Surgical Infections

  • View
    52

  • Download
    7

Embed Size (px)

Text of Surgical Infections

2009

..

: , .. : .-. , .. ... .. ... .. .. : .-. , ..., , . , - ..., , , ..., , , ..., , .-. , ..., , , .-. , ..., , , - , 3

, , . .. , .-. , ..., , , ..., , , .-. , ..., . .. , - , ..., . .. , ..., , ..., . .. , ..., . .. ,

..., , , , ..., , , ..., , , ..., . .. , ..., , ,

, ..., , . .. , ..., , 36 . ..., , , . , - ..., . .. , ,

4

................................................................................................................................ 8 ................................................................................................................... 11 ......................................................................................................................... 13 ............................................................................................................13 .......................................................................................................................................................15 ...........................................................................................................................16 ................................................16 ............................................................. 18 .........................................................22 ........................................................................24 ...........................26 , ....................26 ............................................................................................................................................28 , ..................................................................................................................................28 ..............................................................................................................................................................29 ......................................................................................................................................29 ......................................................................................................................................................................30 ............................................................................................................................................................................30 ...............................................................................................................................................................31 ................................................................................................................................................................32 ........................33 ...............................38 ...........................................................................................38 ..........................39 .........................................................................................................................39 .............................................................................................................................39 ............................................................................................................................................................ 40 ( ) ...............................................................................................................41 ...............................................................................................................41 .............................................................................................................................42 ....................................................................................................................................42 ................................................................................................45 ................................................................................................................................. 46

5

.......................................................................................................50 .................................................................................................................................................................................50 () ..................................................52 .............................................................................................................53 ......................................................................................................55 ....................................................................................................................................................56 - ..................................... 60 ........................................................................................................... 60 ..............................................61 ..................................................................................................................................................................65 ............................................65 ................................................................................................ 66 ..................................................................................................67 .............................................................................................................67 ..........................................................................................70 ......................................................................72 .....................................................................................................................................................................73 ................................................................................................74 ...................................................................................................................................78 ................................................................................................................................................................. 80 ..........................................................................................................................83 .........................................................................................................................84 C ...........................................................................................................88

6

-10 - - - - 10- CEAP Clinic, Etiology, Anatomy, Patophysiology S. aureus ,

IDSA Ig MRSA pH

7

() , , . , 70%. ( , ..) 36%1, 24%2. : 10% . 330 000 . , 700 . 3. , , , 50 . , , - , . . , . . , , Staphylococcus aureus, Streptococcus spp. (Streptococcus pyogenes , G), (Bacteroides fragilis Clostridium spp.)4. S. aureus . , / (MRSA), , - , , , , , . , MRSA, , 8

5. MRSA 65%, ( 5 90%). MRSA- , , , . MRSA- 6-8: - - MRSA. MRSA , (, , ), MRSA-9. ( E. coli Klebsiella spp.), - (). 50%. . , , , , - (/, /) . , , . , , , . , , , 9

. , , , , 10.

10

( , , , ..)11. 1. 1 1.1.

10 L02 A46 L02 L73.2 L02 L08 L03 M79 M72.5 M60 A48 W53-W59 T80-88 E10.5, E11.5 I83.0, I83.2 L89 T30

1-

2-

1.

1.2.

2- 3-

4- 14-

1.2.

2.

11

, , . , . , , (, ), ( , , , , , ). . 12, 13: 1) : , ; 2) : , . : ; , , ; ; 3) , ( ); 4) : . , , , , , , . , , . . , , .

12

, ( : , , ) 14, 15. : 1) , ( , , , .)16, 17; 2) (, , , , , , , .) ( SIRS, , ); 3) : ( , , ), , , , , - , 17-22. . , . . 23, 24.

, , . , . , 13

. , , . , . . . ( ) , . . ( , ) : ? , . S. aureus, S. pyogenes, P. aeruginosa . S. aureus P. aeruginosa. . , . , . , , . , . , , , . , . . , , , . - 14

. . , , , ( ). , . . . , , . , . , , . . : , .

() , . . , , , .