SIRS (Systemic Inflammatory Response Syndrome) yog dab tsi? Puas zoo li hluav taws loj hauv lub cev? Cia peb tham!

Koj puas tau hnov ​​txog ib yam mob hu ua SIRS (Systemic Inflammatory Response Syndrome)? Lub npe no tej zaum yuav tshiab rau koj. Tab sis nws yog ib yam mob txaus ntshai heev uas tuaj yeem tshwm sim hauv peb lub cev. Nws zoo li lub cev ua dhau heev rau ib qho teeb meem me me thiab pib hluav taws loj. Peb puas yuav tham txog qhov no kom meej?

SIRS (Systemic Inflammatory Response Syndrome) yog dab tsi?

Hais yooj yim xwb, SIRS yog thaum peb lub cev teb rau ib yam dab tsi uas ua rau peb ntxhov siab dhau. Xav txog nws zoo li lub teb chaws txoj kev tiv thaiv. Thaum ib tug yeeb ncuab me me tuaj, nws yuav tsum tawm tsam nws raws li txoj kev zoo. Tab sis hauv SIRS, nws zoo li cov tub rog no pib ua tsov rog loj rau ib yam me me. Qhov no ua rau mob o thoob plaws lub cev. Qhov mob o no tuaj yeem ua rau peb cov kab mob tseem ceeb puas tsuaj, ua rau lawv tsis ua haujlwm, thiab qee zaum txawm tias ua rau tuag taus. Yog vim li cas nws thiaj txaus ntshai. Thaum peb tham txog cov khoom ua rau ntxhov siab, lawv yog dab tsi?

• Kev kis kab mob : Kev kis kab mob los ntawm cov kab mob bacteria , cov kab mob virus , cov fungi, thiab lwm yam. Qee zaum, txawm tias qhov txhab me me tuaj yeem ua rau kub taub hau, tab sis yog tias nws hnyav zuj zus, nws tuaj yeem ua rau SIRS.
• Kev Phais Mob: Txawm tias tom qab phais mob loj lawm los, lub cev qee zaum kuj ua tau li no.
• Kev o ntawm lub cev: Thaum muaj kev o ntawm lub cev tam sim ntawd, hnyav heev, piv txwv li, mob pancreatitis .
• Ischemia: Qhov no yog thaum cov ntshav ntws mus rau ib feem ntawm lub cev lossis ib lub cev txo qis. Tom qab ntawd cov hlwb hauv cov cheeb tsam ntawd pib tuag, thiab lub cev tuaj yeem teb rau qhov no thiab.
• Mob qog noj ntshav: SIRS kuj tseem tuaj yeem tshwm sim hauv qee yam mob qog noj ntshav.

Tej yam zoo li no yog cov ua rau muaj SIRS.

SIRS thiab Sepsis puas yog tib yam?

Yog, txawm hais tias muaj kev sib txuas me ntsis ntawm ob qho no, sepsis yog ib qho mob txawv me ntsis ntawm SIRS. Mloog zoo. Yog tias qhov ua rau SIRS yog kev kis kab mob , qhov ntawd yog qhov peb hu ua sepsis . Koj puas nkag siab? Ntawd yog, yuav luag txhua tus neeg uas muaj sepsis muaj SIRS. Vim tias cov tsos mob ntawm SIRS tshwm sim thaum lub cev teb rau kev kis kab mob. Txawm li cas los xij, tsis yog txhua tus neeg uas muaj SIRS muaj sepsis. Vim tias SIRS tuaj yeem tshwm sim tsis yog los ntawm kev kis kab mob xwb, tab sis kuj los ntawm lwm yam ua rau xws li phais, mob qog noj ntshav, thiab ischemia, raws li tau hais ua ntej. Sepsis kuj yog ib qho mob txaus ntshai heev uas xav tau kev kho mob thaum muaj xwm txheej ceev.Yog vim li ntawd nws thiaj li tseem ceeb heev uas yuav tsum paub txog ob qho tib si.

SIRS feem ntau tshwm sim li cas?

Nws nyuaj rau cov kws tshawb fawb hais tias qhov no tshwm sim ntau npaum li cas, vim tias tsis yog txhua tus neeg uas muaj SIRS tuaj txog tsev kho mob raws sijhawm. Tab sis SIRS yog ib qho mob uas tshwm sim ntau hauv chav kho mob ceev thiab chav kho mob hnyav (ICUs) . Hauv ib txoj kev tshawb fawb, lawv tau saib ze li ntawm 27,000 tus neeg mob hauv tsev kho mob. Ntawm cov ntawd, 15% muaj tsawg kawg yog ob qho tsos mob uas yuav raug suav hais tias yog SIRS thaum lawv raug xa mus rau tsev kho mob. Thiab 47% tau ua raws li cov qauv rau SIRS tsawg kawg ib zaug thaum lawv nyob hauv tsev kho mob. Yog li koj tuaj yeem xav txog seb qhov no yuav loj npaum li cas.

Cov tsos mob ntawm SIRS yog dab tsi? Koj paub lawv li cas?

Vim tias SIRS muaj ntau yam ua rau thiab cuam tshuam rau ntau qhov sib txawv ntawm lub cev, cov tsos mob tuaj yeem sib txawv heev. Tab sis yog tias koj muaj ib lossis ntau yam ntawm cov tsos mob no, tsis txhob tsis quav ntsej lawv. Nws yog qhov zoo los nrhiav kev pab kho mob tam sim ntawd. Nov yog qee cov tsos mob:

• Liab thiab o (edema) nyob rau hauv cov cheeb tsam uas raug mob ntawm lub cev: zoo ib yam li o nyob ib ncig ntawm qhov txhab, lossis nws tuaj yeem hnyav dua.
• Mob hnyav heev: Mob tsis taus ntawm thaj chaw uas raug mob.
• Kev poob haujlwm ntawm cov khoom ntawm lub cev: Piv txwv li, tsis tuaj yeem txav ib sab caj npab lossis ceg.
• Qaug zog heev: Tej zaum koj yuav xav tias qaug zog thiab tsaug zog heev uas koj ua tsis tau dab tsi.
• Lub plawv dhia ceev dua li qub (Tachycardia): Lub plawv dhia ceev dua li qub. Nws tuaj yeem tshaj 90 zaus ib feeb.
• Kev ua pa tsis zoo: Ua pa nyuaj, ua pa nrawm dua (ntau tshaj 20 zaug hauv ib feeb).
• Kub taub hau los yog Hypothermia : Lub cev tuaj yeem kub dhau thiab ua rau kub taub hau, lossis, qhov sib txawv, qhov kub ntawm lub cev tuaj yeem poob qis dua 36 degrees Celsius (96.8 Fahrenheit).
• Ntshai los yog txias: Koj pib tshee hnyo zoo li koj kub taub hau.
• Tawv nqaij kub los yog ntub nrog hws: Qee zaum daim tawv nqaij yuav kub los yog ntub nrog hws.
• Mob pob khaus ntawm daim tawv nqaij: Muaj ntau hom mob pob khaus, xws li eczema, tuaj yeem tshwm sim rau ntawm daim tawv nqaij.
• Kev tsis meej pem, kev ntxhov siab, lossis lwm yam kev hloov pauv ntawm lub hlwb: Cov tsos mob xws li kev tsis meej pem, kev ntxhov siab, thiab kev hais lus tsis meej.
• Kev tsis nco qab: Qhov no yog ib qho cim qhia txaus ntshai heev.

Qhov tseem ceeb tshaj plaws:Yog koj muaj cov tsos mob no, thov tsis txhob nyob hauv tsev. Mus rau tsev kho mob ze tshaj plaws sai li sai tau, lossis hu rau 1990 kom tau tsheb thauj neeg mob. SIRS yog xwm txheej ceev hauv kev kho mob.

Cov ua rau muaj SIRS yog dab tsi?

Raws li tau hais ua ntej lawm, SIRS tshwm sim thaum peb lub cev tiv thaiv kab mob ua rau muaj kev ntxhov siab ntau dhau. Feem ntau, peb lub cev siv kev o los pab peb. Xav txog nws, thaum peb raug mob, nws o thiab hloov liab vim tias cov hlwb tuaj tawm tsam nws thiab pib kho qhov txhab. Tab sis hauv SIRS, qhov kev teb no dhau los ua qhov hnyav tsis tsim nyog , thiab qhov kev o no nws tus kheej ua rau peb raug mob hnyav. Nov yog qee qhov laj thawj tseem ceeb uas tuaj yeem cuam tshuam rau tus mob ntawm SIRS:

• Kev nqus cov khoom noj lossis cov kua sai sai: Yog tias cov khoom noj lossis cov kua raug nqos thaum noj mov lossis haus dej, thiab cov khoom no nkag mus rau hauv lub ntsws, qhov no kuj tuaj yeem ua rau muaj SIRS.
• Mob plawv tsis ua haujlwm sai sai: Thaum cov ntshav mus rau ib qho tseem ceeb hauv lub cev, xws li lub hlwb, lub plawv, lossis lub raum, tam sim ntawd nres lossis txo qis heev.
• Kab mob pancreatitis mob hnyav: Qhov no kuj yog ib qho mob hnyav.
• Kev tsis haum tshuaj: Lub cev tuaj yeem ua rau muaj kev tsis haum tshuaj rau qee cov tshuaj.
• Cov kab mob bacterial: Cov kab mob bacterial hnyav xws li mob ntsws thiab mob meningitis.
• Mob qog ntshav (mob qog ntshav): Cov mob xws li mob leukemia, lymphoma, thiab multiple myeloma.
• Kub hnyiab: SIRS kuj tseem tuaj yeem tshwm sim vim yog kub hnyiab loj.
• Erythema multiforme: Qhov no yog ib qho kev ua xua hnyav heev ntawm daim tawv nqaij.
• Tsis muaj ntshav ntws mus rau koj txoj hnyuv thiab txoj hnyuv tawg.
• Kev siv tshuaj uas tsis yog tshuaj kho mob thiab kev siv tshuaj ntau dhau.
• Vasculitis: Qhov no yog ib qho mob o uas tshwm sim hauv cov hlab ntsha.
• Mob Toxic shock syndrome: Qhov no kuj yog ib qho mob uas ua rau tuag taus los ntawm kev kis kab mob bacterial.
• Kev raug mob thiab kev raug mob ntsig txog kev phais.
• Cov mob khaub thuas zoo li tus kab mob khaub thuas kis: Qee zaum txawm tias tus mob khaub thuas ib txwm tuaj yeem hloov mus ua SIRS yog tias nws hnyav zuj zus.
• Kev kis kab mob fungal dav dav rau cov neeg uas muaj lub cev tiv thaiv kab mob tsis muaj zog.

Tam sim no koj yuav nkag siab tias SIRS tuaj yeem tshwm sim rau ntau yam.

Leej twg muaj feem yuav mob SIRS ntau dua?

Muaj ib txhia neeg yuav muaj tus mob SIRS ntau dua li lwm tus. Cia peb kawm seb lawv yog leej twg.

• Hnub nyoog: Cov menyuam yaus thiab cov neeg hnub nyoog tshaj 65 xyoos muaj feem yuav kis tau tus kab mob ntau dua vim tias ob tus neeg no lub cev tiv thaiv kab mob yuav tsis muaj zog me ntsis.
• Muaj lub cev tiv thaiv kab mob tsis muaj zog: Cov neeg uas tab tom kho mob qog noj ntshav, cov neeg uas muaj HIV, thiab cov neeg uas tau hloov pauv lub cev muaj lub cev tiv thaiv kab mob tsis muaj zog, ua rau lawv muaj feem yuav mob SIRS ntau dua.
• Cov mob ntev ntev: Cov neeg uas muaj mob ntev ntev xws li ntshav qab zib, cirrhosis (lub siab tawv), thiab COPD (kab mob ntsws ntev ntev) kuj muaj feem yuav mob ntau dua.
• Kev kis kab mob uas twb muaj lawm: Yog tias koj twb muaj kev kis kab mob lawm, xws li mob ntsws (pneumonia), mob meningitis, lossis mob cellulitis (kev kis kab mob ntawm daim tawv nqaij), nws yuav mob hnyav dua thiab nce mus rau SIRS.

Yog li ntawd, yog tias koj lossis ib tus neeg koj paub muaj cov yam ntxwv no, nws yog ib qho tseem ceeb heev uas yuav tsum paub txog cov tsos mob ntawm SIRS.

Cov kws kho mob kuaj mob SIRS li cas?

Vim tias SIRS yog ib yam mob uas yuav ua rau tuag taus, cov kws kho mob sim kuaj mob sai li sai tau. Lawv siv cov hauv qab no los ua li ntawd:

• Kev kuaj lub cev: Koj lub cev raug kuaj xyuas, tshwj xeeb yog cov cim tseem ceeb xws li kub taub hau, lub plawv dhia, ua pa, thiab ntshav siab.
• Koj cov tsos mob: Peb nug koj kom zoo zoo txog qhov tsis xis nyob uas koj hnov.
• Koj keeb kwm kev kho mob: Koj yuav raug nug txog tej yam xws li cov kab mob yav dhau los thiab cov tshuaj uas koj tau noj.
• Tej zaum yuav muaj SIRS: Yog tias nrhiav tau qhov ua rau muaj SIRS, nws kuj yuav pab tau rau kev kuaj mob.

Feem ntau, tus kws kho mob uas muaj cov tsos mob no yuav xav tias muaj SIRS thiab pib kho tam sim ntawd. Txawm li cas los xij, ntxiv rau qhov ntawd, lawv kuj tseem yuav ua ntau yam kev kuaj mob ntxiv los soj ntsuam koj txoj kev noj qab haus huv thiab txiav txim siab qhov ua rau muaj SIRS. Piv txwv li:

• Kev kuaj ntshav: Cov no tuaj yeem kuaj xyuas ntau yam. Piv txwv li, kev ntsuas metabolic yooj yim, kev suav ntshav tag nrho (CBC) (qhov no kuaj xyuas tus lej ntawm cov qe ntshav dawb), kev kuaj lactic acid, kev kuaj lub siab ua haujlwm, kev kuaj lub raum ua haujlwm, thiab lwm yam.
• Cov pa oxygen hauv cov ntshav.
• Kev kuaj zis.
• Kev kuaj kab mob bacterial: Txhawm rau nrhiav seb puas muaj kev kis kab mob thiab, yog tias muaj, nws yog los ntawm cov kab mob dab tsi.
• Kev ntsuam xyuas duab:Tej yam xws li X-rays lossis CT scans tuaj yeem qhia tau dab tsi tshwm sim hauv lub cev.

Cov qauv SIRS

Yuav kom kuaj tau tias koj muaj SIRS, koj yuav tsum muaj tsawg kawg yog ob yam ntawm cov tsos mob hauv qab no:

• Qhov kub ntawm lub cev: Kub ntau dua 38 degrees Celsius (100.4 Fahrenheit) lossis qis dua 36 degrees Celsius (96.8 Fahrenheit).
• Lub plawv dhia: Nce mus txog ntau tshaj 90 zaus ib feeb.
• Kev ua pa ceev: Kev ua pa ntau ntxiv hauv ib feeb ntau dua 20 zaug, lossis kev txo qis ntawm qhov siab ntawm CO2 hauv cov ntshav tsawg dua 32 mmHg.
• Cov qe ntshav dawb (leukocyte): Nce ntau dua 12,000.

Tab sis rau cov menyuam yaus, cov qauv no txawv me ntsis. Yuav kom kuaj tau tias muaj SIRS, lawv yuav tsum muaj cov qe ntshav dawb tsis zoo thiab qhov kub ntawm lub cev tsis zoo. Qhov no yog vim tias cov menyuam yaus lub plawv dhia thiab ua pa feem ntau siab dua li cov neeg laus me ntsis.

Yuav kho tus kab mob SIRS li cas?

Muaj ob yam tseem ceeb uas yuav tsum xav txog thaum kho SIRS. Ib qho yog kho qhov ua rau muaj SIRS. Qhov thib ob yog tiv thaiv kom tsis txhob muaj ntau yam kab mob ua haujlwm tsis zoo (MODS). Cov kev xaiv kho mob yuav txawv nyob ntawm qhov ua rau muaj SIRS. Txawm li cas los xij, ntawm no yog qee qhov kev kho mob uas feem ntau siv:

• Muab kua dej los ntawm cov leeg ntshav (IV fluids): Qhov no pab kom cov ntshav ntws zoo mus rau cov kab mob hauv lub cev thiab tiv thaiv kom cov ntshav siab tsis txhob poob qis dhau.
• Tshuaj tua kab mob: Yog tias SIRS yog los ntawm kev kis kab mob bacterial, cov tshuaj no yuav raug muab rau.
• Cov tshuaj vasopressor: Yog tias koj cov ntshav siab qis dhau, cov no yog muab los pab kom nws rov qab zoo li qub.
• Corticosteroids: Cov no yog siv los tiv thaiv lub cev kom tsis txhob poob siab lossis pab kom nws rov zoo los ntawm qhov ntawd.
• Kev txhaj tshuaj insulin los ntawm cov leeg ntshav (IV insulin): Tswj cov qib qab zib hauv cov ntshav (yog tias tsim nyog).
• Kev Phais Mob: Piv txwv li, kev phais mob tshawb nrhiav kom tshem tawm cov kua qaub ntawm qhov txhab uas lwj, tshem tawm cov nqaij uas puas lawm, lossis nrhiav seb muaj dab tsi tsis zoo sab hauv.

Xav txog seb, yog koj lub raum tsis ua haujlwm zoo, tej zaum koj yuav tsum tau ntxuav ntshav (ntshiab ntshav). Ib yam li ntawd, yog koj ua tsis taus pa, tej zaum koj yuav tsum tau txuas nrog lub tshuab ua pa.

Puas muaj peev xwm rov zoo los ntawm SIRS? Kev kwv yees li cas?

Kev kwv yees ntawm SIRS nyob ntawm ntau yam.

• Koj tau kuaj pom thiab kho sai npaum li cas.
• Dab tsi yog qhov ua rau muaj SIRS?
• Seb koj puas muaj tej yam uas ua rau koj muaj tus kab mob SIRS (piv txwv li, lub cev tiv thaiv kab mob tsis muaj zog).

Qhov xov xwm zoo yog tias yog kho sai sai, feem ntau cov neeg uas muaj SIRS yuav zoo tag nrho thiab rov qab mus ua neej li qub. Txawm li cas los xij, qhov no yog ib qho mob hnyav uas qee zaum tuaj yeem ua rau tuag taus. Tus nqi tuag los ntawm SIRS yog li ntawm 7%. Tus nqi tuag los ntawm sepsis tshwj xeeb yog raws li nram no:

• Rau sepsis: 1.3%
• Rau kev mob sepsis hnyav: 9.2%
• Rau septic shock (ib qho mob uas tshwm sim los ntawm sepsis): 28%

Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum nrhiav kev pab kho mob sai li sai tau thaum cov tsos mob ntawm SIRS tshwm sim, vim tias muaj kev pheej hmoo ntawm kev tuag.

Cov teeb meem uas yuav tshwm sim los ntawm SIRS yog dab tsi?

SIRS (tshwj xeeb tshaj yog tias yog los ntawm kev kis kab mob) tuaj yeem hloov mus ua mob hnyav lossis mob septic shock. Nws kuj tseem tuaj yeem ua rau muaj ntau lub cev lossis ib lub cev tsis ua haujlwm. Tsis tas li ntawd, cov teeb meem xws li:

• Tsis muaj zog adrenal txaus: Qhov no yog thaum koj cov qog adrenal tsis tsim cov tshuaj hormones tseem ceeb xws li cortisol.
• Kab mob hlwb loj heev: Txhua yam kab mob hauv lub hlwb uas cuam tshuam rau kev ua haujlwm lossis cov qauv ntawm lub hlwb.
• Kab mob ua pa nyuaj heev (ARDS): Kev puas tsuaj loj heev rau lub ntsws.
• Mob transaminitis hnyav: Kev nce ntxiv ntawm cov enzymes uas cuam tshuam rau kev ua haujlwm ntawm daim siab.
• Mob ntsws qhuav sai: Kev puas tsuaj rau lub raum.
• Ntshav txhaws hauv cov leeg ntshav tob (Deep Vein Thrombosis - DVT).
• Kev Sib Kis Kab Mob Hauv Cov Ntshav (Disseminated Intravascular Coagulation - DIC): Qhov no ua rau cov ntshav me me txhaws thoob plaws lub cev, uas ua rau kom los ntshav ntau ntxiv.
• Hemolysis: Kev rhuav tshem cov qe ntshav liab.
• Metabolic acidosis: Ua rau lub cev muaj kua qaub ntau ntxiv.
• Thrombocytosis (cov ntshav platelet ntau ntxiv) lossis thrombocytopenia (cov ntshav platelet tsawg dua).

Qee yam teeb meem no tuaj yeem kho tau thiab kho tau, thiab tuaj yeem thim rov qab. Tab sis qee yam, xws li kev puas tsuaj rau lub hlwb, tuaj yeem nyob mus ib txhis. Yog vim li cas SIRS thiaj li txaus ntshai heev.

Peb ua tau dab tsi los tiv thaiv SIRS?

Txawm hais tias SIRS tsis tuaj yeem tiv thaiv tau tag nrho los xij, muaj ob peb yam uas peb tuaj yeem ua tau los txo qhov muaj feem yuav tshwm sim. Cia peb saib seb lawv yog dab tsi.

• Ib txwm ua raws li kev coj ua huv huv zoo: Sim tiv thaiv kev kis kab mob, tshwj xeeb tshaj yog los ntawm kev ntxuav tes.
• Khaws cov qhov txhab thiab lwm yam qhov txhab kom huv si kom txog thaum lawv zoo: Ceev faj tsis txhob cia qhov txhab me me lwj.
• Tau txais cov tshuaj tiv thaiv kab mob raws sijhawm: Qhov no tuaj yeem tiv thaiv tau ntau yam kab mob.
• Tau txais kev kho mob kom zoo rau cov mob ntev: Nws yog ib qho tseem ceeb kom tswj tau cov kab mob xws li ntshav qab zib thiab ntshav siab.
• Mus ntsib kws kho mob yog tias cov tsos mob ntawm tus mob lossis tus kab mob uas twb muaj lawm zuj zus tuaj: Tsis txhob tsis quav ntsej txog qee yam me me.
• Nrhiav kev kho mob tam sim ntawd yog tias koj raug mob hnyav lossis xav tias muaj kev kis kab mob: Kev kho mob sai sai tuaj yeem tiv thaiv kev puas tsuaj loj.

Cov Lus Xaus Kawg coj mus tsev

Thawj qhov koj yuav tsum nco ntsoov yog tias SIRS (Systemic Inflammatory Response Syndrome) yog ib qho xwm txheej ceev hauv kev kho mob uas tuaj yeem ua rau tuag taus . Yuav kom tiv thaiv SIRS, nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev kho mob tam sim ntawd rau txhua yam kev kis kab mob, teeb meem ntawm tus mob, lossis kev raug mob hnyav. Yog tias tsis kho, SIRS tuaj yeem ua rau muaj teeb meem loj thiab txawm tias tuag tau. Yog tias koj muaj cov yam txaus ntshai rau SIRS (piv txwv li, lub cev tiv thaiv kab mob tsis muaj zog, mob ntev), tham nrog koj tus kws kho mob txog yuav ua li cas tswj cov kev pheej hmoo ntawd, cov tsos mob ntawm SIRS yog dab tsi, thiab yuav ua li cas yog tias lawv tshwm sim. Saib xyuas koj txoj kev noj qab haus huv thiab paub txog. Qhov ntawd yog qhov tseem ceeb tshaj plaws! SIRS, Systemic Inflammatory Response Syndrome, Sepsis, Sepsis, O, Kab mob, Lub cev teb, Kev kho mob thaum muaj xwm txheej ceev