Miyezi ya kuyembekezera kuyembekezera ikufika kumapeto, wamng'ono kwambiri mwa inu amasiyana ndi msonkhano ndi mwana. Chinthu chokha chimene chimasokoneza kuyembekezera mwachimwemwe ndikofunikira kupirira kupweteka. Ngakhale abwenzi-okondana-atsikana amadzimadzimutsa, amati, kupweteka pakubereka - poipa kuposa mano. Musati mudandaule pasadakhale, mukudziwonetsa nokha chithunzi chowopsya cha kubadwa kwautali, kowawa. Choyamba, momwe mumapiririra nkhondo, zidzangowonekera mu "mphindi X". Momwe mungadziwire, mwadzidzidzi mudzagwa mu chiwerengero cha anthu omwe ali ndi mwayi wobala mosavuta komanso mopweteka? Ndipo kachiwiri, lero pali njira zambiri zomwe zimathandiza kuthetsa mkhalidwe wa mkazi wogwira ntchito.
Mtsogoleri wanu
Choyamba, ndikofunika kuti mutha kudzithandizira nokha, izi zikuphunzitsidwa pokonzekera maphunziro olerera ana. Zina mwa njira zovomerezeka zachilengedwe - yoga ndi maselo apadera a zochitika zakuthupi, zomwe zimakulolani kuti muzitha kulamulira minofu ya mitsempha pa nthawi yovuta kwambiri. Kuonjezerapo, kuchepetsa kupweteka ndi kufulumizitsa kuperekera kumathandiza kuchepetsa kusisita (mungathe kupweteka mimba yanu, m'chiuno, kumbuyo kapena kuwapereka kwa manja odalirika a mwamuna wanu, mayi) ndi kupuma bwino pamene mukubereka. Ngakhale ngati mukudabwa mwakumbukira zonse zomwe mwalangizidwa ndi amayi odziwa bwino kapena ophunzitsidwa mu maphunzirowo, mvetserani mwatcheru malamulo a wodwalayo - ndipo mudzapambana! Ndikofunika kwambiri kuti musataye nthawi yoyamba: kukhala pansi, kutsamira kumbuyo kwa mpando, kukhala pambali pake kapena kungosunthira pamapazi mpaka kumapazi - thupi lidzakuuzani momwe zimakhalira kuti azitha kupirira mayesero. Pamene zovutazo zimapweteka kwambiri, gawo la kanseri limawonetsedwa, kapena ngati pali zizindikiro zina zamankhwala zomwe Amayi safuna kulekerera mayesero ndi kupweteka kwakukulu (mwachitsanzo, myopia), mankhwala osokoneza bongo amagwiritsidwa ntchito.
Mugona mokwanira
Njira yoyamba yogwiritsiridwa ntchito mankhwala osokoneza bongo m'ntchito ndi yowopsa kapena yowopsya. Amagwiritsidwa ntchito mankhwala osokoneza thupi mosavuta, kawirikawiri mankhwala amatsenga (Fentanyl, Promedol). Pankhaniyi, sikuti kokha kupweteka kumachepa, amayi omwe ali mwana akhoza ngakhale kugona tulo kwa nthawi ndithu. Izi zimakuthandizani kuti muzitha kusiya ntchito. Komabe, njirayi ili ndi pulback yofunika kwambiri: kupanikizika kwa mayi kumatha kugwa kwambiri kotero kuti kuyendayenda kwapadera kumasokonezeka, monga momwe mwana amalandira mpweya wochepa. Ndipo izi zadzaza ndi mpweya wa oxygen (hypoxia) wa mwana wosabadwayo. Kuonjezera apo, ngati anesthesia idachitidwa mochedwa kwambiri ndipo zotsatira za mankhwalawa zinalibe nthawi yoti apite, mwanayo amabadwira mu matenda ovutika maganizo. Choncho, posachedwapa, "kutchuka" kwakukuru pakati pa madokotala ndi pakati pa anthu akugwiritsira ntchito njira yosiyana - epidural anesthesia (EPA). Amapereka mwayi wambiri wobereka mwana wathanzi, akuiwala za ululu ndi mantha.
Kodi epidural anesthesia ndi chiyani?
Pakalipano, uwu ndi njira yowonjezereka kwambiri ya anesthesia (m'mayiko ambiri, mwachitsanzo, ku France, USA pa EPA amapezeka 70 peresenti ya kubadwa). Ndizowona kuti iyi ndiyo njira yokhayo yokhudza anesthesia, yomwe ikuvomerezedwa ndi Tchalitchi cha Katolika. Epidural anesthesia ikuchitika molingana ndi ndondomeko iyi. Katswiri wa zamagetsi amachititsa kuti malo a epidural ayambe kugwira ntchito (chipolopolo cholimba cha msana) ndi singano yapadera pamtunda wa 3-4 vertebrae kudera la lumbar. Kenaka, kudzera mu singano, dokotala amalowetsa catheter (singano imachotsedwa), kudzera mwa njira yomwe chiwerengero choyambitsa matenda a anesthetic chimayendetsedwa. Pambuyo pa njirayi, "neutralization" ya kumapeto kwa mitsempha, yomwe imayambitsa chiberekero, pamtundu wina umapezeka. Ntchito za mimba za chiberekero zimakhala zosasinthika, ndipo mayi samamva ululu. Sikofunikira kusokoneza epidural anesthesia ndi epidural analgesia. Ndi matenda a epidural anesthesia, njira yeniyeni yothetsera vutoli imayikidwa mkati mwa msana wa msana pamadzi ochepa. Mitsempha yomwe imatha pamlingo wa lumbar imatha kusamvetseka pafupifupi kwathunthu, yotsekedwa, mkazi sangamve kupweteka, miyendo yake imakula. Mkazi amabereka bodza pambali pake kapena kumbuyo kwake, akunyamula msolo wake. Cholinga chodziwikiratu cha njira imeneyi ndi kuchoka kwa mkazi pakubereka, kusagwirizana nawo mu sakramenti la kubala. Ndipo m'maganizo, sizimayi zonse zimatha kutumiza boma. Koma pogwiritsa ntchito epidural analgesia, kufooketsa kwapadera kumajambulidwa mu buku lalikulu. Kuchepetsa kupweteka kwa mitsempha kumachitika chimodzimodzi monga momwe mkazi alili wokonzeka kukhala akubeleka. Amayi akhoza kumenyana, amayenda momasuka ndipo amatenga malo osiyanasiyana pa nthawi ya ululu ndi kubereka. Patapita kanthawi, munthu wodwala matendawa amachititsa kachilombo koyambitsa matenda. Kuphatikiza kwakukulu kwa njira iyi ndikuti mkaziyo amamva njira yoberekera ndipo amatha kuyisamala yekha.
Chenjerani: mavuto
Ngakhale kuti ntchito zonse za kumadzulo ndi zovuta zapakhomo zimagwiritsidwa ntchito, epidural anesthesia ili ndi mavuto ambiri. Zina mwa zotsatira zosasangalatsa zotsatira za ndondomekoyi - kusintha pang'ono kwa magazi mwa odwala, kuphatikizapo mutu ndi migraines, zomwe zingapangitse ngakhale masiku 2-3 mutatha kuwathandiza. Ndipo nthawi zambiri, mavutowa sagwirizana ndi luso la munthu wodwala matenda a anesthesiologist ndi luso la ndondomeko yokha. Nthawi zambiri, mutu umapezeka chifukwa ziwiri:
- M'madera oopsa a mankhwalawa amadziwika kuti sali opangidwa ndi epidural anesthesia. Pofuna kuchepetsa ndalama zonse zomwe zimagwiritsidwa ntchito, muzigwiritsa ntchito mankhwala osakaniza otsika mtengo komanso ochepetsetsa - koma kutero, kusungidwa koteroko sikuyenera kukhala koyenera;
- Zida zopanda pake zimagwiritsidwa ntchito popanga EPA. Koma ngakhale ziphuphu zochepa kwambiri mu singano (burrs kapena ngakhale zida zachitsulo zomwe zingaganizidwe pansi pa microscope) zingawononge ubongo. Pamene singano imachotsedwa, mbali ya zomwe zili mumsana wamtsempha (cerebrospinal fluid) zimayenda, zomwe zimapangitsa kuti zisinthe. Chifukwa cha mavutowa chinachotsedwa ndi kuoneka kwa singano zapamwamba kwambiri zopangira pensulo (monga cone), zomwe zimangokhalira kukankhira pamtunda pamtunda (motero zimakhala bwino pamalo awo oyambirira) - zotsatira zake zimakhala zosavuta. Koma kuchepa kwa chipsyinjo mu ziweto ndi EPA zimayambitsidwa kokha ndi momwe thupi limapangidwira ndi mankhwala osokoneza bongo. Mofanana ndi matenda a anesthesia, kawirikawiri, epidural ikhoza kuyambitsa hypoxia wa mwana wosabadwa, kotero ndikofunikira kuyang'anitsitsa mtima wa mwana pakubereka mwana, osati ndi stethoscope, koma ndi mawonekedwe a mtima.Ngati nthawi zonse zowonongeka zimaganiziridwa ndi kusamalidwa, kubala ndi EPA kudzakuphwanyirani , ndipo ukhoza kubala mwana wathanzi wopanda ululu komanso wopanda mavuto.
Afterword
Masiku ano, akatswiri ofufuza za matenda a maganizo amakhulupirira kuti: EPA ndi imodzi mwa njira zamakono zogwiritsira ntchito anesthesia pakubereka mwana. Komabe, sizowoneka bwino, ngati chifukwa chakuti zimakula kwambiri mtengo wa kubereka. Koma sayansi siimayimilira, asayansi amalephera kuyima pamenepo ndikupitiriza kufunafuna chisamaliro choyenera kwa amayi pakubeleka. Kotero, mwachitsanzo, tsopano ku England kubadwa kumakhala kotchuka kwambiri ... potsutsidwa. Chofunika kwambiri cha njirayi ndikuti akatswiri a zamaganizo omwe amadziŵa bwino maganizo "amayesa nthaka" pasanapite nthawi kuti mkazi atenge kachilomboko, pang'onopang'ono akonzekere nthawi yayitali yonse mimba. Pokhala ndi mimba yamtsogolo, makalasi amaphunzitsidwa kuti adziwe maphunziro, mothandizira maluso atsopano omwe amathandizira kubereka mwana wathanzi popanda ululu ndi mantha. Momwe mungadziwire, mwinamwake, njira iyi posachedwapa idzakhala njira yabwino yoyenera kudwala matenda a anesthesia. Nthawi idzanena.