Isihloko
I-methylene blue nezingane: ukusetshenziswa kwezokwelapha nezikhala ebufakazini
I-methylene blue inokusetshenziswa kwezokwelapha ezinganeni osekuqinisekisiwe, kodwa lokho akusho ukuthi wonke umkhiqizo onayo ufanele izingane. Imininingwane yase-U.S. yokunquma i-PROVAYBLUE ihlanganisa ukwelashwa kwe-methemoglobinemia etholakala kamuva ngomuthi ofakwa emthanjeni. Ayisekeli uhlelo lokusebenzisa umuthi ngomlomo ukuze kuphilwe kahle, umuthi ogcotshwa emlonyeni wosana, noma ukwelashwa kokuqubuka endaweni yenabukeni.
Ngakho umbuzo othi “Ingabe i-methylene blue iphephile ezinganeni?” udinga imininingwane emine eyengeziwe: isifo esixilongiwe, ubudala bengane, ukwakheka komuthi okuqondile, nendlela yokuwusebenzisa. Ngaphandle kwaleyo mininingwane, lo mbuzo uhlanganisa izinqumo eziningana ezihlukene zezokwelapha.
Kusho ukuthini ukusetshenziswa kwezokwelapha ezinganeni
I-methemoglobinemia iwukuphazamiseka kwegazi lapho i-hemoglobin eshintshile ingakwazi ukuthwala umoya-mpilo ngendlela evamile. Imithi ethile namakhemikhali athile kungayibangela. Ukwelashwa kuqondene nokulethwa komoya-mpilo ezicutshini, hhayi indlela isilonda somlomo noma ukuqubuka kwesikhumba okubukeka ngayo. Incazelo yethu yokwelashwa kwe-methemoglobinemia esibhedlela ichaza leyo nkinga ethile yezokwelapha.
Imininingwane yaseYurophu yomkhiqizo i-Proveblue icacisa ukuthi kufanele unikezwe uchwepheshe wezempilo futhi ihlanganisa iziguli ezineminyaka engu-0 kuya ku-17. Emiyalweni yayo yokunquma umuthi, ihlukanisa izingane ezisanda kuzalwa nezinsana ezifinyelela ezinyangeni ezintathu ezinganeni ezindadlana. Iphinde ichaze ukuthi izinsana ezincane kakhulu zisengozini ekhethekile nokuthi ziqashwa kanjani ngesikhathi sokwelashwa. Lo mehluko ubalulekile ngisho nangaphambi kokucabangela esinye isifo noma enye indlela yokusebenzisa umuthi.
Isinqumo sasesibhedlela silinganisa inzuzo yokwelapha ukuphazamiseka okuhlonziwe nezingozi kuleso siguli. Isimangalo esibhekiswe kubathengi sokuthuthukisa ukugxila noma amandla engane ephile kahle siqala ngenzuzo ehlukile ehlongozwayo futhi sidinga ubufakazi baso. Ukuba khona kwesinqumo sokuqala akunikezi ubufakazi obushodayo besesibili.
Isifinyezo sobufakazi ngokobudala nendawo yokwelashwa
Isifinyezo esilandelayo sixhumanisa amaqembu obudala nendawo yokwelashwa esekelwa ngempela yimithombo. Izibalo zase-U.S. zivela esigabeni 8.4 semininingwane yamanje yomuthi ku-DailyMed, eyahlolwa ngomhlaka-12 Septhemba 2026. Zichaza amaqoqo amabili emibiko yeziguli ahlaziywa ngokubheka okwakwenzekile, lapho izingane ezimbili zanikezwa i-PROVAYBLUE kanti eziyishumi nambili zanikezwa omunye umkhiqizo we-methylene blue.
| Ubudala noma iqembu labantu | Ubufakazi nendawo yokwelashwa | Lokho umzali angakuphetha |
|---|---|---|
| Izingane ezisanda kuzalwa ezingaphansi kwenyanga engu-1 | Iziguli ezi-3 emaqoqweni emibiko yeziguli zezingane ase-U.S.; i-methemoglobinemia etholakala kamuva | Ukusetshenziswa kwezokwelapha ezinganeni ezisanda kuzalwa kukhona kulesi simo. |
| Izinsana, kusukela enyangeni engu-1 kuya ngaphansi kweminyaka engu-2 | Iziguli ezi-4 kulawo maqoqo | Ukufakwa kwezinsana akubona ubufakazi bokwelapha izilonda zomlomo ezinsaneni. |
| Izingane, kusukela eminyakeni engu-2 kuya ngaphansi kwengu-12 | Iziguli ezi-4 kulawo maqoqo | Lokhu okubhekiwe kuphathelene nokuphazamiseka kwegazi, hhayi ukuthatha izithasiselo nsuku zonke. |
| Intsha, kusukela eminyakeni engu-12 kuya ngaphansi kwengu-17 | Iziguli ezi-3 kulawo maqoqo | Okubhekiwe entsheni akusekeli uhlelo lokusebenzisa umuthi ukuze kuphilwe kahle. |
| Abantu abadala abathola ukwelashwa komdlavuza | Ucwaningo lokugeza umlomo olwabela ababambiqhaza emaqenjini ngokungahleliwe lwahlola ubuhlungu be-mucositis | Iziguli, isifo, indlela yokusebenzisa umuthi nomphumela kwehlukile ezinkingeni zomphimbo zezinsana. |
| Abantu abadala abane-candidiasis yomlomo | Ucwaningo lokuqala lokuhlola lwaqhathanisa ukwelashwa okuqalwa ukukhanya ne-nystatin | Inqubo yokwelashwa kwamazinyo ayikwazi ukwenziwa ibe ukugcoba udayi emlonyeni wengane nje. |
| Izinsana ezinobubomvu endaweni yenabukeni | Imibiko yabazali ichaza ukuba ngcono ngaphandle kokuthola imbangela | Indaba yokuqubuka ayikwazi ukuqinisekisa i-Candida noma ukuthola ukuthi yikuphi ukwelashwa okusebenzile. |
Lezi yizigaba zobufakazi, hhayi ishadi lemithamo. Iqoqo lemibiko elihlaziywa ngokubheka okwakwenzekile libhala okwenzeke ngesikhathi sokunakekelwa kwezokwelapha; alihlukanisi izingane ngokungahleliwe ukuze kuqhathaniswe izindlela ezahlukene zokwelapha. Lingaba nokubaluleka okukhulu esimweni esiphuthumayo esichazwe ngokucacile, kodwa libe nokubaluleka okuncane ekusetshenzisweni okuhlongozwayo okungahlobene naso. Izifundo zabantu abadala ezisetafuleni zichazwe ngezansi.
Izilonda zomlomo, umphimbo obuhlungu nokhunta lomlomo ezinsaneni kuyimibuzo ehlukene
Abazali bahlangabezana nezeluleko ze-methylene blue mayelana ne-“stomatitis,” amachashaza emphinjeni, ukungaphatheki kahle lapho kuphuma amazinyo, nokhunta lomlomo. La magama awasho into efanayo. I-stomatitis ichaza ukuvuvukala komlomo; ayihlonzi imbangela. Isilonda somlomo singadinga ukuhlolwa okuhlukile kokomphimbo ovuvukele, futhi ukusola i-Candida kudinga okungaphezu kokubona indawo emhlophe noma ebomvu.
Umbuzo womzali ngokwelashwa komlomo wosana olunezinyanga ezine ukhombisa ukungaqiniseki: izinkinga ezabikwa zazihlanganisa okwabonwa emphinjeni nezikhathi zokuphefumula kanzima. Izingxoxo ezinjalo ziveza lokho imindeni ekutshelwayo. Aziqinisekisi ukuxilongwa noma ukuthi ukwelashwa okuhlongozwayo kuyasebenza.
Ucwaningo lwango-2022 lwesigaba 2 lwe-mucositis ehambisana nomdlavuza, olwabela ababambiqhaza emaqenjini ngokungahleliwe, lwaba nabantu abadala abangama-60 abaluqeda. Lwaqhathanisa ukugeza umlomo nge-methylene blue okwengezwe ekwelashweni okuvamile nokwelashwa okuvamile kuphela. Isilinganiso esiyinhloko somphumela sasiwukushintsha kobuhlungu phakathi kwezinsuku ezimbili, kwalandelwa ukuhlolwa kokuphepha kuze kufike ezinsukwini ezingama-30. Lwabika ukuncipha kobuhlungu; abanye ababambiqhaza bezwa ukusha emlonyeni. Lolu kwakuwucwaningo lokulimala kwezicubu okubuhlungu ngesikhathi sokwelashwa komdlavuza, hhayi ubufakazi bokuthi i-methylene blue yelapha ukutheleleka enganeni.
Lo mehluko uyasebenza nasocwaningweni lokulwa nokhunta. Ucwaningo lokuqala lokuhlola i-candidiasis yomlomo lwango-2026 lwabhalisa ababambiqhaza abayi-18 futhi lwaqhathanisa ukwelashwa kwe-methylene blue okuqalwa ukukhanya, okwenziwa endaweni yokwelashwa kwamazinyo, ne-nystatin phakathi kwezinsuku eziyi-14. Umbiko walolu cwaningo ufakwe enkombeni njengophathelene nabantu abadala nabantu abaseminyakeni ephakathi. Wahlola kokubili ukusabela ekwelashweni nokususwa kokhunta, futhi wancoma izifundo ezinkulu. Ukuqalisa ukusebenza ngokukhanya kwakuyingxenye yokwelashwa. Ukususa leyo ngxenye, ukushintsha iqembu lobudala nokushintsha indlela yokusebenzisa umuthi kudala umbuzo omusha wokwelashwa.
Usana futhi alukwazi ukulandela inqubo yomuntu omdala yokugeza umlomo bese lukhafula. Inani elisele emlonyeni, eligwinyiwe noma elisakazekele kwenye indawo lingahluka. Ingxoxo yethu nge-methylene blue yezilonda zomlomo nomphimbo obuhlungu ihlola kabanzi lo mehluko wokuxilongwa nendlela yokusebenzisa umuthi. Izifundo ezingenhla azinikezi uhlelo lokugcoba umuthi ngeswabhu ezinganeni ekhaya.
Kuthiwani ngendawo yenabukeni?
Ukuqubuka endaweni yenabukeni kuyincazelo esekelwe endaweni okuvela kuyo, hhayi ukuxilongwa kokutheleleka ngokhunta. Umhlahlandlela we-American Academy of Pediatrics wokuqubuka okuvamile endaweni yenabukeni uhlukanisa ukucasuka kwesikhumba nokutheleleka ngokhunta, ukutheleleka ngamagciwane nezinye izimbangela. Umswakama, ukuhlikihlana nokuthintana nendle kungalimaza isikhumba ngaphandle kokuthi i-Candida ibe imbangela yokuqala. Ukhunta lungandisa inkinga yokuqubuka osekuvele kukhona.
Uma ububomvu buncipha ngemva kokuba othile egcobe udayi, kusengaba nezincazelo eziningana: isikhumba sahlanzwa kaningi, indlela inabukeni elithintana ngayo nesikhumba yashintsha, kwasetshenziswa omunye umkhiqizo, noma ukuqubuka kwaba ngcono ngokuhamba kwesikhathi. Ngaphandle kokuxilongwa nokuqhathanisa okuwusizo, ukuba ngcono akukwazi ukukhomba ukuthi iyiphi incazelo eqondile.
Imininingwane yemithi yomjovo nezifundo zokwelashwa ngomlomo kubantu abadala ezibuyekeziwe azisekeli ukwelashwa kokuvuvukala kwesikhumba endaweni yenabukeni ezinsaneni nge-methylene blue. Lokho kuwumkhawulo wale mithombo, hhayi ubufakazi bokuthi awukho umbiko wokusetshenziswa esikhumbeni noma kuphi. Uma ububomvu buqhubeka noma buba bubi kakhulu, isinyathelo esilandelayo esiwusizo ukuhlola imbangela. Umkhuhlane, ububomvu obubuhlungu obusakazekayo, ubomvu obuphuma esilondeni noma amabhamuza kudinga iseluleko sezokwelapha ngokushesha.
Kungani ukubala ukugxila komuthi kungakwazi ukuveza uhlelo lokuwusebenzisa enganeni
Ukubala ukugxila kuphendula ukuthi lingakanani inani lento elikhona kumthamo othile woketshezi. Akukwazi ukunquma ukuthi leyo nto kufanele isetshenziswe yini, ukuthi iliphi izinga lokuchayeka elifanele, noma ukuthi lowo mkhiqizo uzifanele yini izicubu okuhloswe ukuwusebenzisa kuzo. Ukuguqula iphesenti libe ngamamiligremu akuzixazululi lezo zinkinga. Ngokufanayo, ukuphindaphinda inani elisetshenziswa umuntu omdala ukuze aphile kahle ngesilinganiso sesisindo sengane uma siqhathaniswa nesomuntu omdala akuzixazululi.
Umhlahlandlela wamayunithi omthamo we-methylene blue uchaza udaba lokulinganisa. Ingxoxo ehlukile yokwakheka kwemithi yomjovo nokusetshenziswa kwayo emthanjeni ichaza ukuthi kungani isixazululo esithengiswa ezitolo nomuthi ohloselwe ukujovwa kungafanele kuthathwe njengokungashintshaniswa.
Ngaphambi kokusebenzisa umuthi onqunyelwe isiguli, qinisekisa:
- Isifo esixilongiwe eselashwayo nenzuzo elindelekile.
- Umkhiqizo oqondile, indlela yokuwusebenzisa neqembu lobudala elihlanganiswa yimiyalelo.
- Ukuthi ukusetshenziswa kugunyazwe emiyalweni yomuthi noma kuyisinqumo esiqondene nesiguli sokuwusebenzisa ngaphandle kwemiyalelo egunyaziwe.
- Ukuthi yimiphi imithi nezimo zempilo ezithinta isinqumo.
- Ukuthi ukusabela ekwelashweni nemiphumela engafuneki kuzohlolwa kanjani.
Izigaba zemininingwane yaseYurophu yomkhiqizo eziphathelene nezimo lapho umuthi kungafanele usetshenziswe khona nokusebenzisana kwayo neminye imithi zikhomba ukushoda kwe-G6PD nokusebenzisana okungaba kubi kakhulu nemithi ethinta i-serotonin. Hambisa uhlu oluphelele lwemithi yengane, okuhlanganisa imikhiqizo engadingi incwadi kadokotela, kumelaphi onquma umuthi. Umhlahlandlela obanzi wokuphepha kwe-methylene blue uchaza lezi zinto ezikhathazayo.
Uma izindebe zengane ziba luhlaza okwesibhakabhaka noma ziba mpunga, iphefumula kanzima, iwa, noma ingasabeli ngendlela ephawulekayo, funa usizo oluphuthumayo kunokuzama i-methylene blue ekhaya. Umhlahlandlela we-FDA wemikhiqizo esetshenziswa lapho izinsana ziphuma amazinyo uchaza ukuthi i-benzocaine ingabangela i-methemoglobinemia. Ukusola ukuthi ingane ichayeke kuyo kudinga ukuhlolwa okuphuthumayo; akusho ukuthi kunomyalelo wokusebenzisa ikhambi lokulwa nobuthi ekhaya.