Ukuvimbela kanye nokunakekelwa kwe-hypothermia ye-intraperative aperaperative - Ingxenye 1

Ukuvimbela kanye nokunakekelwa kwe-hypothermia ye-intraperative aperaperative - Ingxenye 1

I. Umqondo we-hypothermia:

• Ukushisa okuyisisekelo ngaphansi kwe-36 ℃ yi-hypothermia

• Ukushisa okuyisisekelo kungamazinga okushisa emzimbeni womzimba we-pulmonary artery, ulwelwesi lwe-tympanic, esophagus, i-nasopharynx, u-rectum kanye ne-bladder, njll.

• I-Priviperital Hypothermia (InverytententPepericiaperativePotherPotherymia, i-TOWH), i-hypothermia emnene engenzeka ngo-50% -70% we-anesthesiology kanye neziguli ezihlinzayo.

II. I-hypothermia ihlela:

• Ngokwenyama, izinga lokushisa elingu-34 ℃ -36 ℃ livame ukubizwa ngokuthi yi-hypothermia emnene

• 34 ℃ -30 ℃ njenge-helly hypothermia

• I-30 ℃ -28 ℃ iyi-hypothermia ephakathi nendawo

• <20 ℃ ye-hypothermia ejulile

• <15 ℃ Ultra-Deep-Deep Hypothermia

III. Izimbangela ze-hypothermia esebenzisana ne-intraperaterative

(I) okubangelwe:

A. Age:

Abadala:  Umsebenzi we-thermoreguetion ompofu (ukuncipha kwemisipha, ithoni yemisipha ephansi, igazi lesikhumba, i-tube contile umthamo we-strain wehle, umsebenzi ophansi we-cardiovascular Reserve).

Izinsana zangaphambi kwesikhathi, izingane eziphansi zokuzalwa eziphansi:  Isikhungo se-thermoregulatory sithuthukiswa.

B. Physique (amafutha omzimba)

Amafutha angumfaki wokushisa oqinile, kungavimbela ukulahleka kokushisa komzimba.

Wonke amaseli amanoni angabona izinga lokushisa, futhi afudumala ngokukhulula amandla. Isifundo seHarvard University sathola ukuthi le nqubo yokufudumeza incike kwiprotheni ebizwa ngokuthi iprotheni ehlanganayo-1. Lapho umzimba uvezwa ukubanda, inani le-coupling protein-1 kabili.

Ngaphansi kwezimo ezijwayelekile, iziguli zidinga ukuzila amahora angaba ngu-12 ngaphambi kokuhlinzwa. Uma ukuqina kwabo ngokomzimba kumpofu, bazozwela kakhulu ekukhuthazeni okubandayo, okuphumela ekumelaneni nobuthakathaka. Ukugqugquzelwa okubandayo okubangelwa ukuhlinzwa kungadala kalula izinga lokushisa lomzimba ukuze lihle.

C. Isimo sengqondo

Ukuguquguquka ngokomzwelo kwesiguli okufana nokwesaba, ukungezwani, nokukhathazeka kubangela ukuba igazi liphinde libe negazi, lithinte ukubuya kwegazi enhliziyweni nasezinhlokweni, futhi kulula ukudala i-hypothermia ngesikhathi sokusebenza.

D. Ukugula Okubucayi

Ukugula kakhulu, kukhubazeke kakhulu: umthamo wokukhiqiza ukushisa okuphansi.

Ubuqotho besikhumba obukhubazekile: Ukuhlukumezeka okukhulu, amanxeba okugaya, ukushiswa okunzima.

(Ii) Ezemvelo

Izinga lokushisa egumbini lokusebenza livame ukulawulwa ku-21-25 ° C. ngaphansi kokushisa komzimba.

Izinga lokushisa elijwayelekile lokugeleza kwe-laminar lisebenza egumbini lokusebenza kwe-laminar futhi i-contnection esheshayo yomoya wasendlini izokwandisa ukushiyeka kokushisa komzimba wesiguli, okungenzeka ukuthi kudale izinga lokushisa lomzimba wesiguli ukuba liwele.

(Iii) Ukuchithwa kokushisa komzimba

A. Isikhumba Sinit:

Izinga lokushisa lesibulala magciwane liphansi, futhi inhloso yokubulala amagciwane ingatholakala kuphela ngemuva kokuthi i-disinfection yomile. Ukuguquguquka kwesibulala magciwane kususa ukushisa okuningi futhi kwehlise izinga lokushisa lomzimba.

B. Ukugcwala okunamandla:

Ukugeza ngenani elikhulu le-saline evamile noma amanzi omjovo ngesikhathi sokusebenza kuholela ekulahlekelweni kokushisa komzimba, okuyisizathu sokushisa komzimba wesiguli ukuze uphonsa.

C. Ukuhlinzwa okukhulu kuthatha isikhathi eside, futhi isikhathi sokuvezwa kwesifuba nezitho zesisu mude

D. Abasebenzi bezokwelapha abanaso ukuqwashisa ngokulondolozwa kokushisa

Iv.anesthesia

Izidakamizwa zingaguqula indawo ebekiwe yesikhungo se-thermoregulatory.

I-General Anesthesia - Ama-anesthetics amaningi angaxubha ngokuqondile imithambo yegazi, futhi ama-musiclature anokuphumula angavimba impendulo ekuqhaqhazelayo.

I-Regional Block Anesthesia - imicu ebonakalayo yokuhlanza imizwa ebandayo evinjiwe ivinjiwe, ukuze isikhungo sikholelwe ngephutha ukuthi indawo evinjiwe ifudumele.

V. uketshezi nokumpontshelwa igazi

Ukufakwa kwenani elikhulu le-liquid ne-stock stock emazingeni okushisa afanayo noma inani elikhulu loketshezi olushayelayo emazingeni okushisa asekamelweni ngesikhathi sokusebenza kuzofeza umphumela we-hypothermia.

Ukufakwa kwe-intravenous kwe-1l kaketshezi ekushiseni kwegumbi noma iyunithi eli-1 legazi le-4C kubantu abadala kunganciphisa izinga lokushisa lomzimba eliyisisekelo cishe ngo-0,5 ° C.

Kuthunyelwe kusuka ku: zhimin. YUE YUAN. Ucwaningo Nokuba Nokuhlalisana kwe-hypothermia ngesikhathi sokufakelwa kwesibindi sokufathelwa]. I-Chinese Journal of Effein Nursing, 2005