Izifo ezinxulumene nokubonelelwa ngoncedo lwezonyango: iintlobo kunye nokuhlelwa

Izifo ezinxulumene nokubonelelwa ngononophelo lwonyango zifumaneka rhoqo kwiinkqubo zonyango. Futhi musa ukugxeka oogqirha, bazama ukwenza konke okusemandleni ukulibazisa ukuvela kwezi ngxaki. Ngelishwa, bambalwa abantu abaphumelelayo ukuwaphepha.

Inkcazo

Yintoni edibeneyo kwingcamango "yokusuleleka kuhambelana nokubonelelwa ngonyango"? Inkcazo yile ndlela ilandelayo: ezi zibonakaliso zendalo ezincinci ezibonwa kwisigulane emva kokonyango esibhedlele, okanye ukutyelela esibhedlele unyango, okanye emva kwenyanga emva kokukhulelwa esibhedlele.

Elinye igama leli qela lezifo sisifo sosocomial, okanye iVBI. Kukholelwa ukuba usulelo luvele kwisigulane esele sisesibhedlele, ukuba iimpawu zokuqala zesifo azibonakali ngaphaya kweentsuku ezimbini emva komhla wokungeniswa. Isimo esinyanzelekileyo kukuba ukungabikho kokubonakaliswa kwesi sifo kwisigulane ngaphambi kokufakwa kwiziko lempilo.

Izifo ezithintela izibhedlele kufuneka zihluke kwi-iatrogenic kunye nabanomdla, kuba zifana ngokwaneleyo ukuba zidideke. Iatrogenic yintsholongwane ebonakala ngephoso labasebenzi bezonyango ngexesha lotyando okanye ukuxilongwa. Noko ke, amathuba okubonakala, kubonakala kubantu, kunokuba ukhuseleko alinakukwazi ukufumana izifo ezinokuthintela.

Ukukhula

I-epidemiology yezifo ezichaphazelekayo ezinxulumene nokubonelelwa ngononophelo lwezokwelapha, ukugweba uqikelelo lweZiko loLawulo lweZifo (CDC), ludanisa. EUnited States, kwisigidi esigidi nesigidi abantu ngonyaka, ngaphezu kwesigamu safa. EYurophu, eli nani linamawaka angamashumi amabini anesihlanu, eRashiya - amawaka angamashumi amathathu. Kodwa a manani aphantsi awakhulumi ngomgangatho wokhathalelo lwezonyango, kodwa ngokubhekiselele kumgangatho ophantsi lophando lophando.

Ukutheleleka kwe-nosocomial, kukho imigaqo yokusabalalisa eyahlukileyo eyahlula kwezinye izifo zolu hlobo. Ezi zintlukwano yindlela kunye neendlela zokuhambisa, uhlobo oluthile lwesifo, isabelo sabasebenzi basebhedlele ekugcineni nasekunyuseni inani lamatyala. Kwakhona, ezi zifo zilukhuni ukunyanga, kuba ii-microorganism ezihlala kwiziko lempilo zichasene nemiphumo yeziyobisi.

Etiology

Iimbosa ezithintela izifo ezinxulumene nokubonelelwa ngononophelo lwezokwelapha zisasazeka kwihlabathi lonke. Kuza kubekho, ama-agent angamakhulu amabini ama-microbial aziwayo angenza iVBI. Ngaphambi kwexesha le-antibiotics, lawa azintambo ze-anaerobic, i-streptococci kunye ne-staphylococci. Ngoku kuye kwaqulunqwa ukuba imbangela yesifo i-rotavirus, i-cytomegalovirus, i-virus ye-hepatitis kunye ne-HIV.

Ukuba ixesha elide kwintsimi yeziko lezonyango, i-microorganism iqhutyelwa ukhetho lwendalo kunye nokuguqulwa komzimba, ngenxa yoko kukho iimeko ezizinzileyo, ezingabonakaliyo nge-disinfectants, i-quartz kunye ne-antibiotics. Kwizibhedlele ngasinye, isebe kunye nekamelo lokusebenza apho lihlala "ibhaktheriya" ekhethekileyo.

Imithombo kunye nendlela yokuhambisa isifo

Umxholo othi "usulelo oluhambelana nokubonelelwa ngononophelo lwempilo" lubonisa ukuba khona kweemilingo ezintathu ze-epidemiological process:

- umthombo;

- indlela yokuhambisa;

- umntu owamkelekileyo.

Imithombo ye-VBI ingathengiswa kwizigulane ezibhedlele ixesha elide kwaye zihlambulukile kunye ne-microflora yayo, kunye nabasebenzi bezonyango, ngokuqhagamshelana ne-bhakteriya efanayo. Ababhenkethi kwizibhedlele zeentsuku nezihlobo badlala indima yesibini ekusasazeni kwezifo zesibhedlele.

Indlela yokudluliselwa kwayo ingaba nayiphi na enye: i-fecal-oral, u-air-drip, umnxibelelwano okanye ogqithisekayo. Izinto zokudluliselwa kwezixhobo zixhobo, izixhobo zokuphefumula kunye nokujikeleza, iibhedi kunye neengubo zangaphantsi, imibhede, amabhanti kunye ne- sutures, iifreths, i-drain kunye nezinto ezimanzi. Ezi ziquka iipompo kunye neenkomfa, i-plums, izisombululo zokungena kwamanzi, i-water purified, izisombululo ze-antiseptic, amanzi kwiifestile zeentyantyambo, ukuxhaswa kwindlela yokucoca kwomoya kunye njalo.

Amaqela engozi

Izifo ezinxulumene nokubonelelwa ngoncedo lwezonyango kwizigulane zifumaneka rhoqo kubantu abane-immunity. Kakade ke, zonke izigulane ziye zanciphisa ngandlela-thile imisebenzi ekhuselekileyo yomzimba, kodwa kukho abantu abanomdla kakhulu. Ezi ziquka:

Abantu abadala;

Iintsana zokuqala kunye nosana;

- Izigulane ezine-oncological, autoimmune, izifo eziphazamisayo;

- izigulane eziye zenzeke ixesha elide;

- abantu abahlala kwintsimi engabonakaliyo.

Umlinganiselo obhaliweyo unamathuba amaninzi okugula ngexesha likliniki yezokwelapha, ngoko kufuna ukunakekelwa okongeziweyo kubasebenzi bezonyango.

Ukwahlula

Ziziphi iintlobo zezifo ezichaphazelekayo kunye nokubonelelwa ngonyango? Konke kuxhomekeke kubuhlobo boluhlu lwabo. Ngokomzekelo, ukuba sithatha iindlela zokuhambisa, siyahlula: i-aerosol, i-feedary, umnxeba-nendlu, insimbi, isithuba sokutshintshwa, ukusuleleka emva kweenjini, ukumpontshelwa igazi, ukuhlinzwa, iinkqubo zokugcina, nabanye. I-Adrift, njengezinye izifo, i-VBI ingaba nzima, i-subacute kwaye ingapheliyo, kunye neyomeleleyo, ifomati kunye neendlela ezilula.

Kukho ukwahluka kobungakanani besifo obunxulumene nokubonelelwa ngonyango. Ukwahlula luqala ngeemeko ezinzima:

- Ifom ejwayelekile: i-baceremia, i-septicemia, i-septicopyemia, ukunyanyiswa kwebhakteria.

- Ifom yeefowuni.

- Izifo zesikhumba kunye namafutha angaphantsi.

- Izifo zokuphefumula.

Iifom zamazinyo.

- Izifo zesistim sokutya.

- Izifo zesistim kunye nesistim.

- Izifo ze-musculoskelet system.

- Izifo zesimiso senzwa.

- Izifo zesifo senhliziyo.

Iimbangela zeemeko eziphezulu

Ukuthintela ukuthintela izifo ezinxulumene nokubonelelwa ngononophelo lwonyango lujoliswe ekunciphiseni izinga lokufikelela kweentengo. Kodwa ngelishwa, namhlanje onke amanyathelo okuqapha ayisebenzi. Isizathu esibalulekileyo sale nto kubonakala kwiintlanzi ezininzi.

Okokuqala, oku kwenzeka ngenxa yokuba iibhaktheriya zitshintsha, zitshintsha iipropati zazo ngenxa yokusetyenziswa kakubi kwee-antibiotics kunye ne-disinfectants. Le yimiqathango efanelekileyo yokudalwa kwe-microflora kunye nesibini yokusilela.

Ukuxhatshazwa kweprayimari ubuchule bendalo bohlobo olunikeziweyo lwezilwanyana ezincinci ukuxhathisa ama-aggress agents. Umkhwa woogqirha kunoma yisiphi isiganeko sokumisela i-antibiotics ikhokelela ekubeni ukuphuculwa kwonyango kuncitshiswe, kwaye ibhaktheriya iya kugonywa kwiziyobisi. Kodwa kungekhona nje kuphela abasebenzi bezonyango abazityhola le nto. ERashiya, abantu baqhele ukuzithethelela izidakamizwa, kodwa abahambelani nemiyalelo yokusetyenziswa.

Imigaqo yeFleming

Kukho imigaqo emithathu yeFleming, ekhuthazwa yintlangano yempilo yamazwe ngamazwe.

Umgaqo wokuqala ukunyusa ama-antimicrobials, kuphela xa i-agent ekhuselekileyo yentsholongwane iyabakhathalela. Oku kuya kunciphisa ukusetyenziswa kwamachiza okubulala, ukwenza ukuba oogqirha bahlale beqhuba izifundo zobuzwe beeflethi kumachiza, baya kuzisa izidakamizwa zangaphambili kunye nomncinci, othe wathintela.

Umgaqo wesibini uFleming uthi ufanele uqinisekise ukuxininiswa okusebenzayo kweziyobisi kwisilonda. Lo mgaqo uya kunciphisa inani le-antibiotics ezisetyenziswa kwendawo kunye namachiza anikezelweyo ngenjongo yokukhusela. Ukongeza, kuya kwenza ukuba ukhansele amayeza ngokukhawuleza, kunokuba uhambe ngokuthe ngcembe, kwaye utshintshe umthamo kunye neziyobisi, ngokusekelwe kwisifundo sezilwanyana zezilwanyana zamanzi kwiintsuku ezisixhenxe.

Umgaqo wesithathu kukumisela i-antibiotiki kwimizi enjalo kwaye uwazise ngendlela enjalo yokunciphisa imiphumo emibi. Oku kuya kuvumela ukusetyenziswa okunengqiqo kwamayeza.

Ukuqulunqwa kwezithuthi

Izifo ezinxulumene nokubonelelwa ngononophelo lwangonyango azikwazi ukuba khona ngaphandle kwebhetri yezinto eziphathekayo, oko kuthiwa "isigulane sentsholongwane", esiya kuba ngumthombo ongaqhelekanga wokusuleleka kwabanye abantu.

I-bacteriosis yindlela yokusuleleka xa kwenzeka ukuba ulingano lubekwe phakathi komphathi kunye ne-parasite ngokusesikweni kokungabikho kwemiboniso yeklinikhi. Impendulo ye-immunological iyaqhubeka. Ukuba i-microorganism idlulile kwifom efihlakeleyo ukuya kwizigulane ezihlanu, ngoko iguqula iipropati zayo kwaye ibuhlungu.

Amanyathelo okukhusela kweli li lilandelayo:

Ukuhlolwa rhoqo kwezonyango zabasebenzi bezonyango;

- uphando lwebhakteriological zabasebenzi bezibhedlele;

Ukufumana ngexesha kunye nokunyangwa koogqirha abanegciwane;

Ukubeka iliso kwimihla ngemihla yezempilo oogqirha.

Ingozi yokuxilonga kunye neenkqubo zonyango

Izifo ezinxulumene nokubonelelwa ngoncedo lwezonyango (ISMP) azibonakali kuphela emva kokuba isigulane sele sichithe ixesha elithile kunyango lwabanyango, kodwa nangemva kwechungechunge lweendlela zokuxilonga nezonyango ezibangela ukungcola kwezibhedlele zesibhedlele. Ezi ziquka ukumpontshelwa igazi, iilenki, ukuguqulwa kwamathambo kunye nenyama. Phakathi kwamanyathelo okuphinda ahlaziywe yi-intubation, inhalation anesthesia, izixhobo zenkxaso yokuphila, i-statheters staging. Kwakhona, usulelo luyakwenzeka emva kwenkqubo ye-hemodialysis, inhalation kunye neenkqubo ze-balneological.

Ukwahlulelwa ngu-Spaulding

Izifo ezinxulumene nokubonelelwa ngononophelo lwezonyango zingadluliselwa kwiixhobo zonyango. Ngako oko, i-Spalding yahlula ibe ngamaqela amathathu, ithatha ingozi yokusuleleka kwi-flora yesibhedlele njengesibonakaliso.

Iqela lokuqala libalulekileyo. Ezi ziquka izixhobo zokupasa, i-catheters, implants, inaliti kunye ne-liquids injectable.

Iqela lesibini lihle kakhulu: i-endoscopic ne-inhalation izixhobo, izixhobo ze-aneshesia, i-thermometers ye-rectal.

Iqela lesithathu, ngokulandelanayo, alilona lukhulu. Zizo zonke ezinye izinto: iinqanawa, iitonometers, iintonga, izitya, ilinen, i-thermometers ye-axillary.

Thintelo

Ukuthintela ukuthintela izifo ezinxulumene nokubonelelwa ngononophelo lwezonyango kusekelwe kwiingcebiso ze-World Health Organization ukukhusela i-HBI. Ukuthintela okufanelekileyo kufuneka kufake izigaba ezintathu:

- ukunciphisa ukubonakala kwentsholongwane ngaphandle kwesibhedlele;

- ukupheliswa kokusasazeka kwentsholongwane, ngokuthintela uxhulumaniso lwenkqubo yesibhedlele;

- Ukukhutshwa kobungozi ngaphandle kwesibhedlele.

Kule njongo, kukho ukuhlukaniswa kwezigulane ezinezifo ezichaphazelayo ezikhuselekileyo kwiibhokisi ezikhethekileyo kunye nokungena kunye nokuphuma, okungaxhunywanga kunye nalo lonke isebe. Ukongezelela, kwisebe ngalinye lonyango olusetyenziswayo kunye noluntu jikelele lwezixhobo kunye neendawo ezenziwayo. Ubume beli nyathelo lixhomekeke kwisidingo: kumasebe athile-ngokungaphantsi kancinane, kumasebe agqirha, ngokuphindaphindiweyo.

Unyango

Izifo ezinxulumene nokubonelelwa ngononophelo lwezonyango, nangona kunzima, kodwa kusekho unyango lonyango. Ngokufanelekileyo, ugqirha ugunyazisa isicatshulwa esithile se-antimicrobial esicacile sezenzo, esenzelwe uhlobo oluthile lwe-pathogen. Kodwa kwimisebenzi eyenzekayo le nto akunakwenzeka, kuba ukuhlwayela i-microflora nokuhlalutya uvakalelo kuthatha iveki, kwaye isigulane kufuneka iphathwe ngoku. Ngako oko, ugqirha unyanzelekile ukuba anikeze unyango lwezonyango, ngokusekelwe kwizigqibo zakhe. Ukukhethwa kweziyobisi ezichasene nezixhomekeke kulwazi logqirha malunga neyiphi i-microflora ekhoyo kwisebe.

Ukuze i-infathogens ingabikho ukuchasene neziyobisi, kuyimfuneko ukuhambelana nokujikeleza kwamalungiselelo, oko kukuthi, utshintshe zonke ezimbini ukuya kwiinyanga ezintathu. Oku kuya kunceda ukunciphisa ukunyanzelwa nokuphucula iziphumo zonyango.