Tuhinga
E hia te roa e noho ai te puru metilīni i te tinana?
Kāore he wā kotahi kua whakamana hei wā e “kore katoa ai te puru metilīni i tō tinana”. E ai ki ngā kōrero tapanga o nāianei mō te werohanga PROVAYBLUE, tata ki te 24 hāora te haurua-ora i te tangata. I whakatau tētahi rangahau tūao tawhito ake, e 5.25 hāora i muri i te tuku mā te ia toto. E whakaatu ana ēnei tau i te hekenga kukū i inea i raro i ngā āhuatanga rerekē, ehara i te wā kati e kore ai te rongoā i ngā kiko katoa.
He whāiti ake te pātai whai take: ko tēhea hanganga rongoā me tēhea ara tuku, ki ēhea tāngata, i inea ki tēhea tauira, mō te roa pēhea? Kāore te whakatau tata mō te kukū i te toto e āhei ana, ko ia anake, ki te whakaatu āhea tīmata ai tētahi pānga ka rangona e te tangata, āhea haumaru ai tētahi taunekeneke rongoā, mēnā rānei e tika ana te whakamahi ia rā.
He aha tonu tā te haurua-ora e ine ai
Ko te haurua-ora whakakore te wā e heke ai tētahi kukū kua inea ki tōna haurua, i te wāhanga whakakore e tātarihia ana. Ko te haurua-ora whakamutunga e whakaahua ana i te wāhanga tōmuri o te ānau kukū. Ehara i te mea ko te hekenga tere tuatahi i muri i tētahi werohanga.
Hei tauira māmā, whakaarohia ka heke tētahi kukū mai i te 100 waeine kua kōwhiria noa ki te 50 i roto i tētahi haurua-ora. I te wā tuarua he ōrite te roa, ka heke ki te 25, kaua ki te kore. He tātaitanga tēnei mō tētahi tauira ariā māmā, ehara i te whakatau tata mō te puru metilīni e toe ana i te tinana o tētahi tangata ake.
E toru atu anō ngā kupu e whakautu ana i ngā pātai rerekē:
- Te wā ki te kukū mōrahi, arā, Tmax: te wā ka kitea te kukū teitei rawa i ngā tauira kua tangohia.
- Te pānga ki te rongoā, arā, AUC: te horahanga i raro i te ānau kukū-wā, e whakakotahi ana i te kukū me te roanga wā.
- Te urupare haumanu: he panonitanga ki te āhuatanga, ki te putanga rānei e rongoātia ana, pērā i tētahi hekenga kua inea o te methemoglobin.
Ehara i te mea ka tau tahi te kukū mōrahi me te painga mōrahi. Kāore te kukū iti iho e tohu aunoa ana kua mutu tētahi pānga koiora, tētahi taunekeneke rānei.
Te whakataurite i ngā rangahau tangata
He whakataurite taketake tēnei ripanga i te rangahau a Peter, te rangahau a Walter-Sack me ōna tikanga katoa, me te arotake rongoā haumanu a te FDA mō PROVAYBLUE. Ko ngā horopeta rangahau hei tautuhi i ngā whakamātau; ehara i te tohutohu whakamahi. Ko te tikanga o MB ko te puru metilīni.
| Taunakitanga | Ara tuku me te rōpū tāngata | Matū e inea ana, tauira, me te tikanga | Te tango tauira me te hua i pūrongotia |
|---|---|---|---|
| Peter et al., 2000 | 100 mg IV me te tuku mā te waha; e whitu ngā tūao | MB i te toto katoa; wehewehenga matū mā te wai, he tino tōtika | Ngā inenga toto tae noa ki te 4 hāora, e ai ki te ripanga a te FDA; haurua-ora whakamutunga IV 5.25 hāora |
| Walter-Sack et al., 2009, wāhanga IV | 50 mg IV; 16 ngā pakeke hauora i whakaurua, 15 i whakaoti i te whakamātau whakawhiti | MB i te wē toto me te toto katoa; wehewehenga matū me te ine papatipu honohono | Ngā tauira i tangohia auautia tae noa ki te 24 hāora; haurua-ora toharite 18.5 hāora i te wē toto me te 13.6 hāora i te toto katoa |
| Walter-Sack et al., 2009, wāhanga tuku mā te waha | 500 mg o tētahi hanganga rongoā wai mā te waha; ko taua rōpū whakamātau whakawhiti anō | Ko taua matū, aua wāhanga toto, me taua whakamātautau ine anō | Ngā tauira tae noa ki te 24 hāora; haurua-ora toharite 18.3 hāora i te wē toto me te 14.7 hāora i te toto katoa; Tmax toharite i te wē toto 2.2 hāora |
| Arotake FDA, 2016, ngā rangahau whakawhanake werohanga | Kotahi te tukunga IV ki ngā tūao hauora; e whakarāpopoto ana te arotake i tētahi whāngai ā-ia 2 mg/kg, e rima meneti te roa | I inea motuhaketia te MB me te Azure B i te toto katoa me te wē toto mā te wehewehenga matū mā te wai me te ine papatipu honohono | I haere tonu ngā inenga tae noa ki te 72 hāora; e whakaahua ana te arotake i te haurua-ora whakamutunga o MB, tata ki te 24 hāora |
Tikiake i te whakataurite rangahau hei ripanga Markdown.
Ehara ēnei i ngā whakatau tata whakawhiti mō tētahi pūmau koiora kotahi e hāngai ana ki te katoa. Kāore hoki te ripanga e whakatū ana i tētahi ture māmā, arā, he roa ake i ngā wā katoa te noho o te rongoā i muri i te tuku mā te waha i tō te tuku IV. I te rangahau whakawhiti, nā te wāhanga tauira i kōwhiria i rerekē ai te whakatau tata, ahakoa he ōrite tonu te ara tuku.
He aha i rerekē ai ngā tau
He tauira rerekē te toto katoa me te wē toto. Kei roto i te toto katoa ngā pūtau e mānu ana i te wē toto. Ko te wē toto te wāhanga wai ka riro i muri i te wehe i ngā pūtau. He rerekē te pātai ine ka whakautua e tētahi whakamātautau e tatau ana i te rongoā kei ngā pūtau me te wai, i tō tētahi e aro ana ki te wai anake.
He mea nui te roanga wā mātakitaki. Ki te mutu wawe tētahi rangahau, ka iti ake ngā mōhiohio mō te hekenga tōmuri. E tautuhi mārika ana te arotake a te FDA i te roanga o te tango tauira me te ine i te toto, i te wē toto rānei, hei take mō te rerekētanga o ngā kitenga kua whakaputaina mō te nekeneke o te puru metilīni i te tinana. Mā te mātakitaki roa ake ka kitea pea tētahi wāhanga pōturi kāore e tino whakaahuatia e te tango tauira tōmua.
He mea nui te matū e inea ana. Kaua tētahi hua mō te rongoā taketake, tētahi hua mō te matū ka puta i te whakarerekē a te tinana, me tētahi tapeke e whakauru ana i ngā āhua kua hurihia ā-matū, e kīia katoatia ko te “taumata puru metilīni” me te kore whakamārama. E tautuhi ana te whakataurite i ngā matū i pūrongotia, kaua e whakaarohia he ōrite ngā inenga katoa e pā ana ki te puru.
He mea nui te hanganga rongoā. I whakamātauria e te rangahau whakawhiti mā te waha tētahi whakarite wai motuhake. Kāore tana kitenga e whakamana ana i tētahi kapene kāore i tautuhia, i tētahi wai hoko, i tētahi atu ara tuku rānei. Waihoki, he motuhake ngā whakamātau mō te tohatoha ki ngā kiko kiore i roto i te tuhinga a Peter i āna inenga toto o ngā tūao tangata. Kāore aua whakamātau e whakarato ana i tētahi wā mō te whakakorenga i te roro tangata.
E hia te roa kia tīmata ai te pānga?
Kei te tikanga o te kupu “pānga” tēnā. Mō te methemoglobinemia kua puta mai i muri, e rongoātia ana e ngā kaimātanga hauora, ka taea e ngā rata te whai i tētahi tohu toto kua āta tautuhia. E ai ki te tapanga werohanga, o ngā pakeke 12 i whai i ngā inenga tōmua e hāngai ana, e 9 i heke te methemoglobin mā te 50% neke atu i te kotahi hāora i muri i te tuku horopeta. He kitenga tēnā mō te urupare ki te maimoatanga, ehara i te haurua-ora whakakore o te puru metilīni.
Mō tētahi whakarite mā te waha, kāore te taenga ki te kukū mōrahi i te wē toto i te takiwā o te rua hāora i tētahi whakamātau tūao e whakaū ana ka tīmata te pai ake o te arotahi, te hihiko, te mahara rānei i te rua hāora. I ine te rangahau nekeneke rongoā i ngā kukū rongoā, kaua i aua painga. Kāore hoki te kare ā-tinana ka pūrongotia e tētahi tangata e āhei ana ki te tautuhi i tōna kukū wē toto, ki te whakaatu rānei kua tino whakakorea te rongoā ina mutu taua kare.
Te tae mimi, te whakamahi auau, me te wā tango rongoā
Ehara te mimi puru, kākāriki rānei i te whakamātautau kukū kua whakatikahia kia tika te ine. E mōhio ana te tapanga ki te rerekētanga o te tae o ngā wai tinana, engari kāore e hoatu ana i tētahi paepae tae hei whakaū kua whakakorea te rongoā i te tinana. Kāore te mātakitaki i te memeha o te tae e whakakapi i te aromatawai taunekeneke.
Ka panoni hoki te whakamāramatanga i runga i te mahi o ngā tākihi. E ai ki te tapanga o nāianei, ka piki te pānga ki te rongoā ina ngoikore ngā tākihi, ahakoa kāore te haurua-ora i panoni i te ngoikoretanga iti ki te āhua kaha. E whakaatu ana taua rerekētanga kāore te haurua-ora anake e rawaka hei inenga haumaru. Kei tā mātou aratohu haumaru mō te puru metilīni te whakamārama i ngā āhuatanga whānui ake o te tūroro.
Ka ara ake he pātai anō i te whakamahi auau: he aha e toe ana ina tukuna anō te rongoā? Kāore te haurua-ora o te horopeta kotahi e whakaū ana i tētahi hōtaka haumaru mō ia rā, i tētahi tauira whakamahi huringa whai hua, i te haumaru rānei o te whakamahi mō ngā marama maha. Me whai taunakitanga mō te hōtaka whakamahi auau tūturu me ōna putanga hei whakautu i ēnei.
Kaua e whakamahi i tētahi tātaitanga haurua-ora hei whakamutu, hei tīmata anō, hei whakawehe ā-wā rānei i ngā rongoā whakahaunga. Mō ngā whakatau e pā ana ki ngā rongoā whakamauru pōuri me ētahi atu rongoā e taunekeneke ana, me mōhio ki te rārangi rongoā tūturu, te hanganga rongoā, te ara tuku, te hītori o ngā tukunga rongoā, me ngā āhuatanga haumanu. Kei te aratohu mō ngā taunekeneke rongoā o te puru metilīni te whakamārama i ēnei rerekētanga. Hei āwhina i tētahi rata, kaitaka rongoā rānei, tuhia te hua, te rahinga, te ara tuku, te wā o ia tukunga, ngā rongoā i tangohia, me ngā tohumate katoa. He whai take ake aua taipitopito i tētahi rā whakakore kua whakatau tatahia.