Kev kuaj mob sai sai ntawm cov ntshav ntshav ntswg

Kab mob ntshav ntshav (BSI) yog hais txog qhov system information

Cov chav kawm ntawm tus kab mob feem ntau yog tus cwj pwm los ntawm kev ua kom muaj kev ua pa, ua rau muaj kev sib tsoo, ua rau muaj kev kub ntxhov, ua rau muaj kev sib hloov, thiab muaj mob hnyav, poob siab thiab ntau -organ tsis ua tiav, nrog lub neej siab tuag. nrhiav ha) sepsis thiab septic kev lom zem, suav nyiaj rau 40% ntawm cov neeg muaj mob thiab kwv yees li 20% ntawm ICU kis tau. Thiab nws yog qhov cuam tshuam zoo nrog kev raug mob tsis zoo, tshwj xeeb tshaj yog tias tsis muaj kev tiv thaiv kab mob rau lub sijhawm thiab mob focal.

Kev cais ntshav ntawm cov ntshav ntawm tus kab mob

Bacteraemia

Muaj cov kab mob lossis cov fungi hauv cov hlab ntshav.

Chepticemia

Cov kev kuaj mob mob los ntawm kev ntxeem tau ntawm cov kab mob pathogenic thiab lawv cov co toxins rau hauv cov hlab ntshav, yog qhov mob hnyav.

Pyohemia

Lub neej hem hem thaum ua haujlwm ntawm lub cev ntawm lub cev cov lus teb rau tus kab mob.

Ntawm kev txhawj xeeb ntau dua yog ob tus kab mob hauv qab no.

Tshwj xeeb catheter-txuam kab mob ntshav ntshav

Cov kab mob ntshav nrog cuam tshuam nrog cov catheters cog hauv cov hlab ntshav (piv txwv li, cov kws kho mob nruab nrab, lim hiam, thiab lwm yam).

Qhov Tshwj Xeeb Kis Kis Excocarditis

Nws yog ib tus kab mob kis los ntawm kev tsiv teb tsaws ntawm cov kab mob endocardium thiab yog tus kab mob plawv, thiab los ntawm embolic muaj tus kab mob metastasis lossis sepsis vim muaj cov khoom noj khoom plig redundant.

Kev phom sij ntawm cov ntshav ntshav ntshav:

Tus kab mob ntshav ntshav yog txhais tau tias yog tus neeg mob nrog txoj kev mob ntshav thiab cov cim ntawm tus kab mob tus kab mob. Kab mob ntshav ntshav tuaj yeem yog ib qho ntxiv rau lwm cov chaw ntawm mob ntsws, cov kab mob hauv plab, lossis tus kab mob thawj. Nws tau tshaj tawm tias 40% ntawm cov neeg mob uas muaj sepsis lossis sepic poob siab yog tshwm sim los ntawm cov ntshav ntshav [4]. Nws yog kwv yees tias 47-50 lab tus neeg mob sepsis muaj thoob ntiaj teb txhua xyoo, ua rau muaj ntau dua 11 lab tuag, nrog qhov nruab nrab ntawm 1,8 feeb [5].

Muaj kev kuaj mob cov txheej txheem rau cov kab mob ntshav ntswg

01 pcct

Thaum muaj kab mob kis tau thiab mob cov tshuaj tiv thaiv tshwm sim, cov zais pa ntawm cov kab mob sib zog ua kom sai ntawm cov kab mob hnyav thiab yog qhov ntsuas tau zoo ntawm kev raug mob.

0.2 hlwb thiab cov tshuaj nplaum

Cell adhesion molecules (cam) tau koom nrog hauv cov txheej txheem thev naus laus zis, xws li kev tiv thaiv kab mob, thiab ua tau tus mob los tiv thaiv kab mob thiab kev kis tus mob. Cov no suav nrog IL-6, IL-8, TNF-A, VCAM-1, thiab lwm yam.

03 endotoxin, g sim

Gram-tsis zoo cov kab mob nkag mus rau cov hlab ntshav kom tso cov endotoxin tuaj yeem ua rau endoxemia; (1,3)-D-D-Glucan yog ib qho ntawm cov qauv tseem ceeb ntawm cov phab ntsa fungal thiab yog ntau ntxiv hauv cov kab mob fungal.

04 molecular biology

DNA lossis RNA tso rau hauv cov ntshav los ntawm cov kab mob me los kuaj, lossis tom qab muaj kab lis kev cai zoo.

05 ntshav kab lis kev cai

Bacteria lossis fungi hauv cov ntshav coj yog tus qauv kub ".

Cov ntshav kab lis kev cai yog ib qho yooj yim tshaj plaws, feem ntau yog thiab feem ntau siv los txhawm rau txhawm rau txhawm rau txhawm rau paub kev lees paub cov ntshav ntshav hauv lub cev. Ntxov paub txog ntawm cov ntshav kab lis kev cai thiab cov tshuaj tua kab mob thaum ntxov yog cov kev ntsuas thawj zaug uas yuav tsum tau tswj cov ntshav ntshav.

Cov ntshav kab lis kev cai yog tus qauv kub rau kev kuaj mob ntawm cov ntshav ntshav, sib xyaw nrog cov kev ua yeeb yam ntawm cov tshuaj rhiab thiab muab cov phiaj xwm kho kom raug thiab muab cov phiaj xwm kho kom raug. Txawm li cas los xij, qhov teeb meem ntawm lub sijhawm zoo rau cov ntshav kab mob tau cuam tshuam nrog cov neeg mob uas kuaj mob thiab kho tau raws sijhawm thiab kho tau raws sijhawm thiab muaj txiaj ntsig ib teev tom qab 6 teev Thawj hypotension.

Yog li, cov kev coj noj coj ua ntshav tam sim no thiab kev txheeb xyuas cov txheej txheem ntawm cov neeg mob ntshav siab tshaj plaws, qhia txog thawj zaug (qhia meej lossis kev txheeb xyuas kom ceev ceev Kev Tshaj Tawm) thiab Kev Qhia Tertiary (Daim Ntawv Qhia Zaum Kawg, suav nrog lub npe tsis sib xws Thawj daim ntawv qhia yuav tsum tau tshaj tawm rau lub chaw kuaj mob tsis pub dhau 1 teev ntawm qhov kev ceeb toom txog ntshav. Daim ntawv qhia txog qib siab yog ua tiav kom ua tiav sai li sai tau (feem ntau tsis pub dhau 48-72 H rau cov kab mob).