VI. Sakamakon raguwar zafin jiki na ciki
(I) Tasiri kan tsarin zuciya da jijiyoyin jini
(II) Tasiri kan coagulation
Rashin raunin aikin platelet yana rage yawan aikin da ke haifar da jini, yana haifar da tsawan lokaci na zubar jini da kuma ƙara yawan zubar jini. Ƙananan zafin jiki kuma yana haifar da tashewar jini a cikin tashewar jini a cikin jijiya, wanda zai iya haifar da thrombosis mai zurfi a cikin sauƙi.
Yanayin zafin jiki yana ƙasa da 35 ° C, alamun masu zuwa suna da tsayi sosai tare da zafin jiki Alamomin masu zuwa suna da tsayi sosai tare da rage zafin jiki:
Partially kunna prothrombin lokaci (APTT)
Lokacin Prothrombin (PT)
Lokacin Prothrombin (TT)
(III) Ƙaruwar cututtukan cututtuka
Ƙananan zafin jiki na jiki zai iya lalata aikin rigakafi kai tsaye, rage samar da iskar oxygen zuwa fata, da furotin da haɗin glial; a lokaci guda, rashin jin daɗi na ɓangarorin ɓangarorin ɓarna da jinkirin warkarwa na incision yana haifar da haɓakar ƙimar raunin rauni.
Yanayin zafin jiki da ke ƙasa da 35 ° C yana da alaƙa da karuwa sau uku a cikin ciwon rauni da kuma 20% tsawon zaman asibiti.
An cire shi daga:Zhang Y. Kula da yanayin rashin ƙarfi na perioperative [J]. Xinjiang likitancin kasar Sin, 2011.29(04).92-94.Operating dakin jinya 512
(IV) Jinkirin farkawa
-Raguwar jini na visceral a cikin hypothermia
-Rage aikin hanta
-Rage jini na koda da kuma yawan tacewa na glomerular
-Slower miyagun ƙwayoyi metabolism
Hypothermia yana hana aikin jijiya mai tausayi kuma yana rage samar da catecholamine, wanda ke raunana amsawar jiki ga abubuwan motsa jiki na waje, yayin da anesthetics anesthetics a cikin jiki a hankali a hankali, yana haifar da ɗan lokaci mai tsawo don farkawa da extubation.
(V) Rashin lafiya
Yana shafar metabolism na jiki
-Rashin tafiyar da jijiya
-Acidosis, rashin daidaituwa na electrolyte
- Rashin aikin rigakafi
-Yawan iskar oxygen a jiki
- Canje-canje a cikin yanayi na ciki
Hypothermia yana rage yawan kuzarin jiki, kuma ga kowane 1C ƙananan zafin jiki, ana rage yawan adadin kuzari da kashi 6%. A yanayin zafin jiki na 28C, ƙimar rayuwa shine 50% na al'ada.
An cire shi daga: Yu Dingning, Li Duo, Haɗarin hypothermia da maganinta[J]. Magungunan Waje: Tiyatar Magungunan Waje: Tiyata,2004,31(5):258-261.
VII.Hanyoyin gano zafin jiki yayin tiyata
A haƙiƙa, bambanci tsakanin ainihin zafin jiki da yanayin jiki yana da wahala a ƙididdige shi ba tare da alaƙar layi ba, don haka ana ba da shawarar yin amfani da binciken rami na jiki don gano ainihin zafin jiki daidai lokacin da yanayi ya ba da izini.
VIII.Rigakafin hypothermia na perioperative da kulawa
(I) Matsalolin kula da tabin hankali
Ziyarar kafin a yi aiki (kimantawa):
Ta hanyar ziyarar farko, yanayin majiyyaci yana da isassun kima, yin ganewar jinya, ba da shawarar tsarin jinya, yin isasshen shiri, da aiwatar da matakan dumama a ranar tiyata don
hana hypothermia.
A lokaci guda kuma, ta hanyar ziyarar farko, ƙara fahimtar ma'aikacin jinya-majinyata, wanda ke da kyau ga kyakkyawar sadarwa tsakanin ma'aikatan jinya da marasa lafiya. ganewa, wanda ke taimakawa wajen sadarwa mai kyau tsakanin marasa lafiya da ma'aikatan jinya kuma yana rage jin tsoro na marasa lafiya. jin tsoro na marasa lafiya da rage ƙofa don abubuwan motsa jiki masu sanyi. Za a saukar da bakin majinyacin don ƙarfafa sanyi.
(II) Yanayin yanayi
Matsakaicin zafin jiki mai ƙarfi 21-25°C. Kula da zafi a 30-60%
Kula da zafin jiki mai kyau da zafi zai iya rage asarar zafi daga fata kuma hanya ce mai mahimmanci don hana hypothermia.
Yanayin zafin jiki da zafi na dakin aiki ana sarrafa shi ta hanyar kwandishan na tsakiya, za a daidaita zafin dakin zuwa 25 ° C kafin fara aikin majiyyaci, kuma bayan an fara aikin za a daidaita shi zuwa 21-23 ° C. An tabbatar da cewa yanayin da ke shafar canjin zafin jiki ba zai shafi mai haƙuri ba.
(III) Dumamar ruwa
A. Ruwan jiko sun dumama zuwa 37°C:
Saline na Physiological ko ruwa don allura da ake amfani da shi don kashe fata da kurkura ana sanya shi a cikin ma'aunin zafi da sanyio kuma an daidaita shi zuwa 37°C. Cire shi daga ma'aunin zafi da sanyio kafin amfani da shi don rage asarar zafin jiki.
B. Amfani da dumama jiko yayin ƙarin jini:
Lokacin da ake yin ƙarin ƙarin jini, za a yi amfani da na'urar dumama jini don tabbatar da cewa ruwan da aka yi wa majiyyaci yana kusa da zafin jikin majiyyaci.
(IV) Yi amfani da kayan rufe fuska
A m inflatable bargo da ake amfani da su rufe da ba tiyata yankin, da ake ji wani zafin jiki ga jiki surface zafin jiki na high convection gas ana amfani da jiki surface don ƙara haƙuri ta jiki zafin jiki, rage ciki zafi zuwa ƙananan zafin jiki yanayi, da kuma taka rawa na ware jiki da kewaye sanyi yanayi, transdermal fata aiki dumama.
(V) Rage lokacin bayyanawa don sanyawa canjin matsayi
A. Haɓaka daidaitaccen tsarin jeri matsayi don rage lokacin bayyanarwa don canje-canjen matsayi
B. Matsayin Matsayi na Musamman na Tiya
Orthopedics: m matsayi
Thoracic: Matsayi na kwance
Urology: Matsayin kwance
Lithotomy → matsananciyar matsayi: nephrolithotomy percutaneous (PCNL), da dai sauransu.
(VI) hana ruwa
Guji ko rage jiƙan zanen gado.
Rufe takardar bakararre tare da Layer na jakar filastik (idan ba ta gurɓata ba kuma yana shafar filin tiyata).
Hana jiƙa na majiyyaci da lilin gado tare da yawan kurkura yayin tiyata.
Don tiyatar da ke buƙatar ruwa mai yawa, kamar aikin tiyatar urological (prostate electrocision, percutaneous nephrolithotomy, da dai sauransu), Buɗaɗɗen tiyata (buɗaɗɗen maganin ciwon daji na hanji, ciwon hanta, da dai sauransu), tiyatar ciwon daji na gynecological, da dai sauransu.
Taƙaice:
Abubuwan da ke faruwa na hypothermia na ciki ya jawo hankalin ma'aikatan asibiti a hankali ta hanyar sarrafa yanayin jiki da kuma zubar da zafi na jiki kafin da kuma lokacin tiyata, da kuma ɗaukar matakan jinya iri-iri don ƙirƙirar yanayi mai dadi na ciki da na waje zai iya hana intraoperative hypothermia a cikin marasa lafiya. Rage Yana iya rage yawan matsalolin da ke haifar da hypothermia, rage radadin marasa lafiya, rage kwanakin asibiti na asibiti, da kuma rage farashin magani na marasa lafiya, wanda ke taimakawa wajen farfadowa da wuri.
mahaɗin labarin baya: https://www.mecanmedical.com/Prevention-and-Care-of-Intraoperative-Hypothermia-Part-1-id61252817.html
