Timachubu zamkati nthawi zambiri zimakhala ngati njira yothetsera madzi omwe amatuluka m'makutu kuchokera kumatenda a makutu chifukwa madzi amadzimadzi amatha kuyambitsa kumva. Komabe, pali mafunso okhudzana ndi momwe ziphuphu za khutu zimathandizira. Kuphatikizanso apo, timachubu zam'mutu zimakhala ndi zoopsa za opaleshoni, kuphatikizapo chiopsezo cha methacillin chosagonjetsedwa ndi staphylococcus aureus (MRSA), chomwe sichitha mankhwala ambiri opha majeremusi.
Nthawi Yomwe Mungagwiritsire Ntchito Mavala Athu
Nchifukwa chiyani makutu a tympanostomy (tubes) amafunika kuyamba pomwe? Mwana wamng'ono ali ndi chubu lalifupi la eustachian, zomwe zimamupangitsa kuti azivutika kwambiri ndi matenda. Thumba la eustachian silikula mpaka pafupifupi zaka zitatu kapena zinayi.
American Academy of Pediatrics ili ndi malangizo othandizira kuyang'anira matenda a khutu la ana. Matenda a makutu amatha kusankha okha popanda miyezi ingapo. The Academy ikuvomereza kuti mwana yemwe ali ndi matenda otsekemera ndi opusitsa (OME, matenda a khutu omwe amatha kupweteka pakati pa khutu) amatha miyezi itatu kapena kupitilira kuti ayambe kumva.
The Academy ili ndi zoyenera kuchita potsata zovuta zakumvetsera chifukwa cha OME. Ndiye, ngati kutayika kwakumva kuli kwakukulu kapena kofanana ndi 40 decibels (zolimbitsa kapena zazikulu) zimapezeka, opaleshoni (makutu a khutu) akulimbikitsidwa chifukwa kumva kutayika pamtunda umenewo kapena kwambiri kumadziwika kuti kumakhudza "kulankhula, chinenero, ndi maphunziro." Chifukwa cha kuchepa kwakukulu kwakumva kwa 21 mpaka 39 decibels, Academy imalimbikitsa kuyang'anira kuperewera kwakumvetsera chifukwa kuchepa kwakumvetsera pang'ono kumadziwikiranso kukhala ndi zotsatira.
Pamene kumvetsera kuli kovuta koma OME akupitirizabe, kubwereza mayesero omvetsera pakapita miyezi itatu kapena sikisi pambuyo pake.
Mphamvu
Ndi zogwira mtima bwanji makutu a khutu, ndipo ndi miyezi itatu yokwanira kuti mudikire musanapeze ma tubes? Kafukufuku, wotchulidwa mu Aler Health Alert , anachitidwa mu 1991 pa 429 ana osakwana zaka zitatu omwe analandira ma tubes mwamsanga, kapena pakapita miyezi isanu ndi iwiri.
Kafukufukuyu anawunika kukula kwa ana kwa zaka zitatu, zinayi, ndi zisanu ndi chimodzi ndipo sanapeze kusiyana pakati pa chitukuko chawo. Phunziro lotsatira linkachitika pamene ana anali ndi zaka zisanu ndi zinayi ndi zisanu ndi chimodzi, ndipo kachiwiri, palibe kusiyana komwe kunapezeka muzitsulo 48 za chitukuko, kuphatikizapo mayesero ovomerezeka. Olemba apeza kuti mmalo mokhala ndi mavala am'mimba pambuyo pa miyezi itatu yokha ya matenda opatsirana, ndi bwino kuyembekezera ndi kuyang'ana kwa miyezi isanu ndi umodzi kwa makutu onse awiri, ndi miyezi isanu ndi iwiri pamutu umodzi.
Kafukufuku wofanana, womwe unafotokozedwa mu Archives of Disease in Childhood , unachitika kwa ana 395 osachepera zaka zitatu omwe anali ndi makutu osakanikirana pakati pa masiku 90 m'masiku onse awiri, kapena masiku 135 mu khutu limodzi. Ana awa analandira makutu oyambirira mwamsanga kapena pakapita miyezi 9. Iwo anafufuzidwa ali ndi zaka zisanu ndi chimodzi za kusiyana kwa chitukuko pakati pa gulu la "prompt" ndi gulu la "kuchedwa," ndipo palibe anapezeka.
Ngozi
Monga ngati opaleshoni iliyonse, makutu a khutu amayambitsa zoopsa za matenda, kuphatikizapo ngozi ya MRSA. Zomwe Zimayambitsa Matenda ndi Kupewa Matenda (CDC) zimatanthawuza kuti matenda opatsirana opaleshoni ndi omwe amapezeka mkati mwa chaka chokhala ndi thupi lachilendo, monga miyendo ya khutu, yomwe imayikidwa.
Kodi MRSA amapezeka nthawi zingati pakumvetsera kapangidwe ka makutu? Zikuoneka kuti sizinali nthawi zambiri. A December 2000 Archives Of Otolaryngology Head & Neck Surgery inanena kuti kuyambira December 1998 mpaka January 2000, ana asanu ndi atatu omwe analandira MRSA atamva makutu. Olembawo anati izi zinali "chiwerengero cha" 0.2% "cha MRSA, koma sananene kuti chiwerengero cha ana omwe adalandira makutu a khutu chinali chiyani. Komabe, olembawo adanena kuti izi zinali "zotsika kwambiri" chiwerengero cha MRSA.
Kuwonjezera apo, pogwiritsa ntchito nkhani yomwe inafotokozedwa mu Journal 2009 ya Journal of Otolaryngology-Head & Neck Surgery , MRSA sizimawoneka ngati yodziwika mu zikhalidwe za matenda a khutu kapena ayi.
Kuphunzira kwakukulu kwa mitundu yoposa 400 yamitundu yosiyanasiyana kuyambira 2002 kufika mu 2006 kunapeza kuti MRSA inalipo 38 (8.5%) ya zikhalidwe zomvetsera. Kuwonjezera apo, kufufuza kwa kafukufuku wakale kunafikira MRSA mu 7% mwa zikhalidwe za matenda omwe amamva.
N'zotheka, monga momwe Journal Journal ya Laryngology & Otology inanenera , kuti mtundu wa zinthu zomwe zimagwiritsidwa ntchito pa makutu a khutu zingapangitse kusiyana. Kafukufuku wina anayerekezera atatu omwe amaikapo timachubu ta silicone yophimba vancomycin, miyala ya siliva yamalonda yophimbidwa ndi silicone tubes, ndi tippanostomy tubes omwe sanagwiritsidwe ntchito. (Mipata iyi siinayambike mwa odwala aliwonse.) Ofufuza anafufuza kupanga mapulogalamu a MRSA, ndipo anapeza kuti mavotolo a vancomycin anali "opanda ntchito" a MRSA. Zotsatira za phunziroli zimagwirizanitsa lingaliro la khutu lakhutu zakuthupi kukhala chinthu, koma silinayanidwenso mu moyo weniweni.
Kukhumudwa kwa Makolo ndi MRSA Kumvetsera
Palibe umboni wotsimikizira lingaliro lakuti makutu a misozi amachititsa MRSA . Ndipotu, zikhoza kukhalapo musanalowetsedwe kwa makutu amtunduwu chifukwa MRSA imapezeka m'madera onse komanso m'zipatala. Komabe, MRSA kumvetsera ndi zovuta kuchotsa.
Nanga MRSA angamve bwanji bwinobwino? Lipoti lina la 2005 mu Archives Of Otolaryngology Head & Neck Surgery linanena kuti ana asanu ndi limodzi omwe ali ndi MRSA m'makutu sanalabadire mankhwala omwe amachitidwa pakamwa. Onse asanu ndi mmodzi anachiritsidwa bwino pakamwa trimethoprim-sulfamethoxazole ndi m'matope (gentamicin sulfate kapena polymyxin B sulfate-neomycin sulfate-hydrocortisone [Cortisporin]). Ambiri a MRSA apezeka kuti akhoza kutenga trimethoprim-sulfamethoxazole.
> Zotsatira:
> Malangizo Othandizira Otsogolera. Otitis Media With Effusion. American Academy of Pediatrics.Pediatrics Vol. 113 No. 5 May 2004, masamba 1412-1429.
> "Kodi makutu a ana ang'onoang'ono amatha kusintha?" Chidziwitso cha Ana Zaumoyo Feb. 2007: 3.
> Zotsatira za ma typanostomy mavalasi a vancomycin opangidwa ndi methicillin-resistant Staphylococcus aureus mapangidwe apamwamba: kuphunzira mu vitro. Magazini ya Laryngology & Otology (2010), 124: 594-598
> Mafunso Ofunsidwa Kawirikawiri. Kufufuza Site Infection (SSI).
> Yang'anani Yang'anani. Archives of Disease In Childhood. 2006 April; 91 (4): 371-372.
> Methicillin-Resistant Staphylococcus aureus Otorrhea Pambuyo pa Tympanostomy Tube Kuyika. Kusamala Kwambiri. Archives Of Otolaryngology Mutu ndi Opaleshoni Yokwera Vol 126, Dec 2000.
> Kuyang'ana Kukula kwa Maumboni Owonetsera Umboni Otsogolera Maticillin-Resistant Staphylococcus aureus Otitis. Journal of Otolaryngology-Mutu ndi Kuchita Opaleshoni, Vol 38, No 4 (August), 2009: pp 483-494.
> Trimethoprim-sulfamethoxazole komanso ma antibayotiki monga mankhwala opatsirana kwambiri otitis media ndi otorrhea omwe amachitidwa ndi ana a Sthiphilllocus aureus omwe sagonjetsedwa ndi midzi kwa ana. Archives Of Otolaryngology Mutu & Opaleshoni Yamakono 2005 Sep; 131 (9): 782-4.