Sepsisi
Sepsisi | |
---|---|
Mwainisho na taarifa za nje | |
Kundi Maalumu | Infectious diseases![]() |
ICD-10 | A40.–A41. |
ICD-9 | 995.91 |
DiseasesDB | 11960 |
MedlinePlus | 000666 |
MeSH | D018805 |
Sepsisiniinflamesheniya mwili mzima inayosababishwa namaambukizi.[1]Ishara na dalili zinazotokea mara nyingi zinajumuishahoma,kuongezeka kwa mdundo wa moyo,kuongezeka kwa kasi ya kupumua,nakuchanganyikiwa.[2]Kunaweza pia kuwa na dalili zinazohusiana na maambukizi maalum kama vile kukohoa pamoja nanumoniaaumaumivu wakati wa kukojoa,namaambukizi ya figo.Watoto wachanga zaidi, wazee na watu wenyemfumo dhaifu wa kingamwilihuenda wasiwe na dalili za maambukizi maalum nahalijoto ya mwili huenda ikawa chiniau kuwa ya kawaida wala siya juu.[3]Sepsisi kalini sepsisi inayosababishautendakazi duni wa viungoau mtiririko usiotosha wa damu. Mtiririko usiotosha wa damu unaweza kudhihirika katikashinikizo la chini la damu,viwango vya juu vyalakteti kwenye damu,auuzalishaji wa chini wa mkojo.Mshtuko wa unaosababishwa na maambukizini shinikizo la chini la damu kutokana na maambukizi yasiyopungua hata baada ya kuongezwa viowevu vya kutosha kwa vena.[1]
Kisababishi na utambuzi
[hariri|hariri chanzo]Sepsisi husababishwa namwitikio wa kingaunaochochewa na maambukizi.[3][4]Maambukizi haya mara nyingi husababishwa nabakteria,lakini pia yanaweza kusababishwa nakuvu,virusi,auvimelea.[3]Viungo vinavyoathiriwa na maambukizi makuu mara nyingi vinajumuisha: mapafu, ubongo,kibofu cha mkojo,ngozi naviungo vya fumbatio.Vipengele vya hatari vinajumuisha umri mchanga au uzee, mfumo wa kinga uliodhoofishwa na hali kama vilesarataniaukisukari,najeraha kuuaumaunguzo.[2]Utambuzi hutegemea kutimiza angalau vigezo viwili vyasindromu ya kimfumo ya mwitikio wa inflamesheni(SIRS) kutokana na maambukizi tarajiwa.Uchunguzi wa damuhupendekezwa ikiwezekana kabla ya kuanza kutumia antibiotiki; hata hivyomaambukizi ya damusi muhimu ili kudhibitisha ugonjwa huu.[3]Upigaji picha za kimatibabuunapaswa kufanywa ili kufahamu eneo la maambukizi.[1]Visababishi vingine vinavyoweza kusababisha ishara na dalili sawa na hizi zinajumuisha:anafilaksisi,kushindwa kwa utendakazi wa tezi za adrenali,kiasi cha chini cha damu,kushisndwa kwa moyo,nauemboli wa mapafuna kadhalika.[3]
Matibabu
[hariri|hariri chanzo]Sepsisi kwa kawaida hutibiwa kwaviowevu vinavyodungwa kwenye mishipanaantibiotiki.Hii mara nyingi hufanywa katikakitengo cha wagonjwa mahututi.Ikiwakuongezwa viowevuhakuimarishi shinikizo la damu, dawa zakuongeza shinikizo la damuzinaweza kutumika.Usambazaji wa hewa safi kutumia nelinadialisisizinaweza kuhitajika ili kuboresha utendakazi wa mapafu na figo mtawalia.[2]Ili kuongoza matibabu,katheta ya mshipa wa kati wa venanakatheta ya aterizinaweza kuwekwa. Vipimo vingine kama vilekiasi cha damu kinachotoka kwenye moyonavena kava ya juukukolea kwa oksijenipia inaweza kutumika. Watu wenye maambukizi wanahitaji hatua za kinga dhidi yathrombosisi ya mishipa ya ndani,vidonda kutokana na mfadhaikonavidonda kutokana na shinikizo,isipokuwa ikiwa hali zingine zinazuia hatua kama hizi. Wengine wanaweza kufaidika kutokana na udhibiti mkali wa viwango vyasukari ya damukwa kutumiainsulini.[1]Matumizi yakotikosteroidiyana utata.[5]Drotrecoginalfa iliyochochewaambayo awali ilitumika katika maambukizi makali haijadhihirika kuwa bora hivyo iliachwa kuuzwa mwaka wa 2011.[6]
Prognosisi, epidemiolojia na historia
[hariri|hariri chanzo]Wakati mwingine matokeo ya ugonjwa huu hutegemea ukali wake, huku hatari ya kifo kutokana na maambukizi ikiwa juu kwa asilimia 30, maambukizi makali yakiwa juu kwa asilimia 50 na mshtuko wa maambukizi ukiwa juu kwa asilimia 80.[7]Idadi jumla ya visa ulimwenguni kote haijulikani kwani kuna data kidogo kutoka kwanchi zinazoendelea.[7]Makadirio yanaonyesha kuwa sepsisi inawaathiri mamilioni ya watu kila mwaka.[1]Katikanchi zilizoendeleatakriban watu 0.2 hadi 0.3 kwa kila watu 1000 hupata sepsisi kila mwaka au takriban visa milioni moja kila mwaka nchini Marekani.[7][8]Kiwango cha kutokea kwa ugonjwa huu kimezidi kuongezeka.[1]Sepsisi hutokea zaidi katika wanaume kuliko kwa wanawake.[3]Maneno septikemia na sumu ya damu yanayoashiria viumbehai vidogo au toksini zake katika damu hayatumiki mara nyingi kwa sasa.[9][10]Maelezo ya hali hii yamekuwa yakitolewa angalau kuanzia nyakati zaHippocrates.[10]
Marejeleo
[hariri|hariri chanzo]- ↑1.01.11.21.31.41.5Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup; Dellinger, RP; Levy, MM; Rhodes, A; Annane, D; Gerlach, H; Opal, SM; Sevransky, JE; Sprung, CL; Douglas, IS; Jaeschke, R; Osborn, TM; Nunnally, ME; Townsend, SR; Reinhart, K; Kleinpell, RM; Angus, DC; Deutschman, CS; Machado, FR; Rubenfeld, GD; Webb, S; Beale, RJ; Vincent, J-L; Moreno, R (2013)."Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2012"(PDF).Critical Care Medicine.41(2): 580–637.doi:10.1097/CCM.0b013e31827e83af.PMID23353941.Ilihifadhiwa kwenye nyaraka kutokachanzo(PDF)mnamo 2015-02-02.Iliwekwa mnamo2015-08-17– kutokaSurviving Sepsis Campaign.
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suggested) (help) - ↑2.02.12.2"Sepsis Questions and Answers".cdc.gov.Centers for Disease Control and Prevention(CDC). Mei 22, 2014.Iliwekwa mnamo28 Novemba2014.
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:CS1 maint: date auto-translated (link) - ↑3.03.13.23.33.43.5Jui, Jonathan (2011). "Ch. 146: Septic Shock". Katika Tintinalli, Judith E.; Stapczynski, J. Stephan; Ma, O. John; Cline, David M.; na wenz. (whr.).Tintinalli's Emergency Medicine: A Comprehensive Study Guide(toleo la 7th). New York:McGraw-Hill.ku. 1003–14.Iliwekwa mnamoDesemba 11,2012– kutoka AccessMedicine.
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suggested) (help)CS1 maint: date auto-translated (link) - ↑Deutschman, CS; Tracey, KJ (Aprili 2014). "Sepsis: Current dogma and new perspectives".Immunity.40(4): 463–75.doi:10.1016/j.immuni.2014.04.001.PMID24745331.
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:CS1 maint: date auto-translated (link) - ↑Patel, GP; Balk, RA (Januari 15, 2012)."Systemic steroids in severe sepsis and septic shock".American Journal of Respiratory and Critical Care Medicine.185(2): 133–9.doi:10.1164/rccm.201011-1897CI.PMID21680949.
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:CS1 maint: date auto-translated (link) - ↑Martí-Carvajal, AJ; Solà, I; Lathyris, D; Cardona, AF (Machi 14, 2012). Martí-Carvajal, Arturo J. (mhr.). "Human recombinant activated protein C for severe sepsis".Cochrane Database of Systematic Reviews.3:CD004388.doi:10.1002/14651858.CD004388.pub5.PMID22419295.
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:CS1 maint: date auto-translated (link)Kigezo:Update inline - ↑7.07.17.2Jawad, I; Lukšić, I; Rafnsson, SB (Juni 2012)."Assessing available information on the burden of sepsis: Global estimates of incidence, prevalence and mortality"(PDF).Journal of Global Health.2(1): 010404.doi:10.7189/jogh.02.010404(si hai 2015-02-02).PMC3484761.PMID23198133.
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:CS1 maint: DOI inactive as of Februari 2015 (link) CS1 maint: date auto-translated (link) - ↑Martin, GS (Juni 2012)."Sepsis, severe sepsis and septic shock: hanges in incidence, pathogens and outcomes".Expert Review of Anti-infective Therapy.10(6): 701–6.doi:10.1586/eri.12.50.PMC3488423.PMID22734959.
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:CS1 maint: date auto-translated (link) - ↑Bone, R; Balk, R; Cerra, F; Dellinger, R; Fein, A; Knaus, W; Schein, R; Sibbald, W (1992)."Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine"(PDF).Chest.101(6): 1644–55.doi:10.1378/chest.101.6.1644.PMID1303622.Ilihifadhiwa kwenye nyaraka kutokachanzo(PDF)mnamo 2015-03-19.Iliwekwa mnamo2015-08-17.
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