Magungunan ƙwararrun ƙwayar cuta (VAP), wanda aka fi sani da Ventilator da aka samu daga ciwon huhu, shine ciwon huhu wanda ke tasowa tsawon sa'o'i 48 ko tsawon bayan an yi mummunan mai haƙuri. Ciwon huhu da ke tasowa a cikin farkon 48 hours na wani mai haƙuri a kan ventilator, ko kuma kasance a lokacin da aka sanya haƙuri a kan ventilator, ba a la'akari da hade-hade saboda ciwon huhu ya kasance kafin a yi amfani da ventilator.
Tsarin Magungunan ƙwayar cuta da ke ciki
Mai haƙuri zai iya taimakawa wajen hana mai dauke da ciwon huhu ta hanyar kasancewa cikin lafiya mafi kyau kafin aikin tiyata. Wannan yana nufin ba shan taba kafin a tiyata , kulawa da duk wani hakikanin hakori wanda zai iya kasancewa kuma yana yin tsabta mai tsabta. Bugu da ƙari, yin ƙoƙari don kasancewa cikin lafiya mafi kyau ta cin abinci da kyau, yin amfani da bin umarni don amfani da magunguna zai iya inganta lafiyar jiki da hana rikitarwa bayan tiyata.
Alal misali, mai haƙuri da hauka da ciwon sukari wanda yake kula da jini a sukayi akai-akai kuma yana shan maganin su dacewa da lafiya fiye da wanda yake ciwon sukari wanda ya ƙi jinin jini. Tabbatar da lafiyarka kafin aikin tiyata zai taimaka kawai wajen bunkasa aikinka, ko ciwon huhu yana tasowa ko a'a.
Rigakafin
Asibitoci sun ƙaddamar da ladabi don hana haɗarin marasa lafiya masu kwantar da hankali daga bunkasa ciwon huhu.
Kuna iya jin masu kulawa game da "yarjejeniyar VAP" ko kuma "VAP bundle" wanda ke nufin haɗawa da rigakafi a tsarin kulawa.
Saitunan yawanci sun hada da:
- Kulawa da hankali akai: Kowace rana zuwa hudu ya kamata a tsabtace baki don hana kwayoyin ƙaruwa cikin bakin da wuya.
- Matsayi gado tare da kai mai girman zuwa 30 zuwa 45 digiri: Wasu marasa lafiya, bazai yarda da wannan matsayi saboda rauni ko rashin lafiya ba, amma wadanda zasu iya jurewa da girman kai zasu kasance mai yiwuwa su ci gaba da ciwon ciwon huhu yayin da suke kwantar da hankali.
- Rushe da wuri-wuri: hanya mafi kyau don hana ventilator da ke haɗuwa da ciwon huhu shine kada ya kasance a kan mai kwakwalwa. Cire motsin numfashi da kuma barin mara lafiya yayi numfashi a kan kansu a wuri-wuri zai zama mahimmanci ga rigakafi.
- Yi amfani da kayan aiki mai yarwa ko kuma ba da kayan aiki ga mutum mai haƙuri don hana haɗin giciye tsakanin marasa lafiya.
- Yi haƙuri a kai a kai: Tsayawa mai tsabta, tare da wanka na yau da kullum ta yin amfani da tsabtace fata da aka sani da rage yawan kwayoyin cuta akan fata zai iya rage karfin kwayoyin cuta daga fata zuwa baki da huhu.
- Dole ne a wanke tsabta ta hannu kafin a zubar da tubing mai kwakwalwa, ta bada kulawa ta hanyar kulawa ko tacewa.
Wane ne ke da ma'auni ga ƙwararren ƙwayar cuta-wanda aka haɗa da ciwon huhu
Mutanen da ke fama da cututtuka na huhu, irin su COPD da kuma asma suna iya haifar da ƙaddamar da ciwon huhu. Sanarwar wani lamari ne, kamar magunguna ko sake dawowa daga neurosurgery, wani mawuyacin hali ne na ciwon huhu.
Masu shan taba da marasa lafiya wadanda ke da yanayi mai mahimmancin yanayi sun kasance mafi haɗari fiye da magunguna.
Dalili na Kasuwanci
Jigaba mai tsawo: Da ya fi tsayi mai haƙuri ya kasance a cikin wani motsa jiki mafi girman haɗarin VAP, ranar 1 a kan mai kwakwalwa ya fi 4. Saliƙai suna cikin haɗari mafi girma a cikin kwanaki biyar na farko a kan wani mai kwakwalwa.
Reintubation: An haɓaka mai haƙuri don yin numfashi a kansu sannan kuma a sake mayar da ita kuma a mayar da shi a kan motsi yayin da basu iya samun nasarar cimma burinsu na oxygen ba.
Tracheostomy: An bude wacce a cikin wuyansa, an yi tracheostomy don hana lalacewa ta wucin gadi na wugwaro a lokacin da aka dade a kan radiyo.
Wannan budewa abu ne mai mahimmanci ga kamuwa da cuta kamar yadda yake samar da wata hanya don kwayoyin shiga.
Sauye-sauye na yanayin sauyawa: Wannan shine lokacin da aka canza tubing mai haɗa macijin zuwa mai kwakwalwa.
Ƙarshen maganin ƙwaƙwalwar ƙarewa yana da ƙananan ƙananan: Rikicin da yake shiga cikin kututture mai haƙuri yana yawanci a hankali don ya hana iska daga saura. Rashin kwalba da aka ƙaddamar zai ba da izinin iska, amma kuma zai ba da damar maganin kwayoyin halitta a cikin huhu, babban mawuyacin haɗari ga ciwon huhu.
Tashin hankali mai sauƙi: Idan mai haƙuri ba zai iya samun yankin bakin da makogwaro a gaban bututun endotracheal tub din da ya dace don cire ɓoyewa ba, akwai damar samun dama na ɓoye shiga cikin huhu.
Hanyar sakonni daga ICU: Wannan yana nufin ana ɗauke shi, a cikin gado, don gwaji ko hanya, kamar CT scan.
NT tube a wurin: Kulle nasogastric shine tube wanda aka saka a cikin hanci da kuma shiga cikin esophagus don cire ruwa tare da tsotsa ko don ba da damar izinin maganin magunguna, ruwaye ko tubewa a cikin ciki. Lokaci-lokaci za'a iya shigar da tube mai tsayi a cikin wannan salon amma ana ci gaba da zurfi a cikin tashar GI. Irin wannan bututun da ake kira a matsayin magungunan NJ (ƙananan tube) yana zuwa tare da haɗarin ƙwayar ciwon huhu.
Jiyya
A lokacin da zai yiwu, al'adu da ladabi suna samuwa don gano kwayoyin da ke haifar da kamuwa da cutar ciwon huhu. Magungunan maganin rigakafi, wanda ke bi da nau'in kwayoyin cuta, ana ba da yawa lokacin da aka gano cutar ciwon huhu. Idan sakamakon sakamako ya nuna cewa wasu kwayoyin halitta zasu iya zama mafi inganci, za'a iya canza kwayoyin cutar don sakamako mafi kyau.
> Source:
> Dalili na Dama Ga ICU An Sami Huturuci. JAMA. > ftp://72.167.42.190/cardinal/pdf/Risk_factors_for_ICU_acquired_pneumonia_VAP_Cook_JAMA_052798.pdf
> Ma'aikata na Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Cutar { ananan Ruwa. Mahimmanci. > http://www.ccforum.com/content/18/2/208