Ukuvimbela ukusabela kudayi we-IV
Idayi engenayo i-Intravenous (IV) (idayi enikezwe ngaphakathi kwe-vein) -iyaziwa ngokuthi i-radiocontrast media (RCM)-isetshenziswe kabanzi e-United States ngezifundo ezihlukahlukene ze-radiological, ezifana nama-angiograms, ama-x-ray, i-imagery magnetic resonance (MRI), futhi ukuhlolwa kwe-tomography (CT). Ukusabela okubi ku-RCM kuyinto evamile, nakuba ukucindezeleka kuyingozi kakhulu.
Izinhlobo ze-Radiocontrast Media
Ngokuvamile, kunezinhlobo ezimbili eziyisisekelo ze-RCM ezithintekayo ezisetshenziselwa izifundo eziningi zomsakazo.
Zihlanganisa:
- Ionic high-osmolality media media (HOCM)
- Imithombo ye-low-osmolality ye-non-ionic (i-LOCM)
I-LOCM ibe yindlela ekhethwayo yedayi ye-IV eminyakeni yamuva, enikezwe irekhodi elingcono lokuphepha. Noma kunjalo, kubiza kakhulu kune-HOCM.
Ukusabela Okungahle Kuvezwe Idayi Le-IV
Lezi zindlela ezingase zenzeke uma uhlinzekwa i-RCM:
- Ukuphendula okuncane: Lezi zivamile, zenzeka ngamaphesenti amathathu kuya kuma-15 amaphesenti abantu abazitholayo. Iningi lalezi zenzo zithobekile futhi zihlanganisa umuzwa wokufudumala, ukucabangela, nokuhlanza. Ngokuvamile, lezi zimpawu zenzeka isikhathi esifushane futhi azidingi ukwelashwa.
- Ukuphendula okulinganiselwe: Lokhu kuhlanganisa ukuhlanza okukhulu, ukusila, nokuvuvukala, futhi kubangelwa amaphesenti angu-0.02 kuya ku-2 amaphesenti abantu abathola i-RCM. Ngokuvamile badinga ukwelashwa.
- Ukuhlukumeza, ukusabela ngokusongela impilo: Lokhu kuhlanganisa i- anaphylaxis , futhi lokhu kwenzeka ngamaphesenti angu-0.04 kuya kwabangu -00 amaphesenti abantu abathola i-RCM, ngesilinganiso sokufa komuntu ongu-170 000.
Amathuba okusabela ku-LOCM aphansi kakhulu kunalokho ngeHOCM, nakuba ukuphendula okunzima kunawo wonke, kufaka phakathi ukufa, kuye kwabikwa ukuthi kuvela emazingeni afanayo nawo wonke womabili izinhlobo zemidiya yokuphambene.
Ukudla Kwemithi Yokudla Okungenayo I-IV Akuyona I-allergies ngempela
Ungase umangale uma uthola ukuthi ukusabela okwenziwe i-RCM akulona uhlobo lwe- alergic in nature, okusho ukuthi akekho umuntu ophikisayo we-antiergic okwamanje obangela ukuphendula.
Kunalokho, i-RCM yenza ukukhulula ngqo i- histamine namanye amakhemikhali kusuka kumangqamuzana amancane .
Izingozi Zokubhekana Nokudla Kwe-IV
Lezi zici zibonakala zibeka abantu engozini ephezulu yokusabela ku-RCM:
- Ukusabela kwangaphambilini ku-RCM
- I-asthma
- Umlando we-allergies
- Umlando wesifo senhliziyo
- Umlando wesifo sezinso
- Ukuthatha beta-blockers
- Abesifazane
- Ekhulile (kubonakala sengathi usemngciphekweni omkhulu wezenzo ezinzima)
Inganekwane Yokudla Kwezilwandle
Naphezu kwezinganekwane ezithandwayo, ukuba ne-seafood ne-shellfish yokungezwani komzimba akukubeki engozini yokwanda kwe-RCM. I-Shellfish yokungezwani komzimba ingenxa yokuqukethwe kwamaprotheni kulawo okudla, hhayi okuqukethwe kwe-iodine. Ngaphezu kwalokho, uma unesifo sengqondo sokuhlanza i-iodine cleaners noma i-iodides, awunayo ingozi enkulu yokwenza ama-RCM.
Ukuqaphela Ukudla Kwemishanguzo Yokudla Kwegazi
Ngeshwa, asikho uvivinyo olutholakalayo lokuxilonga ukungezwani komzimba ku-RCM. Ukuhlola isikhumba nokuhlolwa kwe-radioallergosorbent (RAST) akubonwanga ukuthi kuyasiza ekuxilongweni. Izindleko ezincane, ukuhlolwa kwezinto zokuhlola nazo azizuzisi, kanye nemibiko yokukhathazeka okukhulu, okusongela ukuphila okwenzeka ngemva kwemali encane ye-RCM enikeziwe, kanye nokuphendula okunamandla nge-DCM emikhulu elandelwayo ngemuva kokuba umuntu ebekezelele umthamo omncane wedayi IV.
Ngakho-ke, ukuxilongwa kwe-RCM yokungezwani komzimba kwenziwa ngemuva kokuba izimpawu zenzeke.
Uma kungenjalo, kungenzeka ukuthi kunqume ukuthi umuntu usengozini enkulu yokuphendula ku-RCM ngokusekelwe ezicini ezinobungozi njengoba kuchaziwe ngenhla.
Ukwelapha Ukunciphisa Ukudla Okungenayo I-IV Dye
Ukwelashwa kwesimo esiphuthumayo ku-RCM kufana ne-anaphylaxis kunoma yisiphi isizathu. Ukwelashwa kungabandakanya i-epinephrine engenamjovo kanye nama- antihistamine , kanye nokusetshenziswa kwamanzi okugcoba okucindezelayo okwehlisa igazi nokushaqeka.
Ukuvimbela Ukuphendula Kudayi Lwe-IV
Uma usuphendule ku-RCM, ukuvimbela ukuphendula kwe-RCM esikhathini esizayo kufanele kufaka okulandelayo:
- Ukukhuluma nodokotela wakho mayelana nezingozi nezinzuzo zokwenza uhlolo nge-RCM nokuthi ngabe ezinye izindlela ziyatholakala yini
- Ukusebenzisa i-LOCM esikhundleni se-HOCM
- Ukusebenzisa imithi ngaphambi kokuphathwa kwe-RCM ukuvimbela noma ukunciphisa ithuba lokuphendula, kubandakanya:
- I-Prednisone, i-50mg yomuntu omdala, ngomlomo ethathwe ngamahora angu-13, amahora angu-7, nehora elilodwa ngaphambi kokuthola i-RCM
- I-Diphenhydramine (Benadryl), i-50mg yomuntu omdala, ithathwe ngomlomo ihora elilodwa ngaphambi kokuthola i-RCM
Imithombo:
> I-Baerlocher MO, Asch M, Myers A. Ukusetshenziswa kwe-Contrast Media. I-CMAJ: I-Canada Medical Association Journal . 2010; 182 (7): 697. i-doi: 10.1503 / cmaj.090118.
> Baig M, Farag A, Sajid J, Potluri R, Irwin RB, Khalid HMI. I-Shellfish Yokuzivocavoca Nezihlobo Ezihlobene Nokwahlukana Kwamagama Okuhle Okushiwo Yi-Media: United Kingdom Survey. I-World Journal of Cardiology . 2014; 6 (3): 107-111. doi: 10.4330 / wjc.v6.i3.107.
> Hong SJ, Cochran ST. Ukusabela okusheshayo kwe-Hypersensitivity kuya ku-Radiocontrast Media: Ukuvimbela Ukuphendula Okuvamile. Kusesikhathini. Kubuyekezwe ngo-September 1, 2017.
> Lieberman P, uNicklas RA, uRandolph C, et al. I-Anaphylaxis-Isibuyekezo Sokuvuselela I-Parameter Update 2015. Ama-Annal ofergy, i-Asthma & Immunology. Novemba 2015; 115 (5): 341-84.
> Pasternak JJ, Williamson EE. I-Pharmacology Pharmacology, Ukusetshenziswa, Nezimo Ezimbi Zama-Contra Aged Iodinated: A Primer for Non-radiologist. I-Mayo Clinic Proceedings . 2012; 87 (4): 390-402. doi: 10.1016 / j.mayocp.2012.01.012.