Izifo ekukhulelweni: I-Septic Shock

-Delile

• Ziyini Izimpawu Zokushaqeka Kwama-Septic?
• Yini Ebangela Ukushaqeka Kwama-Septic?
• Ukutholakala Kanjani Kwe-Septic Ngokuvamile Kuhlonza?
• Kufanele Iphathwe Kanjani I-Septic Shock?
• Ukusakazwa Kwegazi
• Imithi elwa namagciwane
• Ukunakekelwa Okusekelayo
• Ukwelashwa Okuhlinzwa
• Umbono

Kuyini Ukushaqeka Kwama-Septic?

Ukushaqeka kwe-Septic ukutheleleka okunzima futhi okuhlelekile. Lokhu kusho ukuthi kuthinta umzimba wonke. Kubangelwa lapho amagciwane engena egazini lakho futhi kwenzeka kakhulu ngemuva kokuhlukumezeka noma ukuhlinzwa.

Lapho abesifazane abakhulelwe beqala ukushaqeka ngokweqile, imvamisa kuyinkinga yesinye salezi zimo ezilandelayo:

• isisu septic (ukukhulelwa kwesisu okuhambisana nokutheleleka kwesibeletho)
• ukutheleleka okukhulu kwezinso
• ukutheleleka kwesisu
• ukutheleleka kwesikhwama se-amniotic
• ukutheleleka kwesibeletho

Ziyini Izimpawu Zokushaqeka Kwama-Septic?

Ukushaqeka kwe-Septic kwenzeka ngenxa ye-sepsis enamandla. I-Sepsis, ebizwa nangokuthi "ubuthi begazi," ibhekisela ezinkingeni ezibangelwa ukutheleleka kwegazi kokuqala. Ukushaqeka kwe-Septic kungumthelela omkhulu we-sepsis engalawulwa. Zombili zinezimpawu ezifanayo, ezifana nomfutho wegazi ophansi kakhulu. Kodwa-ke, i-sepsis ingadala ushintsho esimweni sakho sengqondo (ukushaqeka) nokulimala komzimba okugcwele.

Ukushaqeka kwe-Septic kudala izimpawu nezimpawu ezahlukahlukene zesistimu, kufaka phakathi:

• ukungahlaliseki nokudideka
• ukushaya kwenhliziyo okusheshayo nomfutho wegazi ophansi (hypotension)
• umkhuhlane ka-103˚F noma ngaphezulu
• izinga lokushisa lomzimba eliphansi (hypothermia)
• isikhumba esifudumele futhi esikhanyayo ngenxa yokwanda kwemithambo yegazi (i-vasodilation)
• isikhumba epholile futhi clammy
• ukushaya kwenhliziyo okungajwayelekile
• ukuphuzi kwesikhumba sakho (i-jaundice)
• ukuncipha ukuchama
• ukopha okuzenzekelayo okuvela esithweni sakho sangasese noma kumchamo

Ungase futhi ube nezimpawu ezihlobene nendawo eyinhloko yokutheleleka. Kwabesifazane abakhulelwe, lezi zimpawu zivame ukufaka:

• ukukhishwa kwesibeletho okukhanyayo
• isizalo sesizalo
• ubuhlungu nobumnene esiswini sakho nasesinqeni (indawo ephakathi kwezimbambo nesinqe)

Enye inkinga ejwayelekile yisifo sabantu abadala sokuphefumula (ARDS). Izimpawu zifaka:

• ukuphelelwa umoya
• ukuphefumula okusheshayo nokusebenza kanzima
• ukukhwehlela
• ukuminyana kwamaphaphu

I-ARDS ingenye yezimbangela ezinkulu zokufa ezimeni ze-sepsis enamandla.

Yini Ebangela Ukushaqeka Kwama-Septic?

Amagciwane ajwayelekile kakhulu abhekene ne-sepsis yi-aerobic gram-negative bacilli (amabhaktheriya amise okwenduku), ikakhulukazi:

• Escherichia coli (E. coli)
• UKlebsiella pneumoniae
• UProteus izinhlobo

Lawa mabhaktheriya anezingqimba ezimbili, ezenza ukuthi amelane kakhulu nama-antibiotic.

Lapho zingena egazini lakho, zingadala umonakalo ezithweni zakho ezibalulekile.

Kwabesifazane abakhulelwe, ukushaqeka okubangelwa yisifo septic kungabangelwa:

• ukutheleleka ngesikhathi sokubeletha nokubeletha
• izigaba zokuhlinzwa
• inyumoniya
• amasosha omzimba abuthakathaka
• umkhuhlane (umkhuhlane)
• ukukhipha izisu
• ukukhulelwa kwesisu

Ukutholakala Kanjani Kwe-Septic Ngokuvamile Kuhlonza?

Izimpawu ezihambisana nokwethuka okubizwa nge-septic zifana kakhulu nezimpawu zezinye izimo ezimbi kakhulu. Udokotela wakho uzohlola ngokuphelele umzimba, futhi kungenzeka a-oda izivivinyo zaselebhu.

Udokotela wakho angasebenzisa ukuhlolwa kwegazi ukufuna:

• ubufakazi bokutheleleka
• izinkinga zokuqina kwegazi
• Izinkinga zesibindi noma izinso
• ukungalingani kwe-electrolyte

Udokotela wakho angalawula i-x-ray yesifuba ukuthola ukuthi unayo yini i-ARDS noma i-pneumonia. Ukuskena kwe-CT, ama-MRIs, nama-ultrasound kungasiza ekuboneni indawo eyinhloko yokutheleleka. Ungadinga futhi ukuqapha kwe-electrocardiographic ukuthola isigqi senhliziyo esingajwayelekile kanye nezimpawu zokulimala enhliziyweni yakho.

Kufanele Iphathwe Kanjani I-Septic Shock?

Kunezinhloso ezintathu ezinkulu ekwelapheni ukwethuka okubangelwa yisifo septic.

Ukusakazwa Kwegazi

Inhloso yokuqala kadokotela wakho ukulungisa izinkinga ngokujikeleza kwegazi lakho. Bangasebenzisa ipayipi elikhulu elifakwa emthanjeni ukukunikeza uketshezi. Bazobheka ukushaya kwenhliziyo yakho, umfutho wegazi, nokukhishwa komchamo ukuze baqiniseke ukuthi uthola inani elifanele lalezi ziketshezi.

Udokotela wakho angafaka i-catheter yenhliziyo elungile njengenye yedivayisi yokuqapha uma ukumnika oketshezi kokuqala kungabuyisi ukujikeleza kwegazi okufanele. Ungase futhi uthole i-dopamine. Lesi sidakamizwa sithuthukisa ukusebenza kwenhliziyo futhi sandisa ukugeleza kwegazi ezithweni ezinkulu.

Imithi elwa namagciwane

Inhloso yesibili yokwelashwa ukukunikeza ama-antibiotics aqondiswe kumabhaktheriya angabakhona. Ngokutheleleka ngezitho zobulili, ukwelashwa okusebenza kahle kakhulu inhlanganisela ye:

• i-penicillin (PenVK) noma i-ampicillin (i-Principen), kanye
• clindamycin (Cleocin) noma i-metronidazole (i-Flagyl), kanye
• i-gentamicin (Garamycin) noma i-aztreonam (i-Azactam).

Ngenye indlela, imipenem-cilastatin (Primaxin) noma i-meropenem (Merrem) inganikezwa njengemithi eyodwa.

Ukunakekelwa Okusekelayo

Inhloso enkulu yesithathu yokwelashwa ukunikeza ukunakekelwa okusekelayo. Imithi eyehlisa umkhuhlane nengubo yokupholisa izosiza ukugcina izinga lokushisa kwakho lisondele kokujwayelekile ngangokunokwenzeka. Udokotela wakho kufanele asheshe akhombe izingqinamba ngokujiya kwegazi bese eqala ukwelashwa ngokufakwa kwama-platelet egazi nezici ze-coagulation.

Ekugcineni, udokotela wakho uzokunika i-oxygen eyengeziwe futhi akubheke eduze ukuze uthole ubufakazi be-ARDS. Isimo sakho se-oxygen sizobhekwa ngokucophelela nge-oximeter ye-pulse noma i-catheter ye-radial artery. Uma ukwehluleka kokuphefumula kubonakala, uzofakwa ohlelweni lokusekelwa komoya-mpilo.

Ukwelashwa Okuhlinzwa

Ungadinga nokuhlinzwa. Imithi yokwelashwa ingasetshenziswa ukukhipha ubomvu obuqoqwe okhalweni lwakho, noma ukususa izitho zangasese ezithintekile.

Uma unesistimu yomzimba ecindezelwe, ungahle unikezwe ukumnika kwamaseli amhlophe egazi. Enye indlela yokwelapha i-antisera (anti-toxin) ebhekiswe kumagciwane ajwayelekile abangela ukushaqeka kweseptic. Le ndlela yokwelashwa ibonakale ithembisa kuphenyo oluthile, kepha isalokhu ihlola.

Umbono

Ukushaqeka kwe-Septic kuyisifo esibi kakhulu, kodwa kubalulekile ukuqaphela ukuthi kuyisimo esingajwayelekile ekukhulelweni. Eqinisweni, i- I-Obstetrics ne-Gynecologyiphephabhuku lilinganisela ukuthi amaphesenti angafika ku-0.01 wakho konke ukulethwa kubangela ukushaqeka okubangelwa ukudangala. Abesifazane abanokunakekelwa okwanele kokukhulelwa mancane amathuba okuthi bahlakulele i-sepsis futhi bathuke. Uma uhlangabezana nezimpawu ezingajwayelekile, kubalulekile ukubiza udokotela wakho ngokushesha ukuvimbela noma yimuphi umonakalo osabalele.