An umzila yokufakelwa yokudlulisela - kuyinto ukudluliselwa lwegciwane ngokusebenzisa kumadivayisi parenteral nezokwelapha zokukhwabanisa zokwelapha kanye kusebenta kwahulumende

Manje imithi uvele ubuchwepheshe hhayi nje njengomuntu kumnandi hhayi igama. Kunengqondo, sinombono wayeyisazi wezokwelapha sethabe nokufa nesineke ngenxa yokungakhokhi ukuthobela imithetho yezempilo esibhedlela isikhathi eside ukhohliwe. Kungani indlela yokufakelwa ukutheleleka esikhatsini setfu ephephile kuragela? Kungani ezibhedlela kanye izibhedlela womama zisekhona "uhambo" staph, i-hepatitis, i-HIV? izibalo Dry uthi imvamisa kuphela ukonakala izifo ezibhedlela kunyuke ngo-20%, kanti inani 22% e-olunzulu neminyango ukunakekelwa eminyakeni yamuva, ekuhlinzeni ku-22%, e Urology kuka 32%, e zabesifazane 12% ezibhedlela ( 33%).

Cacisa, imodi yokufakelwa yokudlulisela - lena okuthiwa ukutheleleka womuntu yokufakelwa izibhedlela ikakhulu ekusetshenzwa koda. Kwenzeka kanjani ukuba abantu ulaliswe esibhedlela ekwelapheni isifo, ngaphezu ukugula kukhona abanye?

ukutheleleka yemvelo

Nge zonke ezihlukahlukene amathuba ukubamba ukutheleleka, ukudluliswa izindlela kwamagciwane kusukela lesiguli enempilo ezimbili nje:

1. Yemvelo sincike nokulandela imithetho ngabanye kanye nemithetho yenhlanzeko.

2. bokuzenzela noma kwezokwelapha imodi yokufakelwa yokudlulisela. Le ndlela yokwenza cishe bathembele ngokuphelele ezintweni kokuhambisana imisebenzi yabo nabezokwelapha.

Nge yemvelo ngendlela isingeniso kwamagciwane kungenzeka by ukuxhumana imvelo pathogenic womuntu. Izindlela ukutheleleka:

-Air uyadedela, okusho sneezing, ukukhwehlela, ukukhuluma (Umkhuhlane, isifo sofuba);

-fekalno-temlomo, ngamanye amazwi, ezingcolile izandla, amanzi nokudla (pheshana emathunjini izifo ezithathelwanayo);

Zikagesi-pin (spectrum ezibanzi kakhulu izifo kuhlanganise Venereal, isikhumba, helminthiasis, imfiva, idiphtheria, akwezinye zabanye).

Kuyamangalisa, ngakho nje ungakwazi ukubamba yisiphi isifo, yavuma impatho esibhedlela.

ukutheleleka yokufakelwa

Ngo nezikhungo zezokwelapha, kunezindlela ezimbili eziyinhloko ukutheleleka iziguli, kwachazwa ngokuthi imodi yokufakelwa yokudlulisela ukuphi. Ziyakwazi:

1.Parenteralny, ukuthi lihlotshaniswa ukuhlukumeza zesikhumba nesembozo lesiguli.

2.Enteralny, lungaba uhlobo oluthile ukuhlola iziguli, kanye nezinqubo ezithile zokwelapha.

Ngaphezu kwalokho, esibhedlela liyakhula futhi okufanayo ukudluliswa zemvelo indlela ngokuphindaphindiwe babhebhethekise isimo iziguli. Ngakho, ungakwazi sithathe ngegciwane ngesikhathi ezinqubweni zokwelapha odokotela nabahlengikazi, kanye nje kokuba esibhedlela.

Izimbangela iziguli ukutheleleka ezindaweni zezempilo

Lapho kukhona khona izimo ezibhedlela iziguli ezinegciwane ngendlela engokwemvelo, futhi kuthinta nendlela lo mshini yokufakelwa yokudlulisela ukutheleleka. Izizathu zimi kanje:

1. izibhedlela njalo eningi nabantu abatheleleke. Ngaphezu kwalokho, cishe 38% labantu, kuhlanganise abasebenzi bezempilo, kuyinto yenethiwekhi kwamagciwane ahlukahlukene, kodwa abantu ukuthi abezwani kukhona abathwali.

inombolo 2.Uvelichenie iziguli (abantu ubudala, izingane) abaye kakhulu kwehlisa ukumelana embundwini umzimba.

3.Obedinenie kakhulu ezikhethekile ezibhedlela izakhiwo ezinkulu, okuyinto uyaqaphela noma ngokungazi kudala imvelo ethize semvelo.

Kwezinye izimo, kukhona isifo yokufakelwa isiguli ngesikhathi izinguquko sigqoka, uma umhlengikazi uyena obapha hhayi enza ngayo umsebenzi wakhe e-buso zokuzivikela futhi amagilavu. Ngakolunye uhlangothi, isiguli kungathelela umsebenzi wezempilo uma afeze manipulations wezokwelapha (igazi izibonelo zalokho, ukuze kunakekelwe amazinyo, njll) ngaphandle buso zokuzivikela, amagilavu, izibuko ezikhethekile.

Imisebenzi kwabasebenzi junior

iziguli Ikakhulu elinegciwane kuncike emsebenzini kwabasebenzi junior. Izibalo elifanayo lithi eRussia wedwa nosocomial ukutheleleka shingellezom wasukuma ukuze 26%, izimuncagazi ezingosomathuba 18%, futhi u-40% salmonellosis!

Yikuphi kulokhu kubangela i umzila yokufakelwa yokudlulisela? Lena ngokuyinhloko ukuntuleka kutfotjelwa nezindinganiso zempilo. Spot amasheke yabonisa ukuthi abahlengikazi ezibhedlela eziningi ekamelweni ihlanzekile, abaphatha, ngisho ezisebenza kahle. Okungukuthi, bonke evele ziphathwa eyodwa indwangu magciwane izixazululo yokuhlanza ekulungiseleleni lokuhlushwa ongaphansi edingekayo ngezindinganiso emahhovisi kanye nezindlu akuyona eyenziwa ukucutshungulwa by izibani asebenza ngebhethri, ngisho ukutholakala kwabo futhi isesimweni esihle.

sad Ikakhulukazi kunjalo ezibhedlela. Orthotopic omama ngegcikwane izithelo, isib, izifo suppurative ukonakala kungenzeka ngenxa yokwephula imithetho ukucutshungulwa antiseptics umzanyana, e zokubelethisa kanye nokugcinwa esizayo. Isizathu kungaba ukuntula buso aphansi ebusweni umhlengikazi noma nabahlengikazi abathwali amagciwane, ingasaphathwa kabi inzalo amathuluzi, amanabukeni nokunye.

imithi elwa namagciwane

Njengoba kuphawulwe ngenhla, ngokuvamile esibhedlela uthola abantu uphethwe akucacile. Isiguli ezinqunyiwe ukuhlolwa laboratory, kanye izindlela zesimanje zokuxilonga, lapho zisebenzisa i-umzila enteral (ngomlomo) ku abafanele ingaphakathi apharathasi umzimba. Nakuba ukulungiselela imiphumela yokuhlolwa, umkhuba isungulwe antibiotic nge spectrum ezibanzi yesenzo. Lena ingxenye encane umkhuba omuhle, kodwa izimbangela ezinkulu zidalwe ngaphakathi nesigqi esibhedlela kwamagciwane, hhayi ukuthatha kubo ngokumelene imithelela (magciwane, kvartsevanie, ukwelashwa). Ngenxa yemvelo esiphelweni izindlela, lezi nesigqi kuthiwa indawo esibhedlela. ukusetshenziswa Ngokungafanele kwamaphilisi laligujwa e 72% eziguli. Ngo-42% amacala kwaba yize. Kulo lonke leli zwe ngenxa engenabulungisa-antibiotic ukwelashwa izinga labantu abangenwa igciwane izibhedlela ifinyelele 13%.

Ukuxilongwa kanye nokwelashwa

Kunengqondo ukuphetha ngokuthi izindlela ezintsha zokuthola izinsuku uphethwe yini kufanele ukusiza ngokushesha futhi ayichaze kahle zonke izinkinga. Zonke iyiqiniso, kodwa lokho akwenzekanga ukutheleleka yokufakelwa iziguli, imishini zokuxilonga kumele iphathwe kahle. Ngokwesibonelo, bronchoscope ngemva esigulini ngasinye ngokuvumelana kwezinkambiso kufanele decontaminated ¾ amahora. Ukuhlola kuye kwabonisa ukuthi lokhu okuncane ihlonishwe lapho, ngoba odokotela Akufanele ahlole iziguli ngesilinganiso esingamaphesenti 5-8, futhi 10-15 ohlwini. Kuyacaca ukuthi isikhathi akwanele ukucubungula imishini ngabo. Kuyefana nasendleleni a gastroscopy, colonoscopy, ipayipi Ukufakwa, ukuthatha wokubhoboza, wezinsimbi luhlolo ephefumula.

Kodwa-ke kunciphisa izinga ukutheleleka umzila enteral yokuphathwa izidakamizwa. Kukhona usongo indlela duodenal kuphela, lapho izidakamizwa iqondiswa nge uphenyo ngqo duodenum. Kodwa setemlomo (imithi ukwamukelwa kanye amaphilisi ngomlomo, kukhanywe noma cha amanzi abo ukuphuza), sublingually (ngaphansi kolimi) kanye buccal (kunenze nisondelane emafilimini ezithaka imithi ethize ukuze mucosal gum nezihlathi) cishe ephephile.

Umzila parenteral yokudlulisela

Le ndlela yokwenza ukudluliswa kuyinto umholi ukusakazeka kwengculaza kanye ne-hepatitis. Kusho indlela peranteralny - ukutheleleka ngegazi, futhi kwephula ubuqotho nolwelwesi lwamafinyila, isikhumba. Endaweni esibhedlela kungenzeka ezimweni ezinjalo:

igazi -perelivanie / plasma;

-zarazhenie nge isipetu ngesikhathi umjovo;

kokungenela -hirurgicheskoe;

Ukufezeka izinqubo zokwelapha.

Ngokuvamile ukutheleleka yokufakelwa kwenzeka imitholampilo zamazinyo nokuhanjelwa wezifo zabesifazane ngenxa yokuthi odokotela zisebenzisa izohlola lwamafinyila iziguli zabo iphathwa kahle ithuluzi, futhi ngenxa umsebenzi odokotela e amagilavu non-oyinyumba.

imijovo

Lolu hlobo lwe-therapy isetshenziswa isikhathi eside. Lapho imijovo kukhona esebenza, bona babhekana ayimpoqo ngaphambi kokufaka isicelo inzalo. Ekusebenteni, ngeshwa baye bahola ekungenweni iziguli izifo eziyingozi, kuhlanganise ingculaza, ngenxa budedengu odokotela. Manje futhi for ekwelapheni (emthanjeni kanye imijovo esicutshini), kanye amasampula egazi asetshenziswa imijovo alahlwayo kuphela, ngakho ingozi ngegciwane yokufakelwa ngokushesha lincane. Abahambisi bosizo oluphuthumayo bathe ziyadingeka ngaphambi inqubo ukuhlola yobunzima iphakheji isipetu futhi ngaphansi kwezimo ungayisebenzisi noma inalidi futhi ngenxa zokukhwabanisa eminye. Isimo siba esihlukile ngamathuluzi kuya endoscope (izinaliti, izinaliti biopsy nezinye), okuyinto ngokuvamile akusingathwa practice. Okuhle kakhulu, basuke nje egxilile isixazululo magciwane.

imisebenzi

Izinga eliphezulu ukutheleleka kwenzeka phakathi nokuhlinzwa. Kuyathakazelisa ukuthi 1941-1945-yalolucwaningo sabhalwa 8% isifo elimele, nasesikhathini sethu, ukusebenza nasezinkingeni ezilandela ngemva kokuhlinzwa izifo ukonakala rose 15%. Lokhu kungenxa yokuthi:

-Sebenzisa phakathi nokuhlinzwa noma ngemva kusaladi kabi inzalo;

inzalo -nedostatochnaya ukusika noma non-cutting;

-wide zisebenzisa izimila ezehlukene (e amathambo, amazinyo, e nezenhliziyo). nezilwanyana ezincane eziningi ziyakwazi ekhona kulezi zakhiwo, futhi amboze ekhethekile ifilimu zokuzivikela ngokwayo, abenze ezingafinyeleleki antibiotic.

Decontamination kufanele kwenziwe ekhethekile Bix, autoclaves noma bamakamelo incike indlela inzalo. It is ezisebenza manje uzama ukusebenzisa alahlwayo oyinyumba embhedeni amashidi, izingubo, odokotela abahlinzayo nababulala iziguli, okumele ukunciphisa ukutheleleka yokufakelwa. Ukuqeda ukutheleleka nge izimila, iziguli ukuchitha postoperatively ethuthukisiwe yokwelapha elwa namagciwane.

ukumpontshelwa igazi

Kukholakala ukuthi ukumpontshelwa igazi kungenziwa wacosha ugcunsula kuphela, iNgculazi kanye ezimbili-hepatitis B igciwane, B no-C Kungenxa lezi Amagciwane isheke ezinikelwe igazi izibonelo zalokho amaphuzu. Kodwa izenzakalo zokuphila zibonisa ukuthi ngisho usebenzisa imijovo alahlwayo kuphela, ukumpontshelwa nge ikhono amagciwane, isifo sokusha kwesibindi kohlobo D, G, TTV, toxoplasmosis, cytomegalovirus, listeria nezinye ukutheleleka. Zonke abaphi ukulethwa igazi, odokotela ziyadingeka ukuze uhlole khona kwalezi izifo. Eqinisweni, ngokuvamile ekuhlaziyeni awunawo isikhathi noma ukunganaki ukumane kuvumelekile. Ngakho-ke, kumelwe ngempela ukuhlola kuthathwe ngokucophelela kusukela egazini abanikelayo. Kodwa lokhu akulona njalo kuze kube namuhla, ngisho imitholampilo ye eMoscow amacala ukutheleleka kweziguli ukumpontshelwa zenzeka. Inkinga yesibili wukuthi kunenqwaba amagciwane soguquko lwegciwane singalawuleka ukuthi ngisho noma ebhekene novivinyo izinhlelo zakamuva ungayazi. Isimo okufanayo ukutheleleka ukufakelwa donor emizimbeni.