Ngaba isibhedlele singafumana isifo? (Iintsholongwane eziNxulumene noNyango lwezeMpilo) Masifumanise kakuhle ngale nto!

Sonke siya esibhedlele okanye ekliniki ukuze sifumane unyango lwesifo esithile. Kodwa ngamanye amaxesha, ngaphandle kokucinga nokucinga, siya kufumana unyango lwesifo esinye kwaye olunye usulelo olutsha lunokungena emizimbeni yethu. Lo ngumbuzo ofanelekileyo kwaye uloyiko oluncinci kubantu abaninzi. Ngoko ke namhlanje siza kuthetha ngezi zifo zidluliselwa kwizibhedlele, oogqirha abazibiza ngokuba yi-'(Healthcare-Associated Infections - HAIs)' okanye '(Nosocomial Infections)', kwaye ezi zimalunga nezi.

Zithini ezi "zifo ezinxulunyaniswa nokhathalelo lwempilo"?

Ngamafutshane, oku kwenzeka xa uya esibhedlele, eklinikhi, okanye kutyando ukuze ufumane unyango lwenye into, kwaye ufumana usulelo olutsha ngelixa ulapho. Ngamanye amaxesha ezi zinokuba lula, kodwa ngamanye amaxesha zinokuba ziimeko ezinzulu nezisongela ubomi . Ezi sulelo zinokwenzeka kungekuphela nje kwizibhedlele, kodwa nakwiindawo ezifana namaziko otyando, iikliniki ze-dialysis, kunye nezibonelelo zokhathalelo lwexesha elide.

Oogqirha baya kuyibiza ngokuchanekileyo le nto ngokuthi yi-HAI kwiimeko ezinje:

• Ukuba usulelo luvela emva kweeyure ezingama-48 zokungeniswa esibhedlele.
• Ukuba usulelo luvela kwiintsuku ezi-3 emva kokuphuma esibhedlele okanye kwigumbi lotyando uze ubuyele ekhaya .
• Ukuba usulelo luvela kwiintsuku ezingama-30 emva kotyando .

Nangona nabani na enokufumana olu hlobo losulelo, abo baneenkqubo zomzimba ezibuthathaka basengozini enkulu. Oku kungenxa yeentlobo zeentsholongwane (iintsholongwane) ezisingqongileyo. Ezi ziquka:

• Iintsholongwane
• Iintsholongwane
• Iifungus `(Iifungus)`

Khumbula, uninzi lwezi HAI zinokuthintelwa. Nangona kunjalo, izigidi zezigulane kunye nabasebenzi bezempilo kwihlabathi liphela bosulelwa zizo minyaka le. Ke ngoko, kubaluleke kakhulu ukuba abasebenzi basezibhedlele kunye neentsapho zezigulane basebenzisane ukujongana nale ngxaki.

Ziziphi iintlobo eziphambili zosulelo ezinokudluliselwa ezibhedlele ngale ndlela?

Kukho iintlobo ezahlukeneyo zosulelo olunxulumene nesibhedlele olufana nolu. Izizathu zalo nazo zahlukile. Makhe sijonge ezona ziphambili.

Usulelo lwe-C. diff (Clostridioides difficile)

Le yenye yezona zifo zixhaphakileyo ezifunyanwa esibhedlele. Ibangela iintlungu zesisu, urhudo, kunye nokudumba kwamathumbu amakhulu (i-colitis). Abanye abantu banamathuba amaninzi okufumana kwakhona kwiiveki ezimbini ukuya kwezisibhozo emva kokuba benayo.

Usulelo lwendlela yomchamo olunxulumene ne-catheter (CAUTI)

Malunga ne-32% yazo zonke izifo zasesibhedlele zezo hlobo. Ungakhumbula ukuba abanye abantu bafakelwa ityhubhu kwisinyi sabo ukuze ibancede bakhuphe umchamo ngokulula, ebizwa ngokuba yi-catheter.Olu sulelo lomchamo lunokwenzeka ngakumbi xa lubanjwe ixesha elide.

Usulelo lwegazi olunxulumene nomgca ophakathi (CLABSI)

Usulelo oludluliselwa ngegazi lumalunga ne-14% yosulelo olufunyanwa esibhedlele. Olu sulelo lwenzeka kubantu abane-central line (central venous catheter). Oku kuquka ukufaka ityhubhu kumthambo omkhulu okufutshane nentliziyo, ukunika amayeza ngayo, kunye nokuthatha igazi ngaphandle kweenaliti rhoqo.

Usulelo lwe-MRSA (i-methicillin-resistant Staphylococcus aureus)

Le ikwayi-HAI eqhelekileyo kakhulu. Yi-`(Staph infection)`, oko kuthetha ukuba yintsholongwane ebangelwa yintsholongwane ebizwa ngokuba yiStaphylococcus. Kodwa eyona nto ikhethekileyo yile kukuba ayixhathisi kwiintsholongwane ezinamandla ezifana nepenicillin, i-amoxicillin, kunye ne-methicillin, oko kuthetha ukuba kunzima ukuyinyanga ngaloo mayeza.

Usulelo lweNdawo yoTyando (SSI)

Malunga ne-22% yazo zonke izifo zasesibhedlele zizifo ezinxulumene notyando. Ezi zifo zinokuchaphazela kungekuphela nje amanxeba okusikwa, kodwa kunye nezicubu kunye namalungu omzimba ngaphakathi emzimbeni, kwaye ngamanye amaxesha kwanezixhobo (ii-implants) ezifana ne-pacemakers okanye amalungu okwenziwa afakwe emzimbeni ngexesha lotyando. Khawuthelekelele, kwilali yethu eselumelwaneni, umalume kaSumane wabuya ekhaya emva kotyando ngenxa ye-appendicitis, kwaye emva kokubuya ekhaya, inxeba ladumba kwaye kwafuneka abuyele esibhedlele. Yiyo loo nto injalo.

I-Pneumonia Enxulumene Nomoya (VAP)

Oku kukwabangela malunga ne-15% yosulelo lwasesibhedlele. Le meko yenzeka kubantu abafumana umoya ongeniswa ngoomatshini . Olu hlobo lwe-pneumonia lwenzeka xa iintsholongwane zingena emiphungeni ngetyhubhu yokuphefumla ye-ventilator, esetyenziselwa ukunceda abantu baphefumle ngokwabo.

Zeziphi iimpawu ezibangelwa lolu hlobo losulelo?

Xa kuvela usulelo olufunyenwe esibhedlele, iimpawu zinokwahluka ngokuxhomekeke kuhlobo losulelo. Nangona kunjalo, nazi ezinye zeempawu eziqhelekileyo:

• Ifiva .
• Ukugodola kukuziva ubanda kwaye ungcangcazela .
• Ubunzima bokuphefumla , ukuziva uxinezelekile esifubeni (ukuphelelwa ngamandla).
• Ukukhwehlela .
• Isisu esibuhlungu .
• Ukuziva ngathi isifuba sakho sibetha ngokukhawuleza (ukubetha kwentliziyo).
• Urhudo (ukungasebenzi kakuhle kwamathumbu).
• Ukuchama rhoqo kunesiqhelo (i-polyuria).
• Ukutsha kunye nentlungu xa uchama (i-dysuria).
• Utshintsho kwimeko yengqondo - ukucaphuka, ukurhawuzelelwa, ukuziva ulahlekelwe zingqondo.

Kutheni ezi ntlobo zosulelo zenzeka ezibhedlele? Zithini izizathu?

Ezi zifo ezinxulumene nesibhedlele zinokubangelwa ziintsholongwane ezahlukeneyo (iintsholongwane). Eminye yemizekelo eqhelekileyo yile:

• Iibhaktheriya ezine-gram-negative: Ezi zinokubangela izinto ezifana nokutyhefa igazi, i-pneumonia, kunye ne-meningitis.
• I-Clostridium difficile (C. diff): Le yintsholongwane enokubangela ukudumba kwamathumbu kunye norhudo olukhulu olusasazeka lula kwabanye.
• I-Staphylococcus aureus (MRSA) engamelaniyo neMethicillin: Olu lusulelo lwebhaktheriya esikhe sathetha ngalo ngaphambili, kwaye ezinye izibulali-ntsholongwane azisebenzi kulo.
• IHepatitis: Eli liqela leentsholongwane ezidluliselwa lula nezichaphazela isibindi.

Kubalulekile nokwazi indlela ezi zifo zisasazeka ngayo. Zinokusasazeka ngamathontsi okuphefumla xa umntu ethimla okanye ekhohlela . Zinokusasazeka nokuba abasebenzi bezempilo abathathi manyathelo afanelekileyo okulawula usulelo (umzekelo, ukuba izixhobo azihlanjwanga kakuhle) .

Ngubani osengozini enkulu yokufumana olu sulelo?

Izinto ezonyusa umngcipheko wakho wokuba nesifo zibizwa ngokuba zizinto ezinobungozi. Usesichengeni sokufumana usulelo olufunyenwe esibhedlele ukuba unyango lwakho luquka:

• Ukuba une-catheters endaweni.
• Ukuba ufumana uncedo lokuphefumla ngesixhobo somoya.
• Ukuba kufuneka uhlatywe rhoqo.
• Ukuba utyando.

Ziziphi iingxaki ezinokwenzeka ngenxa yolu sulelo?

Iingxaki ezinokubakho ngenxa yezi zifo zixhomekeke kuhlobo losulelo kunye nobunzima balo. Makhe sijonge iingxaki ezinokubakho kwiintlobo ezininzi eziphambili ze-HAI:

• Iintsholongwane zegazi ezidityanisiweyo kumgca ophakathi (CLABSI):
• Ukudumba kwengaphakathi lentliziyo (endocarditis)
• Ukuqina kwemithambo yegazi kunye nokudumba (Thrombophlebitis)
• Usulelo lweThambo (i-Osteomyelitis)
• Ithumba
• I-Sepsis (usulelo olunzima olusasazeka emzimbeni wonke, olukwabizwa ngokuba yi-blood poisoning)

• Usulelo kwindawo yotyando (SSI):
• Inxeba lithatha ixesha ukuphola.
• Kuza kufuneka ndiphinde ndityandwe.
• Ukungaphumeleli komzimba ukwamkela izixhobo zonyango ezifakelweyo.
• Usulelo lwemingxunya yomzimba.
• I-Sepsis.

• Usulelo lwendlela yomchamo olunxulumene ne-catheter (CAUTI):
• Usulelo lomchamo.
• I-Sepsis.

• I-pneumonia enxulumene nomoya `(VAP)`:
• Ukungaphumeleli kokuphefumla.
• Ukuqokelelwa kobofu kulwelo lwemiphunga (i-Empyema).
• I-Sepsis.

Oogqirha bazixilonga njani ezi zifo?

Uninzi lwexesha, oogqirha banokubona ukuba umntu une-HAI xa eneempawu esizixubushileyo ngaphambili. Ngamanye amaxesha, iimpawu zokuqala ziba bomvu eluswini, irhashalala, okanye ukuphuma kwegazi kwinxeba elityandwayo . Ukuqinisekisa ukuxilongwa okanye ukuthintela enye imeko, ugqirha wakho unokuyalela uvavanyo lomchamo okanye igazi .

Zithini iindlela zonyango zoku?

Unyango lwe-HAI luxhomekeke kuhlobo losulelo. Oogqirha banokusebenzisa amayeza anjengala:

• Ii-antibiotics ( zosulelo lweebhaktheriya)
• Ii-Antivirals ( zosulelo lwentsholongwane)
• I-Antifungals ( yosulelo lwefungus)

Kodwa kukho enye ingxaki. Ngamanye amaxesha olu nyango lunokungasebenzi kakuhle ngenxa yeemeko ezifana nokunganyamezelani namayeza okubulala iintsholongwane , ukunganyangeki ngamayeza okubulala iintsholongwane, kunye nokunganyamezelani namayeza okubulala iintsholongwane. Oku "kungamelani" kuthetha ukuba iintsholongwane ziye zatshintsha (zavela) ngokuhamba kwexesha kwaye azisasebenzi kumayeza ayenzelwe ukuwabulala. Yiyo loo nto le nto ngamanye amaxesha ezi HAIs kunzima kangaka ukuzinyanga.

Ngoko ke, nangona kungenzeki rhoqo, unyango olungcono lwezi zifo ezinxulumene nesibhedlele kukuzithintela ngaphambi kokuba zenzeke.

Singenza ntoni ukuthintela ezi zifo zibangelwa sisibhedlele?

Ayizizo zonke izifo ezifunyanwa esibhedlele ezinokuthintelwa, kodwa ukuba wena nosapho lwakho nilandela la manyathelo kunye, ninokunciphisa kakhulu umngcipheko wokufumana usulelo.

• Gcina izandla zakho zicocekile. Enye yezona ndlela zilungileyo zokuthintela ukusasazeka kweentsholongwane nokuzikhusela kwizifo kukuhlamba izandla zakho rhoqo. Hlamba izandla zakho ngesepha namanzi ubuncinane imizuzwana engama-20.
• Buza oogqirha kunye nabongikazi abakunyangayo ukuba benza ntoni ukulawula usulelo. Ukuba unenkxalabo okanye uloyiko, ungoyiki ukuthetha ngabo.
• Ukuba une-catheter, soloko ubuza ugqirha okanye umongikazi wakho ukuba isafuneka na. Ngamanye amaxesha isenokushiywa ngaphakathi nasemva kokuba ingasafuneki.
• Ukuba usela amayeza okubulala iintsholongwane , wasele kanye njengoko ugqirha wakho ekuyalele, ngomlinganiselo ochanekileyo nangobude bexesha. Ungayeki ukuwasela de ugqirha wakho akuxelele ukuba wenjenjalo, nokuba uzive ungcono.
• Ngaphambi kokuba ukunike amayeza okubulala iintsholongwane , cela ugqirha wakho ukuba enze uvavanyo ukuqinisekisa ukuba lolona lufanelekileyo kwisifo sakho.
• Buza ukuba bathatha manyathelo mani ukuthintela usulelo ngaphambi nasemva kotyando.Kwakhona, buza ukuba yintoni onokuyenza ukunciphisa umngcipheko wokosuleleka njengoko ulungiselela utyando.
• Funda ukuqaphela iimpawu zosulelo lolusu. Ukuba kukho ukubomvu, ukuphuma kwamanzi emzimbeni, okanye intlungu ejikeleze inxeba lotyando okanye indawo efakwe kuyo i-catheter, oko kungaba luphawu losulelo.
• Fumana inaliti yakho yomkhuhlane kunye neminye imigonyo ecetyiswayo ngexesha. Oku kunokunceda ekukhuseleni kwezinye izifo.

Liyintoni ikamva lomntu oye wasulelwa ngolo hlobo?

Kwiimeko ezininzi, ukuba i-HAI efana nale ifunyaniswa kwangethuba kwaye inyangwa ngokufanelekileyo, abantu banokuchacha ngokupheleleyo. Nangona kunjalo, abantu abanjalo banokufuneka bahlale esibhedlele ixesha elide kwaye banokujamelana nemiqobo eyongezelelweyo kwindlela yabo yokuchacha.

Kwezinye iimeko, ezi zifo zifunyanwa esibhedlele zinokubangela iingxaki ezinkulu zempilo kwanokufa. Umzekelo, ngokutsho kweZiko loLawulo lweZifo kunye nokuThintela (CDC), malunga nabantu abangama-99,000 bayafa minyaka le kwizibhedlele zaseMelika zodwa ngenxa yezi zifo zifunyanwa esibhedlele. Le yingxaki yehlabathi.

Ndifanele ndimbone nini ugqirha?

Ukuba ufumanisa naziphi na iimpawu ezikrokrisayo, okanye ukuba uvakalelwa kukuba iimpawu zakho ziya zisiba mandundu, ngokuqinisekileyo kufuneka uxelele ugqirha wakho. Oku kubaluleke kakhulu ukuba okwangoku ulaliswe esibhedlele okanye usandul’ utyando. Ukuba uvakalelwa kukuba kukho into engalunganga, nokuba kwenzeka ntoni na, bona ugqirha wakho ngokukhawuleza uze ufumane unyango olufunekayo.

Xa sonke sigula, siya ezibhedlele nakwiikliniki ukuze siphile. Kodwa xa sisiya apho size sifumane esinye isifo, oko kubangela ixhala, ukungaqiniseki, mhlawumbi noloyiko oluncinci.

Usulelo lwase-nosocomial lunokubangela iingxaki ezinkulu. Kodwa khumbula, uninzi lwezi HAIs zinokuthintelwa. Sonke sinoxanduva lokwenza indawo esibhedlele ibe yindawo ekhuselekileyo. Ukuba ubona into ocinga ukuba inokuba lusulelo kuwe okanye komnye umntu, ungoyiki ukuxelela iqela lakho lezempilo.

Okokugqibela, izinto ekufuneka uzikhumbule

Ngoko ke, ndiyathemba ukuba ngoku uyaqonda kakuhle ukuba zithini izifo ezifunyanwa esibhedlele, ukuba zenzeka njani, kunye nendlela yokuzithintela. Eyona nto ibalulekileyo kukwazi oku kwaye ukhathalele ukhuseleko lwakho. Ukuba wena okanye umntu omaziyo ulaliswe esibhedlele, ziqaphele ezi zinto. Buza imibuzo, ucime amathandabuzo akho. Emva koko sinokuziphepha ezi zifo zingafunwayo kangangoko kunokwenzeka.

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