Izifo ezihlobene ngokunakekela kwezokwelapha: izinhlobo kanye ngezigaba

Izifo ezihlobene ngokunakekela kwezokwelapha, njalo nazo umkhuba emtholampilo. Futhi ungabeki odokotela, bazama ukuba zenze konke ezingakwenza uyephuza ukuqala la izinkinga. Ngeshwa, gwema abantu abambalwa kakhulu ongakwenza.

definition

Lokho nokutshala izimali ezinhlelweni welithi "elihlobene ne ukunakekelwa kwezokwelashwa, ukutheleleka"? Incazelo sifundeka kanje: kukhona noma iyiphi izimpawu zesifo imvelo microbial, okuyinto kwaphawuleka iziguli emva ukwelashwa ukuvakashelwa esibhedlela noma esibhedlela, noma kungakapheli inyanga emva osenyameni evela esibhedlela.

Enye igama laleli qembu izifo - izifo nosocomial, noma izifo nosocomial. Kukholakala ukuthi ukutheleleka wayevela nesineke esibhedlela, lapho izimpawu zokuqala yavela akukho ngaphambi kwezinsuku ezimbili kusukela irisidi. isimo okugunyaziwe - yokuntuleka ukubonakaliswa nesineke yalesi ukutheleleka ngaphambi ukubekwa endaweni isikhungo sezokwelapha.

Isibhedlela ukutheleleka kumele ahlukaniswe kusuka iatrogenic futhi ezingena ngentuba, ngoba zifana ngokwanele kudidaniswe. Kubhekwe ukutheleleka iatrogenic ezavela ngenxa iphutha izisebenzi zezokwelapha e imithi oyinikiwe noma uphethwe. Ezingena ngentuba liyavela futhi abantu kuka izivikeli mzimba akakwazi ukubamba emuva isheke amagciwane ezingosomathuba.

nokudlanga

Epidemiology izifo ezihambisana nokunikezwa ukunakekelwa kwezokwelashwa, nahlulele by izilinganiso Centre for Disease Control (CDC) kuyinto esidumazayo. E-United elilodwa Ezihlangene amacala ngonyaka eziyisigidi nesigamu, ezingaphezu kuka wafa nengxenye. EYurophu lehla ngokushesha inani bangamaphesenti amabili nanhlanu kube ngokomuzi, Russia - izinkulungwane ezingamashumi amathathu. Kodwa lezo zibalo ongaphakeme azikhulumi mayelana lekunakekela, kanye izinga eliphansi ucwaningo kwezibalo.

Ukuze izifo nosocomial linezimiso ayo esiphelweni, okuyinto ukuhlukanisa kubo kusukela ezinye izifo yalolu hlobo. Lezi umehluko mshini futhi izici yokudlulisela, ngqo nesifo, indima izisebenzi zasesibhedlela ekunakekeleni kanye nekwenyusa linani lalabo amacala. Futhi, ala magciwane kunzima ukuyelapha ngoba izilokazane ezincane ezihlala esikhungweni sezempilo, nemithi.

omsakazo

Amagciwane elihlobene ne ukunakekelwa kwezempilo zivamile embulungeni yonke. Kuze kube manje, kukhona ejenti engaphezu kwamakhulu amabili microbial ukuthi bayakwazi abangele izifo nosocomial. Ngaphambi inkathi yemithi elwa namagciwane base imbewu eletha anaerobic, streptococci futhi staphylococci. Manje luthole ukuthi imbangela ukutheleleka kungaba Rotavirus, cytomegalovirus, isifo sokusha kwesibindi kohlobo amagciwane, ngisho HIV.

Ukuba isikhathi eside ensimini ka esibhedlela, lesi silwanyana is phansi kwemvelo futhi ukuguquka kwezakhi zofuzo, ngenxa okuyinto zikhona ngekhambi elejwayelekile, okuyinto ungowesilisa izibulali-magciwane, futhi imithi elwa namagciwane kvartsevanie. Endabeni ngayinye esibhedlela ngabanye, umnyango ngisho yokusebenza siphile amagciwane zabo "esiyingqayizivele".

Imithombo mshini yokudlulisela

Igama elithi "ukutheleleka elihlobene ne ukunakekelwa kwezempilo" kushiwo khona ezintathu imikhomo inqubo epidemiological:

- Umthombo;

- ukudluliswa indlela;

- umuntu singangena.

HAI imithombo ingase idayiswe abagulayo abaphila esibhedlela isikhathi eside futhi okunobuthi microflora ayo, kanye abasebenzi bezempilo, nabo nsuku zonke nge-bacterium efanayo. Izivakashi ukunakekelwa nokudlala umndeni usuku ukusabalala kwezifo nosocomial babaluleke.

Mshini ukudluliswa kungenzeka cishe noma yikuphi: fecal-temlomo, sisemoyeni, pin noma transmissive. Dlulisa izici amathuluzi, amadivayisi kwezimila nokugeleza kwegazi, izingubo zokulala kanye izingubo zangaphansi, embhedeni, ukugqoka futhi suture impahla, lezi zitho, amanzi kanye izinto ezimanzi. Lezi zihlanganisa ompompi nokucwila, nokucwila, ukumnika izixazululo, amanzi ahlanzekile, izixazululo isinqandakuvunda, amanzi e isitsha sezimbali izimbali, condensate ohlelweni emoyeni yokuhlanza nokunye.

amaqembu ingozi

Izifo ezihlobene ngokunakekela kwezokwelapha, iziguli kaningi kwenzeka kubantu abanegciwane buthaka omzimba. Yiqiniso, zonke iziguli ngezindlela ezingafani, kunciphise imisebenzi okuvikela umzimba, kodwa kukhona abantu Lesi sifo siphatha kakhulu. Lezi zihlanganisa:

- abantu abadala;

- ezizalwa ngaphambi kwesikhathi kanye nezinsana zabo;

- Iziguli umdlavuza, sokuhlasela kwamasosha omzimba, izifo iguliswa;

- ezigulini eziye usehlinzwe eside;

- abantu ababehlala endaweni imvelo abanamusa.

akuxhomekile leseluhleni kungenzeka sigule ngesikhathi isesibhedlela, ngakho ngabo zidinga ukunakekelwa eyengeziwe kusukela abasebenzi bezokwelapha.

ngezigaba

Yiziphi izinhlobo izifo ezihambisana ngokunakekela kwezokwelapha? Konke kuncike, kungasiphi isisekelo zokuhlukanisa kubo. Ngokwesibonelo, uma ukuthatha indlela, ke ukudedela: aerosol, ukudla, contact-yasendlini, amathuluzi, posttranstplantatsionnye, ukutheleleka emva imijovo, ukumpontshelwa igazi, imisebenzi, izinqubo endoscopic nabanye. Nge ukugeleza, kanye nezinye izifo, izifo nosocomial kukhona acute, subacute futhi ezingalapheki, kanye namafomu ezinzima, alungise futhi umnene.

Omunye umehluko wenziwe phakathi ngamazinga ahlukene nokudlanga, okuyinto engenza izifo ezihambisana ne ukwelashwa. Ukwahlukanisa iqala Ezimweni ezimbi kakhulu:

- ifomu Generalized: bacteremia, septicemia, pyosepticemia, ukushaqeka virus.

- ifomu Zendawo.

- Izifo zesikhumba namafutha ongama.

- Lower izifo zokuphefumula.

- ifomu zamazinyo.

- Izifo wokugaya ukudla.

- isifo izinhlelo wokuzala kanye urinary.

- Izifo uhlelo zemisipha.

- izifo ezithile zesimiso sezinzwa.

- Izifo of the yisimiso senhliziyo nemithambo yegazi.

Izizathu eliphezulu legciwane

Ukuvimbela izifo ezihambisana ngokunakekela kwezokwelapha, okuhloswe ngazo ukunciphisa abagulela ukufa jikelele. Kodwa ngeshwa, kuze kube manje, zonke izinyathelo ayizwakali. Isizathu esikhulu salokhu - e ukuvela flora multi ukumelana.

Ngokuyinhloko, lokhu kungenxa yokuthi ama-bacterium liguquke, ishintsha izakhiwo zabo ngenxa ukusetshenziswa engenangqondo antibiotic izibulali-magciwane. Lezi izimo ezikahle ukuze kwakhiwe microflora multiresistant yesibili.

Ukumelana Primary - kuba ikhono lemvelo lolu hlobo bacterium ukuba simelane ejenti nolaka. Isejwayezi odokotela nganoma yisiphi isizathu antibiotic kuholela yokuthi ukuphumelela ukwelashwa kuyehla, kanti ama-bacterium ayabaluleka nemithi. Kodwa hhayi kuphela abasebenzi bezokwelapha unesandla. ERussia, abantu asetshenziselwa ngokuzimela liqoke namagciwane, kodwa musa zithobele yokusetshenziswa.

izimiso Fleming

Kunezinhlobo ezintathu isimiso Fleming ezinconywe-World Health Organization.

Isimiso lokuqala - linqume antimicrobial kuphela lapho i-ejenti ezithathelwanayo ebucayi kubo. Lokhu kuzokwenza kube nomkhawulo nokusetshenziswa kwamaphilisi, odokotela njalo benza afeze ukuzwela izifundo of flora emithi, lizokhuphuka ngaphambili zomuthi nge spectrum emincane isinyathelo iqondiswe.

Eyesibili Fleming isimiso uthi kuyadingeka ukuqinisekisa i okuhlushwa ngempumelelo zomuthi ku lesion. Lo mthetho kuzonciphisa inani kwamaphilisi esetshenziswa ihlelwe ngokulandelana kwezihloko kanye imithi ngenhloso yokuvimbela. Ngaphezu kwalokho, izonikeza ithuba lokukhansela izidakamizwa ngesikhathi esisodwa, kunokuba kancane kancane, kanye ukulungisa umthamo kanye izidakamizwa esekelwe nophenyo lesiguli lokuzinqumela begazi uketshezi izitshalo kanye njalo izinsuku eziyisikhombisa.

Isimiso sesithathu - isidingo antibiotic in umthamo kanye ukwethula kwabo ngendlela ukunciphisa imiphumela emibi. Lokhu izosebenzisa izidakamizwa ezengeziwe enomqondo.

kumiswa amagciwane

Izifo ezihlobene ngokunakekela kwezokwelapha ngeke kube khona kungekho amabhaktheriya zenethiwekhi, okuthiwa "zero nesineke", okuzoba ongabonakali imithombo okutheleleka abanye.

Bacteriocarrier - ifomu ukutheleleka elivela uma phakathi host futhi amagciwane esungulwe ukulinganisela iziguli ngaphandle ukubonakaliswa emtholampilo. ukusabela Immunological siqhubeke kwenzeke ngesikhathi esifanayo. Uma lesi silwanyana esiqhutshwa ifomu esicashile in iziguli amahlanu, lishintsha impahla yayo futhi iba nolaka.

izenzo Zokuzivikela kulokhu yilezi:

- njalo luhlolo basemtholampilo abasebenzi bezempilo;

- luhlolo bacteriological of abasebenzi esibhedlela;

- uma usheshe watholakala futhi ekwelapheni odokotela onegciwane;

- ukulawula Daily isimo sezempilo wezokwelapha.

izinqubo eziyingozi zokuxilonga nokwelapha

Izifo ezihlobene ngokunakekela kwezokwelapha (IHS) avele hhayi kuphela ngemva kokuba isiguli wayechithe isikhathi esithile ekwelapheni esibhedlela, kodwa ngemva eziningana izindlela zokuxilonga nokwelapha, ezinomthelela izitshalo ukungcoliswa esibhedlela. Lezi zihlanganisa ukumpontshelwa igazi, imijovo, ukuhlinzwa zitshala kwezitho nezicubu. Phakathi yokusiza umuntu ukuba aphefumule kuyinto intubation, izinzwa lapho ephefumula, imishini ukwesekwa ukuphila, ukubeka catheters. Futhi, ukutheleleka, zingaba khona ngemva ukwelashwa hemodialysis, inhalations spa ukwelashwa.

Kusigaba Spaulding

Izifo ezihlobene ngokunakekela kwezokwelapha, angadluliselwa ngokusebenzisa amadivaysi ezokwelapha. Ngakho-ke Spaulding wabahlukanisa ngezigaba ezintathu, ukuthatha njengophawu ekulinganisweni esengozini yokungenwa yigciwane le a flora esibhedlela.

Iqembu lokuqala - ezibucayi. Lezi zihlanganisa amathuluzi okuhlinza, catheters, izimila, izinaliti, futhi ukumpontshelwa kwamanzi emigodini.

Iqembu lesibili - polukriticheskie: imishini endoscopic futhi ephefumula, namathuluzi izinzwa, thermometer rectal.

Iqembu lesithathu, ngokulandelana, noncritical. Kuyinto zonke ezinye izinto: umkhumbi, blood pressure ngabaqaphi, izinduku zokuhamba, izitsha, izingubo, ama-thermometer underarm.

zokuvimbela

Ukuvimbela izifo ezihambisana ngokunakekela kwezokwelapha, esekelwe-World Health Organization izincomo nokuvimbela izifo nosocomial. Ngo zokuvimbela ezinhle kufanele kufake lwaluyoba nezigaba ezintathu:

- Ukunciphisa ukutheleleka kusuka ngaphandle esibhedlela;

- ukukhishwa yokungenwa yizifo ngokucindezela isinyathelo inqubo ubhubhane amayunithi;

- ukususwa ngaphandle ngale ukutheleleka esibhedlela.

Ngenxa yale njongo kukhona iziguli ukwahlukanisa nge izifo ezingathi sína kwababhemayo ezithathelwanayo ngo amabhokisi ekhethekile ne input ahlukene futhi okukhipha, okungadingi ukuxhumana nalo lonke kuleli gumbi engangikulo. Ngaphezu kwalokho, e isikwele ngasinye, kanye wamanje eyenziwa jikelele sanitization amathuluzi kanye evele. Imvamisa lezi zenzakalo incike isidingo: e neminyango yangaphakathi imithi - akuvamile, kuhlinzwa, ngokulandelana, maningi amathuba.

ukwelashwa

Izifo ezihlobene ngokunakekela kwezokwelapha, nakuba kunzima, kodwa namanje amenable ukuba ukwelashwa. Kahle kahle, udokotela utjho ejenti ethize elwa namagciwane of spectrum emincane isinyathelo, okuyinto yakhelwe uhlobo eqondile lwegciwane. Kodwa ngo umkhuba lokhu kungenakwenzeka, ngoba microflora kwezitshalo kanye nokuzwela ukuhlaziywa kuthatha amasonto, kanti isiguli ngamunye kudingeka aphathwe ngokushesha. Ngakho-ke, lo dokotela kumele aqoke empiric yokwelapha esekelwe ziphetho. Kukhethwa imithi elwa namagciwane incike ulwazi udokotela ngalokho Flora owandile umnyango.

Ukuze ube Amagciwane kwaphakama yokumelana nomuthi, kubalulekile ukuba banamathele ukujikeleza izidakamizwa, okungukuthi, ukuzishintsha njalo ezinyangeni ezimbili noma ezintathu. Lokhu kuzosiza ukunciphisa ukumelana kanye nokwenza ngcono imiphumela yokwelapha.