Epidural ochititsa dzanzi: zotsatira contraindications, zosokonezeka, ndemanga

Tsiku lililonse zipatala zachipatala ambiri ntchito. Opaleshoni alowererepo sizingatheke popanda analgesia chokwanira, ochititsa dzanzi kuti kwenikweni zofunika, mwinamwake kupirira mavuto ngati amenewo adzakhala mumamva. Pali mitundu yosiyanasiyana ya mankhwala ochititsa dzanzi. Izi tione nkhani chimene chili epidural mankhwala, zina, zikhoza kugwiritsidwa ntchito ngati pali contraindications.

ndi epidural ochititsa dzanzi Kodi

mtundu wa mankhwala ochititsa dzanzi ndi imodzi mwa njira mankhwala ochititsa dzanzi dera. Epidural ochititsa dzanzi - ndi kumayambiriro mankhwala mwachindunji mu malo epidural la ndime msana kudzera catheter lapansi. Mu njira ya mankhwala ochititsa dzanzi ndi zotheka kuti tikwaniritse zotsatira izi:

• Loss ululu tilinazo.
• Kuchepetsedwa kapena pafupifupi Mwamsanga chonse tilinazo.
• Minofu zosangalatsa.

Limagwirira cha zochita za mankhwala ochititsa dzanzi epidural chifukwa chakuti mankhwala likulowerera malaya dural mu danga subarachnoid, chifukwa mu ndime oletsedwa kwa zikhumbo za mitsempha.

Mfundo ntchito mankhwala ochititsa dzanzi epidural

Anthu, msana ndi molekezera mitsempha pa khosi ali Dura lapansi. Epidural dera ili pafupi chipolopolo, nathawa pamodzi msana. Misempha motsogozedwa khosi, manja ndi mapewa amauoloka, kutupa awo zimabweretsa kuwawa m'dera epidural.

Mankhwala kutumikiridwa mu zone zimenezi zimachititsa imfa ya tilinazo ndi kuuma mtima kunadza ululu. Midadada kufala kwa zikhumbo ubongo, zomwe amapereka chotsatira.

Pamene ntchito epidural

Poganizira kuti mtundu uwu wa mankhwala oletsa ululu ntchito pa opaleshoni m'madera zosiyana za thupi, tikhoza kunena kuti chiopsezo ntchito kungakhale zazikulu ang'onoang'ono. Mwachitsanzo, epidural ochititsa dzanzi pa chifuwa, groin, miyendo ndi mimba ndi zochepa yowopsa kuposa analgesia mu khosi ndi manja. Kugwiritsa ntchito mankhwala oletsa ululu ngati mutu ndi kosatheka, chifukwa cha innervation za thupi mwa dongosolo ubongo zoopsa.

Epidural ochititsa dzanzi nthawi zambiri ntchito:

1. Monga mankhwala ochititsa m'deralo, ngati sinafike alowererepo opaleshoni Mwachitsanzo, pa ntchito.
2. Monga adjunct kuti mankhwala oletsa ululu ambiri, ngati nkotheka kuchepetsa chiwerengero cha opioids ntchito.
3. Nthawi zambiri ntchito epidural ochititsa dzanzi pa gawo cesarean.
4. Mu postoperative nthawi zowawa.
5. Zochizira ululu kumbuyo. Pankhaniyi, athandizira m'dera mankhwala epidural ndi analgesics.

Kodi mankhwala ochititsa dzanzi kupereka mmalo, ochititsa dzanzi ambiri kapena epidural akudzipereka pa nkhani iliyonse dokotala.

Njira mankhwala ochititsa dzanzi epidural

Chaka chilichonse mu nkhokwe ya madokotala pali ndalama patsogolo kwambiri kugwira mtundu wa mankhwala ochititsa dzanzi. Pamene pali mwayi wosankha madokotala: wamba kapena epidural mankhwala, yotsirizira amasankhidwa, ngati nkotheka. Great kusankha mankhwala misonkhano limakupatsani kusankha kwa wodwala aliyense njira yabwino kwambiri.

Kuwonjezera zosiyanasiyana mankhwala mankhwala, pali zosiyanasiyana mankhwala oletsa ululu ngati:

1. Mosalekeza. Mu nkhani iyi, mankhwala ochititsa jekeseni mu danga msana nthawi zonse. Mwa njira imeneyi n'zotheka kuti tikwaniritse mpumulo ululu pa nthawi yonse imene ntchito, motero amafuna mankhwala zochepa.
2. Dongosolo nthawi. Chiphaso cha mankhwala amaperekedwa kokha pamene pali kufunika lofunika kwambiri.
3. Mankhwala ochititsa dzanzi pa funso wodwalayo. Pamene ntchito njira imeneyi wodwalayo pansi pa manja a batani. Ngati pali kufunika kwa mankhwala, ndiye pamene inu alemba pa izo m'dera epidural anatumikira mbali ya mankhwala.

Ife madokotala ambiri zinthuzi, amene ali mwangwiro cropped ululu, koma nawobe zoyendayenda, ndi chikumbu yatsala bwino.

Nthawi zina, epidural ochititsa dzanzi kukuonetsedwa

madokotala ambiri amakhulupirira njira ya mankhwala ochititsa dzanzi ndi abwino kwambiri pamene ukugwira ntchito pa mapazi awo. Timatha inu osati kuchotsa ululu ndi kumasuka minofu ngati kuli kotheka, komanso kuchepetsa kutaika kwa magazi.

Zikuonetsa kuti mankhwala oletsa ululu epidural akhoza kukhala ndi makhalidwe osiyana, monga:

1. Iyi ndiyo njira otetezedwa kwambiri impso ndi prostate.
2. Amanena za zinthu zonse m'mimba ndi mafupa a chiuno yaing'ono.
3. Chimagwiritsidwa ntchito pa opaleshoni m'mimba, matumbo.
4. Thiabendazole angagwiritsidwe ntchito pa matenda a mtima ndi matenda a shuga.

Koma zimenezi sizikutanthauza kuti pathologies amenewa nthawi zonse ntchito epidural. Chirichonse anaganiza pa nkhani iliyonse payokha.

Contraindications ntchito

Epidural mankhwala oletsa ululu ali contraindications zotsatirazi: categorical ndi wachibale. Mu gulu loyamba ndi awa:

• Pamaso pa spondylitis tuberculous ndi mavuto ake.
• The yotupa ndondomeko kumbuyo.
• A boma la mantha chifukwa cha kuvulala.
• Pamaso pa kuchuluka kudziwa mankhwala ntchito.
• Kudwala ya ubongo.
• Ngati msana ndi kwambiri olumala.
• Akusokoneza ndondomeko clotting magazi.
• Pali matenda aakulu intraperitoneal patsekeke.
• Ileus.

Wachibale contraindications yokulirapo, kuphatikizapo:

• Onenepa.
• The osasamalika za thupi.
• matenda aakulu a ndime msana.
• zaka ana.
• matenda a ubongo.
• Hypotonia ndi ena ambiri.

Ubwino wa mankhwala oletsa ululu epidural kudzadalira osati pa kudwala alipo ndi thanzi wodwalayo, komanso mankhwala mukufuna kugwiritsa ntchito.

mankhwala ochititsa dzanzi Epidural pa gawo la Kaisara

Pamene pali zizindikiro zonse gawo cesarean, nthawi zambiri m'malo ochititsa dzanzi ambiri ntchito epidural. Njira amasankhidwa pasadakhale, monga pamafunika maphunziro ena.

Dongosolo mankhwala ali pa malo enieni pa mlingo wa m'chiuno kumene molekezera mitsempha zili chingwe msana. mankhwala chikuyendetsedwera kudzera chubu wapadera, ndi catheter pa opaleshoni pa nthawi iliyonse, inu mukhoza kuwonjezera mankhwala.

Chifukwa cha mankhwala, chikumbumtima ndi momveka, ndi tilinazo pansipa lamba kusiyiratu. Mkazi akhoza kuwona ndi kumva madokotala, koma kupwetekedwa.

Mukakumana ndi kusankha - epidural kapena ambiri ochititsa dzanzi pa gawo la Kaisara - ayenera kuganizira zizindikiro ndi contraindications kwa mankhwala ochititsa dzanzi.

Zikuonetsa kuti mankhwala oletsa ululu ngati

Nthawi zambiri, epidural ochititsa dzanzi ntchito:

1. Ngati ntchito anayamba pasadakhale Mwachitsanzo, pa sabata 36-37. mankhwala ochititsa dzanzi amenewa pansi minofu ya mafupa a chiuno, ndipo mutu wa zochitika mwana si zazikulu katundu pa pasadakhale kudzera m'njira kubadwa.
2. Aakulu oopsa.
3. Discoordination ntchito, pamene mbali zosiyanasiyana za mapangano chiberekero yosiyana kwambiri. Epidural ochititsa dzanzi amalola kufooketsa mphamvu ya contractions wa.
4. Pa ntchito yaitali, pamene nthawi yaitali si zosangalatsa zonse. Zimenezi zingachititse kuti anomalies kubadwa, kotero ntchito mankhwala ochititsa dzanzi epidural kwa mkazi kuti tipeze mphamvu.

contraindications

Kuwonjezera umboni, mu nkhani ya gawo la Kaisara komanso ndi contraindications kwa mankhwala ochititsa dzanzi Motero, monga:

• Pamaso kutupa pa puncture malo.
• matenda opatsirana.
• Sayanjana ndi mankhwala.
• Mu kukhalapo kwa chilonda uterine.
• Ngati mwana ili transversely kapena amatenga malo oblique.
• Waung'ono mafupa a chiuno amayi.
• Great kulemera mwana.
• Ngati mkazi sakufuna mtundu wa mankhwala, madokotala sangakhoze ntchito motsutsana ndi chifuniro chake.

Patsogolo ntchito mankhwala ochititsa dzanzi epidural, zotsatira, ubwino ndi kuipa kwa zochita.

Ubwino epidural ochititsa dzanzi pa gawo la Kaisara

Ubwino wa mtundu uwu wa mankhwala oletsa ululu monga:

1. Akazi mu ntchito ndi mu maganizo, palibe chiopsezo intubation kapena kukhumba.
2. No mkwiyo wa chapamwamba thirakiti kupuma monga mankhwala ochititsa dzanzi ambiri, amene makamaka zaphindu kwa odwala mphumu.
3. dongosolo mtima ndi okhazikika, kuyambira mankhwala amachita pang'onopang'ono.
4. Anapitiriza mphamvu ya kuchita kayendedwe wachibale.
5. Ndi mankhwala ochititsa uyu akhoza ziwonjezeke nthawi mankhwala, kuyambira catheter ndi anaikapo mwa mankhwala ochititsa nthawi iliyonse.
6. Pambuyo opaleshoni akhoza kutumikiridwa opioids ululu.

Kuwonjezera ubwino, tisaiwale ndi kuipa kwa mankhwala ochititsa dzanzi zimenezi.

Kuipa ochititsa dzanzi epidural

njira iliyonse ya opaleshoni, komanso mankhwala, ali ndi zovuta zake. The kuipa mankhwala ochititsa dzanzi epidural monga:

1. Cholakwika dzanzi ndi kumayambiriro mankhwala, pamene mankhwala limalowera mu chotengeracho. Zingatipangitse khunyu, kuchepa lakuthwa magazi.
2. Pali chiopsezo jekeseni subarachnoid, amene akufotokozera chifukwa cha okwana chipika msana.
3. Pakuti ochititsa dzanzi zoterezi ndi luso, chifukwa uwu ndi ochititsa dzanzi zovuta kwambiri.
4. Mankhwala othandiza yekha mu mphindi 15-20, kotero opaleshoni sangathe anayamba nthawi yomweyo.
5. Pali chiopsezo cha kuchepa mpumulo ululu pamene molekezera mitsempha si kwathunthu zokhoma anapulumutsa kusapeza pa ntchito.
6. M'pofunika mosamala kusankha mankhwala ochititsa dzanzi pa gawo cesarean, monga ena kuwoloka nsengwa ndi chifukwa cholephera kupuma ndipo kugunda kwa mtima yoopsa.
7. Pambuyo opaleshoni akhoza anamva zowawa, mutu kumbuyo.

Kuti zinthu mwanzeru, ngati inu muli gawo la Kaisara, epidural kapena ambiri mankhwala, muyenera kufufuza "ubwino" ndi "kuipa." Ganizirani contraindications alipo, ndi kusankha mtundu yabwino kwambiri ya mankhwala ochititsa dzanzi.

Zovuta za mankhwala ochititsa dzanzi epidural

Epidural ochititsa dzanzi mavuto amapereka kawirikawiri ndithu, ngakhale Zikatero napeza. Nthawi zambiri cited:

1. Y 1 odwala 20, mankhwala sachita, ndipo molekezera mitsempha si kwathunthu oletsedwa, zikutanthauza kuti analgesia adzakhala sizithandiza.
2. Pamaso pa coagulopathy ndi ngozi kufinya.
3. Mwangozi kuwonongeka pa puncture wa Dura Mater kungayambitse kutayikira la madzimadzi cerebrospinal m'dera epidural. Ndi zinadzala ndi mutu pambuyo opaleshoni.
4. A mlingo waukulu wa mankhwala ululu oopsa, umene inefficient anatseka misewu.
5. Pangakhale zotsatira zoyipa kugwiritsa ntchito mankhwala enieni mankhwala ochititsa.

Kuyambira onse pamwamba Ndizachidziwikire kuti epidural ochititsa dzanzi zotsatira za thanzi aakulu amapereka mu nthawi zina kwambiri.

Reviews za ntchito analgesia epidural

Bungwe ali osiyana Komabe, ngati ena kulekerera ochititsa dzanzi ambiri, kwa ena yochezera epidural ochititsa dzanzi. Reviews iye zimakhala zabwino.

odwala ambiri lipoti yabwino analgesia, akazi pa gawo cesarean mukhoza kuona zochitika zonse za madokotala ndi kumva kulira kwa mwana wake nthawi yomweyo pambuyo pa kubadwa. Pali mpata wabwino kwambiri kuchepetsa ululu pambuyo opaleshoni.

Amayi ambiri amanena kuti ngati muli ndi kuthamanga kwa magazi, kugwiritsa ntchito mankhwala ochititsa dzanzi epidural limakupatsani kusunga malipoti mu osiyanasiyana wabwinobwino, kuti yekha ndi ubwino ntchito.

Koma popanda ndemanga zoipa ndipo simungathe kuchita. Odwala ena muka- ululu pambuyo kwambiri mutu, kupweteka kumbuyo. Pali anthu amene mankhwala chabe sizinayende, ndi anatseka misewu ya molekezera mitsempha sizinachitike.

Kuyang'ana mwa ndemanga zonse, mungapeze mfundo imodzi yokha: aliwonse ochititsa dzanzi amafuna woyenera katswiri njira. Ngati ngakhale zosavuta ochititsa dzanzi kuchitira mosasamala, osati kuwerengera mlingo wa mankhwala aliwonse, n'zotheka kuti zotsatira zapathengo, nthawi zina zovuta kwambiri, ndipo kodi kulankhula za epidural lapansi.

mafunso onse ayenera kukhala chisanadze kukambirana ndi dokotala anu, inu analibe mawonetseredwe osafunika.

Ndithudi, izo zikanakhala zabwino zokhazokha ngati aliyense sanafunikire opaleshoni, choncho safuna ndi ochititsa dzanzi. Koma zenizeni wathu wa moyo wotere kuti nthawi zina ntchito sangathe kupewa kuti apulumutse moyo ndi thanzi. Dzisamalire mukhale ndi thanzi labwino.