Yintoni i-SIRS (Systemic Inflammatory Response Syndrome)? Ingaba ifana nomlilo omkhulu ngaphakathi emzimbeni? Masithethe!

Ngaba wakha weva ngemeko ebizwa ngokuba yi-SIRS (Systemic Inflammatory Response Syndrome)? Eli gama lisenokuba litsha kuwe. Kodwa yimeko eyingozi kakhulu enokwenzeka ngaphakathi emizimbeni yethu. Kufana nomzimba osabela kakhulu kwingxaki encinci uze uqalise umlilo omkhulu. Ngaba singathetha ngale nto ngokweenkcukacha?

Yintoni i-SIRS (iSystemic Inflammatory Response Syndrome)?

Ngamafutshane, i-SIRS kuxa umzimba wethu usabela ngokugqithisileyo kwi-stressor. Cinga ngayo njengenkqubo yokuzikhusela yelizwe. Xa kufika utshaba oluncinci, kufuneka lulwe nalo ngendlela eyiyo. Kodwa kwi-SIRS, kuba ngathi lo mkhosi uqala imfazwe enkulu ngento encinci. Oku kubangela ukudumba okukhulu emzimbeni wonke. Oku kunokubangela ukudumba okunokonakalisa amalungu ethu abalulekileyo, kubangele ukuba ayeke ukusebenza, kwaye ngamanye amaxesha kube yingozi ebomini. Yiyo loo nto kuyingozi. Xa sithetha ngezinto ezibangela ukudumba, zithini?

• Izifo : Izifo ezibangelwa ziibhaktheriya , iintsholongwane , iifungi, njl. Ngamanye amaxesha, kwanosulelo oluncinci lwenxeba lunokubangela umkhuhlane, kodwa ukuba luya lusiba mandundu, lunokubangela i-SIRS.
• Utyando: Kwanasemva kotyando olukhulu, umzimba ngamanye amaxesha unokusabela ngolu hlobo.
• Ukudumba okukhawulezileyo: Xa kukho ukudumba okukhawulezileyo, okuqatha kwindawo ethile emzimbeni, umzekelo, i-pancreatitis .
• I-Ischemia: Oku kwenzeka xa ukuhamba kwegazi kwinxalenye yomzimba okanye ilungu lomzimba kuncipha. Emva koko iiseli kwezo ndawo ziqala ukufa, kwaye umzimba ungasabela koku.
• Umhlaza: I-SIRS inokwenzeka nakwezinye iimeko zomhlaza.

Izinto ezinje zezi zezona zinto ziphambili ezibangela ii-SIRS.

Ngaba ii-SIRS kunye ne-Sepsis ziyafana?

Ewe, nangona kukho unxibelelwano oluncinci phakathi kwezi zimbini, i-sepsis yimeko eyahlukileyo kancinci kune-SIRS. Mamela ngononophelo. Ukuba unobangela we-SIRS lusulelo , yiloo nto siyibiza ngokuba yi-sepsis . Uyaqonda? Oko kukuthi, phantse wonke umntu one-sepsis une-SIRS. Kuba iimpawu ze-SIRS zenzeka xa umzimba usabela kusulelo. Nangona kunjalo, ayinguye wonke umntu one-SIRS one-sepsis. Kuba i-SIRS inokubangelwa kungekuphela nje zizifo, kodwa nakwezinye izizathu ezifana notyando, umhlaza, kunye ne-ischemia, njengoko bekutshiwo ngaphambili. I-Sepsis ikwayimeko esongela ubomi kakhulu efuna unyango olungxamisekileyo.Kungoko ke kubaluleke kakhulu ukuba uzazi zombini ezi zinto.

Ixhaphake kangakanani i-SIRS?

Kunzima kubaphandi ukutsho ngqo ukuba oku kuqheleke kangakanani, kuba ayinguye wonke umntu one-SIRS ofika esibhedlele ngexesha. Kodwa i-SIRS yimeko eqhelekileyo kumasebe egumbi longxamiseko nakwiiyunithi zokhathalelo olunzulu (ii-ICU) . Kolunye uphando, bajonge phantse izigulane ezingama-27,000 ezibhedlele. Kubo, i-15% yayineempawu ezimbini ubuncinane ezaziza kuthathwa njenge-SIRS xa zingeniswa esibhedlele. Kwaye i-47% yayihlangabezana neemfuno ze-SIRS ubuncinane kanye ngexesha lokuhlala kwazo esibhedlele. Ngoko unokucinga ukuba oku kunokuba yingozi kangakanani.

Zithini iimpawu ze-SIRS? Uzibona njani?

Ngenxa yokuba i-SIRS inezizathu ezininzi kwaye ichaphazela amalungu amaninzi ahlukeneyo omzimba, iimpawu zinokwahluka kakhulu. Kodwa ukuba unenye okanye ngaphezulu kwezi mpawu, ungazityesheli. Kububulumko ukufuna ingcebiso yezonyango ngokukhawuleza. Nazi ezinye zeempawu:

• Ububomvu kunye nokudumba (i-edema) kwiindawo ezichaphazelekayo zomzimba: kufana nokudumba okujikeleze inxeba, okanye kunokuba kubi ngakumbi.
• Intlungu ebuhlungu: Intlungu enganyamezelekiyo kwindawo echaphazelekayo.
• Ukungasebenzi kakuhle kwamalungu omzimba: Umzekelo, ukungakwazi ukuhambisa ingalo okanye umlenze.
• Ukudinwa kakhulu: Usenokuziva udiniwe kwaye ulele kangangokuba awukwazi kwenza nto.
• Ukunyuka kwesantya sentliziyo (iTachycardia): Intliziyo ibetha ngokukhawuleza kunesiqhelo. Ingadlula ii-beats ezingama-90 ngomzuzu.
• Ukungaphefumli kakuhle: Ubunzima bokuphefumla, ukwanda kwesantya sokuphefumla (ngaphezulu kwezihlandlo ezingama-20 ngomzuzu).
• Umkhuhlane okanye iHypothermia : Umzimba unokuba shushu kakhulu uze ube nomkhuhlane, okanye, ngokuchaseneyo, ubushushu bomzimba bunokwehla ngaphantsi kwama-36 degrees Celsius (96.8 Fahrenheit).
• Ukungcangcazela okanye ukubanda: Uqala ukungcangcazela ngathi unomkhuhlane.
• Ulusu luvakala lushushu okanye lufumile ngenxa yokubila: Ngamanye amaxesha ulusu lusenokuziva lushushu okanye lufumile ngenxa yokubila.
• Ukuqhambuka kwesikhumba: Iindidi ezahlukeneyo zokuqhambuka, ezifana ne-eczema, zinokuvela eluswini.
• Ukudideka, ukuxhalaba, okanye olunye utshintsho lwengqondo: Iimpawu ezinje ngokudideka, ukuxhalaba, kunye nentetho engacacanga.
• Ukulahlekelwa yingqondo: Olu luphawu oluyingozi kakhulu.

Eyona nto ibalulekileyo:Ukuba unale mpawu, nceda ungahlali ekhaya. Yiya kwisibhedlele esikufutshane ngokukhawuleza, okanye utsalele umnxeba ku-1990 ukuze ufumane i-ambulensi. I-SIRS yimeko engxamisekileyo yezonyango.

Zithini izizathu ze-SIRS?

I-SIRS yenzeka, njengoko bekutshiwo ngaphambili, xa amajoni ethu omzimba esabela ngokugqithisileyo kwi-stressor. Ngokwesiqhelo, umzimba wethu usebenzisa ukudumba ukusinceda. Cinga ngako, xa sifumana inxeba, liyadumba lize lijike libe bomvu kuba iiseli ziza kulwa nalo kwaye ziqale ukuphilisa inxeba. Kodwa kwi-SIRS, le mpendulo iba nzima ngokungeyomfuneko , kwaye oku kudumba ngokwako kusenzakalisa kakhulu. Nazi ezinye zezizathu eziphambili ezinokuchaphazela imeko ye-SIRS:

• Ukufunxa ukutya okanye ulwelo ngokukhawuleza: Ukuba ukutya okanye ulwelo luginywa ngelixa usitya okanye usela, kwaye ezi zinto zingena emiphungeni, oku kunokubangela i-SIRS.
• Ischemia ye-end-organ ischemia: Xa igazi lisiya kwisitho esibalulekileyo, njengengqondo, intliziyo, okanye izintso, ngequbuliso liyema okanye linciphe kakhulu.
• I-pancreatitis ebukhali: Le yimeko enzima kakhulu.
• Impendulo engalunganga kumayeza: Umzimba ungasabela kakubi kwamanye amayeza.
• Usulelo lweebhaktheriya: Usulelo olubi lweebhaktheriya olufana ne-pneumonia kunye ne-meningitis.
• Umhlaza wegazi (i-hematologic malignancy): Iimeko ezifana ne-leukemia, i-lymphoma, kunye ne-multiple myeloma.
• Ukutsha: I-SIRS inokwenzeka ngenxa yokutsha okukhulu.
• I-Erythema multiforme: Le yimpendulo enzima yesikhumba.
• Ukunqongophala kwegazi eliya emathunjini akho kunye nokugqobhoka kwesisu.
• Ukusetyenziswa kweziyobisi ezingezizo ezonyango kunye nokugqithisa.
• I-Vasculitis: Le yimeko yokuvuvukala eyenzeka kwimithambo yegazi.
• Isifo soxinzelelo olunobungozi: Esi sisifo esisongela ubomi esibangelwa lusulelo lwebhaktheriya.
• Ukulimala okunxulumene notyando kunye nokulimala okunxulumene noko.
• Iimeko ezifana nomkhuhlane obangelwa yintsholongwane: Ngamanye amaxesha nomkhuhlane oqhelekileyo ungaguquka ube yi-SIRS ukuba uba mkhulu.
• Usulelo lwefungus oluxhaphakileyo kubantu abaneenkqubo zomzimba ezibuthathaka.

Ngoku mhlawumbi uyaqonda ukuba ii-SIRS zinokwenzeka ngenxa yezizathu ezininzi.

Ngubani osengozini enkulu yokufumana ii-SIRS?

Abanye abantu banamathuba amaninzi okuba ne-SIRS kunabanye. Masifumanise ukuba bangoobani.

• Ubudala: Abantwana abancinci kunye nabantu abaneminyaka engaphezu kwama-65 ubudala basengozini enkulu kuba zombini ezi nkqubo zokuzikhusela komzimba zisenokuba buthathaka kancinci.
• Ukuba nenkqubo yomzimba yokuzikhusela ebuthathaka: Abantu abafumana unyango lomhlaza, abo bane-HIV, kunye nabo baye bafakelwa amalungu omzimba baye babuthathaka kwiinkqubo zomzimba zokuzikhusela, nto leyo ebenza babe namathuba amaninzi okufumana i-SIRS.
• Iimeko ezingapheliyo: Abantu abanezifo ezihlala ixesha elide ezifana nesifo seswekile, isifo sesibindi (ukuqina kwesibindi), kunye ne-COPD (isifo semiphunga esingapheliyo) nabo basengozini enkulu.
• Usulelo olukhoyo: Ukuba sele unesulelo, olufana ne-pneumonia, i-meningitis, okanye i-cellulitis (usulelo lolusu), kusenokwenzeka ukuba lube yingozi kakhulu kwaye luqhubekele kwi-SIRS.

Ngoko ke ukuba wena okanye umntu omaziyo unezi zinto zinobungozi, kubaluleke kakhulu ukuba uqaphele ngakumbi iimpawu ze-SIRS.

Oogqirha baxilonga njani i-SIRS?

Ngenxa yokuba i-SIRS yimeko enokuba yingozi ebomini, oogqirha bazama ukuyixilonga kwangoko. Basebenzisa oku kulandelayo ukwenza njalo:

• Uvavanyo lomzimba: Umzimba wakho uyahlolwa, ingakumbi iimpawu ezibalulekileyo ezifana nomkhuhlane, isantya sentliziyo, isantya sokuphefumla, kunye noxinzelelo lwegazi.
• Iimpawu zakho: Sikubuza ngononophelo malunga nokungonwabi okuvayo.
• Imbali yakho yezonyango: Uza kubuzwa ngezinto ezifana nezifo zangaphambili kunye namayeza owathathayo.
• Unobangela onokubakho we-SIRS: Ukuba unobangela we-SIRS ungafunyanwa, kuya kunceda ekuxilongweni.

Ngokwesiqhelo, ugqirha onezi mpawu uya kurhanela i-SIRS aze aqale unyango ngoko nangoko. Nangona kunjalo, ukongeza, banokwenza nezinye iimvavanyo ezininzi ukuze bavavanye ngakumbi impilo yakho baze bafumane unobangela ochanekileyo we-SIRS. Umzekelo:

• Uvavanyo lwegazi: Olu vavanyo lunokujonga izinto ezininzi. Umzekelo, i-basic metabolic panel, i-complete blood count (CBC) (oku kujonga inani leeseli ezimhlophe zegazi), uvavanyo lwe-lactic acid, uvavanyo lomsebenzi wesibindi, uvavanyo lomsebenzi wezintso, njl.njl.
• Inqanaba le-oksijini egazini.
• Uhlalutyo lomchamo.
• Uvavanyo lokukhulisa iintsholongwane: Ukufumanisa ukuba kukho usulelo na, kwaye ukuba lukho, lubangelwa zeziphi iintsholongwane.
• Uvavanyo lomfanekiso:Izinto ezifana ne-X-ray okanye i-CT scans zinokubonisa okwenzekayo ngaphakathi emzimbeni.

Iikhrayitheriya ze-SIRS

Ukuze kufunyaniswe ukuba une-SIRS, kufuneka ube neempawu ezimbini kwezi zilandelayo:

• Ubushushu bomzimba: Ukunyuka okungaphezulu kwama-38 degrees Celsius (100.4 Fahrenheit) okanye ukwehla okungaphezulu kwama-36 degrees Celsius (96.8 Fahrenheit).
• Isantya sentliziyo: Sinyuke saya kutsho ngaphezulu kwe-90 beats ngomzuzu.
• Izinga lokuphefumla: Ukwanda kwenani lokuphefumla ngomzuzu elingaphezulu kwama-20, okanye ukwehla koxinzelelo lwe-CO2 egazini olungaphantsi kwama-32 mmHg.
• Inani leeseli ezimhlophe zegazi (leukocyte): Ukwanda okungaphezulu kwe-12,000.

Kodwa kubantwana, le migaqo yahlukile kancinci. Ukuze kufunyaniswe ukuba bane-SIRS, kufuneka babe nenani elingaqhelekanga leeseli ezimhlophe zegazi kunye nobushushu bomzimba obungaqhelekanga. Oku kungenxa yokuba izinga lentliziyo yabantwana kunye nezinga lokuphefumla zihlala ziphezulu kancinci kunezabantu abadala.

Iphathwa njani i-SIRS?

Kukho izinto ezimbini eziphambili ekufuneka ziqwalaselwe xa unyanga i-SIRS. Enye kunyango lwesizathu esiyintloko se-SIRS. Enye kukuthintela i-multi-organ dysfunction syndrome (MODS). Iindlela zonyango zinokwahluka ngokuxhomekeke kwisizathu se-SIRS. Nangona kunjalo, nazi ezinye zezona ndlela zonyango zixhaphakileyo:

• Ukunika ulwelo ngomthambo (ii-IV fluids): Oku kunceda ukuqinisekisa ukuhamba kakuhle kwegazi ukuya kumalungu omzimba kwaye kuthintele ukuba uxinzelelo lwegazi lungabi phantsi kakhulu.
• Ii-antibiotics: Ukuba i-SIRS ibangelwa lusulelo lwebhaktiriya, la mayeza ayanikwa.
• Amayeza e-Vasopressor: Ukuba uxinzelelo lwakho lwegazi luphantsi kakhulu, lunikwa ukuze lubuyele esiqhelweni.
• IiCorticosteroids: Ezi zisetyenziselwa ukuthintela umzimba ukuba ungangeni kwingxaki okanye ukunceda uphile kwakhona kuyo.
• I-insulini ngemithambo yegazi (i-insulini ene-IV): Lawula amanqanaba eswekile egazini (ukuba kuyimfuneko).
• Utyando: Umzekelo, utyando lokuhlola ukususa ubovu kwinxeba eliqhumayo, ukususa izicwili ezonakeleyo, okanye ukufumanisa ukuba yintoni engalunganga ngaphakathi.

Khawucinge nje, ukuba unesifo sezintso, unokufuna i-dialysis (ukucocwa kwegazi). Ngokufanayo, ukuba unesifo sokuphefumla, unokufuna ukuqhagamshelwa kwi-ventilator yomatshini.

Ingaba kunokwenzeka ukuba uphile emva kokugula ngenxa ye-SIRS? Injani imbono yakho?

Ukubikezela kwangaphambili kwe-SIRS kuxhomekeke kwizinto ezininzi.

• Indlela owafunyaniswa ngayo isifo waza wanyangwa ngokukhawuleza.
• Yintoni unobangela oyintloko we-SIRS?
• Nokuba unezinto ezinokubangela umngcipheko wokuphuhlisa i-SIRS (umz., inkqubo yomzimba yokuzikhusela ebuthathaka).

Iindaba ezimnandi zezokuba ukuba banyangwa ngokukhawuleza, uninzi lwabantu abane-SIRS luyaphila ngokupheleleyo kwaye banokubuyela kubomi obuqhelekileyo. Nangona kunjalo, le yimeko embi kakhulu enokuba yingozi ngamanye amaxesha. Izinga lokufa elivela kwi-SIRS limalunga ne-7%. Izinga lokufa elivela kwi-sepsis ngokukodwa lilandelayo:

• Kwi-sepsis: 1.3%
• Kwi-sepsis enzima: 9.2%
• Kwi-septic shock (imeko ebangelwa yi-sepsis): 28%

Kungoko ke, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngokukhawuleza xa kuvela iimpawu ze-SIRS, kuba kukho umngcipheko wokufa.

Ziziphi iingxaki ezinokubakho ze-SIRS?

I-SIRS (ingakumbi ukuba ibangelwa lusulelo) ingaqhubekela kwi-sepsis enzima okanye i-septic shock. Ingakhokelela nasekungasebenzini kwamalungu amaninzi okanye amalungu elinye. Ukongeza, iingxaki ezifana nezi:

• Ukungasebenzi kakuhle kwe-adrenal: Oku kwenzeka xa amadlala akho e-adrenal engavelisi iihomoni ezibalulekileyo ezifana ne-cortisol.
• I-Acute encephalopathy: Nasiphi na isifo sobuchopho esichaphazela umsebenzi okanye ulwakhiwo lobuchopho.
• I-Acute Respiratory Distress Syndrome (ARDS): Umonakalo omkhulu emiphungeni.
• I-Acute transaminitis: Ukwanda kwamanqanaba ee-enzyme ezithile ezichaphazela ukusebenza kwesibindi.
• I-acute tubular necrosis: Ukonakala kwezintso.
• Ukuqhekeka kwegazi kwimithambo enzulu (iDeep Vein Thrombosis - DVT).
• I-Disseminated Intravascular Coagulation (DIC): Oku kubangela ukuba kubekho amahlwili egazi amancinci emzimbeni wonke, nto leyo enyusa ukopha.
• I-Hemolysis: Ukwaphuka kweeseli ezibomvu zegazi.
• I-Metabolic acidosis: Ukwanda kwe-asidi emzimbeni.
• I-Thrombocytosis (ukwanda kwenani leeplatelet) okanye i-thrombocytopenia (ukwehla kwenani leeplatelet).

Ezinye zezi ngxaki zinokunyangwa kwaye zinyangeke, kwaye zinokuguqulwa. Kodwa ezinye, ezinje ngomonakalo wengqondo, zinokuba ngunaphakade. Yiyo loo nto i-SIRS iyingozi kangaka.

Yintoni esinokuyenza ukuthintela ii-SIRS?

Nangona ii-SIRS zingenakuthintelwa ngokupheleleyo, kukho izinto ezimbalwa esinokuzenza ukunciphisa amathuba okuba zenzeke. Masibone ukuba ziyintoni na.

• Soloko ulandela iindlela ezilungileyo zococeko: Zama ukuthintela ukosuleleka ziintsholongwane, ingakumbi ngezinto ezifana nokuhlamba izandla.
• Ukugcina amanxeba kunye namanye amanxeba ecocekile de aphole: Lumka ungavumeli nokuba linxeba elincinci libole.
• Ukufumana izitofu ezicetyiswayo ngexesha: Oku kunokukhusela kwiintsholongwane ezininzi.
• Fumana unyango olufanelekileyo lwezifo ezingapheliyo: Kubalulekile ukugcina izifo ezifana nesifo seswekile kunye noxinzelelo lwegazi oluphezulu zilawulwa.
• Bona ugqirha ukuba iimpawu zesifo okanye isifo esikhoyo ziyanda: Musa ukuyityeshela into encinci.
• Funa uncedo lwezonyango ngokukhawuleza ukuba wenzakele kakhulu okanye ukrokrela ukuba unentsholongwane: Unyango olukhawulezileyo lunokuthintela umonakalo omkhulu.

Umyalezo Wokugqibela Wokuya Ekhaya

Into yokuqala ekufuneka uyikhumbule kukuba i-SIRS (Systemic Inflammatory Response Syndrome) yingxamiseko yezonyango enokuba yingozi ebomini . Ukuthintela i-SIRS, kubalulekile ukufuna unyango ngokukhawuleza kulo naluphi na usulelo, iingxaki zemeko yezonyango, okanye ukwenzakala okukhulu. Ukuba ayinyangwa, i-SIRS inokubangela iingxaki ezinkulu kwanokufa. Ukuba unezinto ezinokubangela umngcipheko we-SIRS (umz., inkqubo yomzimba ebuthathaka, ukugula okungapheliyo), thetha nogqirha wakho malunga nendlela yokulawula ezo ngozi, zeziphi iimpawu ze-SIRS, kunye nento omawuyenze ukuba zenzeka. Nyamekela impilo yakho kwaye waziswe. Yiyo leyo into ebaluleke kakhulu! I-SIRS, iSystemic Inflammatory Response Syndrome, iSepsis, iSepsis, ukudumba, uSulelo, Impendulo yomzimba, Unyango oluNgxamisekileyo