Zamkatimu
Ndi Pulofesa Gilles Kayem, dokotala wodziwa za amayi pachipatala cha Louis-Mourier (92)
Londozani mwala
Kaya cesarean ndi yokonzekera kapena yofulumira, mayi wapakati amaikidwa m'chipinda cha opaleshoni. Amayi ena amavomereza, pamene zinthu zili bwino, kuti abambo alipo pambali pake. Choyamba, timatsuka khungu la pamimba ndi mankhwala ophera tizilombo toyambitsa matenda kuchokera pansi pa ntchafu mpaka kufika pachifuwa, ndikutsindika pa mchombo. Kenako catheter ya mkodzo imayikidwa kuti atulutse chikhodzodzo mosalekeza. Ngati mayi woyembekezera ali kale ndi vuto la epidural, wogonetsayo amawonjezera mlingo wowonjezera wa mankhwala oletsa ululu kuti amalize kuthetsa ululu.
Kucheka khungu
Katswiri wobereketsa tsopano atha kupanga opaleshoni ya chiberekero. M'mbuyomu, kudulidwa kwa mzere wapakatikati pakhungu kunkapangidwa pakhungu ndi pachibelekeropo. Izi zinayambitsa magazi ambiri ndipo chilonda cha chiberekero pa nthawi ya mimba yotsatira chinali chosalimba. Masiku ano, khungu ndi chiberekero nthawi zambiri zimadulidwa modutsa.. Izi ndi zomwe zimatchedwa Pfannenstiel incision. Njirayi imatsimikizira kulimba kwambiri. Amayi ambiri amada nkhawa kuti ali ndi chipsera chachikulu. Zimenezi n’zomveka. Koma ngati kudulako kuli kochepa kwambiri, kuchotsa mwanayo kungakhale kovuta kwambiri. Chofunikira ndikudula khungu pamalo oyenera. The classic analimbikitsa m'lifupi ndi 12 mpaka 14 cm. Kudulidwa kumapangidwa 2-3 masentimita pamwamba pa pubis. Ubwino wake? Pamalo amenewa, chipseracho chimakhala chosaoneka chifukwa chili m’khola.
Kutsegula kwa khoma la m'mimba
Pambuyo popaka khungu, dokotala woyembekezera amadula mafuta ndiyeno fascia (minofu yomwe imaphimba minofu). Njira yopangira opaleshoni yasintha m'zaka zaposachedwa motsogozedwa ndi maprofesa Joël-Cohen ndi Michael Stark. Mafuta ndiye kuti minofu imafalikira ku zala. The peritoneum imatsegulidwanso chimodzimodzi kulola kulowa m'mimba ndi chiberekero. Pamimba pamimba pali ziwalo zosiyanasiyana monga m'mimba, m'matumbo kapena chikhodzodzo. Njirayi ndi yachangu. Ndikofunikira kuwerengera pakati pa 1 ndi 3 mphindi kufika pa peritoneal cavity pa gawo loyamba la cesarean. Kufupikitsa nthawi yochitidwa opaleshoni kumachepetsa kutuluka kwa magazi ndipo mwina kumachepetsa chiopsezo chotenga matenda, zomwe zingathandize mayi kuti achire mwamsanga pambuyo pa opaleshoniyo.
Kutsegula kwa chiberekero: hysterrotomy
Dokotala ndiye amalowa m'chiberekero. The hystertomy imachitika m'munsi momwe minofu ndi thinnest. Ndi malo omwe amakhetsa magazi pang'ono pakalibe matenda owonjezera. Komanso, chiberekero chilonda ndi wamphamvu kuposa suture thupi la chiberekero pa mimba yotsatira. Kubadwa kumene kukubwera mwa njira zachibadwa ndi kotheka. Chibelekerocho chikang’ambika, dokotala wachikazi amakulitsa choboolacho mpaka chala ndi kung’amba thumba la madzi. Pomaliza, amachotsa mwanayo ndi mutu kapena mapazi malinga ndi ulaliki. Mwanayo amaikidwa khungu ndi amayi kwa mphindi zingapo. Zindikirani: ngati mayi apanga kale opaleshoni, opareshoni ikhoza kutenga nthawi yayitali chifukwa pangakhale makwerero, makamaka pakati pa chiberekero ndi chikhodzodzo.
Kutumiza
Pambuyo pa kubadwa, woyembekezera amachotsa latuluka. Ichi ndi chiwombolo. Kenako amaona kuti chiberekero chilibe kanthu. Chiberekerocho chimatsekedwa. Dokotala wa opaleshoni angasankhe kuti atulutse kunja kuti aziwombera mosavuta kapena kuzisiya m'mimba. Kawirikawiri, visceral peritoneum yomwe imaphimba chiberekero ndi chikhodzodzo sichitsekedwa. The fascia watsekedwa. Khungu la mimba yako ndi, mbali yake, sutured malinga ndi akatswiri, absorbable suture kapena ayi ndi ma staples. Palibe njira yotsekera khungu yomwe yawonetsa zotsatira zabwinoko zokometsera miyezi isanu ndi umodzi chitatha opareshoni
Njira ya extra-peritoneal cesarean section Pankhani ya extraperitoneal cesarean section, peritoneum sidulidwa. Kuti apeze chiberekero, dokotala wa opaleshoni amachotsa peritoneum ndikukankhira chikhodzodzo kumbuyo. Popewa kudutsa mu peritoneal patsekeke, izo zingakwiyitse dongosolo m'mimba pang'ono. Ubwino waukulu wa njira ya cesarean gawo kwa amene kupereka izo, ndi kuti mayi adzakhala ndi kuchira mofulumira matumbo podutsa. Komabe, njira iyi siinatsimikizidwe ndi kafukufuku wofananiza ndi njira yachikale. Mchitidwe wake chotero ndi wosowa kwambiri. Momwemonso, monga momwe zimakhalira zovuta komanso zowononga nthawi kuchita, sizingachitike muzochitika zilizonse zadzidzidzi. |