Inqaku
Ngaba i-methylene blue inokuchaphazela ii-pulse oximeter neemvavanyo zaselabhoratri?
Ewe. I-methylene blue inokuphazamisa ii-pulse oximeter, izinti zovavanyo lomchamo nezinye izihlalutyi zaselabhoratri. Impembelelo ixhomekeke kwindlela yokulinganisa, kuxinaniso lwedayi nakwixesha. Oku akuthethi ukuba zonke iziphumo ezingaqhelekanga emva kokuchanabeka aziyonyani.
Isiphumo esibonisa ioksijini ephantsi sisafuna ukuhoywa. Funa uncedo lwezonyango olungxamisekileyo xa unokuphefumla nzima kakhulu, iintlungu zesifuba, ukudideka, ukuphelelwa zingqondo okanye imilebe eluhlaza okwesibhakabhaka nengwevu. Qhagamshelana nengcali yezempilo ngokukhawuleza xa ufumana isiphumo esiphantsi ngokungalindelekanga okanye esiqhubeka sisihla, nokuba uziva uphilile. Ingcebiso ye-FDA ngee-pulse oximeter igxininisa ukuba iimpawu neziphumo zemilinganiselo kufuneka ziqwalaselwe kunye, nokuba ioksijini ephantsi inokwenzeka ngaphandle kweempawu ezicacileyo. Xelela iqela elikunyanga ngokuchanabeka kwi-methylene blue; musa ukulinda de idayi iphele ngaphambi kokufuna uncedo.
Indlela idayi ewutshintsha ngayo umlinganiselo
Uvavanyo olusebenzisa ukukhanya lufumanisa ukukhanya, luze luguqulele loo mqondiso kwisiphumo esiphathelele umzimba. Ukuba enye into efunxa ukukhanya ingena kwisampulu, olo guqulelo lunokungachaneki. Isixhobo sinokunika ixabiso elityekele kwicala elithile, sibonise impazamo okanye singakwazi ukubala isiphumo.
Kwi-pulse oximetry, i-SpO₂ exeliweyo iqikelela ukuzaliswa kwehemoglobin yioksijini ngokukhanya okudlula kwizicubu. Uphononongo lukaGorman noShnider lokufunxwa kokukhanya yihemoglobin nayidayi lwabonisa ukuba i-methylene blue ifunxa ukukhanya okwaneleyo kwi-660 nm ukuze kubonakale ngathi ukuzaliswa yioksijini kwehlile. Oku kuchaza isiphumo esiphantsi esingeyonyani emva kokufakwa emthanjeni: ukufunxwa kokukhanya okongezelelweyo kunokuphazanyiswa notshintsho lokuzaliswa kwehemoglobin yioksijini.
Umcu wovavanyo lomchamo unengxaki eyahlukileyo. Iindawo zawo ezineekhemikhali zovavanyo zivelisa imibala etolikwa ngumntu okanye sisihlalutyi. Umchamo onombala onzulu unokuwugquma okanye uwutshintshe loo mqondiso ubonwayo. Akukho nanye kwezi ndlela ezimbini efuna ukuba into yomzimba elinganiswayo ibe itshintshile. Ngokufanayo, akukho nanye ethintela ukwenzeka kwesigulo sokwenene ngexesha elinye.
Itheyibhile yokubhekisela ekuphazamisekeni kweemvavanyo
Itheyibhile yahlula izilumkiso ezikwileyibhile, ingxelo yesigulana nemifuniselo eyafaka idayi ngqo kwiisampulu. Uxinaniso lubhekisela kwidayi ekwisampulu evavanyiweyo, hayi kwidosi emayithathwe okanye kwinqanaba elisegazini eliqikelelwa ngeleyibhile yebhotile.
| Uvavanyo okanye isixhobo | Ukuchanabeka okubhaliweyo noko kwafunyanwayo | Indlela yokuphazamiseka nomda othile womthombo |
|---|---|---|
| I-pulse oximeter | I-PROVAYBLUE efakwa emthanjeni inokunika isiphumo sokuzaliswa yioksijini esiphantsi esingeyonyani ngexesha lokufakwa okanye kungekudala emva koko. | Ukuphazamiseka kokulinganisa ngokukhanya. Ulwazi lokumisela iyeza lucebisa ukuba isampulu yegazi elivela kumthambo othwala igazi lisuka entliziyweni ivavanywe ngenye indlela; aluniki isiphindaphindi sokulungisa esisebenza kuzo zonke iimeko. |
| Intonga yovavanyo lomchamo esebenzisa isalathisi esiluhlaza okwesibhakabhaka, kuquka i-leukocyte esterase | Ileyibhile yemveliso efakwa emthanjeni ilumkisa ukuba idayi ekhutshwa ngomchamo inokuphazamisa ukutolikwa kweziphumo. | Ukuphazamiseka kombala; akuchazwanga uphawu lwemveliso, icala eya kulo impazamo okanye umda woxinaniso. Esi silumkiso asiqinisekisi ubukho bosulelo kwaye asibukhuphi. |
| I-albumin elinganiswa ngentonga yovavanyo xa ithelekiswa neprotheyini yomchamo elinganiswa ngokuba namafu | Ingxelo yesigulana ka-2018 yafumana i-albumin yentonga yovavanyo iyi-3+ (300 mg/dL), kodwa iprotheyini yomchamo iyi-18 mg/dL ngokulinganisa ukuba namafu, emva kokusetyenziswa kweyeza elidibanisa i-methenamine/methylthioninium. | Umchamo owawuluhlaza okwesibhakabhaka noluhlaza ngokunzulu wachaphazela indawo yovavanyo lwe-albumin. Yimeko enye; isishwankathelo asisichazi isihlalutyi okanye indlela iyeza elanikwa ngayo. Ayikuqinisekisi ukuthembeka kwazo zonke ezinye iimvavanyo zeprotheyini. |
| Uhlalutyo lomchamo nge-Roche cobas u601 | Kuphononongo luka-2025 lokongeza idayi kwiisampulu, i-methylene blue kumchamo kwi-≥5 mg/L yachaphazela uninzi lwezinto ezilinganisiweyo. | Ukuphazamiseka komlinganiselo osekelwe kumbala; sisiphumo esifunyenwe ngaphandle komzimba kweli qonga, hayi kuyo yonke imicu okanye kuzo zonke iindlela zokuchanabeka kwezigulana. |
| I-co-oximetry ye-Werfen GEM Premier 4000 | Kwakolo phononongo, igazi lomthambo elivela kubanikeli abasempilweni elongezelelwe idayi ukuya kwi-≥50–70 mg/L lavelisa iziphumo ezingenakubalwa. | Ukungaphumeleli komlinganiselo osebenzisa ukukhanya kuxinaniso olwavavanywayo; ayibobungqina bokuba unyango oluqhelekileyo lusoloko lusenza i-co-oximetry ingathembeki. |
| Izalathisi ze-Roche cobas c502 novavanyo lwee-amphetamine kumchamo lwe-c702 | Ukongeza idayi kwabangela ukuba isalathisi sokuqhekeka kweeseli ezibomvu zegazi sityekele ezantsi ngaphezu kwe-0.1 mg/L, isalathisi samafutha egazini sityekele phezulu ngaphezu kwe-0.01 mg/L, novavanyo lwee-amphetamine lutyekele phezulu ngaphezu kwe-0.08 mg/L. | Ukuphazamiseka kokulinganisa ngokukhanya okuxhomekeke kwindlela esetyenzisiweyo. Isalathisi asikokuxilongwa kwesifo; umqondiso ogqwethekileyo wovavanyo lokukhangela awuqinisekisi ukuchanabeka kwichiza. |
Ababhali bango-2025 babona kungenakwenzeka ukuba ukuphazamiseka abakufumanayo kwiimvavanyo ezingelulo uhlalutyo lomchamo kube yinkxalabo yezonyango kwimeko yabo. Bongeza amagqabaza ngombala womchamo ukuze baphawule uhlalutyo lomchamo olunokuba luchaphazelekile. Uvavanyo lwabo akufanele luguqulwe lube libango elisebenza kuzo zonke iimeko lokuba iimvavanyo zegazi azichaphazeleki okanye iimvavanyo zomchamo azisebenziseki.
Imilinganiselo yeoksijini iphendula imibuzo eyahlukileyo
Isampulu yegazi elivela kumthambo othwala igazi lisuka entliziyweni iluncedo kuphela xa iqela lisazi ukuba nguwuphi umlinganiselo owenziwayo. I-co-oximetry isebenzisa ubude bamaza bokukhanya obuninzi ukwahlula iintlobo zehemoglobin, kuquka i-methemoglobin. Yahlukile kwisivamvo esiqhelekileyo somnwe esisebenzisa ubude bamaza obubini. Ukuzaliswa yioksijini okubaliweyo nenxalenye yehemoglobin elinganiswe ngqo nazo ziziphumo ezahlukileyo. Uvavanyo lwaselabhoratri lweemeko ezimbini ze-methemoglobinemia luchaza ukuba ukuzaliswa yioksijini okubalwa ngemilinganiselo yeegesi zegazi kusekelwe kwingcinga yokuba ihemoglobin iziphatha ngendlela eqhelekileyo. Olo balo lunokulahlekisa xa kukho iintlobo zehemoglobin ezingaqhelekanga.
Uphando lwezonyango lweziphumo ze-co-oximeter ezingangqinelaniyo lubonisa ukuba kutheni oku kubalulekile. Ukuphazamiseka kwalo kwabangelwa yi-sulfhemoglobin, hayi yi-methylene blue. Izixhobo ezahlukileyo zanika amaxabiso angangqinelaniyo ngoxa isigulana sasineziphene zokwenene egazini. Abaphandi bathelekisa iindlela neziphumo zekliniki endaweni yokuthi isigulana okanye sonke isiphumo saselabhoratri “siqhelekile.” Loo mgaqo wokuxilonga uyasebenza naxa idayi enikiweyo ikrokrelwa njengento ephazamisayo.
I-methemoglobinemia kukuphazamiseka kokwenene kokuthuthwa kweoksijini, hayi nje umbala wegazi ongaqhelekanga. Kwisigulana esifumana unyango, ukubonakala ngathi iziphumo zesixhobo sokubeka iliso ziba mbi kunokubonisa ukuphazamiseka okubangelwa yidayi, isifo esiqhubekayo okanye enye ingxaki. Iqela elinyangayo kufuneka lahlule ezi meko. Ileyibhile ye-methylene blue ikwachaza i-anemia yokwenene ebangelwa kukuqhekeka kweeseli ezibomvu zegazi kunye nokunokwenzeka kokubuya kwe-methemoglobinemia. Olo tshintsho emzimbeni akufanele luthathwe njengeziphumo ezingeyonyani ezibangelwa ngumbala.
Ngaba ukusetyenziswa ngomlomo kubangela ingxaki efanayo?
Esona silumkiso sinamandla nge-pulse oximeter esicatshulwe apha siphathelele ukufakwa emthanjeni. Asiniki maxesha okanye mpazamo elindelekileyo yokuzaliswa yioksijini xa umthengi esebenzisa imveliso ngomlomo. Ukuchanabeka ngomlomo kusenokubaluleka kuvavanyo lomchamo: imeko epapashiweyo ebandakanya i-Prosed DS ethathwa ngomlomo, iyeza elidityanisiweyo eliqulethe i-methylene blue, yabhala ngomchamo oluhlaza okwesibhakabhaka noluhlaza yaza yachaza indlela utshintsho lombala olukwenza kube nzima ngayo ukutolika imicu esekelwe kumbala.
Indlela yokunikwa kwemveliso ibalulekile kuba ichaphazela indlela nexesha idayi efikelela ngayo egazini nasemchameni. Ngoko ke imixube yezitofu esetyenziswa kwezonyango kufuneka yahlulwe kwiimveliso ezithathwa ngomlomo xa kuchazwa ukuchanabeka. “Ndisebenzise i-methylene blue” akuloncedo kangako xa kuthelekiswa negama lemveliso, uxinaniso, isixa, indlela esetyenziswe ngayo nexesha.
Akukho thuba linye lokulinda elisekelwe kubungqina kule mithombo elenza zonke iimvavanyo zithembeke kwakhona. Umda woxinaniso lwesampulu awunakuguqulelwa kwiiyure ezidluleyo ukususela ekusetyenzisweni ngaphandle kolwazi olongezelelweyo. Ukutshintsha kombala womchamo okubonakalayo nako akunakuqinisekisa ukuba uvavanyo oluthile luthembekile.
Into omawuyixelele ingcali yezonyango okanye ilabhoratri
Ngaphambi kovavanyo olucwangcisiweyo, nika ingcali yezonyango ecele uvavanyo okanye ilabhoratri olu lwazi lulandelayo:
- Imveliso kanye esetyenzisiweyo okanye ifoto yeleyibhile yayo, kuquka ezinye izithako.
- Isixa esisetyenzisiweyo, uxinaniso, indlela esetyenziswe ngayo nexesha lokuchanabeka kwamva nje.
- Naziphi na iimpawu ezikhoyo ngoku nesizathu sovavanyo.
- Nasiphi na isiphumo esingalindelekanga, kuquka igama lesixhobo nexesha lomlinganiselo ukuba ziyafumaneka.
Musa ukuyeka unyango olumiselweyo okanye ulibazise uvavanyo olungxamisekileyo ukuze isampulu ibonakale iqhelekile. Iqela lezonyango linokugqiba ukuba longeze amagqabaza okutolika, lisebenzise enye indlela eqinisekisiweyo okanye liphinde umlinganiselo xa kufanelekile. Ukuphinda kwangoko kwaloo ndlela ichaphazelekileyo kunokuphinda nje impazamo yayo.
Kubaphandi, umbuzo ohambelana noku ngowokuba ingaba idayi itshintshe okwenzeka emzimbeni okanye ngumqondiso wovavanyo kuphela. Oko kufuna iindlela zokulawula ukuphazamiseka kwe-methylene blue kwimifuniselo. Kwizigulana, igalelo elisebenzayo kukunika ulwazi oluchanileyo ngokuchanabeka, ukuze ilabhoratri iphande umlinganiselo ofanelekileyo endaweni yokuqikelela ngombala kuphela.