Chinyorwa
Zviratidzo zve‘kufa kweutachiona’ mushure memethylene blue: nei tsananguro ichikosha
Kunzwa uchinyanya kurwara mushure mekutora methylene blue hakuratidzi kuti utachiona huri kufa kana kuti chepfu iri kubuda mumuviri wako. Kutemwa nemusoro, kusvotwa, kuneta, kana kudedera zvinhu zvaunocherechedza. Kuzvidana kuti “kufa kweutachiona” kunowedzera chikonzero chisingagoni kusimbiswa nechiratidzo chacho pachacho.
Kana uine zviratidzo zvitsva, usatora imwe dose uchizvisarudzira paunenge uchitsvaga mazano ekurapa. Zviratidzo zvakakomba kana zviri kukurumidza kuwedzera zvinoda rubatsiro rwechimbichimbi. Kana methylene blue yakapiwa munzvimbo yekurapwa, zivisa vari kukurapa pakarepo. Usaedza kutsungirira kuita kwemuviri kuitira kuti chirongwa chekuchengetedza utano chako “chishande.”
Zvinofungidzirwa nemashoko ekuti “kufa kweutachiona”
Tsananguro iyi inowanzova nezvinotaurwa zvitatu zvakasiyana: pane utachiona mumuviri, methylene blue iri kuhurova zvinobudirira, uye kurapa kwacho kuri kuita kuti muviri upindure nekuzvimba. Kunzwa uchirwara mushure mekushandisa chinhu ichi hakusimbisi chero chimwe chezvinhu izvi.
Kusiyanisa izvi kunobatsira pakuita zvisarudzo. “Kusvotwa kwakatanga maawa maviri mushure mekunge ndatora chigadzirwa ichi” kunopa nyanzvi yezveutano mashoko ainogona kuongorora. “Ndiri kubvisa chepfu mumuviri” kunotsiva mashoko iwayo nemhedziso. Kunogonawo kuita kuti munhu arege kucherechedza mumwe mushonga, kukanganisa pakuwanda kwechinhu chiri mumusanganiswa, kana chirwere changotanga panguva imwe chete.
Handina kuwana humbowo kubva muzvidzidzo zvekurapa zvine mapoka ekuenzanisa hunosimbisa kuti kune “muunganidzwa wezviratidzo zvekufa kweutachiona” unogona kutarisirwa kuvanhu vanotora methylene blue kuti vachengetedze utano. Izvi hazvirevi kuti kuita kwese kwemuviri kusina tsananguro kwakamboongororwa. Zvinoreva kuti hapana runyorwa rwezviratidzo kana nguva yazvinotarisirwa kutora zvinotsigirwa nehumbowo zvingashandiswa kukupa chivimbo mumamiriro aya. Mubvunzo wakasiyana wekuti methylene blue inobvisa simbi dzinorema here kana kuti inoshanda kubvisa chepfu unoda humbowo hwekubviswa kwazvo, kwete hwekuti munhu anonzwa sei pashure.
Zvinonyatsorehwa nekuita kweJarisch–Herxheimer
Izwi iri rinoshandiswa mumamiriro ekurapa akatarwa. Nhungamiro yeCDC yekurapa syphilis inotsanangura kuita kweJarisch–Herxheimer sekuita kwemuviri kunongoerekana kwatanga, kunosanganisira fivha, uye kunogona kuitika mukati me24 hours ekutanga mushure mekutanga kurapa syphilis, kazhinji kuchiperekedzwa nekutemwa nemusoro nekurwadza kwetsandanyama. Kunosiyaniswa nekusawirirana kwemuviri nepenicillin. Izvi hazvirevi kuti fivha ipi neipi mushure mechinhu chipi nechipi chinorwisa utachiona ndiko kuita kumwe chete uku.
Mashoko anobatsira emazuva ano anobva muongororo yechipiri ya2025 yedata rechidzidzo chesyphilis chakagovera vanhu mumapoka zvisina kurongwa. Vatsvakurudzi vakaongorora vanhu vakuru 249 vaiva nesyphilis ichiri mumatanho ekutanga mushure mekurapwa kwavo kwekutanga nebenzathine penicillin G yakabaiwa mutsandanyama. Makumi mashanu nevapfumbamwe, kana kuti 23.7%, vakataura zviratidzo zvaienderana nekuita uku. Nguva yepakati yekutanga kwezviratidzo yaiva 4.9 hours uye nguva yepakati yazvakatora yaiva 12.8 hours. Zviratidzo zvakanyorwa pachishandiswa runyorwa rwakafanana kune wese, kwete kusimbiswa nekuongorora kumwe chete kwemurabhoritari kunopa chirwere.
Nhamba idzodzo dzinotsanangura utachiona hwakatarwa, kurapa kwakatarwa, neboka revanhu raiva muchidzidzo. Hadzisi nguva yekumirira kumunhu ari kunzwa kurwara mushure mekutora methylene blue nemuromo. Kunyange mumamiriro akakodzera ekurapa utachiona, nyanzvi yezveutano inofanira kufunga nezvedzimwe tsananguro dzinobvira. Zita racho roga harisimbisi kuti kugara kumba kwakachengeteka.
Tafura yekusiyanisa: zvinocherechedzwa, tsananguro, danho rinotevera
Tafura iyi inosiyanisa zvinogona kutaurwa nezvichiri kuda kuongororwa. Inobatsira pakukurukurirana, haisi nzira yekupa zvibodzwa kuti paonekwe chirwere.
| Zvaunocherechedza | Zvazvisingasimbisi | Zvinofanira kuongororwa |
|---|---|---|
| Kutemwa nemusoro, kusvotwa, kana manyoka mushure mekushandisa chinhu ichi | Kuti utachiona hwakaurayiwa kana chepfu yakaburitswa | Chigadzirwa, uwandu, nguva, zviratidzo zvinoperekedza, nezvimwe zvinogona kukonzera izvi |
| Kudikitira, kusagadzikana, fivha, kana kudedera, kunyanya kana zviri pamwe chete | Chikamu chinodiwa chekuti muviri ujairane nechinhu ichi | Kukuvadzwa neserotonin kunobvira kana chimwe chirwere chinongoerekana chatanga; tsvaga kuongororwa kwechimbichimbi |
| Kushaya simba kutsva, kufema zvakaoma, maziso eyero, kana weti yakasviba | Kuti muviri uri kubvisa chepfu | Kushomeka kwemasero matsvuku eropa kana chimwe chirwere chinobvira; kurumidza kuongororwa nachiremba, nechimbichimbi kana zvakakomba |
| Mapundu paganda pamwe nekuzvimba kwechiso kana pahuro, kufema kuchiridza muridzo, kana kudonha | “Herx” isingakuvadzi | Kusawirirana kwakakomba kwemuviri nechinhu ichi kunobvira; fonera rubatsiro rwechimbichimbi |
| Fivha nekurwadza mushure mekurapwa syphilis yakaonekwa, uchitungamirirwa nenyanzvi yezveutano | Humbowo hwekuti chiratidzo chese chinozouya chine chikonzero chimwe chete | Vari kukurapa vanogona kuongorora kuita kweJarisch–Herxheimer kunobvira pamwe nekusawirirana kwemuviri nemushonga nezvimwe zvikonzero |
Mutsara wekutanga une zviratidzo zvakanyorwa pakati pemigumisiro isingadiwi mumashoko ekunyorera mushonga wePROVAYBLUE. Mashoko aya ane chekuita nemushonga unonyorerwa nachiremba uchipiwa mutsinga kurapa methemoglobinemia inowanikwa mushure mekuzvarwa. Kuwanda kwezviitiko zvakanyorwa ipapo hakufaniri kushandiswa pazvigadzirwa zvinotorwa nemuromo nevatengi, asi njodzi dzawo dzakanyorwa hadzifaniri kupiwa zita rekuti “kubvisa chepfu.” Anoyambirawo nezveserotonin syndrome yakakomba, kusawirirana kwakakomba kwemuviri nemushonga, uye kushomeka kwemasero matsvuku eropa kunokonzerwa nekuparara kwawo, kusanganisira njodzi yakanyanya kana G6PD iri shoma. Kushomeka uku kweropa kunogona kuzononoka kutanga kwezuva kana kupfuura mushure mekurapwa.
Nei kubatana kwezviratidzo kuchikosha
Kusagadzikana kwemudumbu kamwe chete hakuratidzi kuti une serotonin syndrome. Kubatana kwekuchinja kwepfungwa, kukwira kwekupisa kwemuviri, kudikitira, uye kushanda kwetsandanyama kusina kujairika kunonyanya kunetsa. MedlinePlus inotsanangura kuti serotonin syndrome inogona kuisa upenyu panjodzi uye inotsanangura kuti kuongorora kunosanganisira nhoroondo yemishonga pamwe nekuona kuti hazvisi kukonzerwa nezvimwe zvinhu. Usamirira kuti chiratidzo chese chinobvira chioneke usati watsvaga rubatsiro.
Njodzi yekusanganisa zvinhu inoita kuti kudyidzana kwemethylene blue nemimwe mishonga kuve kwakakosha kunyange munhu achiti chinhu chaakashandisa chinowedzerwa pautano. Huya nerunyorwa rwese rwemishonga, kusanganisira mishonga yekuora mwoyo, yemarwadzo, yechikosoro, nezvimwe zvinowedzerwa pautano. Usarega mishonga yakanyorerwa nachiremba uchizvisarudzira kana kugadzira hurongwa hwekumirira kuti mishonga ibude mumuviri kuitira kuti urambe uchitora methylene blue.
Hemolysis zvinoreva kuparara kwemasero matsvuku eropa. NHLBI inotsanangura kuti kushomeka kweropa kunokonzerwa nekuparara kwemasero kunoitika kana kuparara kuchipfuura kutsiviwa kwawo, uye kuziva chirwere ichi kunoda kuongororwa nemiedzo yeropa. Zviratidzo zvekushomeka kweropa zvinogona kusanganisira kufema zvakaoma, kushaya simba, kutsvukirira kweyero kweganda nemaziso, uye weti yakasviba. Izvi hazvisi zviyero zvekubviswa kwechepfu. Methylene blue pachayo inogona kuchinja ruvara rweweti, saka ruvara roga harugoni kusimbisa tsananguro yacho.
Fonera rubatsiro rwechimbichimbi kana uchinetseka kufema, wadonha, uchibatwa nepfari, wavhiringidzika zvakanyanya, kana kuita kwemuviri kuri kukurumidza kuipa. Usazvityaira kana uine dzungu, wakavhiringidzika, kana kugona kwako kuita zvinhu kwakanganiswa neimwe nzira.
Nyora zvakashandiswa usingazvipi zita rechirwere
Kana zviratidzo zvisiri zvechimbichimbi, kurumidza kubata nyanzvi yezveutano kana wemishonga uye shandisa gwaro rezviratidzo nezvakashandiswa kunyora zvinhu zvina:
- Zita rechigadzirwa, chimiro chacho, kuwanda kwechinhu chiri mumusanganiswa, uye mufananidzo wemashoko ari pachigadzirwa.
- Uwandu nenzira yakashandiswa, nguva dzekushandisa, uye chero kuchinja kuchangobva kuitwa.
- Zviratidzo mumutauro wemazuva ose, nguva yazvakatanga, kukomba kwazvo, uye kana zviri kuita nani kana kuipa.
- Mimwe mishonga nezvinowedzerwa pautano, mamiriro eutano ane chekuita nazvo, uye chero mugumisiro unozivikanwa wekuongororwa kweG6PD.
Usatora imwe dose kuti uedze kana zviratidzo zvichidzoka. Usawedzera chinhu “chinosunga chepfu,” kupinda musauna, chirongwa chekutsanya, kana musanganiswa wezvinowedzerwa pautano kuti udzore kuita kwemuviri kwaunofungidzira kuti kubvisa chepfu. Kuwedzera zvimwe zvinoitwa kunoita kuti nhoroondo yezvakashandiswa iome kutsanangura uye hakusimbisi chikonzero chepakutanga. Nhungamiro yakazara yekuchengeteka kwemethylene blue inotsanangura migumisiro isingadiwi inozivikanwa uye nzira yekuzivisa kuita kwemuviri kunofungidzirwa kuti kwakakonzerwa nayo.