Nosocomial pneumonia: pathogens, lapaau a me ka Kāohi

Nosocomial pneumonia - mea he huʻi infectious kaʻina 'ia i loko o ke kino ma lalo o ka aoao o kaʻeleu ola o pathogenic koʻohune. Ano hiʻona o ka maʻi o ka pulmonary airway lesion kāleka me na hoʻomāhuahua o ka buke nui o ka wai. Exudate a laila seeps ma, a komo iloko aeee i loko o kaʻaʻa puʻuwai'aʻaʻa.

Ka moʻolelo o ke aupuni, nā lula no ka haukapila-lilo pneumonia

E hoʻomaka ana mai ka 2014 "naehana Society" hoʻolauna i ke ao nei i ka lapaʻau lula. Ka mea, i ka nānā 'ana ma luna o ka algorithm no kaʻike, a me ka Inc ma wahi, i hiki ma kahi o ka he e hoʻohuoiʻia i ka hoʻomanawanui progresses nosocomial pneumonia. National lula hoʻomohala ma ka poe akamai, clinicians, ola mālama poe hana, ke ehuehu me ka huʻi naehana maʻiʻaʻai.

Pokole, i ka algorithm ninoieo o, eha kikoo.

1. Ike ina e hemahema hospitalization. A maikaʻi olelo hooholo ua i, ina ka hoʻomanawanui pono i olelo ia naehana popilikia, aia no he emi'aʻaʻa perfusion, huʻi pakiko-kaʻapu kōheoheo, hoʻopōʻino ike paka, lolelua ke koko. No e waiho i loko o ka haukapila loa hoomaopopo ana ma ka liʻiliʻi loa hoʻokahi symptom.
2. Hoomaopopo ana i ke kumu o ka maʻi. E hana i kēia, ua hoakaka ke hoʻomanawanui i ka helu o ke keʻena hoʻokolohua haʻawina o liluwelo mea: koko moʻomeheu, ka moʻomeheu, mai ke aa koko, bakposev sputum, kiʻekiʻe-ka māmā holo ho'āʻo e hooholo antigenurii mea koʻohune ano.
3. Hoomaopopo ana i ka lōʻihi o ka nohoʻana. Eia nae, i ka maʻi i ka mea koʻohune ka molekumu o, akā, ua i hookupaaia ka maoli kumu, Inc ua mālama 'ia ma luna o na la he umi. Ma nā complications a extrapulmonary pulakaumaka pākōlea papa i e mai ai i 21 mau lā.
4. Keia Manawa e pono ai inpatient iaʻu. I ka mea ano, e hoomanawanui i ka nele o ka hanu a me ka ole-invasive hoʻokomo ea.

¶ A i loko o ke aupuni lula kauoha kāohi ana. Ka loa ka hoʻokō ka vaccination i ka maʻi palū a me ka pneumococcus, hoonohoʻano nui no nā mea maʻi me ka maʻi pneumonia a me nā kānaka kahiko makahiki pae.

No kaiāulu-lilo pneumonia

Community-lilo nosocomial pneumonia o kekahi e like me ka inoa - kaiāulu-lilo. I ka maʻi ua kena ae la ka maʻiʻaʻai ana i mea koʻohune etiology. I ka papa kuhikuhiE ala hele o ka maʻiʻaʻai - kaiapuni. Alaila, o ka manao paa e e like penei: hoʻoʻino akemāmā lesion kāleka loaa mai ma droplets, kahi o ka luna hui 'ana me nā moku halihali mokulele o ka maʻiʻaʻai i ola mālama' okoʻa no ka hoomanawanui i ole.

Community-loaa ana a me ka nosocomial pneumonia o ka mea koʻohune ho omaka ana diagnosed i loko o nā mea maʻi me ka ho'ēmi i kā e hoʻonele, ka wā i ke kino, ua hiki ia lakou ke ku imua pathogens (pneumococcus, Haemophilus influenzae, Klebsiella). Ka mea, komo i loko o ka lua o na maʻiʻaʻai ma ka nasal ala.

Ke kamepiula pūʻulu nā mamo a kaikaina makahiki pae a me nā mea maʻi me ka maʻi akemāmā maʻi. Ma keia hihia, no ka causative Agena o Staphylococcus aureus.

Community-lilo nosocomial pneumonia: nā loina o ka Mea Maluna o ka maʻi

I mea e hoʻomōhala i nā pono lapaʻau o pneumonia e classify ma kiko'î:

• maʻi ua i pu ma ka emi ana o ka aiiay mana o ka meaola;
• maʻi e uē helu aku i ke kāʻei kua o ka ho'ēmi i kā e hoʻonele;
• maʻi i kupu mai ma ka huʻi kahua o kōkua iā ia,;
• maʻi, i hanaʻia i loko o ka huipūʻana me nā maʻi.

I hookuu, i kaʻike, ua hookupaa iho la ia i loko o nā mea maʻi i i ka pilikia i loko o ka palapala o ka hoemi e hoʻonele e kū'ē i ka backdrop o oncology a hematology. ¶ A i loko o ke kamepiula pae, e hoomanawanui i lawe steroid no ka lōʻihi manawa kiʻekiʻe laʻau heluna. No hoi, he mau manawa, i ka wa o ka maʻi ia lŘlŘ i loko o nā mea maʻi me ka maʻi'ōnaehana paleʻea pathologies.

Eia hou kekahi, he kaawale waeʻano nā kēia 'ano o ka pneumonia ka wehena.

Kauka e hoailona oukou ia ma keia wahi i loko o keʻano papa hana o ke kumu o kekahi ano o ka wehena pneumonia , he haole kino ma ka hui 'ana me a ka maʻi e hoʻomōhala ai.

No nosocomial pneumonia

Kēia manaʻo ua waiho 'inikua ana o ka hoomanawanui, ka wā li nui i loko o ke akemāmā pauku ua hōʻike ma hope o ma kahi o 72 hola ma hope maʻiʻaʻai. Ka pilikia waiho i loko o ka mea ana nosocomial nosocomial pneumonia ua huikau ma ke ano o ka papa, a pinepine na welau o ka make. Ua ua kena ae la ia e koʻohune i noho i loko o nā paia o ka 'inikua kula, hoʻopale i ka hapanui lapaʻauʻia, no laila ia mea loa paakiki, e imi i ka mea mua manawa i ka pololei antibiotic.

Nosocomial Nosocomial pneumonia: nā loina o ka Mea Maluna o ka maʻi

Makakohoʻano o ka haukapila nosocomial pneumonia ua hoʻolaha i loko o ka maʻiʻaʻai anu u:

1. I ke kahua - i loko o ka mua elima lā o ka loaa i ka hoomanawanui i loko o ka haukapila hoʻomaka e hōʻike ahuwale na hoailona o ka maʻi.
2. Late ke kahua - i ka hoike ana o symptoms ua hoopanee ia e oi aku mamua o elima mau lā.

Ke kaumaha ma muli o ka etiology o ka maʻi, he ekolu ano.

1. Wehena nosocomial pneumonia.
2. Postoperative.
3. Ventilator-pili.

Ua mea waiwai 'ana i kumumanaʻo i ka Mea Maluna hooku iho la ia ma ka' ano mea conditional, a ma ka hapanui hihia i diagnosed pneumonia i hui palapala. Kēia, ma ka huli, nui aggravates ke ano o ke ahonui a me ka ho'ēmi i kā ka manawa o ke ola.

wehena

A hooku iho la ke ano o ka maʻi o ka loa, he pono ole. A hiki i ka iho mailoko o nasal mucus loaʻa i loko o ka pulmonary Oihana, ma laila autoinfection kino.

Wai nasopharyngeal - he maikaʻi wahi no pathogenic koʻohune ai, no laila, i kekahi manawa, ma ka ia maʻiʻaʻai, na microorganisms hoʻomaka i ka 'Imi proliferate, a me ia ka poʻea pau i ka ulu ana o ka wehena pneumonia.

postoperative

Hooku iho la ia ma ka 'ano o ka pneumonia ua diagnosed i loko o 18 lapaʻau hihia mai o ka 100, a ua loaʻa wale nō i loko o nā mea maʻi i i undergoneʻoki kino.

Ma keia hihia, i ka maʻiʻaʻai ia lŘlŘ ma ka like me ma ka wehena pneumonia, wale i nasopharyngeal loli ua hou a me ka gastric secretions, i mea ole emi pilikia loa. Nō hoʻi, mai noho aliʻi mai maʻiʻaʻai o ka hoʻomanawanui ka 'inikua kani a me na manao ona. Ma ka Tube a catheter maʻiʻaʻai hiki maʻalahi palahalaha ae ma ka lalo naehana'āpana.

Ventilator-pili

Diagnosed i loko o nā mea maʻi i mea i ka manawa lōʻihi ma ka hua'ōlelo oʻimi hoʻopunipuni akemāmā hoʻokomo ea. Maluhia manawa mea i oi aku mamua o 72 hola i loko o kēia moku'āina, ma ka hahaiʻana i kēlā me kēia lā hele maoli i ka pilikia o ka ulu pneumonia.

Nosocomial pneumonia

Nosocomial pneumonia haukapila pinepine, kena ae la ia e pneumococci. Oia diagnoses mea mai ka 30 a hiki i 50 pakeneka o ka mea a pau lapaʻau hihia.

Ka mea liʻiliʻi loaʻano pākīkē koʻohune i Chlamydia, Mycoplasma a me Legionella. Ma lalo o kā lākou mau keiki, ulu pneumonia mea i oi aku mamua o 30% akā,ʻaʻole e emi malalo o 8%.

ala ae la ka liʻiliʻi loa paha ia e loaʻa kāna hana ku ei ka backdrop o ka ikaika aayoaeuiinoe: Haemophilus influenzae, Staphylococcus aureus, klebsiella a me ka enterobacteria.

Aka nā pathogens o nosocomial pneumonia - maʻi palū nā mea hoʻomaʻi o ke kūlana A a me B, parainfluenza, adenovirus, naehana syncytial mea hoʻomaʻi.

Ka loa, he pono ole pathogens o nosocomial pneumoniaʻano pākīkē type e hiki haawi ala i ka laha outbreaks, - Mycoplasma a me Legionella. Ma ka hihia mua, pinepine ino adolescents a'ōpiopio nā mākua i ka makahiki 25. A Legionella maʻiʻaʻai ia lŘlŘ ma ka wai, e laʻa me, i loko o ka lehulehu manao, i ka ipuʻauʻau a me ka 'ē aʻe.

Nā Papahana O Ka kēia lapaʻau '

Inā he hoomanawanui i, 'ano pneumonia kaiāulu-loaa ana, ka mea, ua pinepine diagnosed e physical ninaninau. I kēlā lapaʻau hihia, no ka pono o ka mālamaʻana i ka hoʻomanawanui ka ana a me na symptoms o ka maʻi hoʻomaka i ka hookaawale kāleka a 'inikua mōʻaukala.

ʻelua mai-hoʻomanawanuiʻike, i like penei:

• Pahu X-Ray - X-Ray lapaʻau 'iaoia i nā papahana i nā kiʻi ma luna o ke ano o na maʻiʻaʻai i loko o kekahi mau Kekoa. Ma ke alo o ka pouli, anuanu mau kikoʻike, ua hookupaa iho la ia. ʻike, ua hoike mai,ʻelua hahauʻana: i ka hoʻomaka o ka lapaau, a ma hope o antibiotic Inc.

• Keʻena hoʻokolohua ho'āʻo ma - ka hoʻomanawanui ua koi 'ia e lūlū mai ke koko no ka Ikepili a me ka manao paa o ka huina helu o nā leukocytes, monakō koko a me electrolytes.
• Microbiological haʻawina - lawe mai i Ka Ikepili o ka pleural loli a me ka 'ia nā pōpō o ka lalo naehana'āpana ua ho'ākāka' ia ma ke alo o antigens i loko o ka mimi.

o nā hualoaʻa o kēia mau PalekanaEND_LINK hana kupono no definitiveʻike, a me ka lapaʻau kumumanao ulu.

Koi no ka iapaau ana o nā mea maʻi

Lapaʻau lula no ka iapaau ana o nosocomial pneumonia e like me ka mea ana i kuhikuhi antibiotics laulā-pae.

Ma hope o ka loaa ana i ke anamanaʻo i nā hualoaʻa ma ka mākaukau o ke kahuna lapaau, e hoʻololi i ka lāʻau i kope kau mai ma luna o oi efficient. Ke kumu o ke ano o pathogenic microorganisms.

Nā loina o ka hana maikaʻi o nā mea maʻi me ka nosocomial pneumonia

Lapaʻau o nosocomial pneumonia ninoieo i koho i ka pono antibiotic, kona regimen, i ke ala o ka hooponopono a me ka laʻau heluna. Ua epa a me ka hele kauka wale. Ua mea no hoi he integral hapa o ka Inc o ka iapaau ana o naehana'āpana remediation (ana o ka hoʻonui loli).

Ke nui wahi mea i loaʻa i ke ahonui i loko o ka moku'āina o physical haʻawina. Oe E hana hanu kino, a me ka mea uuku me ka i loko o ke ano o ka noho-UPS. E hoomanawanui i ka poe ma ka mea ana, e kokua i ka la ia i kahu. Ka mea i komo i loko o ka papa loli o ke kulana o ka hoomanawanui, hiki i ka wai a 'aʻole i stagnate ma kekahi wahi.

Hōʻole 'recurrent maʻi e kōkua Kāohiʻana o nosocomial pneumonia, a wehewehe i ka au mamuli o ka kauka.

antibiotic Inc

Lapaʻau pahuna ma ka paioʻana koʻohune, he mau hoailona ia mea: deliberate a me ka manamana nui. Initially, ua malamaia lakou nei, empirically kikokiko i nā mea a pau nā mea maʻi, a kauoha ia i kauoha mai ai ma hope o hoomaopopo ana i ka causative Agena.

Ka mea nui wale aku ana no i ke ola i:

1. ? Ac? Aaioea kupono antibiotic lapaau.
2. Hoemiia hoʻohana o antimicrobials.

E koho i antibacterial ai 'a me kā lākou laʻau heluna hiki wale kahuna lapaau, pakiko-hope ai' Ua unacceptable.

Ke kēla no ke ola

Ke kaumaha ma muli o ka koho pololei ai ', ka oolea o ka mai, a me ka nui ana o ka hoʻomanawanui hope o ka hana maikaʻiʻole paha e like penei: ke ola, he hōʻemi iki hou ana, lapaʻau e hemahema, relapse, a me ka make.

Ma nosocomial pneumonia ka pahiki o ka make ka nui mamua o ka palapala kaiāulu-lilo.

kāohi ana

Kāohiʻana o nosocomial pneumonia poe eiiieaena 'inikua, a epidemiological ana:

• 'eleu lapaʻau o pili mai;
• kaʻaeʻana a me na rula a me nā ana hoʻohālike o ka kou niho;
• loaa ana immunomodulatory konohiki;
• vaccination.

He nui loa i loko o ka hoʻomaikaʻi i ka hoʻomanawanui i ka hoi - e pale aku relapse - e kanaka hoʻoponopono i ke ana o ka poe noonoo ole rula: regular sanitation o ku una ha i ka lua, me ka puʻu i loli hoʻomāhuahua, physical haʻawina.