Reanimation ndi odwala mwakayakaya

Tima (mwadzidzidzi) mankhwala - njira ya matenda chithandizo moyo pachiswe. Kuwatsitsimula - kuchira ndondomeko zofunika (moyo) ntchito anamwalira kapena pang'ono oletsedwa chifukwa cha matenda. mankhwala awa n'zotheka kukhazikitsa mpaka kalekale kuwunika ndi kusintha ntchito kanthu ndondomeko pa nkhani ya zipolowe kudya ntchito ya ziwalo ndi kachitidwe. Ambiri, kuwatsitsimula ndi odwala mwakayakaya ndi mtima kwambiri, ndipo wotsiriza wa njira alipo panopa kuteteza imfa matenda aakulu (akayakaya) ndi mavuto awo, kuvulala.

mfundo zofunika

Tima mankhwala - njira mankhwala usana ndi usiku, napempha ntchito infusions mtsempha kapena njira detoxification ndi kulamulira zonse zizindikiro kwambiri. Iwo adapeza kuti mwa mwazi ndi thupi madzi, amene mobwerezabwereza kwa mofulumira kutsatira cha kuwonongeka ndi kusintha ntchito somatic wodwala. Njira yachiwiri kulamulira - ndi polojekiti, amene akuyendera hardware ndi kugwiritsa cardiomonitors, analyzers gasi, electroencephalograph ndi zina zipangizo.

Kuwatsitsimula ndondomeko amatchedwa ntchito mankhwala ndi njira hardware thupi abwerera kumka ku moyo zinthu mwadzidzidzi zimachitika. Ngati wodwala boma, kutanthauza kuopseza moyo, akuwuka ku matenda kapena mavuto ake, chifukwa olimba mankhwala ake mwakayakaya. Ngati wodwala mu mkhalidwe kukomoka ndipo sadzakhalanso ndi moyo popanda kusintha mwamsanga ntchito anataya, ndondomeko adzabweranso ndi malipiro amatchedwa kuwatsitsimula.

Chinkhoswe mu nkhani zimenezi mwa kuwatsitsimula. Ndi katswiri yopapatiza, malo a ntchito amene ali odwala mwakayakaya unit. Nthawi zambiri, madokotala yekha ntchito resuscitator kulibe, chifukwa katswiri adzalandira diploma ya opaleshoni ndipo kuwatsitsimula. Kuntchito, mogwirizana ndi mabungwe zogwirizana zimatenga mitundu itatu posts: "Anesthetist", komanso osiyana "kuwatsitsimula" kapena "dzanzi".

Doctor mu odwala mwakayakaya

Doctor mankhwala tima - izo dzanzi. Iye nkhawa ndi kusankha mtundu wa mankhwala oletsa ululu odwala preoperative ndi kuwunika chikhalidwe chawo pambuyo opaleshoni. katswiri A akugwira ntchito iliyonse malo osiyanasiyana mankhwala (kawirikawiri dera kapena chigawo), ndi kulekana amatchedwa HITD. Pangakhale odwala amene kulipidwa ntchito, koma zimatengera kulamulira zizindikiro kwambiri. Komanso, HITD ali odwala ndi kuvulala moyo pachiswe ndiponso matenda, komanso mavuto awo. odwala Postoperative Mwina zinakuchitikirani kuti HITD dokotala Anesthetist.

Dokotala kuwatsitsimula

Dokotala kuwatsitsimula yekha anachitira ndi kubwezeretsa ntchito yofunika kwambiri, nthawi zambiri malo a ntchito ndi siteshoni kapena substation ambulansi. Ankatha kuonana ndi zida, kumene amaphunzira ndi mphunzitsi kuwatsitsimula ambulansi, sakhoza resuscitate wodwala panjira, amene lipindulitsa pa zochitika zonse zokhudzana ndi mankhwala tsoka. Nthawi zambiri, dokotala-resuscitator si chinkhoswe mu mankhwala tima mu HITD koma amakhazikitsa ulamuliro wa ntchito yaikulu ya mtima mu ambulansi ndi. Umene ukugwira mankhwala ndi ulamuliro hardware zachipatala ntchito za mtima ndi kuopseza imfa.

dzanzi

Anesthetist - ndi chitsanzo cha katswiri yopapatiza mbiri pakati zachipatala, mwachitsanzo, mu chipatala khansa kapena pakati perinatal. Apa, kuti ntchito yaikulu ya katswiri ndi kukonza mtundu wa mankhwala ochititsa dzanzi pa odwala amene lidzasendera opaleshoni. Pankhani ya perinatal pakati anesthetist ntchito ndi kusankha mtundu wa mankhwala oletsa ululu odwala amene gawo la Kaisara imagwiridwa. Nkofunika kuti mankhwala tima mwa ana anagwiritsanso ku likulu. Komabe, odwala mwakayakaya wagawo odwala ndi ana akangobadwa kusasintha. Mu HITD ana (makanda) akugwira ntchito neonatologists ndi akulu anali ndi dzanzi.

HITD zipatala opaleshoni

Akayakaya wagawo mu chipatala, ndi kukondera opaleshoni, izo zakonzedwa malinga chiwerengero cha odwala amene amafuna alowererepo, ndi kukula kwa ntchito. Pamene zikunena mu dispensaries oncological pafupifupi nthawi ya ulendo wa wodwalayo mu HITD kuposa mu opaleshoni ambiri. odwala mwakayakaya pano imatenga nthawi yaitali, monga mwa mayendedwe a ntchito amatipeza kuonongeka yofunika nyumba anatomical.

Ngati tikulingalira opaleshoni khansa, ambiri mtheradi wa zikunena amapatsa zoopsa ndi lalikulu buku la nyumba resected. Pamafunika nthawi yaitali kuti apeze mtima, monga pambuyo opaleshoni akadali chiopsezo kuwonongeka kwa matenda, ngakhale imfa ku zinthu zingapo. Pali zofunika kupewa phukusi kapena mavuto mankhwala, n'zodalirika thandizo ndi kubwezeretsa buku magazi, limene mbali amatipeza anataya njira za phukusi la. ntchito izi ndi zofunika kwambiri pa chilichonse konzanso pambuyo ntchito.

HITD zipatala mtima

Cardiology ndi achire Zipatala zambiri kusiyana ndi chakuti pali odwala onse kulipidwa popanda zingasokoneze moyo ndi odwala osakhazikika. Iwo ankafunika kuyambitsa sukulu ndi kusamalila kulamulira chikhalidwe chawo. Pankhani ya matenda mtima kwambiri tcheru amafuna m'mnyewa wamtima infarction ndi mavuto ake mu mawonekedwe a mantha cardiogenic kapena imfa ya nthumbi mtima. Tima mankhwala a infarction m'mnyewa wamtima amachepetsa chiopsezo imfa pafupifupi akuti, kuchepetsa kuchuluka kuvulazidwa ndi kubwezeretsa patency wa mtsempha wamagazi infarct okhudzana, komanso kusintha kuti madokotala ananena zawo wodwalayo.

Malinga ndi unduna wa zaumoyo ndondomeko ndi malangizo lonse, odwala pachimake inatsekeratu amafuna kuyika mu odwala mwakayakaya kuchita miyeso mwadzidzidzi. Thandizo amaperekedwa ndi thandizo wantchito woyamba pa siteji ya kubala, ndiye mukufuna kuti abwezeretse patency ya mitsempha inatsekeratu, amene occluded ndi thrombus a. Ndiye mankhwala wodwala ziziyenda kukwatira resuscitator: tima mankhwala mankhwala, hardware ndi ulamuliro zasayansi ya boma.

Mu HITD mtima, kumene ntchito opaleshoni zimagwiridwa pa zotengera kapena zingwe mtima, ntchito dipatimenti ndi oyambirira postoperative konzanso ndi udindo kutsatira. ntchito izi vysokotravmatichnyh malingaliro ndi limodzi mwa nthawi yaitali achire komanso anatengera. Pali nthawizonse Mwina mkulu wa thrombosis, mtima shunt kapena kuima anapatsa vavu yokumba kapena zachilengedwe.

HITD zida

Reanimation ndi odwala mwakayakaya - ndi makampani ntchito zachipatala, amene kuthetsa zingasokoneze moyo wodwalayo. zinthu izi ikuchitika unit katswiri, amene yokonzedwa bwino. Amaona kwambiri zipangizo zambiri zamakono, chifukwa cha maonekedwe a mtima nthawi zonse muyenera hardware ndi zasayansi kulamulira. Komanso, mankhwala tima ikukhudza kukhazikitsidwa kwa mpaka kalekale kapena pafupipafupi makonzedwe mtsempha.

Mfundo za chithandizo HITD

M'maofesi makolo odwala si pangozi imfa matenda kapena mavuto ake kwa kanthawi kochepa dongosolo kulowetsedwa kukapanda kuleka ntchito kwa cholinga ichi. Mu HITD nthawi zambiri m'malo mwa mapampu kulowetsedwa. zida Zimenezi zimathandiza mosalekeza akabweretsa mlingo wina wa zinthu, popanda kufunika puncture mtsempha nthawi iliyonse amafuna kugwiritsira mankhwala. kulowetsedwa mpope imaperekanso kulowa medicaments mosalekeza kwa masiku kapena zambiri.

mfundo Modern mankhwala tima mayiko ndiponso matenda mwamsanga kale ndipo izi:

• Ntchito yoyamba ya mankhwala - olimba a wodwalayo komanso tione mwatsatanetsatane matenda kufufuza;
• mtima wa matenda vutoli, amene amakwiya kudzitsitsa ndi zimaonekera pa ukupeza, kubweretsa imfa Nkosatheka;
• chithandizo chachikulu matenda boma olimba ndi mankhwala symptomatic;
• Kupha zinthu moyo pachiswe ndi zizindikiro;
• kukhazikitsa zasayansi zoimbidwa kuwunika alili;
• kumasulira wodwala mu chipinda mbiri pambuyo olimba ndi kuwonongedwa kwa zinthu moyo pachiswe.

Laboratory ndi ulamuliro zoimbidwa

Kuunikira chikhalidwe wodwalayo potengera ziyenera a magwero deta atatu. The choyamba - wodwala kafukufuku, kukhazikitsidwa kwa madandaulo, akudzizindikiritsa mphamvu thanzi. Chachiwiri - zasayansi maphunziro anachita pamaso chikuonetseratu ndi nthawi mankhwala, kufanana kwa zotsatira za kufufuza. Gwero lachitatu - mudziwe timapemphera mayeso ndi malangizo. Komanso mtundu wa gwero la nkhani za umoyo wa wodwalayo ndi dongosolo zikuphatikizapo kuwunika zimachitika, magazi oxygenation, pafupipafupi ndi kayendedwe ka ntchito mtima, kuthamanga kwa magazi, ntchito ubongo.

Mankhwala ochititsa ndi wapadera zipangizo

nthambi koteroko mankhwala othandiza monga opaleshoni ndi odwala mwakayakaya ali inextricably zogwirizana. Ogwira ntchito m'madera amenewa, dipuloma ndi mawu "dokotala dzanzi." Izi zikutanthauza kuti nkhani ya opaleshoni, kuwatsitsimula ndi odwala mwakayakaya akhoza chinkhoswe mu umodzi ndi katswiri chomwecho. Ndiponso, izi zikutanthauza kuti ndi zosoŵa za maofesi multidisciplinary zaumoyo, kuphatikizapo m'madipatimenti inpatient cha kukondera opaleshoni ndipo achire, wina HITD yekha. Iwo zida ndi zipangizo kuwatsitsimula, chithandizo ndi mankhwala ochititsa dzanzi asanachite opareshoni.

Kuwatsitsimula ndi odwala mwakayakaya amafuna osakwatiwa-gawo (kapena biphasic) Makina amenewa kapena cardioverter Makina amenewa, electrocardiograph, dongosolo la mpweya makina, mouzirira kulambalala (ngati chofunika ndi bungwe yeniyeni chisamaliro chaumoyo), zimatulutsa ndi machitidwe analizatorskih anafunika kuwunika mosavuta zizindikiro za mtima ndi ubongo ntchito . N'kofunikanso kuti mapampu kulowetsedwa zofunika kusintha kachitidwe mankhwala zonse kulowetsedwa kulowetsedwa.

Opaleshoni amafuna zida kupereka inhalation ochititsa dzanzi. dongosolo chatsekedwa kapena theka-lotseguka, imene mankhwala ochititsa osakaniza yobereka amaperekedwa mu mapapo. Izi zimathandiza kukhazikitsa endotracheal kapena endobronchial ochititsa dzanzi. Nkofunika kuti kusamalira ochititsa dzanzi chofunika laryngoscopes ndi endotracheal (kapena endobronchial) timachubu, catheters kwa catheters chikhodzodzo ndi puncture wa chapakati ndi zotumphukira mitsempha. Zipangizo chomwecho chofunika ndi mankhwala mwakayakaya.

HITD perinatal malo

Perinatal malo - ndi kuchipatala kumene kubereka chichitike, chimene chingalowe zingakhale kupita ndi zosokonezeka. Izi ziyenera anatumiza kwa akazi amene akuvutika padera kapena extragenital kudwala, zingakhale akhoza kuwononga thanzi ntchito. Komanso, payenera kukhala mkazi pathologies mimba zofuna yobereka oyambirira ndi chisamaliro akhanda. Tima neonatal mankhwala - ndi imodzi mwa ntchito malo awa pamodzi ndi kusamalira ochititsa dzanzi odwala amene adzachita opaleshoni.

Chida yokonza HITD perinatal malo

Nthambi Perinatal akayakaya Center ali okonzeka malinga ndi chiwerengero anakonza odwala. Izi zimafuna machitidwe ochititsa dzanzi ndi tima zida chisamaliro, mndandanda anapatsidwa pamwamba. Choncho HITD perinatal malo ali ndi maofesi Dokotala. Iwo ayenera kukhala ndi zipangizo zina zapadera. Choyamba, wamkulu yokumba kupuma ndipo makope sali oyenera akhanda makulidwe a matupi amene ali kochepa.

Masiku ano, maofesi Dokotala chinkhoswe mu makanda unamwino masekeli magalamu 500, tinabadwa gestation masabata 27. Komanso, muyenera wapadera makonzedwe a mankhwala, chifukwa ana obadwa bwino pamaso pa deti yake, chofunika poika kukonzekera ndi surfactant. Izi mankhwala okwera mtengo, popanda zomwe n'zosatheka unamwino ndi wakhanda adza kwa chitukuko cha kuwala, koma popanda surfactant lapansi. zinthu zomwe zimalepheretsa m'mapapo alveoli agwa pansi, zomwe tikuphunzira ndondomeko zotsogolela kunja kupuma.

Features wa gulu la ntchito HITD

HITD ntchito kuzungulira koloko, ndi dokotala pa ntchito masiku asanu ndi awiri pa mlungu. Ichi ndi chifukwa cholephela kuti zimitsani zida pamene ndi udindo kuthandizidwa wodwala makamaka. Malinga chiwerengero cha odwala ndi katundu pa nthambi, chiwerengero cha mabedi aumbike. Aliyense ogona ayenera akhale okonzeka ndi othandizira ndi oyang'anira. Kukhalapo kwa zosakwana chiwerengero cha mabedi, kuchuluka kwa zipangizo mpweya, oyang'anira ndi masensa.

Dipatimenti, limene lakonzedwa odwala 6, ntchito 2-3 resuscitator dokotala dzanzi. Iwo ayenera kusinthidwa pa tsiku lachiwiri kuchokera maola 24 antchito. Zimenezi zimathandiza kuti mungawononge wodwala usana ndi usiku ndi kumapeto kwa sabata, pamene polojekiti odwala maudindo muyezo yekha ntchito dokotala. Anesthetist ayenera kuwunika odwala amene ali HITD. Komanso, iye afunika nawo misonkhano chisamaliro ofunda, ndi kuthandiza odwala nthambi somatic mpaka hospitalization HITD.

Thandizani dokotala Namwino Anesthetist ndi odwala mwakayakaya namwino. The mawerengedwe chiwerengero cha Zachikondi wochititsidwa malingana odwala. 6 mabedi amafuna kukhalapo kwa dokotala wina, anamwino awiri ndi namwino wina. nambala iyi antchito ayenera kupezeka pa aliyense ntchito masana. Ndodo ndiye m'malo ndi kusintha kwina, ndipo nawonso, - wachitatu.