Cov kab mob hauv lub cev xeeb tub: Septic Shock

Zoo Siab

• Cov tsos mob ntawm kev tso quav yog dab tsi?
• Dab tsi Ua Rau Muaj Kev Nyuaj Qog?
• Yuav Tsum Tau Tso Cov Quav Dab Tsi Li Cas?
• Yuav Tsum Tau Siv Cov Khw Sib Ceg Mus Li Cas?
• Kev Ntshav Siab
• Tshuaj tua kab mob
• Pab Txhawb Nqa
• Kev Kho Mob Kho
• Outlook

Septic Shock Yog Dab Tsi?

Kev poob siab ntawm tes yog qhov mob nyhav thiab raug kaw. Qhov no txhais tau tias nws cuam tshuam tag nrho lub cev. Nws mob tshwm sim thaum cov kab mob nkag rau hauv koj cov hlab ntshav thiab nws feem ntau tshwm sim tom qab kev mob lossis kev phais.

Thaum cov poj niam cev xeeb tub tsim muaj septic shock, feem ntau nws yog ib qho kev cuam tshuam ntawm ib qho ntawm cov xwm txheej hauv qab no:

• septic rho menyuam (mis nchuav txuam nrog kev kis tus kab mob uterine)
• mob raum heev
• mob plab
• kis kab mob ntawm cov hnab looj tes amniotic
• uterine tau tus kab mob

Cov tsos mob ntawm kev tso quav yog dab tsi?

Kev tso tawm kis tau tshwm sim vim yog mob nyhav sepsis. Sepsis, tseem hu ua "ntshav lom," yog hais txog cov teeb meem tshwm sim los ntawm tus kab mob sib kis thawj zaug hauv ntshav. Kev poob siab hauv qab yog qhov hnyav tshaj plaws ntawm kev tswj xyuas qhov sepsis. Ob leeg puav leej muaj cov tsos mob sib xws, xws li mob ntshav qis. Txawm li cas los xij, sepsis tuaj yeem ua rau koj txoj kev hloov pauv hauv koj lub hlwb kev xav (poob siab) thiab cov khoom nruab nrog cev puas tsuaj.

Kev poob siab ntawm kev tso quav tau ua rau muaj ntau yam kab ke thiab cov tsos mob, suav nrog:

• nyob tsis tswm thiab disorientation
• lub plawv dhia ceev ceev thiab ntshav siab (hypotension)
• kub cev ntawm 103˚F lossis siab dua
• tsis tshua muaj kev ntsuas lub cev kub (hypothermia)
• daim tawv uas sov thiab ntws vim yog kev tso pa ntawm koj cov hlab ntshav (leeg)
• txias thiab nplaum tawv nqaij
• lub plawv khiav ceev
• daj daj ntawm koj cov tawv nqaij (daj daj)
• tsis tso zis tsawg
• tso ntshav los ntawm koj qhov chaw mos los rau koj tso zis

Tej zaum koj yuav pom muaj cov tsos mob ntsig txog thawj qhov chaw ntawm tus kab mob. Hauv cov poj niam cev xeeb tub, cov tsos mob no yuav muaj xws li:

• discolored uterine tawm
• uterine rhiab
• mob thiab mob hauv koj lub plab thiab flank (thaj chaw ntawm tus tav thiab lub ntsag)

Lwm qhov kev pheej hmoo uas nquag tshwm sim yog cov laus cov pa ua pa nyuaj (ARDS). Cov tsos mob muaj xws li:

• txog siav
• kev ua pa nrawm thiab ua haujlwm
• kev hnoos
• mob ntsws nkees

ARDS yog ib qho ua rau muaj kev ploj tuag thaum muaj mob loj sepsis.

Dab tsi Ua Rau Muaj Kev Nyuaj Qog?

Feem ntau cov kab mob feem ntau ua lub luag haujlwm rau sepsis yog aerobic gram-negative bacilli (tus pas nrig-ntaus cov kab mob), feem ntau:

• Escherichia coli (E. coli)
• Klebsiella pneumoniae
• Kev ua Proteus hom

Cov kab mob no muaj ob daim nyias nyias, uas ua rau lawv tiv taus tshuaj tua kab mob ntau dua.

Thaum lawv nkag rau hauv koj cov hlab ntshav, lawv tuaj yeem tsim kev puas tsuaj rau koj cov kabmob tseem ceeb.

Rau cov poj niam cev xeeb tub, mob septic tshwm sim los ntawm:

• mob tau thaum mob thiab yug menyuam
• cesarean seem
• mob ntsws o
• lub cev tsis muaj zog tiv thaiv kab mob
• khaub thuas (mob npaws)
• rho menyuam
• nchuav menyuam

Yuav Tsum Tau Tso Cov Quav Dab Tsi Li Cas?

Cov tsos mob cuam tshuam nrog septic poob siab zoo heev rau cov tsos mob ntawm lwm qhov xwm txheej hnyav heev. Koj tus kws kho mob yuav ua qhov kev soj ntsuam lub cev kom zoo, thiab lawv yuav yuav txiav txim siab mus kuaj.

Koj tus kws kho mob yuav siv cov ntshav mus kuaj xyuas:

• pov thawj ntawm kev kis tus kab mob
• teeb meem nrog ntshav txhaws
• mob siab los yog mob raum
• electrolyte tsis txaus

Koj tus kws kho mob yuav xoo hluav taws xob rau hauv siab kom nrhiav seb koj puas muaj ARDS lossis mob ntsws. Kev kuaj kab mob hauv CT, MRI, thiab lwm yam yuav pab txheeb xyuas qhov sib kis thawj. Koj tseem yuav xav tau kev xaj hluav taws xob los kuaj xyuas lub plawv tsis xwm yeem thiab cov cim qhia ntawm qhov raug mob rau koj lub plawv.

Yuav Tsum Tau Siv Cov Khw Sib Ceg Mus Li Cas?

Muaj peb lub hom phiaj tseem ceeb hauv kev kho mob tawm ntawm qhov quav kub.

Kev Ntshav Siab

Koj tus kws kho mob lub hom phiaj thib ib yog kho cov teeb meem nrog koj cov ntshav ncig. Lawv yuav siv txoj hlab ntsws loj kom muab dej rau koj. Lawv yuav soj ntsuam koj cov mem tes, ntshav siab, thiab tso zis tawm kom paub tseeb tias koj tau txais cov kua dej txaus li no.

Koj tus kws kho mob tuaj yeem tso lub plawv ntsuas lub plawv yog lwm txoj kev saib xyuas yog tias qhov tso kua dej tsis ua kom rov zoo ntshav txaus. Koj tseem yuav tau txais dopamine. Cov tshuaj no txhim kho txoj haujlwm ntawm lub siab thiab ua kom ntshav txaus rau cov kabmob loj.

Tshuaj tua kab mob

Lub hom phiaj thib ob ntawm kev kho mob yog muab tshuaj tua kab mob rau koj kom tiv thaiv cov kab mob uas feem ntau yuav muaj tau. Txog ntawm caj ces mob hauv chaw mos, ib txoj kev kho tau zoo yog kev sib koom ua ke ntawm:

• penicillin (PenVK) lossis ampicillin (Principen), ntxiv rau
• clindamycin (Cleocin) lossis metronidazole (Flagyl), ntxiv rau
• gentamicin (Garamycin) lossis aztreonam (Azactam).

Hloov pauv, imipenem-cilastatin (Primaxin) lossis meropenem (Merrem) tuaj yeem muab ua ib cov tshuaj.

Pab Txhawb Nqa

Lub hom phiaj thib peb ntawm txoj kev kho yog muab kev pab saib xyuas. Cov tshuaj noj kom txo kub ib ce thiab daim pam txias yuav pab ua kom koj lub siab nyob ze rau qhov nyob ib puag ncig. Koj tus kws kho mob yuav tsum txheeb xyuas qhov teeb meem sai ntawm cov ntshav txhaws thiab pib kho nrog kev ua kom ntshav cov ntshav thiab cov ntshav sib tshooj.

Thaum kawg, koj tus kws kho mob yuav muab cov pa ntxiv rau koj thiab saib koj zoo rau cov pov thawj ntawm ARDS. Koj cov pa oxygen yuav tau saib zoo nrog lub mem tes oximeter lossis txoj hlua pa radial leeg. Yog hais tias ua pa tsis ua hauj lwm pom meej, koj yuav raug tso rau hauv ib qho kev txhawb nqa oxygen.

Kev Kho Mob Kho

Koj kuj tseem yuav xav tau kev phais mob. Kev phais mob tuaj yeem siv rau kev tso dej paug tawm hauv koj lub plab mog, lossis tshem tawm ntawm lub plab mog.

Yog tias koj muaj kev tiv thaiv kab mob hauv lub cev, koj yuav tsum tau raug sau tseg tias muaj cov qe ntshav dawb. Lwm qhov kev xaiv yog kev siv tshuaj antisera (anti-toxin) tiv thaiv cov kab mob ib txwm muaj uas ua rau mob septic poob siab. Qhov kev kho mob no tau tshwm sim muaj kev pom zoo hauv qee qhov kev tshawb nrhiav, tab sis tseem nyob hauv sim.

Outlook

Kev poob siab yog ib qho mob hnyav, tab sis nws yog ib qho tseem ceeb kom paub tias nws yog tus mob muaj tsawg hauv kev xeeb tub. Nyob rau hauv qhov tseeb, lub Obstetrics thiab Gynecologycov ntaub ntawv sau tseg kwv yees tias txog li 0.01 feem pua ​​ntawm tag nrho cov khoom xa tuaj ua rau septic poob siab. Cov poj niam uas tau saib xyuas cev xeeb tub kom txaus yuav tsis muaj mob sepsis thiab ua rau muaj kev ceeb. Yog tias koj muaj cov tsos mob txawv txawv, nws yog qhov tseem ceeb kom hu rau koj tus kws kho mob tam sim ntawd kom tiv thaiv kev puas tsuaj thoob plaws.