Ndi mankhwala ati omwe ali abwino kwa gawo la kansera?
Madokotala samapereka yankho losavomerezeka. Kusankha njira ndi kwathunthu chifukwa cha chikhalidwe cha mkazi, nthawi, kupezeka kwa zinthu zowawa. Posankha kuti ndi mankhwala otani omwe angasankhe kuti azisamala, madokotala amakhala akugawo. Pogwiritsa ntchito njirayi, pali kuphwanya njira yosamutsira kutentha kwa mitsempha pang'ono pamwamba pa malo omwe mankhwalawa amayamba. Wodwala amadziwa kuti zimathandiza kuti anthu asamangogwiritsira ntchito mankhwala osokoneza bongo, osaphatikizapo kuchoka kwa anesthesia, kumachepetsa mavuto. Izi zimaphatikizapo amayi, omwe nthawi yomweyo amalumikizana ndi mwana, amamva kulira kwake.
Mitundu ya anesthesia mu gawo losungira
Poyankha funso la amayi pa zomwe mankhwala am'thupi amachitika mu gawo loperewera, madokotala amatcha mitundu yotsatirayi:
- ambiri, otchedwa "anesthesia";
- dera - msana ndi matenda.
Aneshesia yoyamba ndi gawo lachilendo imagwiritsidwa ntchito pazochitika zosavuta, pamene pali zotsutsana ndi madera ena. Zimakhalapo pakakhala milandu yodetsa nkhaŵa, yomwe imapezeka m'mimba mwa mwanayo, kutuluka kwa mzere wa umbilical. Kuwonjezera apo, mimba yokha imakhala yogwirizanitsidwa ndi zikhalidwe zoterozo, pamene njira yowonjezera ya trachea imakhala yovuta, - kuyambitsa chubu ya anesthesia. Pogwiritsa ntchito njirayi, pali zotheka kuti zomwe zili m'mimba zimalowa mu bronchi, zomwe zimayambitsa kupuma kupuma, chibayo.
Kodi chigawo cha kaseya chimagwiritsidwa ntchito motani ndi matenda osokoneza bongo?
Njira yotereyi ndi yodziwika komanso yothandiza. Ndilo kulumikiza kwa mankhwala kumalo komwe kuli malo a msana. Yambani kusokoneza kwa theka la ora pasanafike nthawi yokonzekera yobereka. Nthawi yeniyeni imeneyi ndi yofunikira kuti mankhwala achite. Malo opangira jekeseni amachiritsidwa ndi yankho la mankhwala ophera tizilombo ndipo malo opangira jekeseni amadziwika.
Ndi mtundu uwu wa anesthesia ndi chigawo cha msuzi pamtunda wa chiuno, singano yapadera, yopanda kanthu, dokotala amathyola khungu. Kenaka, pang'onopang'ono kukula, kufika pamtunda pamwamba pa msana, kumene mizu ya mitsempha imapezeka. Pambuyo pake, phukusi lapadera limalowetsedwa mu singano - catheter, yomwe imakhala ngati chingwe cha mankhwala. Nthano imachotsedwa, kuchoka chubu, yomwe yayitalika, - kukulumikiza kutalika kwake, kubweretsa ku chikwama cha pamapewa, kumene chimakhazikitsidwa. Wothandizira amaperekedwa pang'onopang'ono, ngati kuli koyenera, mlingo wawonjezeka. Kufikira mosavuta kwa catheter kumatsimikiziridwa.
Njira yokhayo yogwiritsira ntchito mankhwalayo imachitidwa pamalo oimirira kapena pambali. Kuvutitsidwa ndi zopanda pake. Azimayi ena amatha kuzindikira kukhumudwa pang'ono, komwe kumawoneka ngati kumverera kwa kupanikizika m'munsi kumbuyo. Mankhwalawa ataperekedwa mwachindunji, wodwalayo samamva kanthu. Ndondomekoyi ndi yothandiza kwambiri.
Chotsatira chake, kukhudzidwa kwathunthu kumachotsedwa, koma chidziwitso cha mayi akudikirira sichidulidwa - amamva mwana wake wakhanda, kulira kwake koyamba. Ponena za kutalika kwa gawo lakale lomwe limakhala ndi matenda osokoneza bongo, madokotala amadziŵa kuti malingana ndi mlingo, kuchotsa kukhudzidwa kumakhala kwa mphindi 80-120. Nthawi ino ndi yokwanira kuti agwire ntchito.
Zotsutsana ndi matenda oopsa omwe amapezeka m'magazi
Njira imeneyi ili ndi makhalidwe abwino, koma palinso zotsutsana. Ndiletsedwa pamene:
- kutupa kwa dera limene kuli kofunika kuti pakhale pustules, papules;
- matenda osokoneza magazi;
- kusagwirizana ndi mankhwala;
- matenda a msana, osteochondrosis;
- zozungulira kapena oblique fetal udindo.
Kulankhula za matenda oopsa a epidural anesthesia mu gawo losungirako, madokotala amavomereza kuti kusokoneza koteroko kumafuna kukhala ndi chidziwitso, kumveka. Kuwonongeka kwa mitsempha ya magazi, mapeto a mitsempha amachititsa zotsatira zosasinthika. Chifukwa cha izi, kugwiritsidwa ntchito kumagwiritsidwa ntchito pazipatala zazikulu, kumene kuli antchito oyenerera, apadera. hardware.
Zotsatira za epidural anesthesia mu gawo losungira
Poona kuti pakugwira ntchito ndi mtundu uwu wa anesthesia, mlingo waukulu wa mankhwala ndi wofunika, zotsatira zake zimapezeka nthawi zambiri. Zina mwa izo ndizoyenera kukumbukira:
- dera lakumbuyo;
- mutu;
- kudumpha m'milingo.
Zozizwitsa izi zimadutsa mosiyana, pambuyo pa maora 3-5. Zili zokhudzana ndi zotsatira pa thupi la mankhwala omwe akugwiritsidwa ntchito. Zovuta pambuyo pa matenda oopsa a anesthesia ndi gawo la msuzi sizinalembedwe kawirikawiri. Zikuphatikizapo:
- Kuphwanya malamulo;
- kuvulala kwa msana, msana wamkati;
- zotsatira zowonongeka ku chigawo chogwira ntchito cha mankhwala.
Kodi minofu ya m'magazi imakhala bwanji pamagulu a mchere?
Ndi mtundu woterewu umene umakhala ndi mitsempha ya mitsempha, mankhwalawa amalowetsa mwachindunji mumadzi ozungulira msana. Pambuyo pa jekeseni, singano imachotsedwa. Mkazi amaperekedwa kuti azikhala pamgone kapena tebulo lochitira opaleshoni mwakuti mikono yake imakhala pa maondo ake, ndipo nsana wake uli pamtunda. Malo opangira jekeseni amachiritsidwa ndi tizilombo toyambitsa matenda, jekeseni pambuyo pake minofu yapansi yomwe imatha kutaya mtima ndipo njirayi imakhala yopweteka kwambiri. Nsupa yayitali ndi yoonda imatulutsidwa. Imayikidwa mwachindunji mu cerebrospinal fluid. Pambuyo kuchotsa singano, gwiritsani ntchito bandage wosabala.
Azimayi omwe akuchitidwa opaleshoni nthawi zambiri amafunsidwa ndi funso lakuti gawo la salean ndilokachita bwanji ndi anesthesia ya msana. Kutalika kwa kayendedwe kotereku kumachokera kwa akatswiri a madokotala, kusowa kwa zovuta panthawiyi. Kawirikawiri, kusokoneza kumeneku kumatengera maola awiri kuchokera nthawi yogwiritsira ntchito mankhwala ndi jekeseni ku dera la lumbar. Mlingo wa mankhwala otsekemera amawerengedwa kufika pamtunda.
Zofananitsa ndi mankhwala opweteka a msana m'magazi osungira
Chigawo cha Kaisareya chokhala ndi anesthesia ya m'mimba sichichitika pamene:
- kusowa kwa ogwira ntchito zachipatala oyenerera;
- kutaya magazi kwakukulu;
- kuperewera kwa madzi m'thupi;
- kusokonezeka kwa dongosolo la magazi coagulation;
- matenda, kutupa pa malo osungira;
- chifuwa;
- kuthamanga kwakukulu;
- kuphwanya ntchito za dongosolo lalikulu la mitsempha;
- pamene mukugwiritsa ntchito opaleshoni ya antiticoagulants.
Zotsatira za anesthesia ya msana m'magazi osokonekera
Kulimbikitsa kotereku kuli ndi zotsatira zina. Kawirikawiri zotsatirazi zimayambira pambuyo pa kupweteka kwa m'magazi ndi gawo la chakudya:
- dontho lakuthwa kupsyinjika;
- mutu;
- kusokonezeka kwa dongosolo lamanjenje;
- kupweteka mmunsi kumbuyo;
- kugonjetsedwa kwa mitsempha ya msana;
- Kuphwanya kukhulupirika kwa mitsempha ya magazi.
Anesthesia wambiri pa gawo la msuzi
Mankhwala oterewa ndi gawo lakale kwambiri ndilo lakale kwambiri. Masiku ano zovuta zimagwiritsidwa ntchito kawirikawiri. Izi zimatheka chifukwa cha kusowa ulamuliro pa udindo wa mayi, pamene akugona tulo tofa nato, samamva kanthu. Zimagwiritsidwa ntchito popanda zida zofunika ndi akatswiri. Anatengedwera ndi intravenous kulowetsedwa kwa mankhwala. Kutalika kwake kumadalira mtundu wa mankhwala, mlingo wake ndi 10-70 mphindi.
Ngati muli ndi chidwi ndi dokotala, ndi chiani chomwe chimapangitsa kuti munthu azidwala matenda a kanseri, amayi omwe ali ndi pakati nthawi zambiri amamva za zabwino za m'deralo. Pachifukwa ichi, madokotala enieni amasonyeza kuti sizipatala zonse zakumayi zomwe zikuchita izo. Zipatala zazikulu zamakono zamakono zimagwiritsa ntchito njirayi nthawi zonse. Choncho n'zotheka kuchepetsa mavuto ndi zotsatira za anesthesia ambiri, zotsatira za mankhwala pa mwana wosabadwa.
Anesthesia wamba chifukwa cha kagawo
Kufotokozera za mankhwala omwe amachititsa kuti mankhwalawa asagwiritsidwe ntchito, ndi bwino kudziwa ndi anesthesia wamba. Amagwiritsa ntchito mankhwalawa, pamene m'pofunika kuchepetsa kutengeka, kuchotsa kupweteka pobaya ndi kupiritsa mankhwala m'kati mwa msana. Mlingo wawung'ono wa mankhwalawo ukugwiritsidwa ntchito. Jekeseni wa Intradermal wapangidwa. Pambuyo pake, mkaziyo samamva bwino kuti alowe.