Odziwika choncho m'mbiri chitsanzo cha kulemba

Mu Russia, mfundo "mbiri mlandu" akadadziwa mwamsanga m'ma 18. History (Kuchokera chiweruzo Greek, lingaliro.) - maganizo dokotala: thanzi wodwalayo, zizindikiro za matenda, zimayambitsa, matenda, mankhwala koyamba ndi zotsatira zake. Mlanduwu mbiri ndi kuvomerezedwa chikalata ntchito zachipatala chikalata za izo ndi ayankhidwa m'nkhaniyi, amene tidzakambirana mitundu yake, zinthu, drafting ndi Chinsinsi.

mitundu epicrisis

Opinion pa zotsatira za mankhwala pamene wodwalayo atachitidwa ndi m'chipatala kunyumba dolechivatsya mbiri choncho amatchedwa - kumaliseche. Mu izo zimapangitsa malangizo kasamalidwe zina wodwala. Pa positi-mortem Odwala akufa epicrisis, mmene chifukwa cha imfa anakhazikitsa. Nthaŵi zina akudwala, kawirikawiri kamodzi pa masiku 10-14 ndi zina choncho mbiri, dzina lake - chosaiwalika m'mbiri choncho.

Mbiri ya matenda ikuchitika tsiku lililonse. Pa tsiku lachitatu wa matenda kapena ngati wodwala ku chipatala kwa masiku woposera khumi amafuna kusamutsa kwa dokotala wina, wodzazidwa ndi mbiri chosaiwalika case, limene limafotokoza mmene wodwalayo, cholinga kwa njira yodziwira zachipatala. Malongosoledwe zingasiyane malingana ndi zimene yotsatira ladzala, pa kusalekerera wodwala matenda, anaika kapena matenda.

zikhalidwe

• Ngati matenda si mu epicrisis kukambirana matenda presumptive, njira yodziwira kwa chitsimikiziro.
• Ngati matenda kale anaika limafotokoza siteji ya matenda, madokotala ananena zawo ake. Akulongosola madandaulo a wodwalayo, zasayansi ndi zofufuza malangizo.
• Kenako gawo epicrisis limafotokoza mphamvu ya mankhwala, mlingo wa mankhwala zofunika kusintha mu mankhwala. Tsimikizani machenjerero zina mankhwala wodwala.
• Patapita choopsa cha matenda, chikalata ichi chapangidwa zambiri ngati n'koyenera.

waukulu

Ndipotu, mbiri nkhani mwachidule gawo m'mbuyomu matendawa ndipo amasonyeza kanthu zina. Mlanduwu mbiri - amatha kugawana za wodwala pakati pa magulu a zachipatala. Makamaka mosamalitsa kutsatira kulanda kafukufuku odwala amene anatulukira TB, matenda a khansa, matenda okhudza ubongo, matenda opatsirana pogonana, matenda cardio-mtima.

Mwachitsanzo

Apa mmene kumaliza chosaiwalika mlandu mbiri - chitsanzo cha zolembedwa.

20.03.11. K.D.A. mtima, zaka 6, malo okhala anapezeka ndi matenda enaake a m'chiwindi. Anatumizidwa ku dipatimenti gastroenterological wa CSTO Moscow, kumene matenda sanali anatsimikizira, kusintha kwa m'mitsempha zipata, splenomegaly anapezeka. Iye anasamutsidwa ku Unduna wa Agriculture №2 CSTO kufufuza zina ndi mankhwala. Iye anavomereza kuti 05.03.11. A boma la kusalekerera zolimbitsa. Yogwira chiwindi si palpable, ndulu 6 cm. An. mkodzo wabwinobwino, paulendo. Magazi - HB - 112 Lake. - 3.4, ratu. - 4.2, mp. - 70, chilinganizo mu mwakale. B \ × Magazi - zizindikiro zonse n'zabwinobwino. UZGD: chiwindi popanda kusintha kwakukulu structural, mpanda wa beseni zipata wandiweyani 108h60 mm, kuchuluka kwa minofu connective, kapamba: 16h15h18 mm, ndulu ya wakulitsidwa, 124h46 mm. Kusintha kwa m'mitsempha zipata. EGD: mu c \ ndi N 3 \ 3 4 esophageal mitsempha kunaikidwiratu; 3,3,5,6 mamilimita cyanotic, pano, ndi mfundo angapo, ndi kusintha kwa m'ndandanda wa m'mimba. Kutsiliza: pangano 4 madigiri. Gastro. CT angiography: mesenteric kuposa Vienna 8 mm, kufutukuka intrahepatic ya ndulu ducts 5 ndi 10 mm. matenda zikutsimikiziridwa.

16.03.11g. Opaleshoni "Younika Baibulo anasiya nthambi ya m'mitsempha zipata chitachitidwa. Mapangidwe splenitis-aimpso anastomosis mbali ndi mbali. Ligation ya kumanzere gonadal mtsempha. " N / nthawi anali kumva ndi ufulu amaganiza chibayo lobar. Imachitika antibacterial, kulowetsedwa mankhwala. N / o ulamuliro (3 tsa / usiku): An. Mkodzo - magazi yachibadwa: HB - 118 Lake. - 7.6, ratu. - 4.4, mp. - 160 njira nkwabwino. D \ × magazi: mapuloteni - 62 g / L (yachibadwa 60) 35 Albumin (mlingo wa 35 g / l), bilirubin 18.9 (ponseponse 14 micromole / lita), alt - 63 (mlingo wa ku 45 IU / l), zizindikiro zina zachilendo.

Iwo inakonzedwa masiku 9-10 pambuyo opaleshoni kuti achotse matabwa, kupanga EGD. Pamene mphamvu zabwino kukonzekera kumaliseche.

Epicrisis (Mwachitsanzo pamwamba) dispensary wodwalayo

Zinali chitsanzo cha ankachitika epicrisis wodwala atagona kuchipatala. Koma pali mbiri chosaiwalika nkhani ya mtima dispensary. mbiri choncho pamafunika younikira mphamvu ya Kupenda prophylactic mankhwala. Matenda Kupenda chofunika patsogolo thanzi la anthu, kumapangitsanso Mwachangu ake. Chipatala muone kukhala wathanzi: amayi apakati, ana asukulu, antchito a makampani ndi zinthu woopsawo ntchito, anthu pafupi zedi ndi anthu (antchito adzasowa chakudya, ogwira ntchito zachipatala, etc.), komanso akudwala matenda aliwonse.

magawo a Kupenda matenda

• Matenda Kupenda zikuphatikizapo magawo 3.
• Kodi mokakamizidwa chizolowezi chiphasochi pa mabizinezi kapena mayeso dispensary (ana, ana asukulu) kuti awunike ukupeza, kudziwa mwamsanga njira iliyonse pathological.
• Zonse wozengereza anaziika wa anthu, anatengedwa chifukwa cha dispensary lapansi. Kutalika chidwi chimadalira pa chikhalidwe cha matenda ndi ranges kuchokera mwezi umodzi mpaka mapeto a moyo wa wodwalayo.
• Analysis wa dispensary lapansi. Kumapeto kwa chaka, dokotala kupezeka chimadzaza chosaiwalika mlandu mbiri ya mtima mu dispensary lapansi. Iye analemba mu mabuku awiri: mmodzi mwa tchati ya ambulatory wodwala, ndi zina - pa mwapadera, lopatsidwa kwa ziwerengero ofesi kwa processing centralized deta mankhwala bwinobwino zimene amaweruza nchito zake.

Chinsinsi

Ndicho chimene ayenera kukhala mbiri chosaiwalika mlandu: Chinsinsi kuti Payenera kukhala ngati zinthu monga:

• dzina lomaliza, dzina loyamba, tsiku lobadwa, zaka zingati zonse, malo okhala.
• Unwrapped ndi matenda wololera.
• mtima madandaulo.
• Mbiri ya matenda.
• The chikhalidwe koyamba kwa wodwala.
• Laboratory ndi mayesero ena.
• Kufunsa ndi akatswiri.
• Kodi mankhwala zinachitikadi. Kaya kupewa matenda kunachitidwa. Ngati ikuchitika ntchito iliyonse limafotokoza njira ya opaleshoni kuposa zamizidwa ndi kusakhala ndi mayendedwe a matenda. Kodi ukupeza wodwalayo, kuchepetsa kapena kuonjezera chiwerengero cha exacerbations ngati anasintha chiwerengero cha masiku a chilema.
• Kuyesa kuti anachita (kuwongolera, kuwonongeka, palibe kusintha).

Epicrisis linaperekedwa kusainira mutu polyclinic dipatimenti.

Pomaliza

ana onse ayenera kuyezedwa ndi dokotala chaka chilichonse, ndipo pa 1 chaka, zaka 3, 6, 7, 10, 14, 15, 16 ndi 17 zaka anagwira Lenileni dispensary. Pa 18 chosaiwalika m'mbiri mlandu anapanga kumasulira munthu amene anakulira zipatala ana akuluakulu.

Choncho, chosaiwalika m'mbiri mlandu analemba munthu aliyense, kuyambira pa kubadwa kwake ndi chikalata ankameteramo ubweya wa munthu aliyense, mu mankhwala, izo ukugwira kuti pasipoti lapansi. Malinga ndi izo, anaphunzira mbiri ya matenda, chimene wodwala amafunafuna thandizo kuchipatala.

M'pofunikanso kuti mbiri choncho amatchedwa "khadi" anthu, ndi dzina ili onse anakumana.