Chii nani yokutindivadza kuti cesarean chikamu: mifananidzo, zviratidzo, contraindications, wongororo

Chikamu cheCesarea inopindira kushanda, umo mwana achangoberekwa anobviswa necheka pamadziro emimba uye chiberekero. Kutenda nemitoo iyi, zviuru zvevana zvinoberekwa gore roga roga, saka mubvunzo wekuti basa iri rinoitwa sei ndeyekunetseka kune vabereki vakawanda munguva yemberi. Panguva imwe chete, chimwe chezvinhu zvinonyanya kukosha kufungisisa pamusoro pekuberekwa kwekuberekwa ndeye rudzi rweaneshesia.

Saka, rudzi rweanesthesia rwakanaka sei nechikamu chechiesarea? Kubva munyaya yaunogona kuwana ruzivo rwemusoro pamusoro pemarudzi anowanzoshandiswa aneshesia mune zvekushanda uku, maitiro avo makuru uye matambudziko.

Kuvhiyiwa kunoitwa sei?

Usati wakaziva kuti anesthesia inobatsira sei chikamu chekudya, iwe unofanira kutaura mazwi mashomanana pamusoro pechikonzero chekupindira kunoitwa.

Munguva yechipatara, mwana achangoberekwa haazviratidzike kuburikidza nemubhedha wokuberekwa, asi anobviswa kuburikidza nekukanganiswa kwechidiki icho chiremba anovhiya anoita pachirongwa cheu uine. Mumazuva ano maimba ekuberekwa kwekudzivirirwa kunoitwa muchikamu chezasi chemuviri, nekuda kwekuti tsvina mushure mekushanda isingaoneki. Iyi nzira yekushungurudza yakazara chaizvo uye inowanzoshandiswa mukuita: mune dzimwe nyika dzeEurope, semuenzaniso muGermany, nenzira iyi, kusvika ku40% yevana vanozvarwa.

Iko kune marudzi maviri ekupindira kwekuvhiya: yakarongwa uye inokurumidza. Ikutanga inopedzerwa kana kune ngozi yekubudirira panguva yekuberekwa kwezvakaberekwa kwezvisikwa chero zvipi zvingakanganisa hupenyu uye hutano hweamai nemwana. Zviratidzo zvekuvhiya iyi zvakanyanya kuderera mapepa emadzimai, kutyisidzira kwe hypoxia, kuberekwa kwakatanga kare, kuberekwa kwakasiyana siyana, nezvimwewo. Nenzira, chirwere chinorongwa chinosarudzwa, sezvo pane nguva yekugadzirira mukadzi ari kushanda nokuda kwekushanda kunouya.

Basa rekukurumidzira rinoitwa kana kune dambudziko rakaoma panguva yekuzvarwa kwekuzvarwa. Muchiitiko ichi, chirwere chinokurumidza muzviitiko zvakawanda chinoitwa kuburikidza uchishandisa aneshehesia yakawanda, chimwe chezvinhu zvinobatsira zvikuru izvo zvinotanga kukurumidza kushandiswa kwemashoko: izvi zvakakosha, nokuti dzimwe nguva panguva yekuberekwa kwakaoma iyo nhoroondo inoenda kwemaminitsi.

Zvinonzwisisika, kuvhiya kwakadaro hakufungidziki pasina kushandisa anesthesia, zvisinei kuti murwere angasapona marwadzo anotyisa.

Ndeapi mavara anargesia anoshandiswa pakusununguka kwekusiya?

Kune miviri miviri mikuru yeaneshesia, iyo inogona kushandiswa mukugadzirisa chikamu chechiesarea: dharare uye general anesthesia. Yokutanga inopedza zvachose kukanganisa kwehafu yepamuviri yemuviri, asi pamwe chete navose, mutsauko wemurwere unodzivisa zvachose, uye mishonga yake yose inogadzikana. Muchiitiko ichi, kusarudzwa kwenzira yakakwana uye yakakodzera yakakwana yeanesthesia inogona kuitwa chete nachiremba, achifunga nezvezvinhu zvekuzvitakura, hutano hwemamai uye zvimwe zvinhu zvakawanda.

Mhando dzeaneshesia nokuda kwecesarea chikamu:

• General anesthesia;
• Mharapara;
• Epidural.

Kubudirira kukuru uye kukanganisa kweumwe neumwe wavo kunotsanangurwa pasi apa.

Ndeipi sarudzo inogona kugadzirwa pakufarisa aneshesia?

Icho chinonyanya kukosha chinonzi anesthesia ndechokuti nekuda kwedambudziko remishonga inopindwa muropa rinobuda mumhepo kana kuti nekaputi yakaiswa muchirwere chekupemha, murwere anonyatsonongedza pfungwa, uye anobva asisirwa kurwadziwa. Zvakakosha kucherechedza kuti neruzhinji anesthesia, kusununguka kwemisimba kunoonekwa, izvo zvinoita kuti zvive nyore kugadzira mamiriro ekushanda anoshanda kune chiremba-chiremba.

Uyu rudzi rweaneshesia kune vakadzi vane chikamu chekuchengetedza, hachiwanzoitiki. Chido chekuita aneshesia chinogona kuitika munyaya dzinotevera:

• Kuvapo kwekupikisa kune dzimwe nzira dziripo dzeaneshesia;
• Kuvapo kwekuneta kwepamusoro mukati mevakadzi;
• Iyo fetus inowanikwa inoonekwa ne hypoxia;
• Kuramba kwomukadzi kubva kune mamwe marudzi anesthesia;
• Chimiro chisina kukodzera mumubereki, kupera kwemutilical mutsara pamwe nemamwe mamiriro ezvinhu emamiriro ezvinhu epfungwa.

Mazuva ano, aneshesia yakawanda ine chikamu chechiesarea inoshandiswa kana inenge ichidikanwa kuti iite pasi pezviratidziro zvinokurumidza, uye kupindira kwekuvhiya kunodiwa kuti utange nokukurumidza kuchengetedza hupenyu hweamai nevana. Inokonzerwa nehuwandu hwekuti aneshehesia yakawanda ine huwandu hunokanganisa.

Kukanganiswa kwevanhu vakawanda anesthesia

Chii chinonzi anesthesia chiri nani nechikamu chechiesarea? Musati mhinduro mubvunzo uyu, ngatitaure nezvekukanganisa kwawo. Vanachiremba vanoedza kudzivisa rudzi urwu rweaneshesia nechikamu chekaseare, sezvo anesthesia inogona kupa huwandu hwakawanda hwezvinetso zvichienzaniswa nedzimwe nzira dzeaneshesia. Pakati pezvinonyanya kuwanda ndeizvi:

• Hypoxia yemukadzi chaiye, iyo inokonzerwa nekuti munguva yeanesthesia kuwanda kwemapapu kunoderera uye kudiwa kwemuviri kwomweya kunowedzera;
• Mukana wekutsvaga, kureva kuti, kupinda mumapapiro ekudzivirira mukati memudumbu zviri mukati, zvakanaka: kana anesthesiologist isinganzwisisi mamiriro acho panguva yakakodzera, migumisiro inogona kuvhiringidza;
• Muzviitiko zvakawanda munguva yeanesthesia, zvinomanikidza zvinowedzera.

Antichetic inogona kukonzera kukanganiswa kwebasa rekufema rechecheche, uyewo kuedza kushungurudzika kwete pamusana pemaitiro ake emagetsi nekuda kwekupindira kwemishonga inorwadza kuburikidza neparcenta. Iyo yekupedzisira inonyanya kukuvadza kana aneshehesia inoshandiswa kusununguka nguva isati yapera. Zvisinei, munhu haafaniri kutya zvikuru: mishonga yemazuva ano inobvumira kuderedza mungozi yemigumisiro yakaipa kumwana kusvika zvishoma, kunze kwechechecheche inogamuchira mishonga inokosha inobvisa migumisiro yevanhu vakawanda aneshesia.

Saka, ndeipi nzira yakanakisisa yekusarudza anesthesia muchikamu chekushaya chirwere, zviri kwauri iwe uye chiremba wako kuti asarudze, asi yeuka kuti aneshehesia yakawanda iri kure nekanakisisa yekugadzirisa kushanda uye inofanira kushandiswa chete kana zvimwe zvingasarudzwa pane chimwe chikonzero kana chimwe Remains. Somuenzaniso, kana amai vane chirwere chisina kugadzikana kana kuti vane chirwere chipi nechipi chezvirwere zvepfungwa, basa racho rinogona kuitwa chete pasi peaneshesia rose, nokuti kune ngozi yakawanda yokuti mukadzi haakwanisi kuramba akanyarara munguva yekushanda uye achapindira nezviito zvechiremba.

Zvinowanzowanzoitika, zvirwere zvepasimia uye zvepineti aneshehesia, kureva, nzvimbo dzenharaunda dzeanesthesia, dzinoshandiswa mukudzidzira - izvi zvipenyu zvakachengetedzeka zvakanyanya, kunze kwezvo, zvinobvumira mukadzi kuti ave mumamiriro ezvinhu akajeka panguva yekuberekwa. Izvi zvinokosha kwete chete nokuti ane mukana wekurumidza kutora pamaoko echecheche. Munguva yechipatara, chirwere chechipatetri uye anesthesiologist chinogona kuramba chichibatana nemurwere, izvo zvinoita kuti zvive nyore kuona kuti zvinetso zvinogona kuitika.

Nzira ye epidural anesthesia

Usati wapindura mubvunzo uyu, zviri nani kuita aneshesia nechikamu chekudya, zvakakosha kuziva kuti chii chinonzi epidural anesthesia. Iyi ndiyo nzira iyo inonzi anesthetic inorohwa mukati mechikamu chepadural chemumumvuri munharaunda ye lumbar. Mushure mokunge anesthesia inokonzerwa nenzira iyi, amai vanoziva panguva yekuvhiya, asi havanzwi kurwadziwa.

Nharaunda yeAnesthesia ine chikamu chekudya inobvumira mukadzi kuti atore chikamu mubasa rekuendesa: kukurukurirana nevanochiremba kana murume aripo mudhidhi, pakarepo batora mwana mucheche mavoko uye vagoisungira pachipfuva. Zvisinei, amai vacho havanzwi kurwadziwa, kunyange zvazvo vamwe vanocherechedza zvishoma panguva yekushanda.

Ichokwadi, pane imwe inokosha kwazvo nuance. Vakadzi vakawanda vane hutano hwemagariro kusarudza kugara muimba yekugadzirira, vanotya kuti munguva yeKesariya vachaziva uye havazonzwi hafu yemuviri wavo. Kazhinji vanaamai vanoomerera kune anesthesia yakawanda. Zvinokurudzirwa kukurukura kutya kwako nechiremba anoshanda uye anesthesiologist, uyo achataura zvakajeka kuti nzira yeanesthesia ichaenderera sei.

Kubatsira kwepachirwere anesthesia

Pakati pezvakakosha zvikuru zvepidural anesthesia ndezotevera:

• Yakasimba kushanda kwemwoyo yematambudziko, kusavapo kwezvinonzi spikes.
• Kuchengetedza kufamba.
• Kusarudzwa kwepamusoro chekufuridzirwa kwepamusoro chekutambudza uye pasina njodzi yekuda.
• Nguva yakareba yeinesthetic effect. Kana zvichidikanwa, anesthesia inogona kuwedzerwa chero nguva ipi, iyo inonyanya kukosha munharaunda iyo mushure mekugadzirisa chikamu, inofanirwa kuita mamwe maitiro, somuenzaniso, kuita mhando yeiyo inonzi fallopian tubes.
• Mukadzi wacho anosiya anesthesia zvakaringana, nguva yekugadzirisa shure kunopfupiswa: munguva maawa makumi maviri chete mushure mekuvhiyiwa, varwere vazhinji vanogona kuzvimirira vakasimuka uye vanofamba.
• Mwana anogona kutorwa uye akabatanidzwa pachipfuva pakarepo mushure mekushanda.
• Zvinokonzerwa kuderedza marwadzo mushure mekusununguka, kuunza painkillers munzvimbo yechirungu.

Kukanganisa kwepachirwere anesthesia

Pasinei nezvose zvakakosha, migumisiro yepidural anesthesia muchikamu cheKesaria ingave inonyadzisa. Izvi zvinofanira kuzivikanwa nekuberekwa kwose kwekusangana:

• Kana chirwere chisina kujowa nomunhu ane ruzivo, njodzi yekuwana mishonga muropa iri yakanaka. Muchiitiko ichi, kushungurudzika kunowedzera, kuwedzerwa kweropa kunowedzera kupera uye kuziva kunopedzwa. Mugumisiro unogona kuva kufa kweamai kana kuti kukanganisa kusingagadziriswi kwehurongwa hwemagetsi.
• Munenge 17% yezviitiko, anesthesia haidziviri zvimwe zvemitsipa, nekuda kwekuti mukadzi anoberekerwa munguva dzechikamu chezviitiko zvinosangana nemafungiro asina kufadza. Nokudaro, usati watanga kushanda, zvakakosha kuongorora kushushikana uchishandisa miedzo inokosha yeurouroyo, somuenzaniso, pini dzinobata. Kana kushandiswa kwemaitiro kusina kushanda zvakanaka, kudzokorora kushandiswa kwemishonga kunodiwa.
• Kana mushonga wacho, nokuda kwekusava nekwo kuiswa kwecatheter, wawira pasi pechirungu chegandangara remutsanga wepelinha, ruvara rwepelinha runogona kuitika, izvo zvinowanzokonzera kukundikana kwekufema. Kuti udzivise izvi, chirwere chiduku chechirwere chinotanga kubudiswa: boka rekuvhiya rinoda mamiriyoni maviri ekumirira kuti rione kana nzira yacho inoshanda zvakanaka.

Zvinosuruvarisa kuti, epidural anesthesia mukushanda kwechikamu chekudzivirira ichi pane zvakaoma, uye kubudirira kwayo kunowanzoenderana nekuziva uye unyanzvi hweyanyanzvi. Kutora tactile kweropa rinenge risina kujeka, nepo musana wemaspine aneshehesia ine chiratidzo chakavimbika ndiko kubuda kunzvimbo ye cerebrospinal fluid. Nokudaro, zvakakosha kusarudza chiremba anokuita kuti uvimbe, uye nyatsoongorora mhinduro yebasa rechipatara, umo mwana wako achazvarwa.

Mharapara anesthesia

Pakutanga, epidural anesthesia yakaratidza kuponeswa kwechokwadi, nokuti yakabvumira kwete kungoita kuti kuberekwa kwemwana kuberekwe zvakakwana, asiwo kwakapa vakadzi mukana wekusatadza kururamisa kwekufunga nekuona panguva yekuzvarwa kwevana vakamirira kwenguva refu. Zvisinei, nekuda kwezvakawanda zvinopesana uye mungozi yemigumisiro yakaipa yakataurwa pamusoro apa, epidural anesthesia zvishoma nezvishoma inopa chikamu kumusana wepamuviri. Vakawanda vanopikisa kuti iyi ndiyo inonyanya kunyorera anesthesia muchikamu chechirea.

Mharapara anesthesia ndiyo kuiswa kwemaitiro anesthetic munharaunda yechipararira yekumusoro. Chirwere ichi chinopinda munzvimbo yemahara yepelinha. Muchiitiko ichi, mhedzisiro yemarudzi ose eesesthesia akafanana: imwe nguva mushure mejojo, iyo inopera kuona inenge hafu yemuviri wayo, uye chiremba anogona kutanga kutora chirongwa chakakodzera.

Zvimwe zveSpinal Anesthesia

Ndeupi anesthesia zviri nani kune chikamu chesaaresa? Ndizvo zvakaoma kupindura mubvunzo uyu, nokuti zvinhu zvose zvakasiyana. Asi isu tinokwanisa kusiyanisa zvakakosha zvinokosha zvepelin aneshesia:

• Kusabatwa kwehutachiona. Kana zvichiitika kuitika kwechirwere chekushaya ropa muropa, kuchinja kubva pamwoyo kana chirwere chinotyisa kunenge kusingaoneki, asi ngozi yemwana haipo.
• Mushure mokuvhiyiwa, muviri unodzorerwa nokukurumidza zvakakwana.
• Kufananidza anesthesia: panguva yekushanda mukadzi ari kubasa haana kurwadziwa.
• Chirwere chinonzi anesthesia chinowedzera kubvisa musculature, iyo inofambisa basa rechiremba.
• Iwe unogona kuenderera mberi kuchibvumirano maminetsi mashomanana mushure mekutungamirirwa kwechirwere, saka kupindira kunotora nguva shoma.
• Mharapara anesthesia yakawanda kwazvo kupfuura epidural. Mukuwedzera, anesthetist anoshandisa chidimbu chakareruka chekuisa mushonga, kuitira kuti pangozi yemutsara wegomba remutsipa kana kujekeswa kusina kukodzera kwekugadzirisa muviri kunoderedzwa.
• Vanachiremba vazhinji vanoona kuti anesthesia yepelinha ndiyo nzira yakanakisisa yechinhu chinonzi anesthetizing caesarean.

Mharapara anesthesia nechikamu chechiesarean: zvinopesana uye zvinokanganisa zvikuru

Zvinosuruvarisa, musana wechipfuva anesthesia inewo zvimwe zvisingabatsiri:

• Mushonga unobudirira kwemaawa maviri, naizvozvo rudzi urwu rweaneshesia haruzoshanda kana uchida kuita chero mamwe maitiro ekuwedzera, uye kana zviitiko zvinetso zvikaitika panguva yekuvhiyiwa, mamwe aneshesia anogona kudiwa.
• Mharapara anesthesia haigoneki kana murwere ane mamwe marudzi ekukuvara kwepamusoro.
• Nokuda kwekurumidza kukurumidza kweanesthesia, ropa rinogona kuderera.
• Kana zviridzwa zvinoshandiswa kugadzirisa zvinodhaka hazvina kunyatsodzivirirwa, zvirwere zvakasiyana-siyana zvinotapukira, zvakadai semaminingitis, zvinogona kuitika.
• Mushure mokuvhiyiwa, vakadzi vakawanda vari mubasa vanoberekera misoro yakakomba, iyo inogona kugara kwemazuva mazhinji uye vhiki.
• Somugumisiro wekusaita kwakakodzera kwekathetera, nzvimbo yehutano, iyo inonzi "pony muswe", inogona kukuvara. Izvi zvinogona kukonzera kusachengetwa kwe sacrum uye nzvimbo yakakosha kuti iparadzwe.
• Mharapara anesthesia haigoneki nedzimwe mhando dzekuora kwepamusoro.
• Mharapara anesthesia haigoneki nechisimba chine nguva isati yasvika pane imwe mamiriro ezvinhu.

Pasinei nematambudziko anotaurwa pamusoro apa, maronda anesthesia anoonekwa seimwe yenzira dzakanakisisa uye dzakachengetedzeka dzakagadzirisa zvikamu zvekudzivirira.

Anesthesia muchikamu cheKesariya: kuongorora

Chii chinonzi anesthesia chiri nani nechikamu chechiesarea? Kuongorora kuti manzwiro evanhukadzi mune izvi kana rudzi rweanesthesia ruchatibatsira kuwana mhinduro kumubvunzo uyu.

Vanaamai vaduku vanocherechedza kuti nzira yekubuda kune anesthesia yakaipa zvikuru: kune manzwiro ekuvhiringidzika, kusuruvara, kurwadziwa musoro uye kurwadziwa mumisungo. Mukuwedzera, hapana chingaitika mushure mekuberekwa kwekutora kutora maoko emwana. Pane imwe mimwe migumisiro yakaipa yehuwandu hweaneshesia: kazhinji mushure mokunge mwana aona kuora mwoyo kupera.

Chii nani yokutindivadza nokuda cesarean chikamu? Reviews kuti nhengo dzomuviri yokutindivadza vakawanda zvakanaka. vanaamai vatsva kuti pashure nzira, hapana kusanzwa, uye mwana anogona pakarepo kushandiswa chipfuva. Zvisinei, sezvinoratidzwa inofambiswa, zvinowanzoitika kusagadzikana mune kwokubatsira uye pakutanga maawa mashomanana pashure Caesarean chikamu, kana rufimbi panobviswa kubva mumuviri, rezasi hafu muviri zvakasimba kudedera. Zvisinei, chete zuva avhiyiwa zvinokwanisika kumira netsoka dzayo, kufamba vakazvimiririra uye kutarisira mucheche.

Spinal yokutindivadza panguva caesarean chikamu ongororo, kunyanya akanaka aiwana. Varwere vanoti haana kuona marwadzo panguva pakuvhiya. Zvisinei, mune zvimwe zviitiko, kwevhiki dzinoverengeka vakadzi chirwere nomusoro uye abdominal kusanzwa.

Sei kusarudza yokutindivadza?

Saka chii nani yokutindivadza nokuda cesarean chikamu? Nyaya ino ndehwokuti vanamai pamuviri nezvirwere kuti yokutindivadza yaishandiswa caesarean chikamu yokutindivadza zivisa. Asi rangarira, chero zvazvingava hakufaniri kutungamirirwa ruzivo pamusoro apa, pakusarudza yokutindivadza! Chete chiremba ane ose mashoko pamusoro utano vanaamai vatsva vanogona kusarudza zvakarurama mhando yokutindivadza. Chokwadi, Murwere anoda hazvigoni kungotariswa. Saka, usati wasarudza pasi iro yokutindivadza zvakanakisisa kuita caesarean chikamu, unofanira kuyera zvayakanakira nezvayakaipira imwe nzira, uye kubvunza chiremba uye anesthesiologist.

To yasarudzwa yokutindivadza hubudirire, unofanira kushandisa zvose kunenge ose nyanzvi ndiani mazano sei kudya pamberi kuvhiyiwa, kana kumuka pashure caesarean chikamu, uye zvokuita kuitira kuti muviri wokugadzirisa nokukurumidza sezvinobvira.