Inqaku
Imethylene blue nabantwana: ukusetyenziswa kwezonyango nezithuba kubungqina
Imethylene blue inokusetyenziswa kwezonyango kubantwana okwamkelweyo, kodwa oko akuthethi ukuba yonke imveliso enayo ibafanele abantwana. Inkcazelo yaseU.S. yokumisela iPROVAYBLUE ibandakanya unyango lwemethemoglobinemia efunyenweyo ngokufaka iyeza emthanjeni. Ayimiseli inkqubo yokuyithatha ngomlomo ngenjongo yempilo-ntle, iyeza lokuthambisa emlonyeni wosana, okanye unyango lwerhashalala yenapukeni.
Ngoko ke, umbuzo othi “Ingaba imethylene blue ikhuselekile ebantwaneni?” ufuna iinkcukacha ezine ezongezelelweyo: uxilongo, ubudala bomntwana, indlela kanye elungiswe ngayo imveliso, nendlela yokuyinikela. Ngaphandle kwezi nkcukacha, lo mbuzo udibanisa izigqibo ezininzi ezahlukeneyo zonyango.
Kuthetha ntoni ukusetyenziswa kwezonyango kubantwana
Imethemoglobinemia sisifo segazi apho ihemoglobin etshintshileyo ingakwazi ukuthwala ioksijini ngendlela eqhelekileyo. Amayeza athile neekhemikhali ezithile zinokuyibangela. Unyango lujolise ekusiweni kweoksijini, kungekhona kwinkangeleko yesilonda somlomo okanye yerhashalala yolusu. Ingcaciso yethu yonyango lwemethemoglobinemia esibhedlele ichaza loo ngxaki ithile yezonyango.
Inkcazelo yemveliso iProveblue yaseYurophu ichaza ukuba kufuneka inikelwe yingcali yezempilo yaye ibandakanya izigulana ezineminyaka eyi-0 ukuya kweyi-17. Kwimiyalelo yayo yokumisela iyeza, yahlula iintsana ezisandul’ ukuzalwa neentsana ukuya kutsho kwiinyanga ezintathu kubantwana abadadlana. Ikwachaza ukuba iintsana ezincinane kakhulu zisengozini ekhethekileyo nokuba kufuneka zibekwe iliso ngexesha lonyango. Lo mahluko ubalulekile nangaphambi kokucingela esinye isifo okanye enye indlela yokunikela iyeza.
Isigqibo esenziwa esibhedlele sithelekisa inzuzo yokunyanga isifo esichongiweyo neengozi kweso sigulana. Ibango elijoliswe kubathengi lokuphucula ingqalelo okanye amandla omntwana osempilweni liqala ngenzuzo ecetywayo eyahlukileyo yaye lifuna ubungqina balo. Ubukho besigqibo sokuqala abuzalisi isithuba sobungqina besesibini.
Isishwankathelo sobungqina ngokobudala nangemeko yokusetyenziswa
Esi sishwankathelo silandelayo sinxulumanisa amaqela obudala neemeko zokusebenzisa ezixhaswa yimithombo ngokwenene. Amanani aseU.S. avela kwicandelo 8.4 leleyibhile yangoku yeDailyMed, eyajongwa nge-12 Septemba 2026. Achaza iingqokelela ezimbini zeemeko zonyango ezaphononongwa emva kokuba zenzekile, apho abantwana ababini bafumana iPROVAYBLUE baza abalishumi elinesibini bafumana enye imveliso yemethylene blue.
| Ubudala okanye iqela labantu | Ubungqina nemeko yokusetyenziswa | Into umzali anokuyigqiba |
|---|---|---|
| Iintsana ezisandul’ ukuzalwa ezingaphantsi kwenyanga eyi-1 | Izigulana ezi-3 kwiingqokelela zeemeko zonyango zabantwana zaseU.S.; imethemoglobinemia efunyenweyo | Ukusetyenziswa kwezonyango kwiintsana ezisandul’ ukuzalwa kukho kule meko ithile. |
| Iintsana, ukusuka kwinyanga eyi-1 ukuya ngaphantsi kweminyaka emi-2 | Izigulana ezi-4 kwezo ngqokelela | Ukuqukwa kweentsana akubobungqina bokunyanga izilonda zomlomo kwiintsana. |
| Abantwana, ukusuka kwiminyaka emi-2 ukuya ngaphantsi kweminyaka eli-12 | Izigulana ezi-4 kwezo ngqokelela | Oku kuqwalaselweyo kuphathelele isifo segazi, kungekhona ukuthatha izongezelelo yonke imihla. |
| Abafikisayo, ukusuka kwiminyaka eli-12 ukuya ngaphantsi kweminyaka eli-17 | Izigulana ezi-3 kwezo ngqokelela | Oku kuqwalaselweyo kubafikisayo akumiseli inkqubo yempilo-ntle. |
| Abantu abadala abafumana unyango lomhlaza | Ulingo lokuhlamba umlomo olwabela amaqela ngokungakhethiyo lwaphanda iintlungu zokudumba kwenwebu ethambileyo | Izigulana, isifo, indlela yokunikela, nesiphumo zahlukile kwizikhalazo zomqala kwiintsana. |
| Abantu abadala abane-candidiasis yomlomo | Ulingo lokuqala lokuphonononga lwathelekisa unyango oluvuselelwa kukukhanya nenystatin | Inkqubo yonyango lwamazinyo ayinakwenziwa nje ukuthambisa idayi emlonyeni womntwana. |
| Iintsana ezinobubomvu kwindawo yenapukeni | Iingxelo zabazali zichaza ukuphucuka ngaphandle kokumisela unobangela | Ingxelo yamava erhashalala ayinakuqinisekisa iCandida okanye ichonge unyango olusebenzileyo. |
La ngamaqela obungqina, kungekhona itshathi yeedosi. Ingqokelela yeemeko ephononongwa emva kokuba zenzekile ibhala oko kwenzekileyo ekunyangweni kwezigulana; ayabeli abantwana ngokungakhethiyo ukuze kuthelekiswe unyango olwahlukeneyo. Ukufaneleka kwayo kunokuba namandla kwimeko yongxamiseko echazwe ngokucacileyo kodwa kube buthathaka kusetyenziso olucetywayo olungahambelaniyo. Izifundo zabantu abadala ezikwitheyibhile zichazwe ngezantsi.
Izilonda zomlomo, umqala obuhlungu, nomngundo womlomo kwiintsana yimibuzo eyahlukileyo
Abazali badibana namacebiso ngemethylene blue “kwistomatitis,” amabala emqaleni, ukungakhululeki xa kuphuma amazinyo, nomngundo womlomo. La magama awathethi into enye. Istomatitis ichaza ukudumba komlomo; ayichongi unobangela. Isilonda somlomo sinokufuna uvavanyo olwahlukileyo kolomqala odumbileyo, yaye ukukrokrela iCandida kufuna okungaphezu kokubona indawo emhlophe okanye ebomvu.
Umbuzo womzali ngonyango lomlomo wosana oluneenyanga ezine ubonisa oku kungaqiniseki: izinto ezixhalabisayo ezaxelwayo zaziquka oko kwabonwa emqaleni nezihlandlo zokuphefumla nzima. Ezo ngxoxo zibonisa oko kuxelelwa iintsapho. Azimiseli uxilongo okanye ziqinisekise ukuba unyango olucetywayo luyasebenza.
Ulingo lwango-2022 lwenqanaba 2 lokudumba kwenwebu ethambileyo okunxulumene nomhlaza, olwabela amaqela ngokungakhethiyo, lwagqitywa ngabantu abadala abangama-60. Lwathelekisa ukuhlamba umlomo ngemethylene blue okongezwe kunyango oluqhelekileyo nonyango oluqhelekileyo lodwa. Esona siphumo sasilinganiswa yayikukutshintsha kweentlungu kwiintsuku ezimbini, kulandelwa ukhuseleko ukuya kwiintsuku ezingama-30. Lwaxela ukuphucuka kweentlungu; abanye abathathi-nxaxheba beva ukutshisa emlonyeni. Esi yayisisifundo sokonzakala kwezicubu okubuhlungu ngexesha lonyango lomhlaza, kungekhona ukubonisa ukuba imethylene blue iyaluphilisa usulelo lomntwana.
Lo mahluko ukwasebenza kuphando lokulwa umngundo. Ulingo lokuqala lokuphonononga i-candidiasis yomlomo lwango-2026 lwabandakanya abathathi-nxaxheba abali-18 lwaza lwathelekisa unyango lwemethylene blue oluvuselelwa kukukhanya, olwenziwa ngugqirha wamazinyo, nenystatin kwiintsuku ezili-14. Upapasho ludweliswe njengoluphathelele abantu abadala nabantu abaphakathi ebudaleni. Lwavavanya impendulo kunyango kunye nokupheliswa komngundo lwaza lwacebisa ukuba kwenziwe izifundo ezinkulu. Ukuvuselela ngokukhanya kwakuyinxalenye yonyango. Ukususa loo nxalenye, ukutshintsha iqela lobudala, nokutshintsha indlela yokufaka iyeza kudala umbuzo omtsha wonyango.
Usana alukwazi nokulandela inkqubo yomntu omdala yokuhlamba umlomo nokutshica. Isixa esishiyeka emlonyeni, esiginywayo, okanye esisasazeka kwenye indawo siya kwahluka. Ingxoxo yethu ngemethylene blue kwizilonda zomlomo nakumqala obuhlungu iphonononga ngakumbi loo mahluko woxilongo nowendlela yokunikela iyeza. Izifundo ezingentla aziboneleli ngenkqubo yokuthambisa iyeza ngomqhaphu kubantwana ekhaya.
Kuthekani ngendawo yenapukeni?
Irhashalala yenapukeni yinkcazelo esekelwe kwindawo ekuyo, kungekhona uxilongo lomngundo. Isikhokelo seAmerican Academy of Pediatrics ngeerhashalala zenapukeni eziqhelekileyo sahlula ukucaphuka kolusu kumngundo wohlobo lwegwele, usulelo lwebhaktheriya, nabanye oonobangela. Ubumanzi, ukukhuhlana, nokudibana nelindle kungonakalisa ulusu ngaphandle kokuba iCandida ibe ngunobangela wokuqala. Umngundo wohlobo lwegwele unokwenza irhashalala esele ikhona ibe mbi ngakumbi.
Ukuba ububomvu buyaphucuka emva kokuba umntu ethabambise idayi, zininzi iingcaciso ezisenokwenzeka: ulusu belucocwa rhoqo ngakumbi, ukudibana nenapukeni kutshintshile, kusetyenziswe enye imveliso, okanye irhashalala iphucuke ekuhambeni kwexesha. Ngaphandle koxilongo nothelekiso olunentsingiselo, ukuphucuka akunakuchonga ukuba yeyiphi ingcaciso echanekileyo.
Iileyibhile zamayeza okutofa nezifundo zokusetyenziswa emlonyeni kubantu abadala eziphononongiweyo azimiseli unyango lwemethylene blue lokudumba kolusu lwendawo yenapukeni kwiintsana. Lowo ngumda wale mithombo, kungekhona ubungqina bokuba akukho ngxelo yokusetyenziswa eluswini naphi na. Kububomvu obuqhubekayo okanye obuba mandundu, inyathelo elilandelayo eliluncedo kukuvavanya unobangela. Umkhuhlane, ububomvu obubuhlungu obusasazekayo, ubofu, okanye amadyungudyungu zifuna icebiso lonyango ngokukhawuleza.
Kutheni izibalo zoxinaniso zingakwazi ukuvelisa inkqubo yomntwana
Ukubala uxinaniso kuphendula ukuba singakanani isixa sento esikumthamo othile. Akunakugqiba ukuba loo nto kufanele isetyenziswe na, ukuba kukuphi ukubhencwa okufanelekileyo kuyo, okanye ukuba loo mveliso izifanele na izicubu ekujoliswe kuzo. Ukuguqula ipesenti ibe ziimiligram akuzisombululi ezo ngxaki. Ngokunjalo nokuphinda-phinda isixa esisetyenziswa ngumntu omdala ngenjongo yempilo-ntle ngomlinganiselo wobunzima bomntwana xa buthelekiswa nobomntu omdala.
Isikhokelo seeyunithi zeedosi zemethylene blue sichaza umba wokulinganisa. Ingxoxo eyahlukileyo yamayeza alungiselelwe ukutofwa nokusetyenziswa emthanjeni ichaza ukuba kutheni isisombululo esithengiselwa abathengi neyeza elilungiselelwe ukutofwa zingenakuphathwa njengezinto ezinokusetyenziswa endaweni yenye.
Ngaphambi kokusebenzisa iyeza elimiselweyo, qinisekisa:
- Uxilongo olunyangwayo nenzuzo elindelekileyo.
- Imveliso kanye, indlela yokuyinikela, neqela lobudala elibandakanywa yimiyalelo.
- Ukuba ukusetyenziswa kuvunyelwe kwileyibhile okanye sisigqibo esenzelwe isigulana ngokwaso sokulisebenzisa ngaphandle kosetyenziso oluvunyiweyo kwileyibhile.
- Amayeza neemeko zempilo ezichaphazela isigqibo.
- Indlela impendulo kunyango neziphumo ezingafunekiyo eziya kuvavanywa ngayo.
Amacandelo enkcazelo yemveliso yaseYurophu angeemeko ezingakuvumeliyo ukusetyenziswa kwayo nangokusebenzisana namanye amayeza achonga ukunqongophala kweG6PD nokusebenzisana okunokuba yingozi kakhulu namayeza achaphazela iserotonin. Yiza noluhlu olupheleleyo lwamayeza omntwana, kuquka iimveliso ezingadingi myalelo kagqirha, kwingcali yezonyango emisela iyeza. Isikhokelo esibanzi sokhuseleko lwemethylene blue sichaza ezi zinto zixhalabisayo.
Ukuba umntwana uba nemilebe eluhlaza okwesibhakabhaka okanye engwevu, ukuphefumla nzima, ukuwa ngenxa yokugula, okanye ukungaphenduli ngokuphawulekayo, funa uncedo olungxamisekileyo kunokuzama imethylene blue ekhaya. Isikhokelo seFDA ngeemveliso zokuphuma kwamazinyo kwiintsana sichaza ukuba ibenzocaine inokubangela imethemoglobinemia. Ukukrokrela ukuba umntwana ubhencekile kuyo kufuna uvavanyo olungxamisekileyo; akudali myalelo wokusebenzisa iyeza lokulwa ityhefu ekhaya.