Hangata li -tubes tsa mahlo li fetotsoe e le tharollo ea ho phehella metsi a mangata litsebeng ka lebaka la tšoaetso ea tsebe hobane mocheso oa metsi o ka baka tahlehelo ea kutlo. Leha ho le joalo, ho na le lipotso tse mabapi le katleho ea li-tubes tsa tsebe. Ho phaella moo, li-tubes tsa tsebe li na le likotsi tsa ho buuoa, ho kenyelletsa le kotsi ea methapo ea methapocillin staphylococcus aureus (MRSA), e sa hanyetsanang le lithibela-mafu tse ngata.
Nako ea ho Sebelisa Li-Tub Tub
Ke hobane'ng ha li-tubes (tympanostomy tubes) li bile li lokela ho qala? Ngoana e monyenyane o na le tube e khutšoanyane ea eustachian, e leng se etsang hore a atamelehe haholoanyane ho mafu. Tsela ena ea eustachian ha e fokotsehe ho fihlela e le lilemo tse tharo kapa tse 'nè.
The American Academy of Pediatrics e na le litaelo tsa ho laola maloetse a tsebe a bana. Hangata mafu a mangata a ikemisetsa ho ikemela ka likhoeli tse 'maloa. The Academy e khothalletsa hore ngoana ea nang le otitis media ka effusion (OME, tšoaetso ea tsebe ea mokokotlo o tsitsitseng metsi a hare-hare) bakeng sa likhoeli tse tharo kapa nako e telele ho hlahlojoa bakeng sa tahlehelo ea kutlo.
Sekolo sa thuto se na le litlhahiso mabapi le seo u lokelang ho se etsa ho latela boima ba tahlehelo ea kutlo ka lebaka la OME. Joale, haeba tahlehelo ea kutlo e kholo ho feta kapa e lekana le li-decibel tse 40 (e leka-lekaneng kapa e khōloanyane) e fumanoa, ho buuoa (li-tubes tsa tsebe) ho buelloa hobane tahlehelo ea kutlo ea boemo bo joalo kapa e kholo e tsejoa hore e ama "puo, puo, le thuto ea thuto." Bakeng sa tahlehelo e fokolang ea kutlo ea li-decibel tse 21 ho isa ho tse 39, Academy e khothaletsa ho hlahloba tahlehelo ea kutlo ea mantlha hobane tahlehelo ea boikokobetso e bobebe e boetse e tsebahala e na le phello
Ha ho utloahala ho tloaelehile empa OME e phehella, ho pheta-pheta liteko tsa ho utloahala likhoeli tse tharo ho isa ho tse tšeletseng hamorao ho khothaletsoa.
Katleho
Ho na le katleho e kae ea li-tubes, 'me ke likhoeli tse tharo nako e telele ho letela pele u fumana li-tubes? Phuputso e boletsoeng Tlhokomeliso ea Bophelo ba Bana , e entsoe ka 1991 ho bana ba 429 ba ka tlaase ho lilemo tse tharo ba ileng ba amohela li-tubes hang-hang, kapa likhoeli tse robong hamorao.
Phuputso ena e ile ea hlahloba tsoelo-pele ea bana ka lilemo tse tharo, tse 'nè le tse tšeletseng' me ha ea fumana phapang pakeng tsa tsoelo-pele ea bona. Thuto ea boithuto e ile ea etsoa ha bana ba le lilemo li robong ho isa ho tse leshome le motso o mong, 'me hape, ha ho na liphapang tse fumanoang mehatong e 48 ea nts'etsopele, ho kenyeletsoa liteko tsa litekanyetso. Bangoli ba phuputso eo ba fihletse hore ho e-na le ho fumana li-tubes ka mor'a likhoeli tse tharo feela tsa tšoaetso e tsitsitseng, ho ka ba molemo ho emela le ho sheba likhoeli tse tšeletseng bakeng sa litsebe, bonyane likhoeli tse robong bakeng sa tsebe.
Phuputso e tšoanang, e tlalehiloeng ho Archives of Disease Nakong ea Bongoaneng , e entsoe ka bana ba 395 ba ka tlase ho lilemo tse tharo ba neng ba phetse metsi a mabeli a bohareng ka bonyane matsatsing a 90 matsatsing ana a mabeli, kapa bonyane matsatsi a 135 ka tsebe e le 'ngoe. Bana bana ba ile ba boela ba amohela li-tubes tsa tsebe kapele kapa likhoeli tse robong hamorao. Ba ile ba hlahlojoa ha ba le lilemo li tšeletseng bakeng sa liphapang tsa tsoelo-pele pakeng tsa sehlopha sa "prompt" le "sehlopha se liehang", 'me ha ho le ea fumanoang.
Likotsi
Feela joaloka ho buuoa leha e le efe, li-tubes tsa mahlo li ama likotsi tsa tšoaetso, ho kenyelletsa kotsi ea MRSA. Litsi tsa Tlhokomelo le Thibelo ea Maloetse (CDC) li hlalosa tšoaetso ea maloetse ea ho buoa e le e etsahalang pele selemo sa ho ba le 'mele o tsoang linaheng tse ling, joalo ka li-tubes tsa tsebe.
Hangata MRSA e etsahala joang ka mor'a hore ho behoe tube ea tsebe? Ha ho bonahale eka ke hangata. Tlaleho ea Otolaryngology Head & Neck Surgery ea December 2000 e ile ea tlaleha hore ho tloha ka December 1998 ho ea ho January 2000, bana ba robeli ba ileng ba amohela li-tubes ba ile ba theha MRSA. Bangoli ba ile ba re sena ke "ts'ebetso ea 0,2%" ea MRSA, empa ha aa ka a bolela hore na palo ea bana ba fumaneng li-tubes tsa tsebe e ne e le eng. Leha ho le joalo, bangoli ba ile ba boela ba re sena ke "boemo bo tlase haholo" ba MRSA.
Ho phaella moo, ho latela sehlooho se hlahang khatisong ea August 2009 ea Journal of Otolaryngology-Head & Neck Surgery , MRSA ha e bonahale eka e tloaelehile litloaelong tsa litsebe tsa tsebe kapa hore li-tubes li ameha kapa che.
Phuputso e kholo ea litloaelo tse fetang 400 tse fapaneng ho tloha ka 2002 ho ea ho 2006 e fumane hore MRSA e ne e le teng ka 38 (8.5%) ea litloaelo tsa tsebe. Ho feta moo, tlhahlobo ea lipatlisiso tsa khale e ile ea fihla ho MRSA ka 7% feela ea litloaelo tsa tšoaetso ea tsebe.
Hape ho ka khoneha, joalokaha ho hlalositsoe ke Journal of Laryngology & Otology , hore mofuta oa lisebelisoa tse sebelisetsoang li-tubes tsa tsebe li ka etsa phapang. Phuputso e bapisitsoeng le tse tharo e beha e 'ngoe le e' ngoe ea li-tubes tse nang le silicone tse koahetsoeng ke vancomycin, li-tubes tsa silicone tse entsoeng ka khoebo tsa silevera, le li-tubesstomy tse sa koahetsoeng. (Li-tubes tsena ha lia ka tsa kenngoa ho bakuli leha e le bafe.) Bafuputsi ba ile ba hlahloba ho thehoa ha li-biofilm tsa MRSA, 'me ba fumana hore li-tubes tse koahetsoeng ka vancomycin li ne li "se na thuso" ea MRSA biofilm. Liphello tsa thuto ena li tšehetsa mohopolo oa litsebe tsa thepa ea tsebe, empa ha e e-s'o hlalosoe bophelong ba sebele.
Batsoali ba Ferekanya le MRSA ka Nako
Ha ho na bopaki bo tšehetsang khopolo ea hore li-tubes li etsa hore MRSA . Ha e le hantle, e ka 'na ea e-ba teng pele ho kenngoa li-tubes hobane MRSA e fumanoa ka har'a sechaba le lipetlele. Leha ho le joalo, ho ka etsahala hore MRSA e se ke ea e tlosa.
Joale, MRSA a ka etsa joang ka katleho? Tlaleho e 'ngoe ea 2005 ho Archives Of Otolaryngology Head & Neck Surgery e boletse hore bana ba tšeletseng ba nang le MRSA litsebeng ha ba arabele li-antibiotics tse tloaelehileng. Bohle ba tšeletseng ba ile ba phekoloa ka katleho ka molomo oa trimethoprim-sulfamethoxazole le marotholi a tsebe (gentamicin sulfate kapa polymyxin B sulfate-neomycin sulfate-hydrocortisone [Cortisporin]). Boholo ba MRSA bo fumanoe bo ka hlaseloa ke trimethoprim-sulfamethoxazole.
> Mehloli:
> Tlhahiso ea Keletso ea Kliniki. Otitis Media With Effusion. American Academy Of Pediatrics.Pediatrics Vol. 113 No. 5 May 2004, maq. 1412-1429.
> "Na lithapo tsa bana ba banyenyane li ntlafatsa ntlafatso ea bona hamorao?" Tlhokomeliso ea Bophelo ba Bana Feb. 2007: 3.
> Metsoana ea tubmpanostomy ea vancomycin e koahetsoeng ka methicillin Staphylococcus aureus sebopeho sa li-biofilm: thuto ea vitro. Journal of Laryngology & Otology (2010), 124: 594-598
> Lipotso tse atisang ho botsoa. Tikoloho ea ho Buoa ea Sesosa (SSI).
> Journal Watch. Litlaleho tsa Maloetse Nakong ea Bongoaneng. 2006 April; 91 (4): 371-372.
> Maticillin-Resistant Staphylococcus aureus Otorrhea Ka mor'a hore Tympanostomy Tube e behoe. Tšoenyeho e Amehang. Li-Archives Of Otolaryngology Head & Neck Surgery Vol 126, Ka 2000.
> Ho ea ho Tsoelo-pele ea Litsamaiso tse thehiloeng Bopaking ba Tsamaiso ea Methicillin-Resistant Staphylococcus aureus Otitis. Litaba tsa Otolaryngology-Hlooho le Mesebetsi ea Ts'ebetso, Vol 38, No. 4 (August), 2009: pp 483-494.
> Trimethoprim-sulfamethoxazole hammoho le lithibela-mafu tse ka sehloohong e le phekolo ea lefuba le leholo la li-otitis le tsamaiso ea meriana e bakoang ke methapo ea methapocillin e thibelang Staphylococcus aureus ho bana. Li-Archives Of Otolaryngology Hlooho & Meriana ea ho Koetlisa 2005 Sep; 131 (9): 782-4.