Kuteteza zotsatira za utoto wa IV
Dothi losakanikirana (IV) (dye loperekedwa kudzera mu mitsempha) -nomwe amadziwika kuti radiocontrast media (RCM) -gwiritsidwa ntchito kwambiri ku United States kwa maphunziro osiyanasiyana, monga maonekedwe, ma-ray, maginito opanga magetsi (MRI), ndi computed tomography (CT). Zotsatira zolakwika kwa RCM ndizofala, ngakhale kuti kupweteka kumakhala kosavuta.
Mitundu ya Radiocontrast Media
Mwachidziwikire, pali mitundu iwiri yofunikira ya ma ARV omwe amagwiritsidwa ntchito pafupipafupi.
Zikuphatikizapo:
- Ionic high-osmolality kusiyana media (HOCM)
- Mitundu yosiyana yosiyana ndi ionic yosmolality (LOCM)
LOCM yakhala mtundu wokondedwa wa utoto wa IV m'zaka zaposachedwa, popatsidwa mbiri yabwino ya chitetezo. Komabe, ndi okwera mtengo kuposa HOCM.
Zochita Zomwe Zingachitike ndi Dye Yayi
Izi ndizo zomwe zingayambe mukapatsidwa RCM:
- Kuchita mwachikondi: Izi ndizofala, zikupezeka pa 3 peresenti mpaka 15 peresenti ya anthu omwe akulandira. Zambiri mwa zochitikazi ndi zofatsa ndipo zimaphatikizapo kumverera mwachikondi, kunyoza, ndi kusanza. Kawirikawiri, zizindikirozi zimachitika kanthawi kochepa ndipo safuna chithandizo.
- Zomwe zimayendera: Izi zimaphatikizapo kusanza kwakukulu, mng'oma, ndi kutupa, ndipo zimachitika pafupifupi 0,02 peresenti mpaka 2 peresenti ya anthu omwe alandira RCM. Nthawi zambiri amafunika mankhwala.
- Zoopsa, zomwe zimawopsyeza moyo: Izi zimaphatikizapo anaphylaxis , ndipo izi zimachitika mu 0.04 peresenti kufika pa00 peresenti ya anthu omwe akulandira RCM, ndi chiwerengero cha imfa ya munthu mmodzi mwa 170,000.
Mpata wokwanira ku LOCM ndi wotsikirapo kusiyana ndi HOCM, ngakhale kuti zotsatira zake zowopsa, kuphatikizapo imfa, zakhala zikuchitika paziwerengero zofanana ndi mitundu yosiyana ya ma TV.
Zovuta Zosakaniza Zovala Zina Zili Sizowopsa Kwambiri
Mwina mungadabwe kumva kuti kusintha kwa RCM sikungakhale kosavomerezeka , kutanthauza kuti palibe antigenic yomwe ilipo yomwe imayambitsa zomwe zimachitika.
M'malo mwake, RCM imamasulira molondola histamine ndi mankhwala ena kuchokera ku maselo akuluakulu .
Ngozi Zomwe Zingachitikire Dye IV
Zinthu izi zimawoneka kuti zikuika anthu pa chiopsezo chachikulu kuti achitepo kanthu kwa RCM:
- Zomwe zinachitika kale ku RCM
- Phumu
- Mbiri ya chifuwa
- Mbiri ya matenda a mtima
- Mbiri ya matenda a impso
- Kutenga beta-blockers
- Akazi
- Okalamba (akuwoneka kuti ali pa chiopsezo choopsa cha kuchitidwa kwakukulu)
Nthano Chakudya Chakudya Chakudya
Ngakhale kuti nthano yodziwika bwino, kukhala ndi chakudya cha m'nyanja ndi nkhono sizingakupangitseni kuti mukhale ndi chiopsezo chachikulu chokhala ndi RCM. Nthendayi yotereyi imachokera ku mapuloteni okhudzana ndi zakudya izi, osati ma ayodini. Kuonjezera apo, ngati muli ndi zovuta zowonjezera ma odzola a ayodini kapena iodides, simungayambe kuchitapo kanthu chifukwa cha zomwe mukuchita ku RCM.
Kuzindikira Kuyezetsa kwa Dye IV
Mwamwayi, palibe mayeso omwe angapezeke kuti adziwe kuti ali ndi vutoli. Kuyezetsa khungu ndi mayeso a radiallergosorbent (RAST) sichinawonetsedwe kuti ndi othandiza pa matendawa. Zochepa, mayeso oyezetsa magazi sizothandiza, komanso zimakhala zoopsa zowopsa, zomwe zimayambitsa moyo umachitika pambuyo pa RCM yaying'ono, komanso zotsatira zoopsa zomwe zimakhala ndi RCM zomwe zimachitika munthu akalekerera kadontho kakang'ono ka IV.
Choncho, matenda a RCM amatha kupangidwa pambuyo poti zizindikiro zachitika.
Apo ayi, n'zotheka kudziwa kuti munthu ali ndi chiopsezo chowonjezereka chochitapo kanthu kwa RCM pogwiritsa ntchito zifukwa zoopsya monga momwe tafotokozera pamwambapa.
Kuchiza Mankhwala Opatsirana Ndi Dayi
Mankhwalawa amachititsa kuti RCM ikhale yofanana ndi ya anaphylaxis. Chithandizochi chingaphatikizepo jekeseni epinephrine ndi antihistamines , komanso kugwiritsa ntchito madzi otsekemera chifukwa cha kuthamanga kwa magazi komanso mantha.
Kupewa Zomwe Zimayendera Dye IV
Ngati mwachitapo kanthu ku RCM, kuteteza zotsatira za RCM ziyenera kukhala monga zotsatirazi:
- Kulankhulana ndi dokotala wanu za kuopsa ndi phindu la kuyesa ndi RCM komanso ngati pali njira zina zomwe zingapezeke
- Kugwiritsa ntchito LOCM osati HOCM
- Kugwiritsa ntchito mankhwala musanayambe kayendetsedwe ka RCM kuti athetse kapena kuchepetsa mwayi wa zochitika, kuphatikizapo:
- Prednisone, 50mg kwa munthu wamkulu, pamlomo amatengedwa maola 13, maola 7, ndi ora limodzi asanalandire RCM
- Diphenhydramine (Benadryl), 50mg kwa munthu wamkulu, amatengedwa maola ola limodzi asanalandire RCM
Zotsatira:
> Baerlocher MO, Asch M, Myers A. Kugwiritsira ntchito Contrast Media. CMAJ: Canadian Medical Association Journal . 2010; 182 (7): 697. lembani: 10.1503 / cmaj.090118.
> Baig M, Farag A, Sajid J, Potluri R, Irwin RB, Khalid HMI. Zilonda Zomwe Zimagwiritsa Ntchito Nkhumba ndi Kugwirizana kwa Kusiyanasiyana Kwasinthidwa kwa Media: United Kingdom Survey. World Journal of Cardiology . 2014; 6 (3): 107-111. do: 10.4330 / wjc.v6.i3.107.
> Hong SJ, Cochran ST. Kuchitidwa kwachidziwitso mwamsanga kwa Radiocontrast Media: Kuteteza Zochitika Zosintha. Zaposachedwa. Idasinthidwa pa September 1, 2017.
> Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis-Chizoloŵezi Choyambira Pakati pa 2015. Zambiri za zozizira, chifuwa chachikulu ndi chithumwa. November 2015; 115 (5): 341-84.
> Pasternak JJ, Williamson EE. Maphunziro a zachipatala, zamagwiritsidwe ntchito, ndi zotsatira zoipa za osiyana ndi ayodinated Agents: A Primer kwa Osati radiologist. Mayo Clinic Proceedings . 2012; 87 (4): 390-402. do: 10.1016 / j.mayocp.2012.01.012.