Nzeve dzesimbi dzinowanzoshandurwa kuva sarudzo yekuramba ichiita mvura inobva munzeve kubva kune hutachiona hwekunzwa nokuti mvura inogadzirisa inogona kukonzera kurasikirwa kwekunzwa. Zvisinei, pane mibvunzo pamusoro pekubudirira kwehutakiti hura. Mukuwedzera, nzeve dzinonzwa dzine njodzi dzekuvhiya, kusanganisira ngozi ye methicillin-resistant staphylococcus aureus (MRSA), iyo inopesana nemishonga yakawanda inorwisa mabhakitiriya.
Nguva Yekushandisa Ear Tubes
Sei nzeve dzinotapira (tympanostomy tubes) dzinotoda kutanga? Mwana muduku ane bhuru shomanana eustachian tube, iyo inomutadzisa kunyanya kutapukirwa. Iyi eustachian tube haina kureba kusvikira anenge makore matatu kana mana.
IAmerican Academy yePediatrics ine mazano ekutarisa utachiona hutano hwevana. Utachiona hutachiona hunogara huchigadzirisa hurumende mumwedzi mishomanana. The Academy inokurudzira kuti mwana ane otitis mhizha nemafuta (OME, utachiona hwekunzwa nehuturi huri pakati pehutsi hwemitsipa) kwemwedzi mitatu kana kupfuura inotaridzirwa kurasikirwa kwekunzwa.
The Academy ine mazano pamusoro pezvaunofanira kuita zvichienderana nekuoma kwekutakurwa kwekunzwa kubva kune OME. Zvadaro, kana kurasikirwa kwekunzwa kwakawanda kudarika kana kuenzana nemakumi mana ekudzivirira (kuenzanisa kana kuwedzerwa) kunowanikwa, kuvhiyiwa (ear ear tubes) zvinokurudzirwa nokuti kurasikirwa kwekunzwa pazera iroro kana kupfuura kunzi kunokonzera "kutaura, mutauro, uye kudzidzira." Nokuda kwekurasikirwa kwakanyanya kwekunzwa kwemashoko 21 kusvika ku 39, Academy inorayira kutarisa kurasikirwa kwekunzwa nokuti kurasikirwa kwekunzwa kunonzwisisika kunowanikwawo kuti ine simba.
Apo kunzwa kunowanzoitika asi OME inopfuurira, kudzokorora miedzo yekunzwa kwemwedzi mitanhatu kusvika kumatanhatu gare gare inokurudzirwa.
Kubudirira
Iko inobatsira sei nzeve dzinotapira, uye ndeye mwedzi mitatu yakareba zvakakwana kuti ungamirira usati wawana mabhesi? Chidzidzo, chakataurwa mu Child Health Alert , chakaitwa muna 1991 pane 429 vana vasati vava nemakore matatu vakagamuchira mabhesi pamwe chete, kana kusvika kumwedzi mipfumbamwe gare gare.
Ichi chiongorori chakaongorora kuburitswa kwevana pamakore matatu, mana, nemakore matanhatu uye havana kuwana mutsauko mukubudirira kwavo. Chidzidzo chekutsvaga chakaitwa apo vana vaiva nemakore mapfumbamwe nemakore gumi nemana, uyezve, hapana kusiyana kwakawanikwa mumatanho makumi maviri ekuvandudzika, kusanganisira kuongorora kwekuongorora. Vanyori vekuongorora vakagumisa kuti panzvimbo pokuwana nzeve dzehutara mushure memwedzi mitatu yehutachiona hunopfuurira, zvingava nani kumirira nekucherechedza kwemwedzi mitanhatu kune nzeve mbiri, uye mwedzi mipfumbamwe kune imwe nzeve.
Chidzidzo chakafanana, chakataurwa muChitupiro cheDaase muChidiki , chakaitwa ne 395 vana pasi pezera remakore matatu avo vakanga vachipfuvura mukati mehutu hutsi hwemazuva makumi mapfumbamwe mumakumbo maviri, kana mazuva makumi mapfumbamwe nemakumi mashanu mune imwe nzeve. Ivana ava vakagamuchira nzeve dzehutori zvichida nokukurumidza kana kusvika kumwedzi mipfumbamwe gare gare. Vakatariswa pazera remakore matanhatu nokuda kwekusiyana kwekukura pakati peboka re "prompt" uye "boka rakanonoka", uye hapana akawanikwa.
Ngozi
Kungofanana nekuvhiyiwa chero kupi zvako, nzeve dzekunzwa dzinobatanidza njodzi dzehutachiona, kusanganisira dambudziko reMMSA. ICentral for Disease Control and Prevention (CDC) inotsanangura chirwere chekurapwa kwepachivande seicho chinoitika mukati megore rekuti uve nechimwe chekunze, semakumbo emawere, akaiswa.
Ndezvipi zvinonzi MRSA inoitika mushure mekunge tambo inogadzirwa? Sezviri pachena kwete izvozvo kazhinji. A December 2000 Nhoroondo dzeOtolaryngology Head & Neck Surgery Nyaya yakarondedzera kuti kubva munaDecember 1998 kusvikira munaJanuary 2000, vana vasere vakagamuchira nzeve dzehutu dzakagadzirwa MRSA. Vanyori vakati izvi zvaive "chiitiko che2.2%" cheMRSA, asi havana kutaura kuti nhamba yevana vakagamuchira nzeve dzehutu yaiva chii. Zvisinei, vanyori vakati zvakare iyi yaiva "yakaderera zvikuru" mamiriro eRSA.
Uyezve, zvichibva pane imwe nyaya yakabuda mumagazini yaAugust 2009 ye Journal of Otolaryngology-Head & Neck Surgery , MRSA haina kuonekwa kuti inowanikwa mumitambo yehutachiona hutachiona kana kuti kwete nzeve dzekunzwa dzinobatanidzwa.
Chidzidzo chikuru chemazana ekutaurira anopfuura mazana mana kubva muna 2002 kusvika muna 2006 chakawana kuti MRSA yaivepo mune 38 chete (8.5%) yemitambo yekunzwa. Mukuwedzera, kubvunzurudzwa kwezvakaitika kare zvakasvika kuMRSA mu 7% chete yemitambo yehutachiona hutachiona.
Izvo zvinogonawo, sezvakataurwa ne Journal of Laryngology & Otology , kuti rudzi rwezvinhu zvakashandiswa kune nzeve dzinonzwa dzingaita mutsauko. Chimwe chekuenzanisa chakaenzanisa zvitatu chinogadzira vancomycin-yakavezwa silicone tubes, yebhizimisi silver oxide yakavezwa silicone tubes, uye isina uncoated tympanostomy tubes. (Aya mazinga haana kuiswa mune chero varwere.) Vatsvakurudzi vakatsvaga kugadzirwa kweMMSA biofilm, uye vakawana kuti vancomycin-yakavezwa mabhute "akanga asingabviri" weMSASA biofilm. Migumisiro yenyaya ino inotsigira pfungwa yekunzwa hutu hutachiona huri chinhu, asi hauna kudzokororwa muhupenyu chaihwo.
Vabereki 'Kushungurudzika neRMSA muNzeve
Hapana humwe uchapupu hunotsigira pfungwa yokuti nzeve dzinonzwa dzinokonzera MRSA . Zvechokwadi, inogona kunge iripo kusati kwaiswa kuvhara kwemashoko nokuti MRSA inowanikwa mune zvose munharaunda uye muzvipatara. Zvisinei, MRSA munzeve zviri pachena kuoma kubvisa.
Ko zvino MRSA inogona sei kunyatsorapwa? Imwe yegore ra2005 mushumo mune Archives Of Otolaryngology Head & Neck Surgery yakataura kuti vana vatanhatu vane MRSA munzeve vakanga vasingateereri kumiromo inowanzorapa mishonga. Vose vatanhatu vakabudirira kuporesa nemuromo trimethoprim-sulfamethoxazole uye matonhe emakumbo (gentamicin sulfate kana polymyxin B sulfate-neomycin sulfate-hydrocortisone [Cortisporin]). Wakawanda MRSA yakawanikwa kuti inogona kuwanikwa ne trimethoprim-sulfamethoxazole.
> Sources:
> Clinical Practice Guideline. Otitis Media Nekukuvadza. American Academy Of Pediatrics.Pediatrics Vol. 113 Nha. 5 May 2004, mapeji 1412-1429.
> "Inzwa hura dzevana vaduku dzinovandudza hupenyu hwavo hwekupedzisira?" Child Health Alert Feb. 2007: 3.
> Migumisiro yevancomycin-yakavezwa tympanostomy tubes pamasikirin-resistant Staphylococcus aureus biofilm maitiro: in vitro study. Journal of Laryngology & Otology (2010), 124: 594-598
> Frequently Asked Questions. Surgical Site Site Infection (SSI).
> Journal Watch. Archives of Disease in Childhood. 2006 April; 91 (4): 371-372.
> Methicillin-Resistant Staphylococcus aureus Otorrhea Pashure peTympanostomy Tube Kuiswa. Kuwedzera Kunetseka. Archives Of Otolaryngology Head & Neck Surgery Vol 126, Dec 2000.
> Kutarisana nekuvandudzirwa kweZvirevo-Based Based Guidelines for the Management of Methicillin-Resistant Staphylococcus aureus Otitis. Nhamba yeOtolaryngology-Musoro & Neck Surgery, Vol 38, Kwete 4 (August), 2009: pp 483-494.
> Trimethoprim-sulfamethoxazole pamwe nemishonga inorwisa mabhakitiriya semishonga kune acute inonzi media inokonzerwa nehutachiona hunokonzerwa nehutachiwana hunogamuchirwa neshicillin-resistant Staphylococcus aureus muvana. Archives Of Otolaryngology Head & Neck Surgery 2005 Sep; 131 (9): 782-4.