafuta.

- Zvirwere Lower kufema.

- Dental chimiro.

- Zvirwere of zvomudumbu hurongwa.

- hweHIV dzokubereka uye Urinary nehurongwa.

- Zvirwere zvetsandanyama nemapfupa hurongwa.

- Zvirwere of tsinga.

- Zvirwere of kumwoyo.

Zvikonzero mukuru kuitika

Kudzivirira zvirwere chokuita mishonga, zvainanga achidzikisa zvinonyatsorehwa hwevanhu vanorwara. Asi zvinosuruvarisa kuti zvevakomana, zvokungwarira zvose hadzibatsiri. Chikonzero chikuru kuti ichi - iri kwaita multi-nemishonga kasvisto.

Zvikurukuru, izvi nokuti utachiona mutate, kuchinja ehupfumi dzavo nokuti safunga kushandiswa inorwisa mabhakitiriya uye mishonga yokuuraya utachiona. Aya mamiriro ezvinhu akanaka nokuti chisikwa microflora yechipiri multiresistant.

Primary nemishonga - chiri nemano iyi mhando mabhakitiriya kudzivisa hasha nevamiririri. The tsika vanachiremba kuti chero chikonzero kuti taurira nemishonga kunotungamirira kuti kubudirira kurapwa ipfupi, uye utachiona vari kuva nemishonga. Asi kwete bedzi vanachiremba ane mhosva. MuRussia, vanhu vari kushandiswa pasina gadzai antibacterials, asi regai kuteerera murayiro kushandiswa.

zvinotaurwa Fleming

Kune zvitatu musimboti Fleming yakarumbidza neWorld Health Organization.

Wokutanga musimboti - mishonga tupukanana chete kana kutapuriranwa mumiririri inonyatsoziva kwavari. Izvi zvichaita kutirambidza kushandisa inorwisa mabhakitiriya, vanachiremba nguva dzose kuita mufambiro utetsa zvidzidzo pamusoro kasvisto mishonga, yakatsviriridza zvinodhaka rakamanikana, achitaura chakarondedzera chiito.

The musimboti Fleming Wechipiri anoti zvinokosha rekuona zvinobudirira wevasungwa zvinodhaka ari lesion. Kutonga uku kuchaderedza chitsama inorwisa mabhakitiriya anoshandiswa topically uye zvinodhaka nachiremba chokudzivirira zvinangwa. Uyezve, achapa mukana kubvisa mushonga kamwe, pane zvishoma nezvishoma, uyewo kuchinja dose uye mushonga kunobva zvomurwere kuferefeta kuti zvoutachiona zvinwiwa zvirimwa kamwe ose mazuva manomwe.

The musimboti wechitatu - kudikanwa taurira nemishonga iri dose uye kuti vazive nenzira kurerutsa Migumisiro. Izvi achashandisa zvinodhaka zvakawanda rationally.

paumbwe kwemabhakitiriya

Zvirwere chokuita okurapwa hahugoni kuvapo pasina kwemabhakitiriya vatakuri, vanonzi "razero murefu", iro richava zvisingaonekwi manyuko chirwere vamwe.

Bacteriocarrier - mufananidzo chirwere inooneka kana pakati hondo uye chisvetasimba isingachinji zvakanakanaka varwere pasina yokuora kuratidzwa. Immunological siyana kuramba kuitika panguva imwe chete. Kana microorganism akasungwa ari Isimba rakadini rinogona kubudiswa chimiro pavarwere mashanu, izvozvo anochinja zvivako ayo uye anova hasha.

Okudzivirira zviito iyi vari:

- dzose kunotoda kuongorora vashandi utano;

- bacteriological kuongorora vomuchipatara;

- mangwanani kuonekwa uye kurapwa kuvarapi hweHIV;

- Daily kudzora mamiriro vanachiremba utano.

Inokuvadza chirwere uye dzokurapwa pachishandiswa

Zvirwere chokuita okurapwa (IHS) kuonekwa chete pashure murwere ambopedza nguva ari muchipatara, asi pashure vanoverengeka chirwere uye dzokurapwa pachishandiswa dzinobatsira utachiona kuchipatara kasvisto. Izvi zvinosanganisira kuwedzerwa ropa, majekiseni, kuvhiya transplanting nhengo uye munyama. Pakati nokumutswa ndiko intubation, inhalation yokutindivadza, midziyo kutsigirwa upenyu, kuisa catheters. Uyewo, chirwere chinogona kuitika mushure hemodialysis kurapwa, inhalations uye Spa kurapa.

Kupatsanura ne Spaulding

Zvirwere chokuita mishonga, anogona kuburikidza zvokurapa namano. Naizvozvo Spaulding akavakamura mumapoka matatu, akatora sechiratidzo classifying pedambudziko roku- muchipatara kasvisto.

Boka rokutanga - dzinonetsa. Izvi zvinosanganisira pakuvhiya, catheters, anodyara, tsono, uye mvura mvura jekiseni.

Boka rechipiri - polukriticheskie: endoscopic uye inhalation zvokushandisa, maturusi nokuda yokutindivadza, rectal thermometers.

Boka rechitatu, ukuwo, noncritical. Ndicho nezvimwe zvinhu zvose: ngarava, BP monitors, madondoro, nezvirongo, linens, axillary thermometers.

dziviriro

Kudzivirira zvirwere chokuita mishonga, pana World Health Organization kurumbidza kuti kudzivirira nosocomial zvirwere. Mukudzivirira yakanaka inofanira kusanganisira zvikamu zvitatu:

- minimization chirwere kubva kunze muchipatara;

- achisiya chirwere kuburikidza chiito pamusoro denda muitiro dzakabatana;

- kubviswa Kusara mhiri chipatara utachiona.

Nokuti chinangwa ichi ikoko kuputira varwere zvakakomba zvinotapukira muna chaihwo mabhokisi yoga kwezvavakaisa goho chisingazivi kukurukura navamwe mupanda. Uyezve, mukamuri imwe neimwe, uye magetsi vakatakura vakawanda sanitization maturusi uye hukawanika. Kakawanda zviitiko izvi zvinoenderana kudiwa: mu munyika mushonga mumadhipatimendi - kashoma, zvomusejari ukuwo, kazhinji.

mabatiro

Zvirwere chokuita mishonga, kunyange yakaoma, asi achiri amenable kuti zvinodhaka mishonga. Zvakanakisa, chiremba prescribes chaiyo inorwisa utachiona nomumiririri rakamanikana chakarondedzera chiito, rakaitirwa kuti dzakananga mhando utachiona hwakakura. Asi tsika iyi haisi zvichibvira, nokuti zvirimwa microflora uye aikanganiswa kuongorora anotora masvondo, uye murwere anoda kubatwa pakarepo. Naizvozvo, chiremba ane kugadza empiric kurapa yakavakirwa zvavanotaura. Pakusarudza mushonga kunobva chiremba ruzivo pamusoro chii Flora akavamba iri dhipatimendi.

Kuti utachiona akasimuka kurapika, zvakakodzera kuomerera majana mishonga, kureva kuchinja navo ose maviri kana mwedzi mitatu. Izvi zvichakubatsira kuderedza nemishonga uye kuvandudza kurapwa zvaitika.