Ama-tubes endle avame ukuphendulwa njengesixazululo sokuphuza okwephuza emlonyeni ezindlebeni zezindlebe ngoba i-buildup ye-fluid ingabangela ukulahlekelwa kokuzwa. Noma kunjalo, kunemibuzo mayelana nokusebenza kwamatayipi endlebe. Ngaphezu kwalokho, izilimo eziyizigaxa zendlebe zinezingozi zokuhlinzeka, okufaka phakathi ingozi yemithi ye-staphylococcus aureus (MRSA) engamelana ne-methicillin, engavumelani nama-antibiotic amaningi.
Isikhathi Sokusebenzisa Izitsha Zendlebe
Kungani ama-tubes endlebe (amashubhu we-tympanostomy) ayenesidingo sokuqala? Ingane encane ifana ne-tube eustachian emifushane, eyenza ukuthi ijwayele ukwelashwa indlebe. Le tube ye-eustachian ayidluli kuze kube neminyaka emithathu noma emine.
I-American Academy of Pediatrics ineziqondiso ekulawuleni izifo zendlebe zobuntwana. Izifo zendlebe zivame ukuxazulula ngokuzimela phakathi nezinyanga ezimbalwa. I-Academy iphakamisa ukuthi ingane enesifo se-otitis ne-effusion (i-OME, ukutheleleka indlebe nge-opharetha endlebeni yomthamo ophakathi) izinyanga ezintathu noma ngaphezulu kuhlolwe ukulahlekelwa kwezindlebe.
I-Academy inezincomo kulokho okufanele ukwenze ngokusekelwe ekulahlekeni kokulalela ngenxa ye-OME. Khona-ke, uma ukulahlekelwa kokuzwa kunkulu noma kuqhathaniswa nama-decibel angu-40 (okulinganiselayo noma ngaphezulu) atholakala, ukuhlinzwa (izindlebe zamathambo) kunconywa ngoba ukulahleka kokuzwa kuleso sizinga noma ngaphezulu kuyathinta "inkulumo, ulimi, nokusebenza kwezemfundo." Ngenxa yokulahlekelwa okuncane kokuzwa kwama-decibel angama-21 kuya ku-39, i-Academy itusa ukunciphisa ukulahlekelwa kwezindlebe ngoba ukulahleka kokuzwa okuncane kuyaziwa nokuthi kunomthelela.
Lapho ukuzwa kuvamile kodwa i-OME iphikelela, ukuphinda ukuhlolwa kwezivivinyo ezinyangeni ezintathu kuya kweziyisithupha kamuva kunconywa.
Ukuphumelela
Ziphumelela kangakanani izimpande zendlebe, kanti izinyanga ezintathu zide ngokwanele ukulinda ngaphambi kokuthola izibhubhu? Ucwaningo olwenziwe ku- Alert Health Alert lwenziwa ngonyaka ka-1991 wezingane ezingu-429 ezingaphansi kweminyaka emithathu ubudala ezathola ama-tubes ngokushesha, noma ezinyangeni eziyisishiyagalolunye kamuva.
Lesi sifundo sibheke ukuthuthukiswa kwezingane eminyakeni emithathu, emine, nesithupha futhi akutholanga umehluko ekuthuthukiseni kwabo. Ucwaningo olulandelayo luyenziwe lapho abantwana bebaneminyaka eyisishiyagalolunye kuya kweshumi nanye ubudala, futhi futhi, akukho ukungafani okutholakala ezinyathelweni ezingu-48 zokuthuthukiswa, kufaka phakathi izivivinyo zokuhlola. Abalobi belo cwaningo baphetha ngokuthi esikhundleni sokuthola izindlebe zezindlebe emva kwezinyanga ezintathu nje zokutheleleka okuqhubekayo, kungaba ngcono ukulinda nokubuka okungenani izinyanga eziyisithupha kokubili izindlebe, okungenani izinyanga ezingu-9 ngomunye oyedwa.
Ucwaningo olufanayo, olubikwa ku- Archives of Disease in Childhood , lwenziwa ngabantwana abangu-395 abangaphansi kweminyaka engamashumi amathathu ababenamaphesenti angama-90 aphakathi kwezindlebe, noma okungenani izinsuku ezingu-135 endlebeni eyodwa. Lezi zingane nazo zathola ama-tubes endlebeni ngokushesha noma ezinyangeni ezingu-9 kamuva. Bahlolwe eminyakeni engu-6 yokuhlukana kwentuthuko phakathi kweqembu "okusheshayo" neqembu "elilibambezelekile," futhi akekho okutholakala.
Izingozi
Njenganoma yikuphi ukuhlinzeka, izindlebe zezintambo ziye zahlobanisa izingozi zokutheleleka, kufaka phakathi ingozi ye-MRSA. I-Centers for Disease Control and Prevention (CDC) ichaza ukutheleleka kwesayithi okuhlinzekwa njengokwenza okungakapheli unyaka wokuba nomzimba wakwamanye amazwe, njengama-tubes endlebe, afakwe.
Ngabe i-MRSA iyenzeka kaningi kangakanani emva kokubekwa kwethebhu yezindlebe? Ngokusobala akunjalo njalo. Isihloko se- Archives Of Otolaryngology Head & Neck Surgery ka-December 2000 sabika ukuthi kusukela ngoDisemba 1998 kuya kuJanuwari 2000, izingane eziyisishiyagalombili ezathola ama-tubes indlebe zakhiwe i-MRSA. Abalobi bathi lokhu kwaba "izibalo ezingu-0.2%" ze-MRSA, kodwa akazange asho ukuthi inani lenani labantwana abathola amashubhu endlebe. Kodwa-ke, abalobi bathi futhi lokhu kwakuyindawo ephansi kakhulu ye-MRSA.
Ngaphezu kwalokho, ngokusekelwe esihlokweni esivela encwadini ka-Agasti 2009 ye- Journal of Otolaryngology-Head & Neck Surgery , i-MRSA ayibonakali yinto ejwayelekile emiphakathini yezinkinga zezindlebe noma ngabe ayikho yini indlebe.
Ukutadisha okukhulu kwamasiko angaphezu kuka-400 amacala avela ngo-2002 kuya ku-2006 bathola ukuthi i-MRSA yayikhona nje kuma-38 (8.5%) amasiko endlebe. Ngaphezu kwalokho, ukubuyekezwa kwezifundo ezedlule kwafika ku-MRSA ngamaphesenti angu-7 nje kuphela emiphakathini yezifo zendlebe.
Kungenzeka futhi, njengoba kuphakanyiswe i-Journal of Laryngology & Otology , ukuthi uhlobo lwezinto ezisetshenziselwa izilimo eziyizigaxa zendlebe zingenza umehluko. Ucwaningo oluqhathaniswa ezintathu lubeka amashubhu e-vanicycin aqoshwe nge-vancomycin, i-commercial silver silver oxide ehlanganiswe nezilimo eziyizigaxa ze-silicone, nama-tubystomystomy angenayo. (Lezi zilimo eziyizigaxa azizange zakhiwe kunoma iziphi iziguli.) Abacwaningi bahlolisise ukwakheka kwe-MRSA biofilm, futhi bathola ukuthi amashubhu aphethwe yi-vancomycin "ayengabikho" e-MRSA biofilm. Imiphumela yalolu cwaningo isekela umqondo wendlebe yezinto zendlebe ibe yisici, kodwa ayizange iphindwe empilweni yangempela.
Ukukhathazeka kwabazali ne-MRSA Endlebeni
Akukho bufakazi bokusekela umqondo wokuthi izindlebe zamatshe zenza i- MRSA . Eqinisweni, kungase kube khona ngaphambi kokufakwa kwamatayipi endlebe ngoba i-MRSA itholakele kokubili emphakathini nasezibhedlela. Kodwa-ke, i-MRSA endlebeni kubonakala kunzima ukuyiqeda.
Kungenzeka kanjani ukuthi i-MRSA endlebeni ingaphathwa ngempumelelo? Omunye umbiko ka-2005 ku- Archives Of Otolaryngology Head & Neck Surgery uthe abantwana abayisithupha abane-MRSA endlebeni babengaphenduli emithi ejwayelekile yomlomo. Bonke abayisithupha baphathwa ngempumelelo ngomlomo we-trimethoprim-sulfamethoxazole kanye namaconsi endlebe (gentamicin sulfate noma i-polymyxin B sulfate-neomycin sulfate-hydrocortisone [Cortisporin]. Iningi le-MRSA litholakale likwazi ukuthatha trimethoprim-sulfamethoxazole.
> Imithombo:
> Umhlahlandlela Wokusebenza Ngokwelashwa. I-Otitis Media Ne-Effusion. I-American Academy Of Pediatrics.Pediatrics Vol. 113 No. 5 Meyi 2004, iphe. 1412-1429.
> "Yenza ama-tubes endlebeni ezinganeni ezincane zithuthukisa ukukhula kwazo kamuva?" Isaziso sempilo yengane Feb. 2007: 3.
> Imiphumela ye-tubmpanostomy ene-vancomycin egcwele i-methicillin-resistant Staphylococcus aureus biofilm ukwakheka: isifundo se-in vitro. I Journal of Laryngology & Otology (2010), 124: 594-598
> Imibuzo evame ukubuzwa. I-Site Site Infection (SSI).
> I-Journal Watch. Ukugcinwa Kwezinkinga Ezinganeni. 2006 ngo-Ephreli; 91 (4): 371-372.
> I-Methicillin-Resistant Staphylococcus aureus I-Otorrhea Ngemuva kokubekwa kweTympanostomy Tube. Ukukhathazeka Okukhathazayo. Amakhompiyutha E-Otolaryngology Head & Meck Surgery Vol 126, Dec 2000.
> Ukubhekelela Ukuthuthukiswa Kwemihlahlandlela Ebukelwe Ebufakazi Yokuphathwa Kwe-Methicillin-Resistant Staphylococcus aureus Otitis. I-Journal of Otolaryngology-Inhloko Nokuhlinzwa Kwezinyosi, Umqulu 38, Cha 4 (Agasti), 2009: iphe 483-494.
> I-Trimethoprim-sulfamethoxazole kanye nama-antibiotic asendulo njengokwelashwa kwe-otitis media ejulile ne-otorrhea ebangelwa ama-staphylococcus aureus angenakuphikiswa komphakathi e-methicillin ezinganeni. I-Archives Of Otolaryngology Inhloko Nokuhlinzwa Kwezinwele 2005 Sep; 131 (9): 782-4.