Nā maʻi i ka hāpai ʻana: Septic Shock

Anter

• He aha nā hōʻailona o Septic Shock?
• He aha nā kumu o Septic Shock?
• Pehea ʻike pinepine ʻia ai ka ʻike ʻana i ka Septic Shock?
• Pehea e mālama ʻia ai ka Shock Septic?
• Kaapuni Koko
• Nā Antibiotics
• Mālama Kākoʻo
• Nā Hana Lapaʻau
• Outlook

He aha ka Septic Shock?

ʻO ka haʻalulu Septic kahi maʻi ʻino a ʻōnaehana hoʻi. Kuhi kēia i ka hopena o ke kino holoʻokoʻa. Kumu ʻia ia ke komo ka bacteria i loko o kou kahe koko a pinepine pinepine ia ma hope o ka trauma a ʻoki paha.

Ke hoʻomohala nā wahine hāpai i ka haʻalulu septic, he mea maʻamau ia o kekahi o nā ʻano aʻe:

• septic abortion (kahi hāpai keiki e pili ana i ka maʻi uterine)
• maʻi kīnā koʻikoʻi
• maʻi ʻōpū
• maʻi o ka ʻeke amniotic
• maʻi ʻaʻano uterine

He aha nā hōʻailona o Septic Shock?

Kū ka weliweli septic ma muli o ka nui o ka sepsis. ʻO Sepsis, i kapa ʻia hoʻi he "lāʻau make koko," pili i nā pilikia i hoʻokumu ʻia e ka maʻi koko mua. ʻO ka haʻalulu Septic ka hopena ma hope o ka sepsis kaohi ʻole. Loaʻa nā hōʻailona like i like ʻole, e like me ke kaomi haʻahaʻa haʻahaʻa loa. Eia nō naʻe, hiki i ka sepsis ke hana i nā loli i kāu kūlana noʻonoʻo (haʻalulu) a me ka hōʻino ʻana o nā mea nui.

Hana ʻo Septic shock i nā ʻano ʻōuli ʻōnaehana a me nā ʻōuli, e like me:

• hoʻomaha a me ka disorientation
• ka wikiwiki o ka puʻuwai a me ke kaomi haʻahaʻa (hypotension)
• fiva o 103˚F a ʻoi paha
• mahana wela o ke kino (hypothermia)
• ʻili mehana a ʻulaʻula hoʻi ma muli o ka dilation o kou kīʻaha koko (vasodilation)
• ʻili anuanu a paʻakikī
• kuʻi ka naʻau kaulele
• melemele o kou ʻili (jaundice)
• hoʻemi urination
• kahe koko ʻole mai kāu genital a i ʻole urinary tract

Hiki paha iā ʻoe ke ʻike i nā hōʻailona e pili ana i ka pūnaewele mua o ka maʻi. I nā wahine hāpai, e hoʻopili pinepine kēia mau ʻōuli i:

• hoʻoiho uterine discolored
• palupalu ʻo uterine
• ʻeha a palupalu i loko o kou ʻōpū a me ka ʻaoʻao (ka wahi ma waena o nā iwi ʻaoʻao a me ka uha)

ʻO kekahi komplication maʻamau ka mākua respiratory respiratory syndrome (ARDS). ʻO nā hōʻailona me:

• pokole o ka hanu
• hanu wikiwiki a hana
• ʻūhā
• ʻūhū māmā

ʻO ARDS kekahi o nā kumu nui o ka make i nā hihia o ka sepsis koʻikoʻi.

He aha nā kumu o Septic Shock?

ʻO ke koʻohune ʻoi aku ka hopohopo no nā sepsis ka aerobic gram-negative bacilli (koʻokoʻo koʻokoʻo koʻokoʻo), ma ke ʻano nui:

• ʻO Escherichia coli (E. coli)
• Klebsiella pneumoniae
• Palaka ʻano laha

ʻO kēia mau koʻohune he ʻelua mau membrane, kahi e pale aku ai i nā lāʻau ʻaloʻalo.

Ke komo lākou i kāu kahe o ke koko, hiki iā lākou ke hōʻino i kāu mau mea ola.

I nā wahine hāpai, hoʻomaka ʻia ka weliweli septic e:

• nā maʻi i ka wā hana a me ka lawe ʻana
• paukū cesarean
• pulumonia
• ʻōnaehana pale nawaliwali
• influenza (ka maʻi palū)
• hāpai keiki
• hāʻule hāʻule

Pehea ʻike pinepine ʻia ai ka ʻike ʻana i ka Septic Shock?

ʻO nā ʻōuli e pili ana i ka haʻalulu septic e like loa me nā ʻōuli o nā kūlana koʻikoʻi ʻē aʻe. E alakaʻi ana kāu kauka i kahi hoʻokolohua kino piha, a e kauoha paha lākou i nā hoʻokolohua hoʻokolohua.

Hiki i kāu kauka ke hoʻohana i nā hoʻokolohua koko e nānā no:

• hōʻike o ka maʻi
• nā pilikia me ke kāpili ʻana i ke koko
• nā pilikia o ke ake a me ka hakuʻala
• uila kaulike ʻole

Hiki i kāu kauka ke kauoha i kahi x-ray umauma e ʻike inā he ARDS a i ʻole ka ponia. Hiki i nā CT scans, MRIs, a me nā ultrasounds ke kōkua i ka ʻike ʻana i ka pūnaewele maʻi nui. Pono paha ʻoe i ka loiloi electrocardiographic e ʻike i nā rhythm puʻuwai kūlike ʻole a me nā hōʻailona o ka ʻeha i kou puʻuwai.

Pehea e mālama ʻia ai ka Shock Septic?

ʻEkolu mau pahuhopu nui i ka mālama ʻana i ka haʻalulu septic.

Kaapuni Koko

ʻO ka pahuhopu mua o kāu kauka e hoʻoponopono i nā pilikia me kou holo o ke koko. Hiki iā lākou ke hoʻohana i kahi catheter intravenous nui e hāʻawi iā ʻoe i nā wai. E nānā lākou i kāu pulsa, ke kahe o ke koko, a me ka puka mimi e ʻike pono i ka loaʻa ʻana o nā huina kūpono o kēia mau wai.

Hiki i kāu kauka ke hoʻokomo i kahi catheter puʻuwai ʻākau e like me kahi mea pono e nānā ai inā ʻaʻole hoʻōla ka infusion wai mua i ka holo o ke koko kūpono. Hiki paha iā ʻoe ke loaʻa i ka dopamine. Hoʻomaikaʻi kēia lāʻau i ka hana o ka puʻuwai a hoʻonui i ke kahe o ke koko i nā mea nui.

Nā Antibiotics

ʻO ka pahuhopu ʻelua o ka hoʻomaʻamaʻa ʻana e hāʻawi iā ʻoe i nā antibiotic i hoʻokapu ʻia e kūʻē i nā bacteria. No nā maʻi maʻi genital, kahi lapaʻau maikaʻi loa ka hui pū ʻana o:

• penicillin (PenVK) a i ʻole ampicillin (Principen), hoʻohui
• clindamycin (Cleocin) a i ʻole metronidazole (Flagyl), hoʻohui
• gentamicin (Garamycin) a i ʻole aztreonam (Azactam).

ʻOkoʻa, hiki ke hāʻawi ʻia imipenem-cilastatin (Primaxin) a i ʻole meropenem (Merrem) ma ke ʻano he hoʻokahi lāʻau.

Mālama Kākoʻo

ʻO ke kolu o nā pahuhopu nui o ka mālama ʻana e hāʻawi i ka mālama kākoʻo. ʻO nā lāʻau e hōʻemi i ka fiva a me kahi kapa hoʻoluʻu e kōkua i ka mālama ʻana i kou mahana ma mua o ka hiki. E hoʻomaopopo koke kāu kauka i nā pilikia me ke kāpili ʻana o ke koko a hoʻomaka i ka mālama ʻana me ka hoʻopili ʻana o nā pā koko a me nā mea coagulation.

ʻO ka mea hope loa, e hāʻawi aku kāu kauka iā ʻoe i ka oxygen kākoʻo a nānā pono iā ʻoe no nā hōʻike o ARDS. E kiaʻi pono ʻia kāu kūlana oxygen me kahi oximeter pulse a i ʻole ka catherter arter radial. Inā maopopo ʻole ka hanu ʻole, kau ʻia ʻoe i kahi ʻōnaehana kākoʻo oxygen.

Nā Hana Lapaʻau

Koi paha ʻoe i ke ʻoki. Hiki ke hoʻohana ʻia i nā hana ʻoki kino e hoʻokahe i ka pus i hōʻiliʻili ʻia i loko o kāu pelvis, a i ʻole e hemo i nā kino pelvic i loaʻa i ka maʻi.

Inā loaʻa iā ʻoe kahi ʻōnaehana pale i hōʻoki ʻia, e kuhikuhi ʻia ʻoe i kahi infusion o nā hunaola keʻokeʻo. ʻO kahi koho ʻē aʻe kahi antisera (anti-toxin) therapy i hoʻomākaukau kūʻē ʻia i nā bacteria maʻamau e hoʻonāukiuki i ka septic. Ua hoʻohiki ʻia kēia hana i kekahi mau noiʻi, akā ua waiho mau ʻia me ka hoʻokolohua.

Outlook

ʻO ka haʻalulu Septic kahi maʻi nui, akā he mea nui e hoʻomaopopo he ʻano laha ʻole ia i ka hāpai ʻana. I ka ʻoiaʻiʻo, ka Nā Obstetrics a me nā GynecologyKuhi ka puke pai a hiki i ka 0.01 ka pākēneka o nā hoʻopakele āpau e hoʻonāukiuki i ka septic. ʻO nā wahine i lawa ka mālama hāpai hāpai ʻana he mea liʻiliʻi ia e hoʻomohala i nā sepsis a me ka hopena o ka haʻalulu. Inā ʻoe e ʻike i nā ʻōuli maʻamau, pono e kāhea koke aku i kāu kauka e pale aku i nā hōʻino ākea.