Ho thibela liphetoho ho dae ea IV
Lebala le bitsoang Intravenous (IV) (lesela le fanoang ka mothapo) -ane le tsejoang e le mecha ea phatlalatso ea radiocontrast (RCM) -e sebelisoa haholo United States bakeng sa lithuto tse fapa-fapaneng tsa radiological, tse kang angiograms, x-rays, imaginous magnetic resonance (MRI), le computed tomography (CT) e hlahloba. Liphetoho tse bohloko ho RCM li tloaelehile haholo, le hoja ho kula ho le joalo.
Mefuta ea Mecha ea litaba ea Radiocontrast
Ka kakaretso, ho na le mefuta e 'meli ea motheo ea RCM e entravenous bakeng sa lithuto tse ngata tsa radiological.
Li akarelletsa:
- Ionic e phahameng-osmolality phapang mecha (HOCM)
- Mefuta e fokolang ea osmolality e fapaneng le e-ionic (LOCM)
LOCM e fetohile mofuta o khethiloeng oa tee ea IV lilemong tsa morao tjena, ha e fuoa tlaleho e sireletsehileng ea polokeho. Leha ho le joalo, e theko e boima ho feta HOCM.
Liphetoho Tse ka Etsoang ka Lesela la IV
Tsena ke maikutlo a ka 'nang a etsahala ha u filoe RCM:
- Boitšoaro bo bonolo: Tsena li tloaelehile, li etsa karolo ea 3 ho ea ho karolo ea 15 lekholong ea batho ba li fumanang. Boholo ba liphello tsena bo bonolo ebile bo akarelletsa boikutlo ba mofuthu, ho nyekeloa ke pelo le ho hlatsa. Ka kakaretso, matšoao ana a etsahala ka nako e khutšoanyane mme ha a hloke phekolo.
- Boitšoaro bo itekanetseng: Tsena li kenyelletsa ho hlatsa ka matla, ma-hives le ho ruruha, 'me ho hakanyetsoa ho karolo ea 0,22 ho ea ho 2 lekholong ea batho ba fumanang RCM. Hangata ba hloka phekolo.
- Bohloko bo tebileng, liketso tse sokelang bophelo: Sena se akarelletsa anaphylaxis , 'me sena se etsahala ka 0,04 lekholong ho ea ho karolo ea 0,02 lekholong ea batho ba fumanang RCM, ka tekanyo ea lefu la motho a le mong ho 170,000.
Monyetla oa ho arabela LOCM o tlase haholo ho feta oa HOCM, le hoja liketso tse matla ka ho fetisisa, tse kenyelletsang lefu, li tlalehiloe hore li tla etsahala ka litekanyetso tse tšoanang le mefuta e 'meli ea mecha ea ho bapisa.
Ho Fokotsa ho Tsamaea ha Meriana ho E-na le Lijo Tse Hlileng Hase Hantle
U ka 'na ua makatsoa ha u utloa hore ho itšoara ha maikutlo ho RCM ha ho hlile ha ho tšoaetsoe ke tlhaho, ho bolelang hore ha ho na antigenic e teng hona joale e bakang karabelo.
Ho e-na le hoo, RCM e lokisa li- histamine le lik'hemik'hale tse ling ho tloha mast cells .
Likotsi Tsa Likarabo ho Dye ea IV
Lintho tsena li bonahala li beha batho kotsing e kholo ea ho itšoara ho RCM:
- Liketso tsa nakong e fetileng ho RCM
- Pherekano
- Histori ea ho kula
- Histori ea lefu la pelo
- Histori ea lefu la liphio
- Ho nka beta-blockers
- Tsehali
- Batho ba seng ba hōlile (ba bonahala ba le kotsing e kholo ea liketso tse matla)
Tšōmo ea Lijo Tsa Leoatleng
Ho sa tsotellehe litšōmo tse tloaelehileng, ho ba le lijo tsa leoatle le shellfish, lintho tsohle tse fapaneng ha li u fe kotsing e eketsehileng ea ho arabela ka RCM. Likokoana-hloko tsa lefuba li bakoa ke liprotheine tse nang le dijo tsena, eseng dikahare tsa iodine. Ho phaella moo, haeba o na le menyetla ea ho hloekisa li-iodine kapa li-iodine, ha u na kotsi e eketsehileng bakeng sa liketso tsa RCM.
Ho lemoha ho ba le phepo ea ho itšireletsa ka bongata
Ka bomalimabe, ha ho na teko e fumanehang bakeng sa ho fumana hore na ho na le menyetla efe ho RCM. Ho hlahlojoa ha letlalo le ho hlahlojoa ha radioallergosorbent (RAST) ha ho e-s'o bontšoe hore ho molemo ha ho fumanoa. Metsotso e seng mekae, litekanyetso tsa teko ha li na thuso, le litlaleho tsa liketsahalo tse matla, tse sokelang bophelo tse hlahang ka mor'a hore ho fanoe ka RCM e fokolang, hammoho le liketso tse matla le tekanyo e kholo ea RCM e hlahang ka mor'a hore motho a mamelle tekanyo e nyane ea tee ea IV.
Ka hona, ho hlahlojoa ha RCM ho tsoa hohle ho etsoa feela ka mor'a hore matšoao a hlahe.
Ho seng joalo, ho ka khoneha ho fumana hore motho o kotsing e kholo ea ho arabela ho RCM ho itšetlehile ka lisosa tsa kotsi tse hlalositsoeng ka holimo.
Kalafo bakeng sa Tlhahlobo ea ho Etsa Leseli ho ea ho IV
Kalafo ea ho arabela ka thata ho RCM e tšoana le ea anaphylaxis ho tloha sesosa leha e le sefe. Kalafo e ka kenyelletsa epinephrine e nang le kankere le li -antihistamine , hammoho le tšebeliso ea metsi a mangata a fokolang khatello ea mali le tšabo.
Ho thibela Sepheo sa Dye ea IV
Haeba u bile le karabelo ho RCM, ho thibela likarabo tsa RCM nakong e tlang ho kenyeletsa tse latelang:
- Ho buisana le ngaka ea hau ka likotsi le melemo ea ho etsa tlhahlobo le RCM le hore na mekhoa e meng e fumaneha
- Ho sebelisa LOCM ho e-na le HOCM
- Ho sebelisa meriana pele ho tsamaiso ea RCM ho thibela kapa ho fokotsa menyetla ea liketso, ho akarelletsa:
- Prednisone, 50mg bakeng sa motho e moholo, ka molomo o nkiloeng lihora tse 13, lihora tse 7 le hora e le 'ngoe pele a fumana RCM
- Diphenhydramine (Benadryl), 50mg bakeng sa motho e moholo, o nkoa ka molomo hora pele a amohela RCM
Lisebelisoa:
> Motlakase MO, Asch M, Myers A. Tšebeliso ea Contrast Media. CMAJ: Mokhatlo oa Mokhatlo oa Bongaka oa Mokhatlo oa Canada . 2010; 182 (7): 697. doi: 10.1503 / cmaj.090118.
> Baig M, Farag A, Sajid J, Potluri R, Irwin RB, Khaled HMI. Li-Shellfish Allergy le Relation ho Lintho tse sa tšoaneng tsa boitsebiso bo iodinated Media: United Kingdom Survey. World Journal of Cardiology . 2014; 6 (3): 107-111. doi: 10.4330 / wjc.v6.i3.107.
> Hong SJ, STchran ST. Likarabo tsa Hang-hang tsa Hypersensitivity ho Radiocontrast Mecha ea litaba: Thibelo ea liphetoho tse tloaelehileng. E maemong. E fetotsoe ka la 1 September, 2017.
> Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis-Tlhahlobo ea Tlhahlobo ea 2015. Annals ea mafu a ho phekola, ho ba le pherekano le ea immunology. November 2015; 115 (5): 341-84.
> Pasternak JJ, Williamson EE. K'hemik'hale ea Meriana ea Meriana, Mesebetsi le Litšusumetso Tse Ntle Tsa Mahlahana a Iodinated: A Primer bakeng sa Ntle-radiologist. Mayo Clinic Proceedings . 2012; 87 (4): 390-402. doi: 10.1016 / j.mayocp.2012.2012.01.012.