Cryptogenic sepsis: Zviratidzo uye kurapwa

Sezvo chikazozikamwa, anogumbura zvirwere zvinogona kukanganisa chero nhengo. Vari rakakamurwa mhando mbiri: chakasimba uye chisingaperi kwendangariro. Panguva Chaiyo chirwere uye vabatwe anogumbura pathologies kazhinji kunotungamirira kune mushonga wakakwana kana kanganwiro. Kana rokuzvidzivirira simba, chirwere mberi. Pasinei nzvimbo, nzvimbo kuzvimba anogara delimited. Kukanganiswa nezvinhu acho kana kupararira anogona kuitika pasina kurapwa. Somugumisiro, kwemabhakitiriya inoramba kupinda muropa. Ichi chirwere inonzi sepsis. kuomesa kwakadaro zvikuru ngozi nokuti zvinogona kuita kuti kuvhunduka uye rufu.

Cryptogenic sepsis - chii?

Zvichienderana nzvimbo inokosha yokuwana kuzvimba marudzi vanoverengeka sepsis. Zvinokosha kuyeuka kuti kuna ingress kuti utachiona muropa kungaita chero chirwere. Kazhinji nemabayo, anogumbura dzinotsanagura ganda, muromo, otolaryngology. Mune zvimwe zviitiko, chinangwa haisi. Ipapo mamiriro anonzi "cryptogenic sepsis." chirwere ichi hazvirevi kuti chikuru anogumbura yakanangana asipo. Kunyange zvakadaro, panguva yokurohwa kwemabhakitiriya akatokundwa kupinda muropa uye dzakapararira muviri. Saka hazvibviri kuti asimbise chikonzero sepsis. Izvi Chirwere ishoma vamwe. Cryptogenic sepsis - ropa chepfu bacteria hakuna hwakagadzwa chikuru anogumbura kukoshesa. Kazhinji zvokurwara kunoitika muna vakurumidze vacheche, vanhu vane simba zvirwere. Kazhinji, chirwere kwakaoma. Kana nenguva kupa mushonga anogona kurapa.

The zvinokonzera cryptogenic sepsis

Kana kuisa chikuru anogumbura pfungwa kwakaoma, uye utachiona nechekare rakapinda mumba ropa, iro pachena zvokuongorora kuti "cryptogenic sepsis." The zvinokonzera chirwere ichi chingava zvakasiyana. Anowanzoitwa etiology rakasiyana nemamwe marudzi sepsis. Musiyano ndechokuti kuzvimba chero nhengo hwapedyo zvakare nokukurumidza kana kutapata mune murwere yekudyidzana ipfupi. Panguva ino kubva pakatanga chirwere pamberi chirwere (budiriro kamuri) ipfupi. Panyaya iyi, murwere haana nguva kunzwisisa chii zviratidzo yakatanga naye pakutanga. Varwere vakawanda, chikuru nzvimbo zvinogona kuwana mushure ongororo. Kana achiri asina kuwanikwa, kuti zvokurwara iri semhosva cryptogenic sepsis. Zvinokonzera chirwere:

1. Noutachiona. Causative vaishandira sepsis anogona kuva chero tusingaoneki. Kakawanda izvozvo staphylococci uye streptococci, Proteus, Pseudomonas aeruginosa uye Escherichia coli coli.
2. Conditionally pathogenic microflora. Sezvo chikazozikamwa, mumuviri pane zvakawanda mabhakitiriya kuti varipo vari kwose kwose. Akaroromesawo masoja kudzivirira mikana microflora anotanga ichiwedzera, zvinoita kuti zvirwere zvakasiyana-siyana. Somugumisiro, anogona kuva cryptogenic sepsis.
3. Zvirwere zvinokonzerwa pathogenic notumwe (Candida).
4. Primary uye yechipiri immunodeficiency (HIV).
5. Nguva Prematurity, vacheche pamwe yakaderera nokuberekwa uremu (pasi 2 kg).
6. Intrauterine chirwere.

The mashandiro pamusoro sepsis

Cryptogenic sepsis - chii? chirwere yakadaro pasina chirwere chikuru chinogona kuita kuti ropa chepfu. Cryptogenic sepsis anonziwo chikuru, kana idiopathic. It kunoitika kuburikidza ingestion kuti utachiona kupinda muropa. Somugumisiro, utachiona rakapararira muviri. Somugumisiro, anogumbura maronda vanogona riri munzvimbo dzakawanda. Uyewo, kukura kwemabhakitiriya kudhaka. Muzviitiko zvakadaro, dziviriro yezvirwere mumuviri haakwanisi kutsungirira vakawanda utachiona. Kazhinji ichi chirwere kunotungamirira kune kutyorwa kumwoyo. Somugumisiro dzichiri kwemabhakitiriya kuvhunduka. kuomesa Izvi ngozi zvikuru uye kakawanda zvinouraya.

Kupatsanura cryptogenic sepsis

Kwakapiwa kuti mukuru nzvimbo yacho pathological pfungwa hazvizivikanwi, cryptogenic sepsis haina Classified maererano etiological hwaro. Kunyange zvakadaro, zvinokosha kuti kusimbisa kutapuriranwa mumiririri pokugara asingaurayiwi kurapa. Kufanana nevamwe mhando sepsis, ichi musimboti zvokurwara kunogona kuitika nenzira mbiri. Zvisinei, kupatsanura ichi hazvirevi kukanganisa fungidziro chirwere. Cryptogenic chimiro ropa chepfu:

1. Septicemia. Rinoreva kuvapo kwemabhakitiriya kana fungal microflora, achiparadzira nomuviri. Asi utachiona hatuzoumbiki foci chirwere.
2. Pyosepticemia. Kuwedzera pamberi utachiona muropa riri akaona Colonisation zvomukati. utachiona Vazhinji chirwere vari vaunganidza (yakaiswa) mumapapu, uropi, abdominal mhango. Somugumisiro, nzvimbo idzi zviri vakaumba foci kuti purulent kuzvimba.

The kunotoda kosi kusiyanisa fulminant, chenjera uye chisingaperi sepsis. Muchiitiko chokutanga, hosha ikabuda pamazuva okutanga pashure nayo utachiona kupinda uye kunoratidzwa kwazvo dysfunction zvomukati uye hurongwa. Chenjera sepsis rinovapo mavhiki anenge 2-4. Chirwere vachiona irambe kwemwedzi inoverengeka kana kunyange kwemakore. It kunoratidzwa pokumuka exacerbations uye remissions. Mune zvimwe zviitiko, pane nzira nzira subacute kuti sepsis. Its nguva anobva 6 kusvika 12 mavhiki.

Zviratidzo cryptogenic sepsis

Just tarisa ropa nokuda kusabereka, zvinokwanisika kutonga kana munhu cryptogenic sepsis. Zviratidzo chirwere ichi chinogona kufanana nezvimwe zvirwere zvakawanda. Izvi imhaka yokuti zvose anogumbura pezvakaitwa yakatanga kudhaka. Zvisinei, chiremba wako anogona chifungidziro chirwere pachishandiswa noruzhinji kunotoda mufananidzo. Pakutanga, zvakadai chirwere chinorehwa chete achisiya mamwe anogumbura zvirwere. Kusiyanisa zvinotevera zviratidzo sepsis:

1. Inosimudzira muviri tembiricha kuti 39-40 inegumi. Hyperthermia iri achiperekedzwa chills, vangadikitira uye kutemwa.
2. Kudzikira. Kana sepsis kunoitika muutera, marwadzo mune tsandanyama uye mapfundo pasina imwe localization, ungaderedza kudya.
3. Tachycardia - kwakawedzera kwemwoyo.
4. BP.
5. Inosimudzira zvazvingava kufema.
6. Zvemamiriro chiropa mabasa. Kugadzirwa jaundice rinowanika, kuwedzera kukura mumuviri (hepatomegaly).
7. Gastrointestinal maronda. Mune vamwe varwere, pane chigaro agumbuka (manyoka), kuda kurutsa uye kurutsa.
8. Chimiro hemorrhages paganda.

uye nezvimwe zvingaratidza kuitika panguva kukura septicopyemia. Ivo kuvimba localization kuti anogumbura maronda. Kazhinji kuva endocarditis, mabayo.

Chirwere dzekuziva nadzo cryptogenic sepsis

For chirwere dzekuziva kuti sepsis zvinosanganisira kurapwa zvinoratidza chirwere uye kuchinja vakachengeta panguva Murabhoritari kana richishanda nzira. Chekutanga kuteerera mukuru ezvinhu omurwere. At kwayo kuwedzera kwemazuva mashomanana, pasinei veMubatanidzwa asingaurayiwi mushonga, zvinogona vakafungira cryptogenic sepsis. Zviratidzo kuti inoratidza chirwere, - ndewevhu (grey) Ruvara ganda, yakanyanya simba, kurwara uye chitarisiko ganda hemorrhages. Panewo yokutura kuratidzwa kurapwa kungasanganisira kungonzwa kuti jaundice uye hepatomegaly. In pamberi zvezviratidzo izvi hwobva hospitalize murwere uye kuitisa ongororo.

Laboratory uye richishanda Diagnostics

Cryptogenic sepsis kana paine zvinokosha kuchinja murabhoritari parameters. The KLA akacherekedza leukocytosis, thrombocytopenia, uye kupererwa neropa, uyewo kumhanyisa of ESR. Mabhakitiriya anogona kuvapo kwete ropa asiwo weti. Kuchinja akaona nokukanganisika indices. Izvi zvinosanganisira chimiro C-reactive mapuroteni, kungawedzera kwevari bilirubin, alt, AST (pamwe chiropa chirwere). The chikuru zvechinguvana pamusoro sepsis chinhu bvunzo ropa kusabereka (ropa tsika pamusoro microflora). Nokudzidza ichi tinogona kuona causative mutumwa chirwere uye kubatwa.

Diagnostics rinoitwa kuziva septic maronda. Nokuti akaita bhokisi X-ray, Ultrasound pakati mudumbu uye chiuno. Kazhinji kuwanikwa kuzvimba mumapapu - nemabayo, akawedzera chiropa - hepatomegaly.

Cryptogenic sepsis: bumbiro maererano ICD-10

Kungofanana zvokurwara, hosha ane chairo remitemo iri International kupatsanura. Ari kuisa zvichienderana nayo utachiona kuti akakonzera cryptogenic sepsis. ICD-10 - chaiyo kupatsanura, iro rinongoshanda pasi rose. Nhoroondo dzokurapa iri kutanga kunyorwa, nokuzvidzora chirwere, uye ipapo bumbiro remitemo. Kana cryptogenic sepsis Cipher kuda A41.9 (septicemia unadjusted). Kuona Bumbiro ICD-10 chiremba chero yezvokurapa sangano munyika imwe nyika kunzwisisa chii nechirwere chaizofumurwa kumurwere.

Possible matambudziko anoitika sepsis

Panguva isiri nzira kurapa sepsis kuva chakakomba matambudziko. Pakati pavo - ezvinhu nehana, pulmonary embolism, kwemabhakitiriya endocarditis, sitiroko, kuneta uye ropa. Mumwe nomumwe izvi zvinhu zvinogona kukonzera rufu murwere. Naizvozvo, mukuronga chirwere ichi chinhu kudiwa kwokukurumidzira kutanga asingaurayiwi uye symptomatic kurapa.

Cryptogenic sepsis kurapwa

The kuonekwa chirwere wokutanga anofanira muchipatara uye worongera mubhedha anoshivirira zororo. Uyewo, nezviyero izvi zvinokosha vanenge vanofungidzirwa cryptogenic sepsis. Treatment ndiye anosarudza pakarepo pashure kuongorora chirwere. The chikuru boka mishonga - ndivo inorwisa mabhakitiriya. Ipa wemishonga 2-3 zvinodhaka. Zvinowanzoshandiswa "Penicillin" zvinodhaka "ceftriaxone", "Gentamycin", "Imipenem" uye t. D. Sezvo chipo kudhaka basa aizomupa mishonga. Nomutsinga achiita crystalloid uye colloid mapedzero kubudikidza zvinoratidza vakatakura ropa. Also kuratidzwa immunostimulant, antipyretic uye marwadzo nevamiririri. Panoongororwa nzvimbo chirwere kuvhiya kupindira kunokosha. With kukura septic kuvhunduka raitongwa vasopressors ( "Dopamine" gadziriro). Meals varwere vaiita parenterally kana kubudikidza vachiongorora.

The fungidziro pamusoro cryptogenic sepsis

The fungidziro pamusoro sepsis cryptogenic kunobva mukuru mamiriro muviri murwere (rokuzvidzivirira), zera, nenguva kurapwa. With zvakakwana kurapwa uye hapana matambudziko vakachengeta kunaya zvizere. Chinonyanya yakanaka fungidziro ndiyo subacute uye chisingaperi sepsis. Kana fulminant chirwere kazhinji zvinouraya. Pasinei inorwisa mabhakitiriya kurapa, mwero wokufa kwevanhu chirwere ichi anenge 50% nyaya.

Prevention cryptogenic sepsis

Sepsis kazhinji ikabuda vanhu vachitambura nekuora anogumbura zvirwere. Naizvozvo, matanho zvinosanganisira nokukurumidza kurapwa chirwere foci, kugamuchira immunostimulatory mishonga uye mavhitaminzi. Kudzivirira zvirwere vacheche nevana vadiki, amai vanotarisira vanofanira kubvisa tsika dzakaipa, negashiro mishonga kugarotamba chando.