Njira yokumba matendawa - ndi kufala kwa tizilomboto mwa zipangizo parenteral kuchipatala mpheto achire ndi matenda

Tsopano mankhwala anaonekera umisiri osati monga wosangalatsa dzina. Zingaoneke, ndi maziko a inde zachipatala m'chigonjetso imfa mtima chifukwa sanali kugwilizana ndi malamulo thanzi kuchipatala kuti kalekale. N'chifukwa chiyani njira yokumba matenda mu nthawi otetezeka ikupita patsogolo wathu? Chifukwa mu zipatala ndi zipatala umayi adakali "kuyenda" staph, matenda a chiwindi, HIV? ziwerengero youma limanena kuti pafupipafupi yekha septic matenda m'zipatala chinawonjezeka ndi 20%, pamene chiwerengero cha 22% mu Dipatimenti akayakaya zaposachedwapa, mu opaleshoni kuti 22%, mu urology kuposa 32%, mu matenda achikazi 12% mu zipatala ( 33%).

Kulongosolerana, akafuna kupanga matendawa - izi ndi otchedwa anthu yokumba matenda zipatala makamaka njira olanda. Bwanji kuti anthu anavomereza kuti kuchipatala kukalandira chithandizo cha matenda, kuwonjezera kudwala pali ena?

matenda zachilengedwe

Ndi mitundu yonse ya mwayi kugwira matenda HIV njira tizilombo ku wodwalayo wathanzi ziwiri zokha izi:

1. Natural amadalira kugwilizana ndi malamulo payekha ndi malamulo a ukhondo.

2. yokumba kapena mankhwala ndi mode yokumba wa HIV. limagwirira ili pafupi kwathunthu amadalira kugwilizana ntchito zawo ogwira ntchito kuchipatala.

Ndi chilengedwe oyamba a tizilombo toyambitsa matenda kumachitika ndi kukhudzana ndi chilengedwe tizilombo anthu. Njira za matenda:

-Air-dontho, mwachitsanzo sneezing, kutsokomola, akulankhula (fuluwenza, TB);

-fekalno-m'kamwa, i.e., manja zonyansa, madzi ndi chakudya (thirakiti m'mimba nthenda);

Chipangizo chamagetsi-pini (waukulu kwambiri sipekitiramu matenda kuphatikizapo venereal, khungu, helminthiasis, malungo, diphtheria, ndipo anthu ambiri).

Amazipanga, momwemo inu aigwire matenda alionse, anavomereza chithandizo kuchipatala.

matenda yokumba

Mabungwe zachipatala, pali njira ziwiri zikuluzikulu za matenda a odwala, yodziwika monga mode yokumba wa HIV. Ali:

1.Parenteralny, zimene zimagwiritsa ndi kuphwanya khungu wodwalayo chimakwirira.

2.Enteralny, lingathe mitundu ina ya Kupenda odwala, komanso zina zochizira.

Komanso, kuchipatala ndi wotukuka ndi chimodzimodzi kufala zachilengedwe limagwirira mobwerezabwereza kukulitsa mkhalidwe wa odwala. Chotero, inu mukhoza kutenga matenda pa njira madokotala ndi anamwino, komanso kungokhala chipatala.

Zimayambitsa odwala matenda zipatala

Kodi pali zinthu zipatala odwala matenda kudzera zachilengedwe, ndiponso mmene limagwirira yokumba la kufalitsa matenda. Pali zifukwa motere:

1. zipatala nthawi zonse anthu ambiri matenda. Komanso, pafupifupi 38% ya anthu, kuphatikizapo ogwira ntchito zaumoyo, ndi chotengera cha tizilombo toyambitsa matenda osiyanasiyana, koma anthu sadziwa kuti ali zonyamulira.

2.Uvelichenie chiwerengero cha odwala (anthu akale, ana) amene kwambiri adatchithisira pakhomo kukana wa chamoyo.

3.Obedinenie kwambiri apadera zipatala mu maofesi zikuluzikulu, zimene bwino kapena mosadziwa amalenga yeniyeni chilengedwe zachilengedwe.

Nthawi zina, pali matenda yokumba wodwala pa kusintha kuvala, ngati namwino ndi mwini wake wa kusagwira ntchito mu chigoba kumatenda ndi magolovesi. Tikawonetsetsa wodwala kupatsira ntchito zaumoyo ngati iye akuchita mwai zachipatala (magazi zitsanzo zosankhidwazi, chisamaliro mano, etc.) popanda chigoba zodzitetezera magolovesi, magalasi apadera.

Jobs ndodo junior

odwala kwakukulukulu kachilombo zimadalira ntchito ndodo junior. The ziwerengero omwewo akuti mu Russia yekha nosocomial matenda shingellezom anauka kwa 26%, majeremusi osiyanasiyana kwa 18%, ndi 40% ya nsomba!

Amene Pankhaniyi zimayambitsa njira yokumba wa HIV? Izi makamaka kupanda kumvera ndi mtima wonse ndi mfundo thanzi. macheke malo anasonyeza kuti anamwino zipatala zambiri m'chipinda woyera, wolunjika, ndipo ngakhale zikugwira ntchito bwino. Ndicho, pamalo onse ankachitira nsalu imodzi njira masaka kuyeretsa kukonzekera ndende wamng'ono kuposa mogwirizana ndi mfundo mu maofesi ndi nyumba si ikuchitika processing ndi nyali khwatsi, ngakhale kupezeka ndi bwino.

Zomvetsa chisoni kwambiri ndi nkhani mu zipatala. amayi Orthotopic matenda kapena zipatso, mwachitsanzo, matenda suppurative septic kumachitika chifukwa kuphwanya malamulo processing antiseptics umbilical chingwe, mu obstetrics ndi kukonza tsogolo. chifukwa mwina kupanda masks pulayimale pa nkhope ya namwino kapena anamwino amene ali ndi tizilombo toyambitsa matenda, osanenapo zipangizo bwino chosawilitsidwa, matewera ndi zina zotero.

maantibayotiki

Monga taonera, kawirikawiri kuchipatala alandira anthu ndi matenda bwinobwino. Wodwala Kwalamulidwa mayesero choyezera, komanso njira zamakono matenda, imene ntchito njira enteral (ndi pakamwa) ziwalo mu M'mimbamo zida thupi. Pokonzekera zotsatira za, lomwe linakhazikitsidwa chizolowezi mankhwala opha ndi sipekitiramu yotakata kanthu. Ichi ndi mbali yaing'ono ya azimuth zabwino, koma zimayambitsa zazikulu zimene analenga mkati mwa mitundu chipatala tizilombo toyambitsa matenda, osati motani iwo ndi zotsatira za (disinfection, kvartsevanie, mankhwala). Chifukwa zachilengedwe njira kafalitsidwe, tizilombo ta awa kuwavomereza chipatala. Popanda kugwiritsa ntchito mankhwala unkachitika mu 72% odwala. Mu 42% milandu zinali pachabe. Dziko lonse chifukwa cha popanda mankhwala mankhwala mliri mu zipatala wafika 13%.

Matendawa ndi mankhwala

Zingatanthauze kuti njira zatsopano za matenda ayenera kuthandiza mwamsanga ndipo mukazindikira mavuto onse. Onse oona, koma zimenezo sizinachitike matenda yokumba odwala, zida matenda ayenera kugwiridwa molondola. Mwachitsanzo, bronchoscope pambuyo wodwala aliyense malinga ndi malamulo ayenera decontaminated ¾ maola. Chiphasochi Tsopano taonetsa kuti iyi pang'ono kulemekezedwa komwe, chifukwa madokotala Asaifufuze odwala pa mlingo wa 5-8, ndi 10-15 pa mndandanda. Zikuonekeratu kuti nthawi zokwanira pokonza zipangizo kwa iwo. N'chimodzimodzinso ndi gastroscopy, colonoscopy, catheter mayikidwe, kutenga puncture, malangizo Kupenda inhalation.

Koma kumachepetsa mlingo wa matenda enteral njira ya utsogoleli wa mankhwala. Pali kuopseza yekha mmatumbo njira, pamene mankhwala ndi kutumikiridwa ndi kafukufuku wa mwachindunji mu duodenum ndi. Koma m'kamwa (kuvomereza mankhwala ndi mankhwala kudzera pakamwa, cholizira kapena madzi akumwa), sublingually (pansi lilime) ndi buccal (kulumikiza mafilimu a mankhwala enieni kwa mucosal chingamu ndi masaya) pafupifupi otetezeka.

The parenteral njira za kufala

limagwirira Izi HIV ndi mtsogoleri kufalikira kwa Edzi ndi matenda a chiwindi. Kumatanthauza njira peranteralny - matenda kudzera m'magazi ndi kuphwanya umphumphu wa nembanemba wa mucous, khungu. Chilengedwe chipatala n'zotheka mu Zikatero:

-perelivanie magazi / madzi;

-zarazhenie kudzera syringe pa jekeseni;

-hirurgicheskoe alowererepo;

Pokwaniritsa chamankhwala.

Kawirikawiri matenda yokumba amapezeka m'zipatala mano ndi kupita kwa gynecologist chifukwa chakuti madokotala ntchito kuyendera mucous odwala awo bwino ankachitira chida, komanso chifukwa cha ntchito ya madokotala magolovesi sanali wosabala.

jakisoni

mtundu wa mankhwala ntchito kwa nthawi yaitali. Pamene syringes ndi reusable, iwo ali pansi mokakamizidwa patsogolo ntchito yolera yotseketsa. Zochita mwatsoka iwo zachititsa kuti matenda a odwala matenda oopsa, kuphatikizapo AIDS, chifukwa chosasamala lalikulu la madokotala. Tsopano ndi chithandizo (mtsempha ndi jekeseni mu mnofu), ndi zitsanzo magazi akugwiritsidwa kokha syringes disposable, kotero chiopsezo matenda yokumba yomweyo sanamvere. Anthu amenewa ayenera pamaso ndondomeko fufuzani zikayamba za phukusi syringe ndi m'mikhalidwe ayi ntchito kapena singano kachiwiri kwa mpheto zina. Koma n'zosiyana ndi zipangizo kwa endoscope (masingano, biopsy masingano ndi zina), amene zambiri kuwagwiritsa ntchito kuchita. Chabwino, iwo ali chabe kumizidwa mu njira masaka.

ntchito

Mlingo mkulu wa matenda limapezeka pa opaleshoni. N'zochititsa chidwi kuti 1941-1945-ntchentche chinalembedwa 8% matenda a wovulalayo, ndipo mu nthawi yathu, ntchito postoperative matenda septic anakonzeka 15%. Ichi ndi chifukwa:

-Use pa opaleshoni kapena pambuyo Mavalidwe bwino chosawilitsidwa;

-nedostatochnaya yolera yotseketsa kudula kapena osakhala kudula;

-wide ntchito amadzala osiyana (mu zamafupa, mu mano, mu cardiology). tizilombo ambiri amatha alipo mu nyumba izi, iwo kuphimba wapadera zoteteza filimu yokha, kuwapanga kuwerengedwa mankhwala.

Decontamination ayenera ikuchitika wapadera Bix, autoclaves kapena zipinda chimene chimadalira pa njira yolera yotseketsa. Iwo ukugwira ntchito tsopano akuyesera kuti agwiritse ntchito disposable wosabala mapepala bedi, zovala, madokotala ndi odwala, amene ayenera kuchepetsa matenda yokumba. Kuthetsa matenda kudzera amadzala, odwala amathera postoperatively kuzikonzanso mankhwala antibacterial.

magazi

Akukhulupirira kuti magazi akhoza anatola chindoko yekha, AIDS ndi awiri a chiwindi B HIV, B ndi C. Ndi chifukwa tizilombo toyambitsa matenda awa cheke kupereka magazi mfundo zochepa chabe pamalangizo. Koma chitsanzo chosonyeza kuti ngakhale ntchito kokha syringes disposable, kuikidwa ndi luso popereka mavairasi, chiwindi D, G, TTV, toxoplasmosis, cytomegalovirus, listeria ndi matenda ena. othandizira ndalama zonse yobereka magazi, madokotala ayenera kuonanso pamaso pa matendawa. Ndipotu, nthawi zambiri kusanthula alibe nthawi kapena kungoti analola chosasamala. Choncho, ife ayenera cheke mosamala otengedwa magazi woperekayo. Koma iyi si nthawi zonse lero, ngakhale mu zipatala wa Moscow milandu matenda a odwala ndi kuika zimachitika. Vuto chachiwiri n'chakuti pali zambiri tizilombo ta mutated kuti ngakhale atsopano machitidwe mayeso sakuzindikira. The vuto lomwelo ndi matenda ndi kumuika mwiniwake matupi.