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"?au nh? ?au ??", "?au nh? banh da x? th?t" ? l  nh?ng  cu v von  ?? ?? ni ln n?i ?au khng g snh ???c, ko di lin t?c nhi?u gi?, th?m ch c? ngy m ng??i ph? n? khi "v??t c?n" ph?i t? mnh tr?i qua. N?i ?au ? th?m ch ?  m ?nh 1 s? b m? tr? t?i m?c khng dm sinh con n?a.


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   ?? khng ?au l m?t thu?t ng? ni v? vi?c gi?m ?au cho s?n ph? b?ng cc k? thu?t dng thu?c v khng dng thu?c. V?i s? ti?n b? c?a y h?c, ngy nay k? thu?t ???c ?a chu?ng nh?t l Gy t ngoi mng c?ng lin t?c. Cc bc s? Gy m h?i s?c c th?  ??t 1 Catheter ngoi mng  c?ng, qua 1 Syringe ?i?n,  ?? b?m 1 l??ng thu?c t nh? lin t?c vo khoang ngoi mng c?ng bao b?c xung quanh t?y s?ng gip gi?m ?au khi chuy?n d?. S?n ph? s? t ph?i ch?u ?au, ?? m?t s?c, cu?c chuy?n d? s? x?y ra nh? nhng h?n, nhanh h?n, v do ? em b t b? sang ch?n h?n. K? thu?t ny ???c p d?ng t?i Php t? nh?ng n?m 1970. ? n??c ta B?nh vi?n Ph? S?n Hng V??ng ? th?c hi?n nh?ng ca ??u tin vo n?m 1987, Sau ? ? ???c p d?ng kh r?ng ri ? 1 s? b?nh vi?n l?n nh?: BV T? D?, BV Ph? s?n Trung ??nghng ch?c ngn s?n ph? ? ???c ?n nh?n ni?m h?nh phc l?n lao nh?t c?a ng??i m? m khng ph?i tr?i qua ?au ??n. Tuy v?y ?y l 1 th? thu?t nn c?ng c th? c 1 s? bi?n ch?ng m s?n ph? v gia ?nh c?n hi?u r, v ng??i lm th? thu?t ph?i lun c? g?ng ?? gi?m thi?u t?i ?a t?n su?t x?y ra.

   Gy t NMC ???c  ti?n hnh th? no?

   S?n ph? s? ???c bc s? s?n khoa khm v tin l??ng ?? ???c, bc s? gy m s? khm ton di?n ?? ch?n l?a cc tr??ng h?p c ch? ??nh, gi?i thch cho s?n ph? v ???c s?n ph? k gi?y t? nguy?n xin lm gi?m ?au.

   Cu?c gy t ngoi mng c?ng s? do cc bc s? giu kinh nghi?m th?c hi?n.

   Tr??c khi gy t s?n ph? s? ???c  truy?n d?ch ?? trnh t?t huy?t p do tc d?ng t gy ra. Khi gy t s?n ph? c th? ng?i cong l?ng ho?c n?m nghing tri. M?t m?i tim nh? gy t t?i ch? vng c?t s?ng s? gip s?n ph? khng ?au khi lm th? thu?t. Bc s? GMHS s? ??a 1 kim chuyn d?ng vo t?i khoang ngoi mng c?ng. Qua kim ny, 1 Catheter s? ???c lu?n vo trong khoang mng c?ng, kim chuyn d?ng s? ???c rt ra, v s?n ph? c th? n?m tho?i mi v?i Catheter nh?, m?m m?i ny.

   Khi gy t NMC s?n ph? s? tr?i qua nh?ng c?m gic g?

   T?i th?i ?i?m ti?n hnh th? thu?t, khi gy t t?i ch? s?n ph? s? c c?m gic ?au nh? 1 m?i tim thng th??ng. Khi b?t ??u b?m thu?c qua Catheter c th? c?m nh?n ???c 1 dng mt d??i l?ng ( ho?c khng th?y g c?). t pht sau s?n ph? s? th?y ?? ?au. Ty theo ng??i ?i khi s? c c?m gic m ?m ? 2 bn chn, t nh? ki?n b 2 bn chn, hay n?ng ? chn.

   S?n ph? c l?i g khi gy t ngoi mng c?ng ?

   Gy t NMC s? gip s?n ph? trnh ???c ci ?au nh? ?au ??, cu?c chuy?n d? s? tr? nn nh? nhng, s?n ph? s? hon ton tho?i mi v c?m nh?n ???c t?ng giai ?o?n c?a cu?c ?? v khng b? m?t s?c.
   Nh? tc d?ng c?a thu?c gi?m ?au, bc s? s?n khoa c th? ch? huy ???c cu?c ?? theo xu h??ng t?t nh?t cho m? v thai. Trong tr??ng h?p ph?i m? l?y thai c?p c?u th c th? s? d?ng chnh Catheter ny ?? lm v c?m.

   Gy t c h?i g cho s?n ph? v thai nhi khng ?

   L 1 th? thu?t y khoa nn bn c?nh l?i ch to l?n m n ?em l?i, gy t NMC c?ng c nh?ng nh??c ?i?m v bi?n ch?ng nh?t ??nh.

   Thu?c t c th? gy gin m?ch, t?t huy?t p, v c th? ?nh h??ng ??n cung c?p mu cho thai nhi. M?t s? s?n ph? c th? th?y bu?n nn, tot m? hi, m?t x?u hay kh th? v t?t huy?t p. C th? phng trnh b?ng truy?n d?ch tr??c khi gy t. Trong khi gy t huy?t p m? v tim thai lun ???c theo di st sao lin t?c.

   C?n co TC c th? ph?n no b? ?nh h??ng b?i thu?c t, nh?ng b?ng vi?c theo di t?n s? v c??ng ?? c?n co t? cung b?ng Monitoring s?n khoa, cc bc s? s?n khoa v n? h? sinh s? bi?t ???c chnh xc khi no v b?ng cch no ?? can thi?p lm t?ng c?n co t? cung.

   Gy t NMC khng lm t?ng t? l? m? ?? hay can thi?p d?ng c? khi s? thai.

   M?t s? bi?n ch?ng t g?p

   Trong m?t s? tr??ng h?p s?n ph? c th? ?au ??u vi ngy sau ??, ?au c th? t? h?t ho?c h?t sau khi dng thu?c c?ng nh? n?m ngh? ng?i ?ng t? th?.

   Nhi?m trng khoang NMC l 1 bi?n ch?ng n?ng c th? x?y ra, Tuy nhin c th? th? gi?m thi?u bi?n ch?ng ny b?ng cch tun th? tuy?t ??i cc nguyn t?c v trng.

   Ngoi ra Y v?n cn ghi nh?n cc tr??ng h?p tai bi?n ch?y mu gy t? mu NMC v?i t?n su?t th?p (0,04%). C th? pht hi?n chnh xc bi?n ch?ng ny b?ng ch?p cng h??ng t? ?? c ph??ng php x? l thch ?ng.

   S?n ph? no c th? ???c gy t ?

T?t c? cc s?n ph? c nhu c?u gi?m ?au m bc s? s?n khoa tin l??ng ?? ???c, C? TC ch?a m? qu 6cm,  khng c cc ch?ng ch? ??nh gy t.

   Nh?ng s?n ph? no khng nn gy t ? 
  
   ? l cc ch?ng ch? ??nh nh?: d? ?ng thu?c t, nhi?m trng ton thn n?ng, r?i lo?n huy?t ??ng v cc ch?c n?ng s?ng n?ng, ti?u c?u < 100.000/mm, b?t bu?c ph?i dng thu?c ch?ng ?ng  sau ??, ti?n s? b?nh l th?n kinh ho?c b?nh t?y s?ng
C?ng khng nn lm t NMC trong cc tnh hu?ng c?p c?u m tnh m?ng c?a m? ho?c con b? ?e d?a.

   T?i B?nh vi?n Ph? n? Thnh ph? ? N?ng:

   Tuy m?i thnh l?p, nh?ng v?i s? ch?p thu?n c?a ban gim ??c v s? ??ng thu?n c?a cc b?n s? s?n khoa v n? h? sinh, khoa GMHS ? b?t ?u tri?n khai ph??ng php  ?? khng ?au trn 8 s?n ph? ??u tin c k?t qu? t?t.

   V?i gy t ngoi mng c?ng, chng ti s? gip cc b?n v??t qua giai ?o?n kh kh?n ?? ?n nh?n h?nh phc tuy?t v?i: LM M?. Tuy nhin gy t NMC khng ph?i l b?t bu?c, vi?c ?? th??ng khng ph? thu?c vo vi?c b?n c gy t NMC hay khng. Ch?n l?a ?? khng ?au b?ng gy t NMC, hay t? ch?u ??ng c?n ?au chuy?n d? hon ton l quy?t ??nh c?a b?n.

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