Mishonga yakanakisisa chinhu chandisina ini kana mwana wangu takatora, vakadzi vakawanda vanofunga. Uye vese nyanzvi vanobvumirana neizvi. Kuchengetedzwa kwako uye utano hwechechecheche ibasa guru rechiremba. Ndicho chikonzero iwe une kodzero yekuwana ruzivo rwemishonga ichazoshandiswa pakuberekwa. Chiremba anofanira kukuudza kuti zvinoshandiswa nemishonga zvinoshandiswa sei mumamiriro ako ezvinhu, zvichienderana nehutano hwehutano, nguva yekuzvitakura uye yakawanda inogadzirwa. Kubva pane yakarongwa, iwe unogona kusarudza chero mishonga, uyewo nzira iyo inoshandiswa. Usabvunzurudza iwe unogona kungoitika pane chimwe chekuti kune ngozi chaiyo muupenyu hwako uye hupenyu hwemucheche. Munyaya iyi, basa rako guru nderokuwana nyanzvi yakanaka uye kuvimba naye zvizere. Ive wakadzikama, pasina chidikanwi uye uchapupu hunokosha, hapana masangano achaitwa kwauri.
Pasina kurwadziwa
Zvechokwadi, une simba rakakwana remukati kuti uende kuburikidza nehutano hwose hwekuonekwa kwomwana. Zvisinei, kunyange mukadzi akashinga angada kubatsirwa kubva kunze. Iko kune mapoka akawanda emishonga inorwadza inoshandiswa muzvikamu zvakasiyana zvekuberekwa. Zvakakosha kuziva kuti ndiyo yakanakisisa painkiller yekubudisa.
1. Kugadzirira
Kana iwe ukaberekera kwekutanga, danho iri rinogona kudhonza kwemaawa mazhinji. Kusiyanisa panguva ino, sekutonga, hazviwanzoitiki, asi kakawanda kunorwadza. Kana isingatungamiri kumucheto wemukirini, unogona kupiwa intramuscular anesthesia - ichakubvumira kuti udzike mukati mekuvata uye kurara maawa mashoma anorwadza, izvo zvichachengetedza simba rako pakuzvarwa kunouya. Anesthesia yakadaro inobatsira mukati meawa 3-4.
Migumisiro
Chirwere chinonzi anesthesia chinogona kukonzera kugona kwe fetus pa cardiotocogram, iyo yakanyorwa pakuberekwa. Asi mushure memagumo emishonga, zvigumisiro zvinobva zvadzokera kune zvakasikwa.
2. Chikamu chakashanda chebasa
Munguva iyi, unogona kushandisa zvose intramuscular anesthesia uye epidural anesthesia. Muchiitiko chekutanga zvakakosha kuita jekisi 30-40 maminitsi asati aonekwa mwana, zvisinei kuti mwana angaberekwa akarara uye asina usimbe. Usanetseka, munguva pfupi iye achawana basa rake rairo.
Ne epidural anesthesia, mishonga inowanikwa munharaunda yepachirwere munharaunda ye lumbar (muviri wakadzika unoregererwa nekunzwisisika). Rudzi urwu rweanesthesia haruna chinotyisa uye harunopindi ropa ramai kana mwana. Zvisinei, anesthesia yakadaro haina kukodzera munhu wose. Kupindirana kune iyo kuwedzera kukura kana kushandiswa kwepamusoro pamusana. Chimwe chiitiko chinokosha ndiko kugadzirwa kwehondo nguva dzose (ine periodicity yemaminitsi 2-3). Kana iwe ukaita anesthesia kare, kuberekwa kunogona kuderera.
Migumisiro
Inramuscular anesthesia haina mamiriro akaipa. Mushure meawa maawa 3-4, anesthetics zvachose inoparadzanisa uye haigoni muropa.
Kana chirwere chepestin aneshesia chinoshandiswa muchikamu chekushaya chirwere, misoro inokwanisika. Zvinonzwisisika zvakabviswa nehuwandu hunoita. Neuralgic zvipembenene munyaya iyi hazvishamisi. Nzvimbo iri pahutano iyo jekisi inogadzirwa haisati iine vertebral canal, zvinenge zvisingakwanisi kupinda mumisungo yakabuda. Nzira yekuitisa anesthesia yakadaro yakashanda zvakajeka kwazvo.
Unoda mishonga inorwisa mabhakitiriya here?
vakadzi ndivo vanotakura Gulu B Streptococcus, iro rinowedzera huwandu hwekutengesa chirwere ichi kune mwana achangoberekwa. Kunyanya, streptococcus, ine uipi husina kunaka pane placenta, inogona kukonzera fetal hypoxia. Ndiko kusaka, pavhiki yekusvika 36 yekusununguka, vanaamai vese vari mberi vachakurudzirwa kuita smear (kubva kunze kwenhengo dzebereki) kuti vasarudze kuvapo kwe streptococcus. Kana ikawanikwa, maantibayoti (akadai sepenicillin) anoshandiswa pakuberekwa. Dzimwe nguva mishonga inorwisa mabhakitiriya yakanyorerwa vakadzi vane chinangwa cheprophylactic. Somuenzaniso, kana mukadzi ane pamuviri maawa masere apfuura akasiya mvura, uye basa rekuberekwa harina kutanga.
Wedzera kuwedzera
Ingo iwe unokurumidzira matamba pasina munhu anoda. Asi kana kamwe-kamwe kune mamiriro ezvinhu apo kudzivisa kunogona kukanganisa mamiriro emwana uye hupenyu hwemamai, vanachiremba vanogona kukurudzira basa rebasa. Somuenzaniso, kana mukadzi achisvika kumusha wekuberekwa ane maitiro asina kukodzera, veVedas vakabva maawa mashanu akapfuura, kana mumatambudziko akaoma, kana zvichifanira kuti basa riwire pasi masikati.
1. Kugadzirira
Muchikamu chekugadzirira chebasa, gadziriro yakakosha inoshandiswa muchimiro chegelisi, iyo inotanga kupinda mumudzimai. Inoumbwa nemafananidzwa emhando dzemhando dzepanyama dze prostaglandin, dzinogadzirisa chibereko chechibereko chekuuya kwekuuya - kuchidzikisa, kuchiita chikafu, kugovera kuvhura.
2. Chikamu chakashanda chebasa
Muchikamu chinoshanda chebasa, kana zvipembenene zvisina simba zvakakwana uye kazhinji, chirwere chechibereko chechibereko hachizaruri kana basa rebasa rakatanga zvisingakurumidze kumira, kushandisa oxytocin, iyo inowedzera kuwanda kwezvipembenene zvehutano. Irodovozbuzhdenie yakadaro inowanzoitwa pamwe ne anesthesia. Oxytocin inoshandiswa nerubatsiro rwechidonho kusvikira kutanga kwezvipembenene nguva dzose uye kuvhura kwechirwere. Nguva yekushandiswa kwayo yakanyatsotarisana nevamwe - kune mumwe munhu maawa manomwe, kune mumwe munhu 16. Kana mushure mokunge kukurudzira kwaisava nemigumisiro, inomiswa, uye basa racho rinopera nechikamu chekusiya. Itaurwa iyo oxytocin inonyanya kuvhara mishonga yeropa uye naizvozvo ndiyo inokonzera kuwedzerwa kweropa mumamai mune ramangwana uye kusava kwe okisijeni (hypoxia) mumucheche hakuchina tariro. Izvozvo zvinoshandiswa pamidziyo yemagadzirirwo emagetsi ehomoni ino chaiyo yakagadzirwa ne placenta inoderedzwa.
Migumisiro
Zvakakosha kushandisa oxytocin, mushure mekunge wakamirira, apo chibereko chechivivhisi chave chakanaka, chakakura. Kuwedzeresa kwakanyanya kwechiremba vanoronga izvi zvinokurudzira mugadziriro yebasa (chirwere chechivhadziro chinowedzera, chakaoma) kazhinji chinotungamirira chikamu chekudzivirira.
Chokwadi
Kushandiswa kwemasope uye papaverine mubasa isayenzi haisi yakarurama. Kazhinji mishonga iyi inorayirwa kuitira kuti isunungure chibereko chechivharo uye inokurumidza kushandiswa kwemitemo. Kunyange zvakadaro, vanogona kungobvisa maronda emusana, asi chibereko chechivharo chinoshandiswa. Mumamiriro ezvinhu aya, kushandiswa kwavo hakuna maturo.
Deep dive
Kune imwe nyika, general anesthesia inowanzoshandiswa pakuberekwa. Somuenzaniso, muUnited States, chete 5-7% yezvikamu zvekusiya. Izvo munyika yedu iyo nguva yakawanda yekushandiswa kwayo inosvika 70%! Pakutanga, chirwere chinonzi intravenous chinopiwa kuna amai, mukadzi wacho anobhabhatidzwa muhope, mushure mokunge magasi anonyadzisa anowanikwa kuburikidza nehuputi chaiyo, achihutsigira muhurumende iyi yose mukushanda.
Allergic zvinoshandiswa kune zvinodhaka zvinowanzoitika mumukadzi mumwe chete nemamiriyoni. Dambudziko guru kune amai nechecheche rinoratidzika kune zvakaitika uye kubatana kweboka rechiremba. Kuti ushandise zvinodhaka kuti upinde muropa recheche mune zvishoma, unoda kubvisa kubva muchibereko nokukurumidza sezvaunogona.
Mukuwedzera, zvakakosha kuti mwana wacho akawira pakarepo mumaoko eineonatologist. Anogona kusveta uye kuora simba kwemapfupa ekufema. Kana chikamu chichimedza amniotic fluid, zvakakosha kuti mumwe munhu amubatsire kuchenesa pahuro. Mumwe nyanzvi anoongorora mamiriro emwana. Kana asingaratidze chero zviratidzo zve hypoxia (kushaya oxygen), achabva aina vamwe vana, kunze kwekutariswa kwakanyanya. Kana pane, kusungirirwa kushandiswa kwemasikisi emhepo kunogona kudiwa. Chero zvazvingava, mitezo yese yekushandisa aneshesia rose kumwana inopedzwa mumazuva ekutanga ehupenyu hwake.
Vakadzi vanonyatsopikisa kushandiswa kwemishonga chero ipi zvayo vanogona kuisa gwaro rinokosha vasati vaberekwa. Inoratidza kuti pamwe nemigumisiro yemagetsi, vanofungidzira vose.
Mune zvimwe zviitiko, kana mukadzi ane zvipikisa zvinorwadza zvisingaitisi kumuromo wechirwere, zvinokwana kugadzirisa muviri wemvura. Muchiitiko ichi, kusvibiswa kwemisumbu yomuviri kunoderedza, uye zvipikiso zvinoshanda
Izwi rekutanga reesesthesia mubasa panguva yechikamu chechigadziro yakashandiswa muna 1847 nechigunyanisi J. Simpson. Yaiva chloroform.
Kuchengetedza kunonzwisisika
Muzvipatara zvakawanda zvekuberekwa, vanaamai vese vari mberi vachaisa dorosi ne saline. Sei? Kuzokwanisa kupindura pakarepo kune chero mamiriro ezvinhu epakukurumidza uye nokukurumidza kubvisa. Kuberekwa kunotarisirwa, asi zvisingazivikanwi, nzira. Ndicho chikonzero nei tichida kuva nekusingaperi kune mutsara, kuitira kuti mumatambudziko akakurumidza kuburikidza nekatheta unogona kukurumidza kuisa mishonga inodikanwa. Dzimwe nguva vanaamai vanozotevera vanorayirwa doro re saline ne glucose. Izvi zvinonyanya kukosha kune avo vasina kudya asati aberekwa. Muchiitiko ichi, glucose ichava iyo yakanakisisa inopa simba, iyo, pasina mubvunzo, inobatsira amai pakuberekwa uye shure kwavo, apo inogona kutanga kumanikidzira mwana wavo akamirira kwenguva refu. Shysiological saline uye glucose zvakachengeteka zvachose kuna amai nemwana.