Nā mea palahēhē hou pili i ka mālama ': ano a me ka Mea Maluna

Nā mea palahēhē pili me ka mālama ', mau pilikia ma lapaʻau hana. A mai'āhewa na kumu, ka mea, e ho'āʻo ana e hana na mea a pau i hiki e holo koke i ka hoouka kaua ana o kēia mau complications. Eia naʻe, loaʻa loa mau kanaka la e hiki ai.

ka wehewehena

I hoʻokomo kālā i loko o ka manaʻo o "pili me ka mālama ', maʻiʻaʻai"? Definition heluhelu penei: i kekahi hoailona o ka maʻi microbial ano, i ka nānāʻana aku i loko o nā mea maʻi ma hope iapaau ana i loko o ka haukapila a haukapila kipa no ka lapaʻau, ai loko o ka mahina ma hope o hookuuia mai ka haukapila.

Kekahi inoa no keia pae ana o lakou i na mai - nosocomial nā mea palahēhē, a nosocomial nā mea palahēhē. Ua Ua manaoio aku i ka maʻiʻaʻai i hele mai, mai ke hoomanawanui i loko o ka haukapila, i ka wa a ka mea mua symptomsʻikeʻia i mua o nā lā mai o ka loaa ana mai. OAXA ano - ka nele o ka hoʻomanawanui hoike ana mai o keia maʻiʻaʻai ma mua o ia i hoʻokomo i loko o ka 'inikua kula.

Haukapila maʻiʻaʻai pono e ike okoa mai iatrogenic a me ka opportunistic, no ka mea, e like lawa ia e pioloke. Noonoo iatrogenic maʻiʻaʻai, i ikea no i ka hewa o ka 'inikua nā limahana i loko o ka papa o ke kanaka a me kaʻike,. Opportunistic no hoi i ke kanaka ma mua o ka'ōnaehana paleʻea'ōnaehana mea,ʻaʻole hiki ke paʻa hoʻi i loko o ponopono opportunistic koʻohune.

prevalence

Epidemiology o nā mea palahēhē pili i ka hoʻolako 'ana i mālama', i poe lunakanawai no na koho Center no ka maʻi Na Makuahine (CDC) Ua loaa ole ia. Ma ka United States o kekahi, a me ka hapalua miliona hihia no ka makahiki, oi ma mua o ka hapalua o make. Ma Europa, i ka huahelu mea he iwakāluakumamālima tausani kānaka, Rusia - he kanakolu tausani. Akā, ua haʻahaʻa na kii mai i olelo e pili ana i ka pono o ka malama, a me ka poe ilihune ka pono o ke ana helu noiʻi.

No ka nosocomial nā mea palahēhē i kona hua iho o ka propagation, i maopopo ia lakou, mai maʻi 'ē aʻe o keia ano keia ano. Mau oko ao nō i keʻano papa hana, a kumumea o EYI, ka specificity o ka maʻiʻaʻai, i ke kūlana o ka haukapila limahana i loko o ka malama ana a me ka ulu i ka helu o ka hihia. Nō hoʻi, i kēia mau nā mea palahēhē i noho pilikia e hana, no ka mea microorganisms e noho i loko o ke ola hale, e hoʻopale i ka ai '.

etiology

Pathogens pili me ka ola mālama nō, he pono ole ma o ka poepoe honua. I ka lā, loaʻa nōʻelua haneri oi ma mua o microbial konohiki mea i hiki ke i nosocomial nā mea palahēhē. Ma mua o ke au o antibiotics ka mea, ua anaerobic bacillus, streptococci a me ka staphylococci. Ua ua manawa hookupaa i ke kumu o ka maʻiʻaʻai hiki e rotavirus, cytomegalovirus, hepatitis nā mea hoʻomaʻi, a hiki HIV.

I kekahi manawa lōʻihi ma luna o ka mokuna o ka haukapila, ka microorganism ua malalo i maoli koho a me mutations, like me ka hopena o a ma laila e hoʻopale ke kanana nei, i Transcend disinfectants, a me antibiotics kvartsevanie. Ma kēlā me kēia kanaka haukapila, oihana, a hiki i ka pae'ōnaehana ola lākou "hanana" koʻohune.

Sources a me maomeka o EYI

Ka manawa "maʻiʻaʻai pili me ka ola mālama" 'o ia hoʻi ka mua o ka ekolu'ō koholā epidemiological kaʻina:

- kahi;

- EYI hana;

- susceptible kanaka.

HAI kumu e kuai e hoomanawanui i ka poe ma ka haukapila no ka lōʻihi manawa, a ua hoʻohaumiaʻia kona microflora, e like me ola mālama poe hana, i kela la hui 'ana me ka ia koʻohune. Malihini i ka lā malama a me ka ohana hula i loko o ka laha ana o nosocomial nā mea palahēhē haumāna a Mānoa.

Ke EYIʻano papa hana paha eʻaneʻane kekahi: fecal-ku una, airborne, kui a transmissive. Aoaao kumumea i na hana, maalea no ka hanu a me ka holo, kīhei pili a me ka huihui, wahi moe, ua kahikoia a nani a me ka suture mea, ʻimi hoʻopunipuni mau lala, nōkahea a me ka pulu mea. Mau nā faucets a me e poholo, e poholo, infusion pāʻoihana, maloko wai, antiseptic pāʻoihana, i ka wai i loko o vases no ka pua, condensate i loko o ka lewa, i ka hoʻomaʻemaʻe'ōnaehana, a no laila, ma luna o.

kamepiula pūʻulu

Nā mea palahēhē pili me ka mālama ', e hoomanawanui i pinepine ana i loko o kanaka me hoʻonāwaliwaliʻia'ōnaehana paleʻea nenoai. O ka papa, i ka hoʻomanawanuiʻana a pau i ka loli iki ana degere, hoemiia ka aiiay oihana o ke kino, akā, he mau kanaka e noho loa susceptible. Mau nā:

-ʻelemākule e kanaka;

- premature na kamalii uuku a me nā pēpē i;

- nā mea maʻi me ka maʻi 'aʻai, autoimmune, allergic maʻi;

- e hoomanawanui i ka poe i undergone loa-ʻia ana;

- na kanaka e noho ana ma ka environmentally unfriendly ?? eoi?.

I makemake ai contingent mea loa paha ia e maʻi ana i loko o ka haukapila, no laila, no ia e pono ai a piʻi aʻela ka mālama mai i ka 'inikua koʻokoʻo.

Mea Maluna

He aha nō i nāʻano o nā mea palahēhē pili me ka ola mālama? Ua pau hilinaʻi nui ma luna, ma ka 'aelike, e classify ia. No kekahi laʻana, ina e lawe i ke alanui, alaila, hookuu aku: aerosol,'aiaola, kūkā me-ko ka hale ona, na mea paahana, posttranstplantatsionnye, maʻiʻaʻai ma hope o injections, koko transfusions, ana, a me nā kaʻina hana endoscopic. Me ka pele, e like me nā maʻi, nosocomial nā mea palahēhē i huʻi, subacute a me ka maʻi, e like me ke koʻikoʻi, lōpū a me ka mehana 'ano apau loa.

Kekahi hoʻokaʻawale ua i waena o kekahi mau degere o ka prevalence, a hiki e nā mea palahēhē pili me ka mālama '. Mea Maluna hoʻomaka me ka loa hihia:

- Generalized palapala: bacteremia, septicemia, pyosepticemia, mea koʻohune kŰia.

- IIeEeAIEUIeXAIIUE palapala.

- nā mea palahēhē o ka ili a me ka subcutaneous momona.

- Lower naehana nā mea palahēhē.

- kahua niho palapala.

- nā mea palahēhē o ka digestive nenoaiu.

- maʻiʻaʻai o ka reproductive a me ka urinary nenoai.

- nā mea palahēhē musculoskeletal kahua.

- nā mea palahēhē o ka'emi ko kahua.

- nā mea palahēhē o ka mea'ōnaehana mānowai koko nenoaiu.

Ke kumu no ka mea hiki wale mai kiʻekiʻe o

Kāohiʻana o nā mea palahēhē pili me ka mālama ', nona ma hoemi i ka nohona ma morbidity. Akā naʻe, i ka lā, a pau nā mea hoʻomakaʻala i ineffective. Ke kumu nui no keia - i loko o ka muli o ka nunui-hoʻopale flora.

Kuhikuhi, keia mea no ka mea, o ka koʻohune mutate, huli hou ae la ko lakou mau waiwai, no ka mea o irrational pono o antibiotics a me disinfectants. Mau mea maikaʻi rula no ka mea i hanaia microflora haumāna multiresistant.

Helu ia'ku - ia mea he kumu hiki o kēia 'ano o ka koʻohune, e pale akuʻano pākīkē konohiki. I ka maʻa a kauka no kekahi kumu e hoakaka ia antibiotics hiki aku ai i ka mea i ua hoemiia ka laulā o ka lapaau, a me na koʻohune e lilo hoʻopale i ka ai '. Akā,ʻaʻole wale nō ka 'inikua koʻokoʻo mea e'Āhewa. Ma Rusia, kanaka e hoʻohana i kū kaʻawale koho i kekahi antibacterials, akā, mai hoopili aku i na olelo ao no ka hana.

me nā loina Fleming

Aia i ekolu rula Fleming e waiho ma ka World Health Organization.

Ka rula mua - i hoakaka ia antimicrobials wale i ka wa a ka infectious Agena mea ikepili koʻikoʻi ia ia. Kēia, e kali i ka hoʻohana 'ana o nā antibiotics, kauka manawa e hana pā lonoaʻili haʻawina o flora no laau lapaau, i ka mua ai' me ka ololi, directional pae o ka hana.

Ka lua o ka loina hooponopono Fleming mai nei i ka mea pono e hōʻoia i ka hoʻokō lehulehu o ka lāʻau i loko o ka lesion. Keia rula, e emi ka nui o nā antibiotics hoʻohana topically a me ka ai 'hoakaka ia no ka kāohi hana. Eia hou, ka mea e i ka manawa e ana i ka lāʻau ma kahi hoʻokahi, aole i mua o ke kiʻekiʻe o, e like me e hoʻomaʻa i ka mahele lāʻau, a me ka lāʻau ma muli o ke ahonui o ka hoʻokolokolo 'ana i ka liluwelo fluids hua hookahi o kela mea i na la ehiku.

Ke kolu o ka rula - i ka pono e hoakaka ia antibiotics ma ka mahele lāʻau, a e hoʻolauna iā lākou i loko o ke ala, e kń i ka hopena maikaʻi 'ole. Kēia e hoʻohana ai 'hou rationally.

i ke kahua o ka koʻohune

Nā mea palahēhē me ka mālama 'hou pili i hiki ole nei me ka koʻohune nā moku halihali mokulele, no laila,-kapaia o "' Aʻohe hoomanawanui", a e eʻike makaʻole kumu o ka maʻiʻaʻai no ka 'ē aʻe.

Bacteriocarrier - heʻano o ka maʻiʻaʻai e 'ōili mai ka wā ma waena o kaua a me ka parasite hookupaaia koena i loko o nā mea maʻi me ka lapaʻau hoike ana. Immunological reactions e hoʻomau e ana i ka ia manawa. Inā ka microorganism ua paʻa i loko o ka latent ano i loko o elima nā mea maʻi, e hoʻololi kona waiwai, a lilo houʻano pākīkē.

Kāohi hana ma keia hihia e:

- regular lapaʻau ninaninau o ke ola hana;

- bacteriological ninaninau o ka haukapila kookoo;

- i ka loaʻaʻana a me ka hana o ka iho mailoko o na kahuna lapaau;

- kela la i keia mana o ka moku'āina o ka 'inikua ola.

Mea weliweli a PalekanaEND_LINK a me ka pākōlea hana

Nā mea palahēhē pili me ka mālama '(IHS) hōʻike,ʻaʻole wale nō ma hope o ka hoʻomanawanui i malaila, i kekahi manawa i loko o ka haukapila lapaʻau, akā, ma hope o ka helu ana o PalekanaEND_LINK a me ka pākōlea hana e hoʻonui ana i ua hoʻohaumiaʻia haukapila flora. Mau nā koko transfusions, injections,ʻoki kino transplanting nā loko a me nā'aʻaʻa. I waena o resuscitation mea intubation, inhalation anesthesia, lako a pan no ke ola kākoʻo, hoonoho iho la catheters. No hoi, maʻiʻaʻai ke'ākoʻakoʻa ma hope o hemodialysis lapaau, inhalations a me Spa kūlana kanaka.

Mea Maluna ma Spaulding

Nā mea palahēhē pili me ka mālama ', hiki e pū i hiki ma' inikua manaʻo. No ia mea, Spaulding māhele aʻela iā lākou i loko oʻekolu pūʻulu, e lawe me ka hoailona o classifying i ka pilikia o ka aoao hana i ka haukapila flora.

Ka mua pūʻulu - pilikia. Mau nāʻoki lāʻau lapaʻau mea, catheters, implants, paipu, a me ka loli ka pahu kui.

Ka lua o ka pūʻulu - polukriticheskie: endoscopic a me ka inhalation pono, na mea paahana no ka anesthesia, rectal ana wela.

Ke kolu o ka hui, pakahi, noncritical. O nā mea a pau i nā mea a pau: o ka moku, ke koko, nā kahu nānā, oaʻiʻo, mau kīʻaha, linens, axillary ana wela.

Kāohi

Kāohiʻana o nā mea palahēhē pili me ka mālama ', ma muli o World Health Organization koi no ka Kāohiʻana o nosocomial nā mea palahēhē. Ma maikai Kāohiʻana e hoʻohui i ekolu kūlana:

- minimization o ka maʻiʻaʻai mai waho o ka haukapila;

- loa o ka maʻiʻaʻai ma ka hana ma luna o ke ahulau kaʻina huahelu;

- i ka wehe 'ana o ke koe ma kela aoao o ka haukapila maʻiʻaʻai.

No keia mea, aia'īpale nā mea maʻi me ka mea infectious ka maʻi i loko o kūikawā pahu me ka hookaawale hoʻokomo o a me ka auaiaea, a 'aʻole e kamaʻilio me ke koena o ka pahu. Eia kekahi, ma kela a me keia pahu, a me ka he lawe mau sanitization mea paahana a me surfaces. Ke alapine (frequency) o kēia mau hanana hilinaʻi nui ma luna o ka pono: ma ka lapaau na oihana - kākaʻikahi,ʻoki lāʻau lapaʻau, niioaaonoaaiii, oi paha.

lapaʻau

Nā mea palahēhē pili me ka mālama ', inā me ka pilikia, akā, amenable nō i ka lāʻau Inc. Maikaʻi loa, ke kauka prescribes he maopopo antimicrobial Agena o ka puali pae o ka hana, a ua papahana no i kekahiʻano o ka pathogen. Akā, ma ka mea keia mea ka apuepue hiki, no ka mea, ka mea iʻohi microflora a me ka pā lonoaʻili Ka Ikepili i pule, a me ka nele i ka hoʻomanawanui i ka e hana koke ia. Nolaila, ua ke kauka e koho i empiric Inc ma muli o kā lākou mau manaʻo iho. Ke koho ana o ka antibiotic hilinaʻi nui ma luna o ke kauka o ka ike e pili ana i ka flora ka i lanakila ma o ka 'Oihana.

I mea e loaʻa pathogens Kū aʻela lāʻau ia'ku, ia mea pono e hoopili aku i ke kuapo o ka ai ', oia hoi, e hoʻololi ia kela mau a ekolu na malama paha. Kēia e kōkua ho'ēmi i ia'ku a me ka hoʻoikaika 'ana lapaʻau nā haumāna.