Kodi Anesthesia Ndi Otetezeka Mukakhala ndi COPD?

Kumvetsetsa Zowopsa za Umoyo

Kodi mukudandaula za chiopsezo cha anesthesia chifukwa cha matenda osokoneza bongo (COPD) ?

Kuphatikiza kwa COPD ndi aneshesia kungakhale ndi ngozi yaikulu. Kukhalitsa kwa nthawi yaitali kwa anthu omwe ali ndi COPD ovuta omwe opaleshoni nthawi zambiri amakhala osauka. Palinso vuto lalikulu la vuto la postoperative, makamaka m'mapapo. Koma kodi izi zikutanthauza kuti odwala COPD sayenera opaleshoni?

Mtundu uliwonse wa opaleshoni umaphatikizapo zoopsa. Kudziwa zoopsa pasanayambe nthawi yowonjezereka, kukonzekera koyambirira, ndi kuyang'anira bwino kwa anesthesia kungathandize kuchepetsa ngozizi. Tiyeni tiwone bwinobwino zomwe izi zikuphatikizapo:

Chizindikiro Choopsa

Kudziwa zoopsa pasanayambe nthawi yowonongeka kumayambira ndi mbiri yakale ndi kuunika kwa thupi. Nkhani zomwe dokotala angakayikire ndizo:

• Zochita zanu zolimbitsa thupi , makamaka ndi kukwera mapiri ndi masitepe.
• Ngati, ndi kangati, mwakhala mukulakwitsa kwa COPD ndipo ngati munayamba mwakhala m'chipatala kwa iwo.
• Ngati munayamba mwafunsapo mpweya wabwino wosakanikirana kuti muthe kupuma.
• Mbiri yanu yosuta - onse omwe ali osuta komanso omwe kale anali osuta ali pachiopsezo chachikulu.
• Ngati pakali pano muli chifuwa ndi / kapena mankhwala otukuta-omwe amakhala ndi chiopsezo chapamwamba cha mavuto opatsirana.
• Matenda ena-kusamvetsetsa zochitika zachipatala zomwe zilipo (comorbid conditions) ndizofunikira kwambiri pozindikira zifukwa zina zoopsa.

• Kaya muli ndi zizindikiro za matenda a mapapo.
• Momwe thupi lanu limakhalira, omwe ali ndi thanzi komanso olemera kwambiri, ali ndi chiopsezo chowonjezeka.

Zochita Zowonongeka

Kuyesedwa

Musanachite opaleshoni, dokotala wanu akhoza kulamula mayesero awa:

• Chifuwa cha X-ray - chimathandiza kuzindikira matenda omwe ali pakali pano kapena mavuto ena m'mapapo.

• EKG - kumathandiza kuzindikira mavuto a mtima omwe angawonjezere ngozi ya opaleshoni.
• Spirometry - amagwiritsidwa ntchito kuti onse azindikire ndikuzindikira kuopsa kwa COPD.
• Kuyezetsa kwapopopayi - amauza dokotala momwe mpweya umapitsidwira bwino kuchokera ku alveoli yanu kupita kumagazi anu.
• Mayeso a kuyenda kwa mphindi zisanu ndi chimodzi - kumathandiza kukhazikitsa zolimbitsa thupi.
• Magetsi a m'magazi - amathandiza kuzindikira kuti okosijeni ndi okosijeni ndi okosijeni mumagazi.

Kukhathamiritsa

Kukonzekera koyambirira kumaphatikizapo khama loyanjana pakati pa inu ndi dokotala wanu ndipo mukhoza kugawa m'magulu anayi otsatirawa:

1. Kusuta fodya. Chifukwa osuta panopa ali ndi chiopsezo chochulukirapo chokhala ndi mavuto opatsirana opatsirana pogwiritsa ntchito opaleshoni, omwe akusuta ayenera kusiya masabata asanu ndi atatu asanafike. Mukasuta fodya, onani ndondomeko yonse ya kusuta fodya.
2. Kugwiritsa ntchito mankhwala osokoneza bongo. Odwala ambiri a COPD amapindula ndi kutenga mlingo umodzi wa bronchodilator musanayambe kugwira ntchito. Ngati mukufuna kugwiritsa ntchito mankhwala anu pankhaniyi, kapena ngati mumagwiritsa ntchito inhaler m'malo mwa nebulizer, onani ndondomeko iyi ndi ndondomeko ya momwe mungagwiritsire ntchito nebulizer kuti mutsimikizire kuti mukupindula mokwanira mankhwala anu. Kuonjezerapo, ngati ndinu mmodzi mwa ambiri ndipo mukuyesera kukumbukira kuti mankhwala amachitiranji COPD, fufuzani zambirizi pomvetsetsa bronchodilators anu .

1. Kuchiza kwa matenda ndi / kapena kuchulukitsa. Kukhala ndi matenda a mapapu kapena kuchulukitsa kwa COPD kungatsutsane ndi anesthesia. Contraindicate ndi njira yodabwitsa yokamba kuti simungakhoze opaleshoni. Zizindikiro za matenda opatsirana ayenera kuchitidwa ndi antibiotic nthawi yomwe musanayambe kugwira ntchito.
2. Chifuwa cha thupi. Kusungunula musanayambe opaleshoni kumathandiza kuchotsa chowonjezera, chomwe chingayambitse kupuma kapena pneumonitis. Dzikumbutseni za njira zisanu zoyendera maulendo othawa pamsewu ndipo onetsetsani kuti mukutsitsimulira pulojekitiyi poyeretsa madzi .

Kusamalira Mavuto Panthawi ya Opaleshoni

Dokotala wanu ndi anesthesiologist adzagwirira ntchito limodzi kuti athetse mavuto omwe amapezeka ndi anesthesia ndi COPD pa opaleshoni yanu.

Zovuta zomwe zili m'munsimu ndizochepa chabe zovuta zomwe mungayang'ane:

• Bronchospasm
• V / Q zolakwika
• Mucus plugs
• Pneumothorax
• Hypo-ventilation yamagetsi

Chifukwa cha mtundu wa Matenda a Anesthesia

Ngati n'kotheka, kupeŵa anesthesia wambiri ndibwino kuti kuchepetsa ngozi. Lankhulani ndi dokotala wanu za njira zomwe zingatheke, monga anesthesia kumidzi kapena kumidzi . Kafukufuku apeza kuti anthu omwe ali ndi COPD amakhala ndi chiopsezo chochepa cha chibayo komanso kuthamangitsidwa kwa mpweya ngati dera la anesthesia likugwiritsidwa ntchito m'malo mwa anesthesia. Kufupikitsa nthawi ya opaleshoni komanso kutalika kwa nthawi yomwe muli ndi anesthesia, ngati izi zikufunika, zingakhale zothandiza.

Zovuta Zilipo

Takhala tikukambirana za kuchepetsa mavuto, ndipo mwinamwake mwamvapo kuchokera kwa ena kuti kuchitidwa opaleshoni ndi COPD ndizoopsa, koma ndi chani chomwe chingachitike? Kodi ziwopsezozi ndi ziti makamaka? Anthu ena amafuna kudziwa chomwe chingachitike, koma ena samakonda kuganizira za izo. Ngati muli munthu amene akufuna kudziwa, pali zinthu zingapo zomwe zingakhale zovuta ngati anthu omwe ali ndi COPD akuchitidwa opaleshoni ndi anesthesia.

• Matenda opatsirana monga chibayo
• Sepsis (matenda a "thupi lonse" omwe ndi ovuta kwambiri)
• Pneumothorax (mapaipi otayika)
• Kulephera kupuma
• Machiritso osavulaza ovulaza
• Kulephera kuyamwa kwa mpweya wabwino - Kwa opaleshoni yambiri, chubu imayikidwa panjira yanu kuti mupereke mpweya wabwino. Chodetsa nkhaŵa kwambiri ndi matenda a m'mapapo ndi chakuti vuto linalake la opaleshoni m'mapapo lidzakupangitsani kukhala "wodalira mpweya" ngakhale mutakhala mukupuma bwino popanda chithandizo.
• Hypoxia - Kuwonongeka kwa minofu ndi selo imfa chifukwa cha mpweya wosaperewera kwa thupi, kuphatikizapo ubongo.
• Magazi amagazi ndi mapiritsi amadziwika kwambiri kwa anthu omwe ali ndi COPD, makamaka ngati opaleshoni imafuna kuti mukhale osatopa kwa nthawi ndithu.
• Kumangidwa kwa mtima

Odwala onse a COPD ali pachiopsezo chachikulu chokhala ndi mavuto pambuyo pa opaleshoni yomwe imakhudza anesthesia. Kusamalira mwachidwi pa nthawi iliyonse yopaleshoni ndi kofunikira pofuna kuonetsetsa kuti munthu akuchira mosavuta.

_Zotsatira:

_{Cheng Q, Zhang J, Wang H, et al. Zotsatira za zotsatira zabwino za Hypercapnia ndi Zowonongeka Zowonongeka za Zovuta Pakati pa Odwala Opeza Mapulogalamu Opangira Bronchi Pakati pa Anesthesia. Mapulo One . 2015. 10 (7): e0130771.}

_{Hausman M, Jewell E, Engoren M. Regional Versus General Anesthésia mu Odwala Opaleshoni Odwala Matenda Opatsirana Opaleshoni: Kodi Kupewa Aneshesia Wonse Kumachepetsa Kuopsa kwa Zovuta Zotsatira? Anesthesia ndi Analgesis . 2015. 120 (6): 1405-12.}

_{Kim H, Lee J, Park Y, ndi al. Zotsatira za magulu a GOLD of Chronic Obstructive Disease pa Matenda Opaleshoni. Magazini Yachilendo Yopanda Kulepheretsa Matenda Opatsirana . 2016. 11: 281-7.}

_{Kiss G, Claret A, Desbordes J, Porte H. Thoracic Epidural Anesthesia kwa Opaleshoni ya Opaleshoni ya Galamukani mwa Odwala Dyspnoeic Oopsa Osatchulidwa ndi General Anesthesia. Kugwiritsa Ntchito Opaleshoni Yophatikizapo Opaleshoni Ndiponso Opaleshoni Yophulika . 2014. 19 (5): 816-23.}