VI. Mmetụta nke intraoperative ahụ okpomọkụ mbelata
(M) Mmetụta na usoro obi
(II) Mmetụta na coagulation
Ọrụ platelet adịghị ike na-ebelata ọrụ ihe na-akpata mkpụkọ, na-ebute ogologo oge ọbara ọgbụgba na ịbawanye ọnụ ọgụgụ ọbara ọgbụgba. Okpomọkụ dị ala na-edugakwa na nkwụsị nke ọbara na stagnation nke ọbara na veins, nke nwere ike ịkpata thrombosis miri emi ngwa ngwa.
Okpomọkụ ahụ dị n'okpuru 35 ° C, ihe ngosi ndị a na-agbatịkwu ogologo oge na ọnọdụ okpomọkụ Ihe ngosi ndị a na-agbatị nke ukwuu na mbelata okpomọkụ:
Oge prothrombin na-arụ ọrụ nke ọma (APTT)
Oge prothrombin (PT)
Oge prothrombin (TT)
(III) Ọrịa mbepụ na-abawanye
Okpomọkụ ahụ dị ala nwere ike imebi ọrụ ahụ ji alụso ọrịa ọgụ, belata nnyefe oxygen na anụ ahụ, yana protein na njikọ glial; N'otu oge ahụ, adịghị mma perfusion nke peri-incisional anụ ahụ na-egbu oge ọgwụgwọ mbepụ na-eduga na ọnụ ọgụgụ na-abawanye nke ọnụ ọgụgụ nke ọnya ọrịa na-abawanye.
Okpomọkụ intraoperative n'okpuru 35°C jikọtara ya na mmụba okpukpu atọ nke ọrịa ọnya yana ọnụnọ ụlọ ọgwụ dị ogologo 20%.
Ewepụtara na: Zhang Y. Nlekọta nke hypothermia perioperative[J]. Xinjiang Chinese ọgwụ,2011.29(04).92-94.Operating room nurse 512
(IV) Mkpọlite egbu oge
- Mbelata ọbara visceral na hypothermia
-Ibelata ọrụ imeju
-Ibelata mgbaba ọbara gbasara akụrụ yana ọnụego filtration glomerular
-eji nwayọọ nwayọọ ọgwụ metabolism
Hypothermia na-egbochi ọrụ akwara ọmịiko ma na-ebelata mmepụta catecholamine, nke na-ebelata nzaghachi anụ ahụ na mkpali mpụga, ebe anestetiiki na-emeziwanye ahụ n'ime ahụ nwayọ nwayọ, na-ebute oge dị ogologo maka ịmụrụ anya na extubation.
(V) Nsogbu metabolic
Na-emetụta metabolism nke anụ ahụ
-Iji nwayọọ nwayọọ na-eduzi akwara
-Acidosis, electrolyte ahaghị nhata
-Immune dysfunction
-Mmụba oxygen oriri
-Mgbanwe na gburugburu ebe obibi
Hypothermia na-ebelata ọ̀tụ̀tụ̀ shuga dị n'ahụ́, na maka 1C ọ bụla dị ala, ọ̀tụ̀tụ̀ metabolic na-ebelata site na 6%. Na okpomọkụ nke 28C, ọnụego metabolic bụ 50% nke nkịtị.
Ewepụtara na: Yu Dingning, Li Duo, Ihe ize ndụ nke hypothermia na ọgwụgwọ ya[J]. Ọgwụ nke mba ofesi: Ọgwụ ịwa ahụ nke mba ofesi: ịwa ahụ, 2004,31 (5): 258-261.
VII. Ụzọ nke ịchọpụta okpomọkụ n'oge ịwa ahụ
N'ezie, ọdịiche dị n'etiti isi na okpomọkụ dị n'elu ahụ siri ike ịkọ n'enweghị njikọ njikọ, ya mere, a na-atụ aro ka iji nyochaa oghere ahụ iji chọpụta nke ọma okpomọkụ nke ahụ mgbe ọnọdụ na-enye ohere.
VIII.Mgbochi nke perioperative hypothermia na nlekọta
(I) Ihe enyemaka gbasara mmụọ
Nleta tupu ịwa ahụ (ntụle):
Site na nleta tupu ịwa ahụ, a na-enyocha ọnọdụ onye ọrịa nke ọma, mee nyocha nọọsụ, tụọ atụmatụ nọọsụ, mee nkwadebe zuru oke, ma mejuputa usoro ikpo ọkụ n'ụbọchị ịwa ahụ.
gbochie hypothermia.
N'otu oge ahụ, site na nleta tupu ịwa ahụ, mee ka ndị nọọsụ mara onye ọrịa, nke na-eme ka nkwurịta okwu dị mma n'etiti ndị nọọsụ na ndị ọrịa. nnabata, nke na-eme ka nkwurịta okwu ka mma n'etiti ndị ọrịa na ndị nọọsụ ma na-ebelata ụjọ ndị ọrịa. Ahụhụ ndị ọrịa na iwetu ọnụ ụzọ ha maka mkpali oyi. A ga-ebelata ọnụ ụzọ onye ọrịa maka mkpali oyi.
(II) Okpomọkụ gburugburu
Okpomọkụ ụlọ na-agbanwe agbanwe 21-25°C. Idobe iru mmiri na 30-60%
Ịdebe okpomọkụ kwesịrị ekwesị na iru mmiri nwere ike ibelata okpomọkụ site na akpụkpọ ahụ ma bụrụ ụzọ dị irè iji gbochie hypothermia.
A na-achịkwa okpomọkụ na iru mmiri nke ime ụlọ ahụ site na etiti ikuku ikuku, a ga-edozi ọnọdụ okpomọkụ nke ụlọ ahụ na 25 Celsius C tupu mmalite nke ọrụ onye ọrịa, na naanị mgbe mmalite nke ọrụ ahụ ga-agbanwe ya na 21-23 ° C. A na-ekwe nkwa na onye ọrịa agaghị emetụta gburugburu ebe obibi nke na-emetụta mgbanwe nke okpomọkụ ahụ.
(III) Mmiri mmiri
A. Mmiri infusion kpoo ọkụ ruo 37°C:
A na-edobe saline ma ọ bụ mmiri maka injection nke a na-eji kpochapụ akpụkpọ ahụ ma sachaa n'ime igwe ọkụ ma gbanwee ruo 37 Celsius. Wepụ ya na temometat tupu ejiri ya belata okpomọkụ ahụ.
B. Iji infusion warmer n'oge mmịnye ọbara:
Mgbe a na-eme nnukwu mmịnye ọbara, a ga-eji ngwaọrụ na-ekpo ọkụ mmịnye ọbara mee ihe iji hụ na mmiri a na-agbanye n'ahụ onye ọrịa dị nso na okpomọkụ nke ahụ onye ọrịa.
(IV) Jiri akụrụngwa mkpuchi ihe
A na-eji nwayọọ inflatable blanketị na-ekpuchi ndị na-abụghị nke ịwa ahụ ebe, na-etinye a ụfọdụ okpomọkụ na ahụ elu okpomọkụ nke elu convection gas na-etinyere n'elu ahụ elu na-amụba onye ọrịa ahụ elu okpomọkụ, mbenata esịtidem okpomọkụ na ala okpomọkụ gburugburu ebe obibi, na-egwu ọrụ nke ikewapụ ahụ na gburugburu oyi na gburugburu ebe obibi oyi, transdermal akpụkpọ arụ ọrụ kpo oku.
(V) Mbelata oge mkpughe maka ngbanwe ọnọdụ ọnọdụ
A. Zụlite usoro nhazi ọkwa ọkwa iji belata oge ikpughe maka mgbanwe ọnọdụ
B.Ọnọdụ maka ọnọdụ ịwa ahụ pụrụ iche
Orthopedics: ọnọdụ dị mfe
Thoracic: ọnọdụ dina n'akụkụ
Urolọji: Ọnọdụ dị n'akụkụ
Lithotomy → ọnọdụ dị mfe: nephrolithotomy percutaneous (PCNL), wdg.
(VI) mkpuchi mmiri
Zenarị ma ọ bụ wedata itinye mpempe akwụkwọ.
Na-ekpuchi mpempe akwụkwọ na-adịghị mma na akwa akwa nke akpa rọba (ọ bụrụ na ọ naghị emerụ ahụ ma na-emetụta ubi ịwa ahụ).
Gbochie ịrapara nke onye ọrịa na akwa akwa akwa akwa akwa mmiri n'oge ịwa ahụ.
Maka ịwa ahụ nke chọrọ nnukwu mmiri na-esi ísì ụtọ, dị ka ịwa ahụ urological (prostate electrocision, percutaneous nephrolithotomy, wdg), Ịwa ahụ mepere emepe (ọgwụgwọ ọrịa cancer intestinal na-emeghe, imeju imeju, wdg), ịwa ahụ cancer gynecological, wdg.
Nchịkọta:
Ihe omume nke intraoperative hypothermia ejirila nwayọọ nwayọọ dọta uche nke ndị ọrụ ụlọ ọgwụ site na ịchịkwa elu ahụ na oghere ahụ na-ekpochapụ okpomọkụ tupu na n'oge ịwa ahụ, na ịnakwere usoro nọọsụ dị iche iche iji mepụta ebe dị mma n'ime na mpụga ahụ nwere ike igbochi hypothermia intraoperative nke ọma na ndị ọrịa. Mbelata O nwere ike ibelata ọtụtụ nsogbu nke hypothermia kpatara, belata ihe mgbu nke ndị ọrịa, belata ụbọchị ụlọ ọgwụ nke ụlọ ọgwụ, ma belata ụgwọ ahụike nke ndị ọrịa, nke na-enyere aka mgbake n'oge.
Njikọ akụkọ gara aga: https://www.mecanmedical.com/Prevention-and-Care-of-Intraoperative-Hypothermia-Part-1-id61252817.html
