Mwedzi yekumirira yakaneta iri kuuya kumagumo, muduku kudarika iwe unoparadzana kubva pamusangano nemwana. Chinhu chimwe chete chinosvibisa tariro inofadza ndeyodiwa yekufamba nemarwadzo. Kunyange vavakidzani "vakanaka" -vasikana vanosimudza, vanoti, kurwadziwa pakubereka - zvakanyanya kudarika mazino. Usavhunduka zvisati zvaitika, uchizviwisira mufananidzo wakaipisisa wekuberekwa kwenguva refu, kunorwadza. Chokutanga, kuti iwe unotsungirira zvakanakisisa sei hondo, inoratidzwa chete mu "nguva X". Nzira yekuziva sei, kamwe-kamwe iwe uchawira muhuwandu hwevane njodzi vanoberekera nyore nyore uye vasingarwadzi? Uye rwechipiri, nhasi kune nzira dzakawanda dzinobatsira kudzikisa mamiriro emukadzi ari kubasa.
Iwe pachako mutungamiriri
Chokutanga uye chakakosha, zvakakosha kuti iwe uwane kuzvibatsira iwe, izvi zvinodzidziswa mukugadzirira kwemakadzi ekudzidzisa. Pakati pezvirongwa zvepanyama zvakaratidza - yoga uye zvikamu zvakasiyana-siyana zvekuita muviri, zvichikubvumira kuti utore masimba emisipiresi panguva yakakosha zvikuru. Mukuwedzera, kuderedza marwadzo nekukurumidza kusununguka kunobatsira kunonoka kupisa (unogona kurova mimba yako, mahudyu, pasi kumashure kana kuisa kune maoko anovimbika emurume wako, amai) nekufema zvakanaka panguva yekuberekwa. Kunyange kana uchibva wakashamisika iwe unokanganwa zvinhu zvose zvawakapiwa nevadzidzisi vane ruzivo kana kudzidziswa mune zvidzidzo, kunyatsoteerera mirairo yechiguniti - uye iwe uchabudirira! Zvakakosha kuti usarasika mumatambudziko okutanga: kugara, kumira shure kwechigaro, uine rutivi parutivi rwake kana kungoshanduka kubva patsoka kusvika kumakumbo - muviri pachako uchakuudza pane chinzvimbo chakanakisisa kuti atsungirire kuedza. Kana zvipembenene zvichinyanya kurwadza, chikamu chekasea chinoratidzwa, kana kana kune zvimwe zviratidzo zvoutano izvo Amai vasingadi kubvumira kuedza kwakasimba uye kurwadziwa (somuenzaniso, myopia), zvinodhaka zvinoshandiswa zvinoshandiswa.
Mukurara kwakanyarara
Nzira yekutanga yekurapa zvinodhaka mumishanguro inopinza kana kuti inoruscular anesthesia. Zvinoshandiswa nemishonga zvinoshandiswa nyore nyore pakuita muviri, kazhinji zvinoratidzika zvinoratidzika (Fentanyl, Promedol). Muchiitiko ichi, kwete chete murwere unorwadza unoderedzwa, amai vari mumwana vanogona kutowira muhope dzenguva yakati. Izvi zvinokubvumira kuti usunungure kubva kubasa. Zvisinei, iyi nzira ine chinhu chinokonzera kukanganisa: kukanganiswa kwemasimba kwemai kunogona "kuwira" zvakanyanya zvokuti kupararira kwe-utero-placental kunovhiringidzika, semugumisiro wekuti mwana anogamuchira oxygen shoma. Uye izvi zvinoputika nehogijini nyota (hypoxia) ye fetus. Mukuwedzera, kana anesthesia yakaitwa nguva yakanyanyisa uye zvinoitika zvechirwere zvaisina nguva yekuenda kwete, mwana anoberekerwa muhutano hwehutano hwekurapa. Saka, munguva ichangopfuura, "mukurumbira" mukuru kune vose vanachiremba uye pakati pevanhu vari kushandisa nzira yakasiyana - epidural anesthesia (EPA). Anopa mikana yekuberekera mwana ane utano, achikanganwa kurwadziwa uye kutya.
Chii chinonzi epidural anesthesia?
Pari zvino, iyi ndiyo nzira inowanikwa yakawanda yeanesthesia (munyika dzakawanda, somuenzaniso, muFrance, USA iri pasi peEPA inowanikwa makumi manomwe ekuberekwa kwevana). Zvinoda kuziva kuti iyi ndiyo nzira chete yeanesthesia, iyo inogamuchirwa neChechi yeKaturike. Epidural anesthesia inoitwa maererano neshoko iri. Anesthesiologist inoita kuputika kwepachikafu nzvimbo (yakaoma ganda remutsara) nemushonga unokosha pamwero we 3-4 vertebrae munharaunda ye lumbar. Zvadaro, kuburikidza nenyuchi, chiremba anoisa catheter (iyo nheyo inobviswa), iyo inoshandiswa nayo chirongwa chakakosha chekugadzirisa chirwere chinogadziriswa. Mushure mekuita kwakadaro, "neutralization" yemagetsi ekuguma, izvo zvinoita kuti chiberekero, kusvika pamwero unoitika. Mabasa emisumbu yemubereki semugumisiro inoramba ichichinjwa, uye amai havazonzwi kurwadziwa. Hazvina kudikanwa kukanganisa epidural anesthesia uye epidural analgesia. Ne epidural anesthesia, kugadziriswa kwegadziriswe yeanesthetic inopindirwa munzvimbo yepelinha mune zviduku zvishoma. Nzira inopera pamwero we lumbar inorasikirwa nekunzwisisika zvakakwana zvachose, yakavharwa, mukadzi haanzwi kunzwa kupesana, mamakumbo ake anokura. Mukadzi anozvara akarara ari parutivi rwake kana kumushure kwake, achisimudza chifuti chake. Nzira yakajeka yekusagadzikana kweyi nzira ndeyekusagadzikana kwemukadzi pakuberekwa, asi kwete kusabatanidzwa mune saramende yekuberekwa. Uye mupfungwa, kwete mukadzi wese anogona kuendesa hurumende yakadaro. Asi nechirwere chinonzi epidural analgesia, kushaya simba kwakanyanyisa kunetseka kunoshandiswa muhuwandu hwakawanda. Kugadziriswa kwemarwadzo ekurwadziwa kwezvipfeko kunoitika zvakanyatsonaka sokuti mudzimai anononoka kuva mukubereka. Amai vanogona kurwa, vanofamba vakasununguka uye vanotora nzvimbo dzakasiyana panguva yebasa nekuberekwa. Mushure mechinguva, anesthetist anowedzera imwe chirwere chekushaya manzwiro. Kuwedzera kukuru kwemuitiro ndeyekuti mukadzi anonzwa nzira yekuzvarwa uye anokwanisa kuzvidzora zvakasununguka.
Cherechedza: zvinetso
Pasinei nokupararira kwose kwose kumadokero uye mumitambo yekudzivirira mhuri, epidural anesthesia ine zvinetso zvakawanda. Pakati pezvinhu zvisingafadzi migumisiro mushure mekugadzirisa - shanduko shoma muropa reropa mune varwere, pamwe nemusoro wemusoro uye migraines, iyo inogona kukura kunyange mazuva 2-3 mushure mokupindira. Uye muzviitiko zvakawanda, zvinetso hazvina kufanana nehutano hwe anesthesiologist uye ruzivo rwemagetsi ehurongwa wacho pachahwo. Kazhinji kazhinji, musoro unowanikwa nekuda kwezvikonzero zviviri:
- mune epidural space drug inoshandiswa iyo isingatauri yepidural anesthesia. Kuti kuderedze mari yakawanda yehutano inoshandiswa kushandiswa kweanesthetics yakaderera yezinga rekunatswa - asi kune iyi, iyo yakachengetwa haifaniri kuva yakakosha;
- Mashoma mashizha anoshandiswa kutungamirira EPA. Asi kunyange zvikanganiso zviduku-duku mujinga (burrs kana kunyange zvimedu zvesimbi zvinogona kuongororwa pasi microscope) zvinogona kukuvadza uropi. Apo nheyo inobviswa, chikamu chezvinhu zviri mumugwagwa wepinini (cerebrospinal fluid) inoyerera, zvichiita kuti kuchinja kwezvinetso mairi. Ichi chikonzero chematambudziko chakabviswa nekuonekwa kwepamusoro-soro mabhesi ane pencil sharpening (muchimiro chekoni), iyo inongokonzera mapepa emamambo (ipapo inonyatsochengetedza nzvimbo yavo yepakutanga) - sechikonzero, nzira inoenda pasina zvinetso. Asi kuderera kwekumanikidzwa mumakondohwe neEPA kunokonzerwa chete nemunhu mumwechete anoita muviri kumuviri wekushaya muviri. Sezvo neanesthesia, mune zvisingawanzoitika, chirwere chinopisa chinogona kukonzera hypoxia ye fetus, saka zvakakosha kutarisa kubata kwomwoyo kwomucheche pakuberekwa, kwete chete ne stethoscope, asi nemwoyo wekucherechedza.Kana nguva dzose dzataurwa dzichifungidzirwa uye dzinochengetwa, kuberekwa neEPA kuchava nyore kwauri , uye iwe unogona kubereka mwana ane utano husina hurombo uye pasina zvinetso.
Afterword
Nhasi, vazhinji vanogadzirisa zvipembenene-gynecologists vanobvumirana: EPA ichiri imwe yenzira dzemazuva ano dzeanesthesia pakuberekwa. Kunyange zvakadaro, haisi yakanaka, kana chete nokuti inonyanya kukosha mari yekuberekwa. Asi sayenzi haina kumira, vashandi vezvipatara havasi kumira ipapo uye vanoramba vachitsvaga kutarisira kwakakwana kwevakadzi munguva yekuberekwa. Saka, semuenzaniso, ikozvino muEngland kuberekwa kunowanzozivikanwa ... pasi pekutengesa. Chinokosha chegadziriro ndeyekuti avo vanoona nezvepfungwa "vanoongorora tsvina" pamberi pekugadzirisa kwemukadzi kunopisa, chigamba nechigadzirira chigadzirisa nguva inokosha panguva dzose pamuviri. Nemamizimu emangwana, makirasi anoitwa kuti ataure matanho, zvichikonzera unyanzvi huchangobva kuwanikwa huri kubatsira kubereka mwana ane utano pasina kurwadziwa uye kutya. Nzira yekuziva, zvichida, iyi nzira munguva yemberi iri pedyo ichava nzira yakakodzera kune epidural anesthesia. Nguva ichataura.