Inqaku
Imethylene blue ihlala ixesha elingakanani emzimbeni?
Imethylene blue ayinalo ixesha elinye eliqinisekisiweyo lokuba “iphume ngokupheleleyo emzimbeni wakho”. Ilebhile yangoku yenaliti ye-PROVAYBLUE ichaza ukuba ixesha lokuncipha ngesiqingatha ebantwini limalunga neeyure ezingama-24. Uphando oludala olwenziwa kumavolontiya lwaqikelela iiyure eziyi-5.25 emva kokunikezelwa emthanjeni. La manani achaza ukuhla koxinaniso olulinganisiweyo phantsi kweemeko ezahlukeneyo, hayi ixesha elimiselweyo ekuthi emva kwalo zonke izicubu zingabi nalo iyeza.
Umbuzo oluncedo kufuneka ucace ngakumbi: loluphi ulungiselelo nendlela yokunikezelwa, kubaphi abantu, kulinganiswa kweyiphi isampulu, kwixesha elingakanani? Uqikelelo loxinaniso egazini alunakukuxelela lodwa ukuba isiphumo osivayo kufuneka siqale nini, ukuba unxibelelwano namanye amayeza lukhuseleka nini, okanye ukuba ukusetyenziswa mihla le kufanelekile na.
Yintoni kanye kanye elinganiswa lixesha lokuncipha ngesiqingatha
Ixesha lokuncipha ngesiqingatha ngexesha lokususwa emzimbeni lixesha elithathwayo ukuze uxinaniso olulinganisiweyo lwehle ngesiqingatha kwinqanaba lokususwa elihlalutywayo. Ixesha lokuncipha ngesiqingatha kwinqanaba lokugqibela lichaza inxalenye yamva yegophe loxinaniso. Asisoloko sithetha ukuhla okukhawulezayo kokuqala emva kwenaliti.
Njengomzekelo owenziwe lula, masithi uxinaniso lwehla ukusuka kwiiyunithi eziyi-100 ezikhethwe nje ukuya kweziyi-50 ngexesha elinye lokuncipha ngesiqingatha. Ngexesha lesibini elilinganayo, lwehla luye kwi-25, kungekhona kuziro. Olu lubalo lomfuziselo owenziwe walula, hayi uqikelelo olulungiselelwe umntu othile lobungakanani bemethylene blue esaseleyo emzimbeni.
Amanye amagama amathathu aphendula imibuzo eyahlukeneyo:
- Ixesha lokufikelela kuxinaniso oluphezulu, okanye Tmax: lixesha apho kufunyanwa uxinaniso oluphezulu kwiisampulu.
- Ukuchanabeka, okanye AUC: yindawo ephantsi kwegophe loxinaniso ngokuhamba kwexesha, edibanisa uxinaniso nobude bexesha.
- Impendulo kunyango: lutshintsho kwimeko okanye kwisiphumo esinyangwayo, njengokuncipha okulinganisiweyo kwemethemoglobin.
Uxinaniso oluphezulu akufuneki lube ngexesha elinye nenzuzo enkulu. Uxinaniso oluphantsi aluthethi ngokuzenzekelayo ukuba isiphumo sebhayoloji okanye unxibelelwano namanye amayeza luphelile.
Ukuthelekiswa kophando lwabantu
Itheyibhile iluthelekiso olwenziwe ngokutsha lophando lukaPeter, lophando lukaWalter-Sack kunye neendlela zalo ezipheleleyo, kunye nophononongo lwe-FDA lwenzululwazi yamayeza ekliniki lwe-PROVAYBLUE. Iidosi zophando zichonga iimvavanyo; aziyomiyalelo yokusetyenziswa. MB ithetha imethylene blue.
| Ubungqina | Indlela yokunikezelwa neqela labantu | Into ehlalutywayo, isampulu, nendlela | Ukuthathwa kweesampulu nesiphumo esixeliweyo |
|---|---|---|---|
| Peter nabanye, 2000 | 100 mg IV nangomlomo; amavolontiya asixhenxe | MB egazini elipheleleyo; ichromatography yolwelo esebenza ngokugqwesileyo | Iprofayili yegazi ukuya kutsho kwiiyure ezi-4, njengoko ibekwe kwitheyibhile yi-FDA; ixesha lokuncipha ngesiqingatha kwinqanaba lokugqibela le-IV ziiyure eziyi-5.25 |
| Walter-Sack nabanye, 2009, iqela le-IV | 50 mg IV; kwabhaliswa abantu abadala abasempilweni abali-16, abali-15 balugqiba uphando apho kwakutshintshiselwana ngeendlela zokunikezelwa | MB kwiplasma nasegazini elipheleleyo; ichromatography edityaniswe nespectrometry yobunzima elandelelanayo | Iisampulu eziphindaphindiweyo ukuya kutsho kwiiyure ezingama-24; ixesha eliphakathi lokuncipha ngesiqingatha ziiyure eziyi-18.5 kwiplasma neeyure eziyi-13.6 egazini elipheleleyo |
| Walter-Sack nabanye, 2009, iqela lokunikezelwa ngomlomo | 500 mg yolungiselelo olusemanzini olunikezelwa ngomlomo; kwaelo qela lophando lokutshintshiselana ngeendlela | Into ehlalutywayo, amacandelo egazi, novavanyo ziyafana | Iisampulu ukuya kutsho kwiiyure ezingama-24; ixesha eliphakathi lokuncipha ngesiqingatha ziiyure eziyi-18.3 kwiplasma neeyure eziyi-14.7 egazini elipheleleyo; i-Tmax ephakathi kwiplasma ziiyure eziyi-2.2 |
| Uphononongo lwe-FDA, 2016, uphando lophuhliso lwenaliti | Ukunikezelwa kube kanye nge-IV kumavolontiya asempilweni; uphononongo lushwankathela ukufakwa kwe-2 mg/kg ngomthambo kwimizuzu emihlanu | MB ne-Azure B zilinganiswe ngokwahlukeneyo egazini elipheleleyo nakwiplasma ngechromatography yolwelo edityaniswe nespectrometry yobunzima elandelelanayo | Imilinganiselo yaqhubeka ukuya kutsho kwiiyure ezingama-72; uphononongo luchaza ixesha lokuncipha ngesiqingatha kwe-MB kwinqanaba lokugqibela elimalunga neeyure ezingama-24 |
Khuphela uthelekiso lophando njengetheyibhile ye-Markdown.
Olu ayiloqikelelo olunokutshintshiselwana lwexabiso lebhayoloji elingaguqukiyo elisebenza kumntu wonke. Kwaye itheyibhile ayimiseli umgaqo olula wokuba ukuchanabeka ngokunikezelwa ngomlomo kusoloko kuhlala ixesha elide kunokuchanabeka nge-IV. Kuphando lokutshintshiselana ngeendlela zokunikezelwa, icandelo lesampulu elikhethiweyo latshintsha uqikelelo nangaphakathi kwendlela enye yokunikezelwa.
Kutheni amanani ahluka
Igazi elipheleleyo neplasma ziisampulu ezahlukeneyo. Igazi elipheleleyo liquka iiseli ezidada kwiplasma. Iplasma yinxalenye yolwelo efunyanwa emva kokwahlula iiseli. Uvavanyo olubala iyeza kwiiseli nakulwelo luphendula umbuzo womlinganiselo owahlukileyo kolobala iyeza elikulwelo kuphela.
Ixesha lokuqwalasela libalulekile. Uphando oluphela kwangoko lunolwazi oluncinane malunga nokuhla kwamva. Uphononongo lwe-FDA luchonga ngokucacileyo ubude bexesha lokuthatha iisampulu nokulinganisa egazini xa kuthelekiswa neplasma njengezizathu zokwahluka kwidatha epapashiweyo yendlela imethylene blue ehamba ngayo emzimbeni. Ukuqwalasela ixesha elide kunokubonisa inqanaba elicothayo elingachazwa kakuhle kukuthatha iisampulu kwangoko.
Ikhemikhali elinganiswayo ibalulekile. Isiphumo seyeza lokuqala, isiphumo semveliso yokucolwa kwalo emzimbeni, nesixa esipheleleyo esiquka iintlobo eziguqulwe ngokwekhemikhali akufanele zonke zibizwe ngokuba “linqanaba lemethylene blue” ngaphandle kokucacisa. Olu thelekiso luchonga izinto ezixeliweyo ezihlalutywayo endaweni yokuphatha yonke imilinganiselo enxulumene nombala oluhlaza okwesibhakabhaka ngokungathi iyafana.
Ulungelelwaniso lwemveliso lubalulekile. Uvavanyo lokunikezelwa ngomlomo olwalutshintshiselana ngeendlela lwavavanya ulungiselelo oluthile olusemanzini. Isiphumo salo asiqinisekisi ikhepsuli engachazwanga, ulwelo oluthengiswa ezivenkileni, okanye enye indlela yokunikezelwa. Ngokufanayo, iimvavanyo zokusasazeka kwizicubu zeempuku ezikwinqaku likaPeter zahlukile kwimilinganiselo yegazi yamavolontiya angabantu ekwelo nqaku. Aziniki ixesha lokususwa kwayo engqondweni yomntu.
Kuthatha ixesha elingakanani ukuqala ukusebenza?
Oko kuxhomekeke kwinto ethethwa kukuthi “ukusebenza”. Kwi-methemoglobinemia efunyenweyo enyangwa ngabezonyango, oogqirha banokulandelela isalathisi segazi esichazwe ngokucacileyo. Ilebhile yenaliti ichaza ukuba abantu abadala abali-9 kwabali-12 abanemilinganiselo yokuqala efanelekileyo babenokuncipha kwemethemoglobin okungenani ngama-50% kwiyure enye emva kokunikwa idosi. Oko kukuqwalaselwa kwempendulo kunyango, hayi ixesha lokuncipha ngesiqingatha kwemethylene blue ngexesha lokususwa emzimbeni.
Kulungiselelo olunikezelwa ngomlomo, ukufikelela kuxinaniso oluphezulu kwiplasma malunga neeyure ezimbini kuvavanyo lwamavolontiya akubonisi ukuba ukugxila, amandla, okanye inkumbulo eqaqambileyo ziqala ukuphucuka emva kweeyure ezimbini. Uphando lwendlela iyeza elihamba ngayo emzimbeni lwalulinganisa uxinaniso lweyeza, hayi ezo nzuzo. Indlela umntu athi uziva ngayo nayo ayinakuchonga uxinaniso kwiplasma yakhe okanye ibonise ukuba iyeza lisuswe ngokupheleleyo xa loo mvakalelo iphela.
Umbala womchamo, ukusetyenziswa okuphindaphindiweyo, namaxesha okuthatha amayeza
Umchamo oluhlaza okwesibhakabhaka okanye oluhlaza awulovavanyo olulinganisiweyo loxinaniso. Ilebhile iyaluchaza utshintsho lombala wolwelo lomzimba, kodwa ayiniki mda wombala oqinisekisa ukususwa kweyeza kuwo wonke umzimba. Ukubukela umbala usiba buthathaka akunakuthatha indawo yovavanyo lonxibelelwano namanye amayeza.
Ukusebenza kwezintso nako kuyayitshintsha indlela yokutolika. Ilebhile yangoku ichaza ukwanda kokuchanabeka xa ukusebenza kwezintso kuphazamisekile, nangona ixesha lokuncipha ngesiqingatha lingatshintshanga xa ukuphazamiseka kwakuncinane ukuya kokuphakathi. Lo mahluko ubonisa ukuba kutheni ixesha lokuncipha ngesiqingatha lodwa lingengomlinganiselo opheleleyo wokhuseleko. Isikhokelo sethu sokhuseleko lwemethylene blue sichaza izinto ezibanzi ezinxulumene nesigulana.
Ukusetyenziswa okuphindaphindiweyo kuzisa omnye umbuzo: yintoni esaseleyo xa kusenzeka ukuchanabeka okulandelayo? Ixesha lokuncipha ngesiqingatha emva kwedosi enye alimiseli ishedyuli ekhuselekileyo yemihla ngemihla, indlela esebenzayo yokusebenzisa nokumisa ngamaxesha athile, okanye ukhuseleko lokusetyenziswa kangangeenyanga. Ezo zinto zifuna ubungqina malunga nenkqubo yokusetyenziswa ngokuphindaphindiweyo kunye neziphumo zayo.
Musa ukusebenzisa ubalo lwexesha lokuncipha ngesiqingatha ukuze uyeke, uqalise kwakhona, okanye wahlule amaxesha okuthatha amayeza abhalwe ngugqirha. Izigqibo ezibandakanya amayeza okulwa ukudakumba namanye amayeza anokusebenzisana nawo zifuna uluhlu lwamayeza athathwayo ngokwenene, ulungiselelo, indlela yokunikezelwa, imbali yokuchanabeka, kunye neemeko zonyango. Isikhokelo sonxibelelwano lwemethylene blue namanye amayeza sichaza lo mahluko. Ukuze unike ugqirha okanye usokhemesti ulwazi, bhala imveliso, isixa, indlela yokunikezelwa, ixesha ngalinye lokuchanabeka, amayeza athathiweyo, kunye nazo naziphi na iimpawu. Ezo nkcukacha ziluncedo ngakumbi kunomhla oqikelelweyo wokususwa kwayo emzimbeni.