Baylonfiritis antibiyootiko. Hurgumada kilyaha, daaweynta (daawooyinka)

Mid ka mid ah baylonfiritis ka cudur kalyaha ugu badan waxaa loo arkaa. cudurradana waa hab ballaaran. Caabuq ku jira miskaha kelyaha iyo koobka, iyo unugyada isgoyska (interstitial). Caabuqa dhacdaa mid dibadda loo sii marayo Nidaamka kaadida ama wadada hematogenous (dhiiga) ka dillaacay kale. Dheeraad ah u falanqeeyaan baylonfiritis muujiyey. Daaweynta, diyaarinta soo reebay sidoo kale lagu tilmaami doonaa in maqaalka.

Guudmarka

The wareer weyn ee waxaa loo arkaa baylonfiritis bakteeriyada group ✰Malax mid, Escherichia iyo Pseudomonas aeruginosa, Proteus, streptococci, enterococci. Inta badan badan tahay in ka yar in uu arkay horumarka cudurada bandhigi fangaska ama fayrusyada. Baylonfiritis waxaa inta badan keena ururada wareer ah microbial ama L-foomamka. Arintaan ku kala duwan yihiin gobolka qabsiga qolof-yar lagu gartaa iska caabin sare daawooyinka. Tani waxa ay adag tahay daawaynta kaliya ka dhigaysa, laakiin sidoo kale si loo baadho cudurka. Cudurku wuxuu si degdeg ah uu noqdo ka ba'an ee marxaladda chronic. Sidaa darteed, antibiotics for kelyaha baylonfiritis waa in la magacaabay sida ugu dhaqsaha badan.

tallaabooyin daweynta

antibiotic kasta oo baylonfiritis waa in ay leeyihiin qaybaha kala duwan ee hawl-daweynta, tallaabo bactericidal sare, nephrotoxicity ugu yar. Daawada waa in sidoo kale raaca kaadida xaddiyo fara badan. Liiska antibiotics in loo qoro in cudurada lagu tilmaamay waxaa ka mid ah aminopenicillin ilaaliyo benisiliinta, cephalosporins, karboksipenitsilliny, aminoglycosides, fluoroquinolones. Next, ka fiirso wixii antibiotics waxaa inta badan loogu hurgumada kilyaha.

aminopenicillin

Khubarada ayaa isku dayaysa in aan qoray, kuwaas oo daroogada in hurgumada kilyaha. Waxay waxaa lagu gartaa hawl dabiici sare ka dhanka ah Proteus, E. coli, enterococci. Ay khasaare ugu weyn waxaa loo arkaa inay saameyn gaadhista beta-lactamases - ensaymes soo saaray noocyo kala duwan oo wareer ah caafimaad ahaan ku habboon. Maanta, kuwaas oo antibiotics at barar ku dhaca kelyaha laguma talinayo (pathology ee uurka marka laga reebo) sababta oo ah heerka kor u adkaysta (adkaysta) nooc ee E. coli (30%) daraa.

benisiliinta ilaaliyo

antibiotics Kuwani waayo, kelyo xanuun waxaa loo tixgeliyaa in hab xulasho. Medicaments muujiyaan waxqabad sare sheyga xad taban oo ay soo saaraan a beta-lactamase, iyo sidoo kale bakteeriyada garaam-positive, oo ay ku jiraan penicillin u adkaysta iyo coagulase-negative ✰Malax mid. Heerka xasiloonida, taas oo nooc bandhig of coli Escherichia in benisiliinta ilaaliyo, waa ay yar yihiin. antibiotic inta badan loogu baylonfiritis "Amoxicillin" oo macnaheedu yahay "clavulanate". isku darka waxa lagula talinayaa hoosta 625 mg / 3 p. / Day. ama parenterally at 1.2 g / 3 p. / maalintii. Duration daaweynta - ka todobo ilaa toban maalmood. qaab cusub oo sheegay in isku darka antibiotic waxaa loo arkaa in hurgumada kilyaha "Flemoklav Soljutab". daroogada ayaa la xaqiijiyay waxtarka leh cudurada kaadi-mareenka. Oo macnaheedu yahay "Flemoklav Soljutab" waxaa loo ogol yahay si loogu isticmaalo bukaanka qaba saddex bilood uurka leh.

Daawooyinka foomamka adag

Xaaladaha daran, iyo xaaladaha looga shakisan yahay cudurka xanaajiyeen by Pseudomonas aeruginosa, waa la magacaabi karaa karboksipenitsilliny. Gaar ahaan, waa sida antibiotic ah in hurgumada kilyaha, sida "ticarcillin". In koox la mid ah, oo ay tahay hab ah "Carbenicillin". Intaas waxaa sii dheer karboksipenitsillinov laga yaabaa in lagu talinayaa ureidopenitsilliny. Waxaa ka mid ah daawooyin sida "azlocillin", "Piperacillin". Waa in la ogaadaa, si kastaba ha ahaatee, in benisiliinta pseudomonas laguma talinayo sida monosredstva. Tan waxa u sabab jaaniska sare ee iska caabin ah microbial iyaga koorsada of therapy. In daaweynta baylonfiritis isticmaalo isku mid ah kuwan daroogada iyo inhibitors beta-lactamase. Gaar ahaan, isku darka qoro oo ka mid ah hab soo socda: "ticarcillin" + acid Clavulanic, "tazobactam" + "piperacillin". Sidoo kale loo isticmaalaa waa isugeynta antibiotics fluoroquinolones antipseudomonal iyo aminoglycosides. medicaments noocan oo kale ah ee loo xilsaaray, oo ay cudurrana u nosocomial daran faafa nidaamka kaadida.

cephalosporins

daawooyinka waxay leeyihiin awood u leh inay isku uruursadaan ee parenchyma kelyaha iyo kaadi-fiirsashada ku filan sare. Cephalosporins kala duwan nephrotoxicity dhexdhexaad ah. Daawooyinkan waxaa ku jira meesha hoggaamineed maanta soo noqnoqoshada caga in bukaanka qaba hurgumada kilyaha iyo cudur kaadi mareenka. Waxaa jira ka ab dhowr ah oo cephalosporins. Waxaa loo kala qaybiyey sidii spectrum ee hawlaha iyo heerka uu caabiga beta-lactamases:

• jiilka 1-dii. diyaar garowga waxay leeyihiin qaybaha kala yar oo waxqabad. Waxay door dhaqmaan on cocci Gram-positive iyo dabcan ba'an bahal ma khuseyso.
• jiilka 2aad. cephalosporins waxay leeyihiin qaybaha kala ballaaran garoomada. Waxay firfircoon yihiin marka la eego E. coli iyo dhawr kale oo Enterobacteriaceae. Waayo, daawooyinka kooxdaan waxaa ka mid ah, tusaale ahaan, waxay ka dhigan tahay "Cefuroxime."
• Qarni 3aad. Cephalosporins kooxdan waxaa loo isticmaalaa in cudurada adag. Daawooyinka laguu qoro sida gudaha (oo macnaheedu yahay "ceftibuten," "cefixime"), iyo parenterally (daawooyinka "ceftriaxone", "cefotaxime"). Xaaladan danbe caan ku yahay bar-nolosha dheer iyo isticmaalka laba siyaabood si loo soo saaro jidhka ka, kaadida iyo bile. In koox ka mid ah jiilka saddexaad cephalosporins daawooyinka la joogo, soo bandhigista dhaqdhaqaaqa ka dhanka ah aeruginosa Pseudomonas. Tani, gaar ahaan, waxay ka dhigan tahay sida "Cefoperazone" "Ceftazidime" iyo diyaarinta ingibitorzaschischenny "Cefoperazone" + "Sulbactam".
• Qarni 4aad. Cephalosporins kooxdan waxay leeyihiin oo dhan sifooyinka of daroogada oo ka mid ah qaybaha hore, laakiin waxa ay si firfircoon uga sii cocci Gram-positive yihiin.

aminoglycosides

Daawooyinkan waxaa lagu talinayaa in foomamka adag ee hurgumada kilyaha, iyo sidoo kale halis ah cudurada nosocomial. Kooxdu waxay of aminoglycosides ka mid ah hab sida "Amikacin," "Tobramycin", "netilmicin", "gentamicin." Xaaladaha daran, daawooyinka, kuwaas oo lagu daro cephalosporins iyo benisiliinta. Aminoglycosides waxaa si liidata nuugo ka soo mareenka caloosha iyo mindhicirka. Marka tan la eego, waxay la qaadi doonaa doorbidayaa parenterally. Digo ee daroogada waxaa lagu fuliyaa beddelin kaadida. Waayo, bukaanka qaba kelyaha waa lagama maarmaan si ay ula qabsadaan qiyaasta. The darrada aminoglycosides waa in ka mid ah ay nephrotoxicity loogu dhawaaqaa iyo ototoxicity. inta jeer ee lumista maqalka ee bukaanka ilaa 8%, oo dhaawac kelyaha (muujiyey sida neoliguricheskoy failure sida caadiga karo) - 17%. Tani waxay lagama maarmaan si ay u bixiyaan daaweyn in ay gacanta ku habka of heerka HOL, potassium, kariyaatiniin ah. Sababtoo ah ee ra'yi dhiibashada ee ku tiirsanaanta ee dhibaato fiirsashada ee medicaments dhiig loo isticmaalo maamulka hal wadarta qiyaasta maalin kasta. Nidaamka noocan oo kale ah, iyo waxyaabo kale, waxay ka caawisaa si loo yareeyo suurtagalnimada of horumarinta nephrotoxicity. Sababaha of dhacdo dhibaatooyinka ka mid ah:

• noqnoqoshada isticmaalka nacasta la nasasho ah oo hal sano ka yar.
• da'da Old.
• daaweynta muddada dheer la diuretics.
• codsiga Complex la adeegsanayo kooxda cephalosporins in qaadashada sare.

fluoroquinolones

Daawooyinka Kuwani waa, in sannadihii ugu danbeeyay daaweynta ee la doortay. Waxaa loo qoray in goobaha bukaan-socodka iyo bukaan-jiifka. Waayo, jiilka kowaad fluoroquinolones waxaa ka mid ah daawooyin sida "Ciprofloxacin", "pefloxacin," "Ofloxacin". Waxay firfircoon ka dhanka ah wareer ah ugu badan ee nidaamka Fistula yihiin. Faa'iidada of daroogada waa ay sumoobo hooseeyo, bar-cimri dheer, taas oo iyana, wuxuu kuu ogolaanayaa inaad si ay u laba jeer qaado maalintii. Fluoroquinolones qanci karo qaab kaadida, unugyada kelyaha, dhiig-fiirsashada ku filan sare dulqaadan. Daawooyinka codsatay labada parenterally iyo hoosta laakiin waxay ka dhigan tahay "Norfloxacin" (waxaa loogu tala galay maamulka afka). ka fluoroquinolones qarniga labaad (daawooyinka "lomefloxacin", "Levofloxacin", "Moxifloxacin", iwm) waa firfircooni badan marka la eego garaam-positive sheyga, gaar ahaan PNEUMOKOCKER. Isla mar ahaantaana waxay la mid ah sida jiilka hore ee daroogada, tallaabo xoog bakteeriyada garaam-negative (marka laga reebo Pseudomonas aeruginosa) leeyihiin.

prophylaxis of baylonfiritis

Si looga fogaado noqoshada ama hoose ee cudurada ay lagama maarmaan tahay in la baabi'iyo dhammaan kiciya la filayo. Prophylaxis of baylonfiritis waxaa ka mid ah kala duwan oo ka mid ah tallaabooyinka. Tani waxay ka mid noqon kara caadi ah ee cunto, shaqo iyo nasasho, hurdo iyo xillo. Xaalad lagama maarmaan ah ka saarida waadaxa ah ee barafowga. fiiro gaar ah in la bixiyo, in ay gobolka guud ee jirka - waxaa muhiim ah in ay jiraan infections lahayn. In xiriir this, waa inuu noqdaa macquul ah in la sameeyo therapy cudurada: colitis, suus, gastritis iyo kuwa kale.