Zvirwere muKubata: Septic Shock

Zvemukati

• Ndeapi Zviratidzo zveSeptic Shock?
• Chii Chinoita Kuti Septic Shock?
• Septic Shock Inowanzoongororwa Sei?
• Septic Shock Inobatwa Sei?
• Kutenderera kweropa
• Mishonga inorwisa mabhakitiriya
• Kutsigira Kuchengeta
• Zvirwere zvekuvhiya
• Outlook

Chii chinonzi Septic Shock?

Septic kuvhunduka kwakanyanya uye systemic hutachiona. Izvi zvinoreva kuti zvinokanganisa muviri wese. Inokonzerwa kana mabhakitiriya achipinda muropa rako uye inowanzoitika mushure mekukuvara kana kuvhiyiwa.

Kana vakadzi vane nhumbu vachikura septic kuvhunduka, zvinowanzo kuve kusangana kweimwe yeanotevera mamiriro:

• septic kubvisa nhumbu (kupererwa nepamuviri kwakabatana nehutachiona hutachiona)
• chirwere chakakomba cheitsvo
• chirwere chepamuviri
• hutachiona hweamniotic sac
• hutachiona hutachiona

Ndeapi Zviratidzo zveSeptic Shock?

Septic kuvhunduka kunoitika nekuda kwekuoma kwakanyanya sepsis. Sepsis, inonziwo "chepfu yeropa," zvinoreva matambudziko anokonzerwa nehutachiona hwekutanga hweropa. Septic kuvhunduka ndiyo yakanyanya kukonzeresa yekusadzora sepsis. Ose ane zviratidzo zvakafanana, senge yakanyanya low BP. Nekudaro, sepsis inogona kukonzera shanduko mune yako yepfungwa mamiriro (kuvhunduka) uye kwakapararira kwemitezo kukuvara.

Septic kuvhunduka kunokonzera akasiyana masystemic zviratidzo uye zviratidzo, zvinosanganisira:

• kusagadzikana uye kusagadzikana
• kukurumidza kwemoyo uye kuderera kweropa (hypotension)
• fever ye103˚F kana yakakwira
• tembiricha yemuviri yakaderera (hypothermia)
• ganda rinodziya uye rakatsetseka nekuda kwekuwedzera kwemitsipa yako yeropa (vasodilation)
• inotonhorera uye inonamira ganda
• zvisina kujairika moyo wakarova
• yero yeganda rako (jaundice)
• kuderera kwekuita weti
• kubuda ropa kamwe kamwe kubva panhengo yako yekubereka kana yeweti

Iwe unogona zvakare kuona zviratidzo zvine chekuita neyekutanga saiti yehutachiona. Mune vakadzi vane nhumbu, izvi zviratidzo zvinowanzo sanganisira:

• yakashandura uterine kubuda
• uterine unyoro
• kurwadziwa uye unyoro mudumbu rako uye parutivi (nzvimbo iri pakati pembabvu nehudyu)

Chimwe chinetso chakajairika ndeyevanhu vakuru vekufema kushungurudzika chirwere (ARDS). Zviratidzo zvinosanganisira:

• mweya wekufema
• kukurumidza uye kushanda kufema
• kukosora
• kuzara kwemapapu

ARDS ndechimwe chezvikonzero zvikuru zvekufa mune zviitiko zvepsipsi yakasimba.

Chii Chinoita Kuti Septic Shock?

Mabhakitiriya akajairika anokonzera sepsis ndeaya aerobic gram-negative bacilli (mabhakitiriya akaumbwa netsvimbo), kunyanya:

• Escherichia coli (E. coli)
• Klebsiella pneumoniae
• Proteus mhando

Aya mabhakitiriya ane mairi maviri, izvo zvinoita kuti zvinyanye kurwisa maantibioti.

Kana dzikapinda muropa rako, dzinogona kukonzera kukuvara kunhengo dzako dzakakosha.

Mumadzimai ane pamuviri, septic shock inogona kukonzerwa ne:

• hutachiona panguva yekusununguka uye kusununguka
• zvikamu zvekusiya
• chirwere chemabayo
• kushaya simba kwema immune
• furuwenza (dzihwa)
• kubvisa nhumbu
• nhumbu

Septic Shock Inowanzoongororwa Sei?

Zviratidzo zvinosanganisirwa ne septic kuvhunduka zvakafanana nezviratidzo zveimwe yakakomba mamiriro. Chiremba wako anozonyatsoongorora muviri, uye vanogona kuraira bvunzo dzevarabhoritari.

Chiremba wako anogona kushandisa kuongororwa kweropa kutsvaga:

• humbowo hwehutachiona
• matambudziko nekugwamba kweropa
• chiropa kana itsvo matambudziko
• kusaenzana kwe electrolyte

Chiremba wako anogona kuraira chipfuva x-ray kuti uone kana iwe uine ARDS kana pneumonia. CT inoongorora, MRIs, uye ultrasound zvinogona kubatsira kuona iyo yekutanga hutachiona saiti. Iwe unogona zvakare kuda electrocardiographic kuongorora kuti uone zvisina kujairika moyo zvimiro uye zviratidzo zvekukuvara kumoyo wako.

Septic Shock Inobatwa Sei?

Kune matatu makuru zvibodzwa mukurapa kwe septic kuvhunduka.

Kutenderera kweropa

Chinangwa chako chekutanga chechiremba kugadzirisa matambudziko neropa rako. Ivo vanogona kushandisa hombe intravenous catheter kukupa iwe mvura. Vanozoongorora kupomba kwako, kuwedzerwa kweropa, uye kubuda kweweti kuti uve nechokwadi chekuti unogashira huwandu hwakafanira hwemvura idzi.

Chiremba wako anogona kuisa catheter yemoyo chaiyo seimwe mudziyo wekutarisa kana iko kwekutanga kuyerera kwemvura kusingadzorere kutenderera kweropa kwakakodzera. Iwe unogona zvakare kugamuchira dopamine. Mushonga uyu unovandudza mashandiro emoyo uye unowedzera kuyerera kweropa kunhengo huru.

Mishonga inorwisa mabhakitiriya

Chinangwa chechipiri chekurapa ndechekukupa mishonga inorwisa mabhakitiriya yakanangana nemabhakitiriya angangoita. Nezve hutachiona hutachiona, kurapwa kwakanyanya musanganiswa we:

• penicillin (PenVK) kana ampicillin (Principen), pamwe chete
• clindamycin (Cleocin) kana metronidazole (Flagyl), pamwe
• gentamicin (Garamycin) kana aztreonam (Azactam).

Neimwe nzira, imipenem-cilastatin (Primaxin) kana meropenem (Merrem) inogona kupihwa semushonga mumwe chete.

Kutsigira Kuchengeta

Chinangwa chechitatu chikuru chekurapa ndechekupa rubatsiro rwekutsigira. Mishonga inoderedza kupisa muviri uye jira rinotonhodza zvinobatsira kuchengetedza tembiricha yako padhuze nepakajairika sezvinobvira. Chiremba wako anofanira kukurumidza kuona nyaya nekugwamba kweropa uye kutanga kurapwa nekumukirwa kweropa maplatelet uye coagulation zvinhu.

Chekupedzisira, chiremba wako anokupa yekuwedzera okisijeni uye nekukutarisa iwe padhuze neuchapupu hweARDS. Nzvimbo yako yeoksijeni ichaongororwa zvakanyanya pamwe neopulse oximeter kana radial arteri catheter. Kana kukundikana kwekufema kukava pachena, iwe uchaiswa pane yekutsigira oxygen system.

Zvirwere zvekuvhiya

Iwe unogona zvakare kuda kuvhiyiwa. Kurapa kwekuvhiya kunogona kushandiswa kubvisa pus yakaunganidzwa mumapapiro ako, kana kubvisa nhengo dzehutachiona dzakatapukirwa.

Kana iwe uine yakadzivirirwa immune system, iwe unogona kupihwa kunyorera kuyerwa kwemachena maseru eropa. Imwe sarudzo ndeye antisera (anti-toxin) kurapa kwakanangana neakajairika mabhakitiriya anokonzera septic kuvhunduka. Iyi kurapa yaonekwa ichivimbisa mune kumwe kuongorora, asi ichiri kuyedza.

Outlook

Septic kuvhunduka chirwere chakakomba, asi zvakakosha kuti uzive kuti chinhu chisingawanzoitika pakubata. Muchokwadi, iyo Obstetrics uye Gynecologymagazini inofungidzira kuti inosvika ku0.01 muzana yezvose zvinotakura zvinokonzeresa kukatyamara. Vakadzi vane yakakwana mimba yekuchengetwa vane kashoma kukura sepsis uye zvinokonzeresa kuvhunduka. Kana iwe ukasangana nezviratidzo zvisina kujairika, zvakakosha kufonera chiremba wako ipapo ipapo kudzivirira chero kukuvara kwakapararira.