Èbu eŋu kpɔ be ɖe atike aɖewo, vevietɔ esiwo wozãna na dɔléle sesẽwo, ate ŋu agblẽ nu le wò tosese alo dadasɔ ŋua? Esia nye dɔléle si wonya le atikewɔnyawo me si woyɔna be tome aɖi . Togbɔ be aɖi nya si ŋu nètsi dzi ɖo hã la, egɔmesese le vevie ŋutɔ na wò nyonyo. Le Nirogi Lanka la, míedi be míakpe ɖe ŋuwò nàse nusi tututu esia fia gɔme.
Nukae nye Totoxicity?
Kpuie ko la, to me aɖi dzɔna ne atike aɖe gblẽ nu le to ememetɔ ŋu abe eƒe nugbegblẽ le ame ŋu ene. Woɖe nya sia tso "oto," si gɔmee nye to, kple "aɖi," si gɔmee nye aɖi me. Le nyateƒe me la, eƒo nu tso nɔnɔme aɖe si me nu aɖe kpɔa ŋusẽ ɖe wò to ememetɔ ƒe wɔwɔme tsɛwo dzi abe aɖi ene.
Sidzenu suesuesue siwo sea nu gɔme, siwo kpɔa wò nusese ƒe ŋutete kple wò dadasɔ siaa gbɔ la le wò to ememetɔ me. Atike aɖewo—abe esiwo wozãna tsɔ daa dɔlékui sesẽwo alo kansa ene—ate ŋu agblẽ nu le lãmenugbagbevi siawo siwo sea nu gɔme, si ana woazu aɖi le tome.
Nukawoe nye to me aɖi ƒe dzesiwo?
Dzesiawo toa vovo ŋutɔ le ame ɖekaɖekawo dome. Woate ŋu adze ne ènya dze atike aɖe zazã gɔme ko, alo woate ŋu adze egɔme vivivi le ɣeyiɣi aɖe megbe. Le go aɖewo siwo mebɔ o me la, dzesiawo mate ŋu ado goe o vaseɖe esime wowu atikewɔwɔa nu ɣleti geɖe alo ƒe geɖe gɔ̃ hã.
Zi geɖe la, dzesi gbãtɔawo dometɔ ɖekae nye gbeɖiɖi siwo mele afima o, abe ɖiɖi, ɣlidodo, alo ɣlidodo ene, sese. Ðɔktawo yɔa esia be tomeʋuʋu , eye zi geɖe la, ate ŋu anye nuxlɔ̃amedzesi kaba be ame ƒe to megasesẽ o.
Dzesi bubu siwo bɔ dometɔ aɖewoe nye:
- Tosese ƒe kuxi (le to ɖeka alo evea siaa me).
- Sese le ɖokuiwò me be yemeli ke o alo yeƒe dadasɔ , vevietɔ ne èle zɔzɔm alo le atrakpuiwo liam.
- Azɔlizɔzɔ sesẽ le zã me alo le teƒe siwo akaɖi mekɔna tututu o.
- Azɔlizɔzɔ si keke (azɔlizɔzɔ kple wò afɔwo didi wu) be nàda asɔ.
- Seselelãme si nye be nusiwo le teƒe ɖeka le tsatsam, si woyɔna be oscillopsia .
- Taɖuame, taɖuame, alo ɖeɖiteameŋu atraɖii.
Bu ale si gbegbe wòsesẽna be nàdze agbagba awɔ wò gbesiagbedɔwo ŋu esime nèle sesem le ɖokuiwò me be yeƒe afɔwo le ta ƒom alo mèli ke o. Ne ède dzesi dzesi siawo la, ele vevie be nàbu wo nu vevii.
Aleke esia kpɔa ŋusẽ ɖe ɖeviwo dzii?
Le ɖeviwo, vevietɔ amesiwo gakpɔtɔ le nuƒoƒo srɔ̃m gome la, aɖi si le to me ate ŋu akpɔ ŋusẽ ɖe woƒe nusɔsrɔ̃ kple hadome tsitsi dzi vevie. Abe dzila ene la, nɔ ŋudzɔ ɖe dzesi siawo ŋu:
- Esesẽna be wò susu nanɔ nu ŋu le suku alo ne èle dɔ yeyewo srɔ̃m.
- Ðeɖiteameŋu kabakaba ne ehiã be nàɖo to ɣeyiɣi didi.
- Avuwɔwɔ be woase ame bubuwo gɔme, heheɖemegbe le nuƒoƒo me, alo asiɖeɖe le eŋu ƒe dzidziɖedzi. Esia ate ŋu ana nuƒoƒo ƒe tsitsi nahe ɖe megbe gɔ̃ hã.
Ne ɖevi si dina vevie zi geɖe be yeasrɔ̃ nu la le avu wɔm kpata be yeƒe susu nanɔ nu ŋu alo toa nyatoƒoe enuenu be ɖeɖi te ye ŋu la, mègabu eŋu be enye dzimaɖitsitsi ko o—anyo be nàdzro dzimaɖitsitsi siawo me kple wò ɖeviwo ƒe dɔdala.
Nukatae tome aɖi dzɔna?
Atike siwo wu 200 ye li siwo wonya be woate ŋu agblẽ nu le to me, siwo ate ŋu agblẽ nu le to ememetɔ ŋu. Wo dometɔ aɖewo hiã be woaŋlɔ atike na wo, gake bubuwo, abe vevesesenutsitike aɖewo ene, li siwo womeƒlena le atikedzraƒe o.
Ele vevie be míaɖo ŋku edzi be atike geɖe siwo do ƒome kple tome ƒe aɖi nye atike siwo xɔa ame ɖe agbe . Le kpɔɖeŋu me, atike siwo wozãna na kansa alo dɔlékui sesẽwo hiã vevie. Le nɔnɔme mawo me la, zi geɖe la, viɖe si le agbe takpɔkpɔ me sɔ gbɔ wu afɔku si ate ŋu ado tso to me.
Gakpe ɖe eŋu la, ne wozã atike siawo dometɔ geɖe le agbɔsɔsɔ gã ŋutɔ me, si womeŋlɔna na dɔnɔ akpa gãtɔ zi geɖe o.
Atikewo ƒe hatsotso vevi aɖewo siwo ate ŋu ahe afɔku sia vɛ dometɔ aɖewoe nye:
Aminoglycoside Dɔlékuiwutikewo
Esiawo nye dɔlékuiwutikewo ƒe hatsotso aɖe si wozãna na dɔlékuiwo ƒe dɔléle sesẽwo. Tsɔ kpe ɖe atikewɔmɔnu ŋu la, wonye nusiwo hea tome aɖi vɛ wu dometɔ ɖeka. Kpɔɖeŋu aɖewoe nye:
- Amikacin ƒe atike
- Gentamicin ƒe atike
- Kanamycin ƒe atike
- Neomycin si woyɔna be Neomycin
- Netilmicin ƒe atike
- Streptomycin si nye atike si woyɔna be streptomycin
- Tobramycin ƒe atike
- Vancomycin (wodea hatsotso sia me ɣeaɖewoɣi) .
Atike Siwo Wotsɔna Naa Atikewo
Atike siwo wozãna tsɔ daa kansa vovovowo ate ŋu agblẽ nu le to ŋu ɣeaɖewoɣi:
- Carboplatin si nye nuɖuɖu si woyɔna be carboplatin
- Cisplatin ƒe atike
Loop Diuretics (“Tsitikewo”) .
Atike siawo kpena ɖe ayikuwo ŋu woɖea dze kple tsi si sɔ gbɔ ɖe ŋutilãa me ɖa. Wo dometɔ aɖewoe nye:
- Bumetanide ƒe atike
- Ethacrynic acid si woyɔna be acid
- Furosemide ƒe atike
- Torsemide ƒe dɔwɔwɔ
Nu bubuwo
Mebɔ o la, nusiwo gbɔna hã ate ŋu ahe to me aɖi vɛ:
- Quinine: Wozãnɛ tsɔ daa asrãdɔ.
- Salicylates: Esiawo nye vevesesenutsitike siwo womeŋlɔ na ame o . Esi wonya nyuie wue nye Aspirin . Zi geɖe la, ne wozã atike gbogbo aɖewo siwo nɔa anyi didi ko hafi kuxiwo doa mo ɖa.
- Nutoa me ƒe atikewo : Ne wodo go nusiwo le abe mercury , tin, lead, alo carbon monoxide ene la, ate ŋu ahe nɔnɔme sia vɛ ɣeaɖewoɣi.
Nukawoe nye afɔku siwo le eme?
Afɔku si le tome aɖi me la mesɔ na amesiame o. Le atike si zãm nèle nu la, wò ɖɔkta aɖe afɔku tɔxɛ siwo le wò afɔku me, siwo zi geɖe dometɔ aɖewoe nye:
- Atike ƒomevi si woazã: Afɔku le atike aɖewo ŋu le dzɔdzɔme nu wu bubuwo.
- Agbɔsɔsɔme si woazã: Atike si wole dodom ƒe agbɔsɔsɔme.
- Ɣeyiɣi Didime: Ɣeyiɣi didi kae nèle atikeawo nom.
- Atikewɔwɔ ɖekae: Atike geɖe siwo ate ŋu agblẽ nu le tome ŋu nono le ɣeyiɣi ɖeka me ate ŋu ana afɔkua nadzi ɖe edzi.
Tsɔ kpe ɖe eŋu la, numekulawo va kpɔe be domenyiŋusẽfianu aɖewo ate ŋu awɔ akpa aɖe. Le kpɔɖeŋu me, domenyiŋusẽfianu ƒe tɔtrɔ tɔxɛwo ate ŋu ana ame aɖewo nate ŋu axɔ aɖi to tome bɔbɔe wu ne wole aminoglycoside dɔlékuiwutikewo zãm.
Kuxi siwo ate ŋu ado tso tome ƒe aɖi me
Zi geɖe la , nusiwo atike siwo wua to me gblẽna le wò to ememetɔ ŋu la nyea nusi womate ŋu atrɔ o . Esia fia be àte ŋu ado go kuxi siwo anɔ anyi ɣeyiɣi didi le wò tosese kple dadasɔ ŋu.
Le ɖevi suewo koŋ gome la, tosese ƒe kuxi siawo ate ŋu axe mɔ na woƒe ŋutete be woasrɔ̃ nuƒoƒo, gbegbɔgblɔ nasu wo si, eye woatu dzeɖoɖo ƒe ŋutete veviwo ɖo. Bu eŋu kpɔ: ne ɖevi mete ŋu sea nyawo nyuie o la, aleke wòate ŋu asrɔ̃ wo zazã nyuie?
Togbɔ be nusiwo agblẽ le ŋuwò ate ŋu anɔ anyi ɖaa hã la, wò ɖɔkta ate ŋu alé ŋku ɖe wò nɔnɔmea ŋu vevie, ada dzesi aɖewo koŋ ne wodo mo ɖa, eye wòana kpekpeɖeŋu si hiã be wòakpe ɖe ŋuwò nàkpɔ tɔtrɔ siawo gbɔ.
Aleke wokpɔa nɔnɔme sia dzea sii?
Ne èkpɔ dzesi aɖewo la, ahiã be nàyi Tomeŋutinunyala (ENT eŋutinunyala) alo Toŋutinunyala gbɔ. Woanɔ te ɖe wò dzesiwo dzi awɔ dodokpɔ tɔxɛwo atsɔ akpɔ wò to ememetɔ ƒe lãmesẽ.
Vevietɔ la, wò ɖɔkta ate ŋu ado wò tosese kple dadasɔ kpɔ hafi adze atike si ate ŋu agblẽ nu le tome ŋu gɔme. Woate ŋu agbugbɔ dodokpɔ siawo awɔ ɣeaɖewoɣi le wò atikewɔwɔa katã me hã. Esia wɔnɛ be míete ŋu dea dzesi tɔtrɔ ɖesiaɖe si menya kpɔna dzea sii bɔbɔe o si nugbegblẽ le ame ŋu hena vɛ kaba ale si míate ŋui.
Dodokpɔ kawoe wowɔna?
Be nàda alesi wò to ememetɔ le dɔ wɔm la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò:
- Odiogram: Dodokpɔ sia dzidzea wò ŋutete be nàse gbeɖiɖi vovovowo, siwo dometɔ aɖewoe nye gbeɖiɖi fafɛ kple sesẽ, gbeɖiɖi vovovowo, kple alesi nèse nuƒoƒo gɔme nyuie.
- Auditory Brainstem Response (ABR) dodokpɔ: Esia daa alesi wò tomeka wɔa nu ɖe gbeɖiɖi ŋu kple alesi dzesi mawo yia wò ahɔhɔ̃ me la kpɔna.
- Otoacoustic Emissions (OAEs) dodokpɔ: Taɖa ƒe lãmenugbagbevi siwo le tsɛ siwo le wò tomeka me la naa ʋuʋudedi fafɛ ŋutɔ le gbeɖiɖi ƒe ŋuɖoɖo me. Dodokpɔ sia dzidzea ʋuʋudedi mawo be woatsɔ anya alesi gbegbe lãmenugbagbevi siawo le dɔ wɔm nyuie.
- Vestibular test battery: Esia nye dodokpɔ siwo kplɔ wo nɔewo ɖo be woatsɔ aku nu me le dadasɔ ƒe nyawo ŋu, siwo dometɔ aɖewoe nye Videonystagmography (VNG) si wotsɔ léa ŋku ɖe ŋku ƒe ʋuʋu ŋu, Vestibular Evoked Myogenic Potentials (VEMPs), rotary chair dodokpɔ, kple video Head Impulse Testing (vHIT).
Aleke wodaa aɖi si le tome?
Nublanuitɔe la, ne wodzudzɔ atike si naa tome aɖi la mate ŋu atrɔ nusiwo gblẽ xoxo o. Gake ne wodzudzɔ atike ƒe agbɔsɔsɔme si wozãna alo asitɔtrɔ le eŋu (ɣesiaɣi si wòanya wɔ le atikewɔwɔ me) ate ŋu axe mɔ ɖe eƒe gbegblẽ ɖe edzi nu.
Abe alesi míegblɔe ene la, atike geɖe siwo wua tome nye atike siwo xɔa ame ɖe agbe. Eyata wo nu tsotso alo tɔtrɔ ɖedzesiwo wɔwɔ le wò atikewɔwɔ ƒe ɖoɖoa ŋu menyea tiatia ɣesiaɣi o.
Le nɔnɔme mawo me la, wò atikewɔlawo ƒe ƒuƒoƒoa alé ŋku ɖe ale si nèwɔa nui ɖe atikeawo ŋu nyuie eye wòakpe ɖe ŋuwò nàkpɔ dzesi ɖesiaɖe si ado mo ɖa la gbɔ.
Dɔwɔnu kple mɔnu siwo woatsɔ akpɔ dzesiwo gbɔe
Togbɔ be zi geɖe la, nusiwo gblẽna la nɔa anyi ɖaa hã la, mɔ nyui aɖewo li siwo dzi nàto ana wò agbenɔnɔ nanyo ɖe edzi:
- Tomemɔ̃wo: Mɔ̃ siawo kpena ɖe amesiwo ƒe to me gblẽna ŋu be wosea nuƒoƒo nyuie wu eye wònana kadodo nɔa bɔbɔe wu.
- Tomemɔ̃ siwo wotsɔ dea tome: Esia nye amekoko ƒe elektrɔnikmɔ̃ si wozãna na ame ɖekaɖeka siwo ƒe to me gblẽ vevie siwo meɖea vi na tomemɔ̃ siwo wozãna ɖaa o.
- Vestibular rehabilitation: Esia nye kamedede tɔxɛ aɖe. Ne èwɔ dɔ kple atikewɔla la, àsrɔ̃ kamedede siwo akpe ɖe wò ahɔhɔ̃ ŋu wòatrɔ ɖe to ememetɔ ƒe masɔmasɔ ŋu, si ate ŋu aɖe taɖuame kple malikenyenye dzi akpɔtɔ ŋutɔ ne èle zɔzɔm.
Ðe woate ŋu axe mɔ ɖe aɖi si le to me nua?
Menye ɣesiaɣie woate ŋu axe mɔ ɖe enu keŋkeŋ o, elabena ɣeaɖewoɣi la, atike siawo hiã vevie le atikewɔwɔ me be woaɖe wò agbe.
Gake dzesiawo nyanya kaba wɔnɛ be wò ɖɔkta te ŋu dea nu nyaa me enumake eye ate ŋu aɖe nusiwo agblẽ le eŋu la dzi akpɔtɔ. Ne èle atike aɖe si wonya be ate ŋu ahe tome aɖi ƒe afɔku vɛ la zãm la, wò ɖɔkta alé ŋku ɖe ŋuwò nyuie eye wòaɖo aɖaŋu na wò le nuxlɔ̃amedzesi siwo tututu ŋu wòle be nàlé ŋku ɖo ŋu.
Ɣeyiɣi didi kae nɔnɔme sia nɔa anyi?
Nusiwo to ememetɔ gblẽna le to ƒe aɖi ta la nye nusi womate ŋu atrɔ o , si fia be enɔa anyi ɖaa. Gake wò ɖɔkta ate ŋu atrɔ asi le wò atikewɔwɔ ƒe ɖoɖoa ŋu (afisi wòanya wɔ le) be wò nɔnɔmea nali ke eye wòaxe mɔ ɖe ŋgɔyiyi bubu nu.
Esi wònye be zi geɖe la, womate ŋu adzudzɔ atike siawo siwo xɔa ame ɖe agbe o ta la, wò ɖɔkta awɔ beléle na wò ɣeyiɣi didi ƒe ɖoɖo si sɔ ɖe dɔléle si nèkpɔ koŋ nu be wòakpe ɖe ŋuwò nàto kuxi siawo me nyuie.
Aleke mawɔ alé be na ɖokuinye alo vinye?
- Ƒo nu kple wò ɖɔkta gaglãa tso afɔku siwo le atike ɖesiaɖe si woŋlɔ na wò me kple eƒe nugbegblẽ le ame ŋu ŋu. Mègahe ɖe megbe gbeɖe le nyabiabia me o.
- Ne ède dzesi tɔtrɔ aɖe le wò tosese, dadasɔ, alo seselelãme bubuwo ŋu le atike yeye zazã gɔme vɔ megbe la, te ɖe wò ɖɔkta ŋu enumake, aleke kee wòɖadze nu sue aɖee o.
- Ne dzila alo vidzikpɔlae nènye la, lé ŋku ɖe viwòa ƒe nuwɔna ŋu nyuie. Esi wònye be ɖeviwo ate ŋu aʋli vevie be yewoaɖɔ dzesiawo ta la, lé ŋku ɖe dzesiwo abe susu ƒe dɔwɔwɔ sesẽ, ɖeɖiteameŋu ɣesiaɣi, alo dziɖeleameƒo ene ŋu, si ate ŋu atso tosese alo dadasɔ ƒe nya siwo womekpɔ dze sii o gbɔ ɣeaɖewoɣi. Ne ɖikeke le ŋuwò la, di dɔnyala ƒe nukpɔsusu.
Aleke gbegbee aɖi si le to me dzea egɔme kabae?
Esia toa vovo ŋutɔ tso ame ɖeka gbɔ yi bubu gbɔ. Le ame aɖewo gome la, eƒe nugbegblẽ le ame ŋu dzena le atikewɔwɔ gɔmedzedze megbe kpuie. Le ame bubuwo gome la, ɖewohĩ dzesiawo madze o vaseɖe ɣleti geɖe alo ƒe geɖe megbe hafi. Esi wònye be atikewɔwɔ aɖewo tsia megbe ta la, ele vevie ŋutɔ be nàwɔ ɖe wò ɖɔkta ƒe ŋkuléle ɖe nu ŋu ƒe ɖoɖo si wòwɔna ɣeyiɣi didi aɖe dzi hena tosese kple dadasɔ me dzodzro.
Ðo ŋku edzi be atike geɖe siwo do ƒome kple aɖi si le tome, abe dɔlékuiwutike aɖewo kple atike siwo wozãna tsɔ daa dɔlékuiwo ene, xɔa ame ɖe agbe. Togbɔ be wotsɔa afɔku vaa to ememetɔ me hã la, zi geɖe la, viɖe si dona tso dɔdamɔnu me—si nye dɔlékui sesẽ aɖe dada alo dɔléle si ate ŋu ade ame ƒe agbe afɔku me dada—ƒoa afɔkuawo ta sãsãsã.
Ne èle atike aɖe si ate ŋu akpɔ ŋusẽ ɖe wò to dzi zãm la, dzro nuxlɔ̃amedzesiawo me kple wò ɖɔkta. Zi alesi wokpɔ tɔtrɔwo kabakabae la, zi nenemae wò Nirogi Lanka belélenameha ate ŋu ana kpekpeɖeŋu kple asitɔtrɔ siwo nèhiã la kaba.
Nu vevitɔ kekeake si dzi wòle be nàɖo ŋkui (Take-Home Message) .
Kpuie ko la, nu vevi siwo míetsɔ tso míaƒe numedzodzroa me lae nye esi:
- Totoxicity fia to ƒe gbegblẽ si atike aɖewo hena vɛ. Esia ate ŋu akpɔ ŋusẽ ɖe wò tosese kple wò dadasɔ dzi tẽ.
- Nɔ ŋudzɔ ɖe nuxlɔ̃amedzesiwo abe tomeʋuʋu (to me ƒe ɖiɖi), to ƒe dɔmawɔmawɔ nyuie, alo taɖuame atraɖii ŋu.
- Togbɔ be afɔku sia le atike aɖewo siwo xɔa ame ɖe agbe me hã la, zi geɖe la, viɖe siwo dona tso atikewɔwɔ me sɔ gbɔ sã wu nusiwo ate ŋu ado tso eme. Gake nyatakaka nana ame eye wòawɔ nu do ŋgɔ le vevie ŋutɔ.
- Ne woŋlɔ atike aɖe si wonya be eɖea to me na wò la, dzro nusianu si ŋu nètsi dzi ɖo me kple wò ɖɔkta eye nàkpɔ egbɔ be yede dodokpɔ siwo katã wokafu na wò.
- Ne ède dzesi dzesi yeye aɖewo, aleke kee wòɖadze nu sue aɖeke o, gblɔe na wò ɖɔkta enumake. Nudede nyaa me kaba ate ŋu akpe ɖe ame ŋu be nɔnɔmea nagagblẽ ɖe edzi o.
Wò lãmesẽ dzi kpɔkpɔ nye wò agbanɔamedzi, eye le Nirogi Lanka la, míele mɔ kpɔm be nyatakaka sia ana ŋusẽ wò be nàwɔ nu ma tututu!
