EVENTRATII

8/16/2019 EVENTRATII

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CUPRINS

INTRODUCERE..................................................................................................2

CAPITOLUL I......................................................................................................3

EVENTRAŢIILE..................................................................................................3I.1.Definiţie...........................................................................................................3

I.2.Etiopatogenie...................................................................................................3

I.3.Anatomo-patoogie..........................................................................................!

I.".Ca#ifi$a%ea e&ent%aţiio%.................................................................................!

I.!.Ta'o( $ini$....................................................................................................)I.*.E+amen( $ini$ ..............................................................................................)

I.).T%atament( e&ent%aţiio%.................................................................................,

CAPITOLUL II.....................................................................................................

TUDIU DE CA/................................................................................................


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II 1 P 0 ii 1

INTRODUCERE

E#teti$a $o%p((i 8i a%e %909$inie n anti$:itate; n$9 0in an( 35 .


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0iaf%agm((i. Cee mai f%e$&ente o$ai9%i fiin0 a ni&e( pe%ete(i a'0ominaante%io%; #(nt $on#i0e%ate p%ototip(%i 0e 0e#$%ie%e ae e&ent%aţiio% .

A$e#te :e%nii #e p%eint9 $a o ?(mf9t(%9@ #a( p%ot%(ie; a #a( ap%oape 0eona (nei $i$at%i$i $:i%(%gi$ae. De8i $e mai f%e$&ent apa% 0e-a (ng( inieime0iane; p%a$ti$ o%i$e ope%aţie a'0omina9 ante%ioa%9 poate (te%io% 0e&ota oe&ent%aţie F$:i%(%gie inte#tina9; $:i%(%gie &a#$(a%9; $:ia% 8i in$iii mi$i;apen0i$e$tomie; apa%o#$opieG.Dimen#i(nea 0efe$t((i :e%nia% e#te (n pa%amet%( impo%tantH e&ent%aţii mai mi$i

0e " $m a( (n %i#$ 0e %e$i0i&9 $( m(t mai mi$ 0e$t e&ent%aţii $( 0imen#i(nimai ma%i.(nt mai m(te $atego%ii 0e fa$to%i $a%e inf(enţea9 negati& p%o$e#( 0e$i$at%ia%e a p9gii ope%ato%iiH

aG Factori care ţin de actul chirurgical (factori locali): #(p(%aţia p9gii J e#te fa$to%( $e mai f%e$&ent in$%iminat; apa%e p%in

ne%e#pe$ta%ea %eg(io% 0e a#ep#ie; :emo#taa 0efi$ita%9 $( fo%ma%ea (n(i:ematom #('$(tanat $a%e #e infe$tea9 #e$(n0a% #a( 0ato%it9 nat(%ii #epti$e aafe$ţi(nii $:i%(%gi$ae Fpe%itonita; $:i%(%gie %e$to-$oi$9G>

tip( 0e apa%otomie J $ee o'i$e 8i &e%ti$ae pa%ame0iane 0a( $e mai%i0i$at p%o$ent 0e e&ent%aţii p%in inte%e#a%ea ine%&aţiei; #e$ţi(nii pan(%io% anatomi$e 8i 0eo%gania%ea iniio% 0e fo%ţ9. n apa%otomiie #('om'ii$aeapa%iţia e&ent%aţiio% e#te fa&o%iat9 0e a'#enţa foiţei po#te%ioa%e a te$ii 0%epţio%

i 0 i i '0 i i


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-po#tt%a(mati$e a$$i0entae - #e 0e&ot9 $a (%ma%e a p%o0($e%ii (nei %(pt(%im(#$(o-apone&%oti$e; :ematom; $on#e$inţe ae a$$i0ent((i; $e 0ete%min90ete%io%a%ea $aitati&9 a pe%ete(i a'0omina>-p%in a$t ope%ato% - apa% $a o $on#e$inţ9 a (no% e&enimente o$ae $e 0ete%min90e:i#$enţa pan((i m(#$(o-apone&%oti$ #(t(%at; #(p(%aţia fiin0 $ea maif%e$&enta $a(9.-$( fa$to% $a(a in0i%e$t - apa% $a (%ma%e a 0ete%io%9%ii $aitati&e a pe%ete(im(#$(o-apone&%oti$ a'0omina n e&o(ţia ato% afe$ţi(ni $(m #(nt %a:iti#m(;

o'eitatea; 0egene%e#$enţa #eni9; ne&%ita 0ia'eti$9. După numărul de orificii

e&ent%aţii (nio%ifi$iae J #impe>e&ent%aţii m(tio%ifi$iae J $ompe+e.

După dimensiunile orificiului parietal ; 0eo#e'imH e&ent%aţii mi$i J 0iamet%( $oet((i 0e 3 $m; $( &o(m $t o $ai#9;

(8o% %e0($ti'ie> e&ent%aţii mio$ii J 0iamet%( 0e 3-15 $m; &o(m $t o po%to$a9> e&ent%aţii ma%i J 0iamet%( 0e pe#te 15 $m 8i #a$( $t (n pepene; p%in

o%ifi$i( a%g :e%nia9 o ma#9 ma%e 0e &i#$e%e a'0ominae; g%e( %e0($ti'ie> e&ent%aţii gigante J $( o%ifi$i( foa%te a%g; p%in $a%e :e%nia9 o ma%e

pa%te 0in &i#$e%ee a'0ominae Fe&ent%aţii K$( pie%0e%ea 0e 0omi$ii(G;0ete%minn0 t('(%9%i $a%0io$i%$(ato%ii 8i %e#pi%ato%ii.

D ă di l t fi


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eventraţiile iliace $ mai f%e$&ente pe 0%eapta; pot fi a#o$iate $( oe&ent%aţie ing:ina9; at(n$i $n0 igament( ing:ina e#te $omp%omi# #a( $( oe&ent%aţie me0ian9 #('om'ii$a9>

eventraţiile flancurilor F1-1;"MG - #(nt #it(ate nt%e %e'o%0( to%a$i$infe%io% 8i $%ea#ta iia$9;

# eventraţiile pararectale "i eventraţiile după inciia tip %fannenstiel -#(nt m(t mai %a%e&

După stadiul evolutiv

$e&ent%aţii #impe-e&ent%aţii $ompi$ate

După evoluţie eventraţiile strangulate Fap%o+imati& !MG - #e p%o0($ fie p%in

$on#t%i$ţie a ni&e( $oet((i; at(n$i $n0 o%ifi$i( e#te #t%mt; fie p%in&o&((#( (nei an#e fi+ate n #a$( 0e e&ent%aţie #a( #t%ang(a%e int%a#a$(a%9 n$a( #a$((i 0e e&ent%aţie m(ti0i&e%ti$(a%.

eventraţiile cu ulcere trofice cutanate - #(nt ntot0ea(na#(p%ainfe$tate>

eventraţiile parastomiale> eventraţiile cu evisceraţie secundară - #(nt e+$epţionae 8i $ompi$9

n gene%a (n ($e% t%ofi$ $(tanat. După topografie


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ap%e$ie%ea %e0($ti'iit9ţii 8i a t('(%9%io% f(n$ţionae 0ete%minate 0ee&ent%aţieH

- p%eenţa t('(%9%io% %e#pi%ato%ii n p%im( %n0- t('(%9%i 0e t%anit- t('(%9%i $a%0io-$i%$(ato%ii

I.,.T%atament)! e&ent%aţii!o%

E#te $:i%(%gi$a; 0i#$(ta'i 0oa% a 'ona&ii ta%aţi; &%#tni$i; t(8ito%i$%oni$i; ma%ii o'ei $a%e pot 'enefi$ia 0e t%atament o%tope0i$ F15G.

n e&ent%aţiie #t%ang(ate inte%&enţia $:i%(%gi$a9 a%e $a%a$te% 0e (%genţ9 .Inte%&enţia $:i%(%gi$a9 ee$ti&9 e#te in0i$at9 0(p9 minim 8a#e (ni 0e a

ope%aţia p%ima%9 #a( 0e a #tinge%ea o%i$9%(i fo$a% #(p(%ati& pa%ieta.

O(ie$ti&e!e t%atament((i $:i%(%gi$a #(nt $om(ne o%i$9%ei afe$ţi(ni p%ot%(i&eH

0i#e$ţia #a$((i; t%ata%ea $onţin(t((i 8i %einteg%a%ea &i#$e%eo% n a'0omen %efa$e%ea pe%ete(i a'0omina.

P%in$ipaii timpi ope%ato%i #(ntH


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CAPITOLUL II

STUDIU DE CA-

II.1.P!an e /ng%i0i%e $a n%.1C)!ege%ea ate!o%

N(meH V

V%#taH ! ani

e+H ma#$(in

Ante$e0enteH - :e%e0o$oate%aeH tata


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B($oa#eH no%ma $oo%ate

Apa%at %e#pi%ato%H to%a$e no%ma $onfo%mat; ia pa%te a mi#$a%ie%e#pi%ato%ii

Apa%at $a%0io-&a#$(a%H gomote $a%0ia$e %itmi$e; 'ine '9t(te; p(# pe%ife%i$ p%eent

7i$at; #pinaH (#oa%a #penomegaie i#tem ne%&o#H o%ientat tempo%o-#patia

Apa%at (%o-genita H o9 %enae i'e%e

RECOANDARI LA E4TERNARE $om'ate%ea 0(%e%ii; %egim aimenta%

:ipo#o0at; :ipo$ao%i$; e&ita%ea efo%t((i fii$ ma%e #i a f%ig((i; %e&eni%ea a$ont%o 0(pa ) ie.


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E&ent%atie p%eope%ato%ie

Ne&oia

f(n0amenta9

Diagno#ti$ 0e

n(%#ing

O'ie$ti&e Inte%&entii p%op%ii Inte%&entii

0eegate

E&a(a%e

Ne&oia 0e a fi$(%at; ng%iit;0e

a p%otea

teg(mentee #i

m($oa#ee.

Difi$(tate 0e a#e ng%ii; 0e a-#i

p%otea

teg(mentee #i

m($oa#ee

0ato%it9 0(%e%ii #i

ameteio%.

Pa$ient( #9 p%einte

teg(mentee #i

m($oa#ee $(%ate;

integ%e.

Pa$ient( #9 ai'9

o #ta%e 0e 'inefii$ #i p#i:i$.

A#i#tenta me0i$a9e+po%ea9 o'i$ei(%ie

pa$ient((i.

A#i#tenta me0i$a9

panifi$9 (n p%og%am 0e

igien9 $( pa$ient( n

f(n$tie 0e a$ti&it9tie #aeini$e.

A(t9 pa$ient(; n f(n$tie

0e #ta%ea gene%a9 #9 #i

fa$9 'aie #a( 0(# #a(i

efe$t(ea9 t(aeta pe

%egi(ni.

La in0i$atiame0i$((i #e &a

a0mini#t%a

t%atament(.

Pa$ient( p%eint9

teg(mentee #i

m($oa#ee

$(%ate.

Pa$ient(

'enef$ia9 0e o#ta%e 0e 'ine

fii$ #i p#i:i$.

Ne&oia 0e a

$om(ni$a.

Teama

pa$ient((i n

ne$e#itatea

Pa$ient( #9 fie

$apa'i #9

a$(m(ee

A#i#tenta me0i$a9

ini#te#te pa$ient( $(

p%i&i%e a #ta%ea #a

A0mini#t%ea9

me0i$atia

%e$oman0at9

Pa$ient( a

a$(m(at

$(no#tintee

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$(noa#te%ii 'oii.

In#(fi$iente

$(no#tinte

0e#p%e 'oa9.

$(no#tintee

ne$e#a%e.

Pa$ient( #9 fie

e$:ii'%at p#i:i$.

e+pi$n0(-i #$op( #i

nat(%a inte%&entiei.

A#ig(%9 (n me0i( 0e

#e$(%itate ini#tit.

7amiia%iea9 pa$ient( $(

me0i( am'iant.

0eme0i$. ne$e#a%e $(

p%i&i%e a 'oaa

#a.

Ne&oia 0e a

eimina.

Defi$it 0e &o(m

i$:i0ian 0ato%it9

t%an#pi%atiio% #i

&9%#9t(%io%.De#:i0%ata%e.

Pa$ient( #9 fie

e$:ii'%at :i0%o-

ee$t%oiti$ #i

a$i0o-'ai$.Pa$ient( #9 fie

e$:ii'%at p#i:i$.

A#i#tenta me0i$a9 n&at9

pa$ient( 0e#p%e %eatia

nt%e ne&oie 0e a 'ea; a

mn$a; a fa$e e+e%$itiifii$e #i a eimina pent%(

a-#i #ta'ii p%op%i( o%a% 0e

inge#tie-e+$%etie.

A#i#tenta me0i$a9

#(p%a&eg:ea9 p(#(;

apetit(; #emnee 0e

0e#:i0%ata%e; #$(n(;

0i(%ea; g%e(tatea

$o%po%a9.

La in0i$atia

me0i$((i &a

a0mini#t%a

t%atament( p%e#$%i#.

Pa$ient( e#te

e$:ii'%at;

&oemi$ #i :i0%o-

ee$t%oiti$.Pa$ient( e#te

e$:ii'%at p#i:i$.

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Ne&oia 0e a

0o%mi; a #e

o0i:ni.

Difi$(tate n a

#e o0i:ni.

Pa$ient( #9 ai'9

#(n #omn

o0i:nito% #i #9

'enefi$iee 0e (n

$onfo%t fii$ #i

p#i:i$ a0e$&at.

A#i#tenta me0i$a9

mentine $on0itiie

me0i$ae ne$e#a%e

#omn((i; n&at9 pa$ient(

#9 pa%$ti$e te:ni$i 0e

%ea+a%e; e+e%$itii

%e#pi%ato%ii; nto$me#te (n

p%og%am 0e o0i:n9

$o%e#p(n9to%

o%gani#m((i.A#i#tenta me0i$a9

$%eea9 (n $imat 0e

n$%e0e%e; n$(%aa9 #i

ini#te#te pa$ient( pent%(

a-#i %e$9p9ta e$:ii'%(

p#i:i$; %e#pe$t9 o%ee 0e#omn ae 'ona&((i.

La in0i$atia

me0i$((i

a0mini#t%ea9

mio%ea+ante ti

#e0ati&e ti e

(%m9%e#te

efe$t(.

Pa$ient(

p%eint9 (n #omn

o0i:nito%.

Ne&oia 0e a #e

mi#$a #i 0e a

Ate%a%ea

integ%it9tii

Pa$ient( #9 #e

poat9 mi#$a

A#i#tenta me0i$a9

in#taea9 pa$ient( n pat

A0mini#t%ea9 a

in0i$atia

Pa$ient( #e

0epa#ea9 f9%9

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a&ea o '(n9

po#t(%9.

p#i:i$e #i fii$e

0ato%it9 0(%e%ii #i

an+iet9tii.

#ing(%. %e#pe$tn0 poitiie

anatomi$e ae $o%p((i;

a#ig(%9 igiena

teg(menteo% #i a ene%iei

0e pat; efe$t(ea9 e+e%$itii

pa#i&e #i a$ti&e; n&at9

pa$ient( poitia a0e$&at9

n f(n$tie 0e ne$e#itate.

me0i$((i

antiagi$e #i

#o(tii

pe%f(a'ie.

a(to%.

1"


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II.2.P!an e /ng%i0i%e $a n%.2

C)!ege%ea ate!o%

N(meH T

P%en(meH I

V%#taH )) ani

InatimeH 1;)5 m

4%e(tateH 5 g

Lo$aitateaH Nimaie#ti

P%ofe#iaH pen#iona%

Ante$e0enteH


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ta%e 0e n(t%itieH 0e#:i0%ata%e

Teg(menteH a$ope%ite $( t%an#pi%atii %e$i




7i$at; #pinaH (#oa%a :epatomegaie

i#tem ne%&o#H o%ientat tempo%o-#patia

Apa%at (%o-genita H oe %enae i'e%e

PARAETRII 5I-IOLO6ICI PREOPERATOR

E+amina%i pa%a$!ini$e 73.7".271' anaie 0e a'o%ato%; %a0iog%afiea'0ominaa


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#e &a int%o0($e o #on0a 7oe pent%( (%ma%i%ea 0i(%eei>

#e &o% monta 2 inii &enoa#e.

P%egati%ea !o$a!a

#e #pa9 pieea 0e pe a'0omen; #i %egi(nea 0in (%; in#i#tan0(-#e a pi(%i #i om'ii$>

#e %a0e $( g%ia pioitatea>

#e 0einfe$teaa pieea $( anti#epti$ Fe+H a$oo; 'eta0ineG.

Ing%i0i%i!e po#tope%ato%ii pana !a in#ta!a%ea (o!na&)!)i in pat

p%egati%ea $ame%ei F25-22CG; ae%i#it9>

p%egati%ea mate%iaeo% in &e0e%ea %eanima%ii po#tope%ato%ii>

p%egati%ea pat((i; ene%ie 0e pat $(%ata; pat $( #omie%a mo'ia.

S)p%a&eg8e%ea #i ing%i0i%i!e imeiate


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Ne&oia

f(n0amenta9

Diagno#ti$ 0e

n(%#ing

O'ie$ti&e Inte%&en ii p%op%iiț Inte%&en iiț

0eegate

E&a(a%e

Ne&oia 0e a0o%mi #i a #e

o0i:ni.

Difi$(tate 0e a#e o0i:ni

0ato%at9 0(%e%ii.

In#omnii.

Pa$ient( #9 'enefi$iee 0e (n

#omn

$o%e#p(n9to%

$antitati& #i

$aitati&.

Pa$ient( #9 fie

a$ti&; $oope%ant.

A#i#tenta me0i$a9 mentine$on0itiie ne$e#a%e

#omn((i %e#pe$tn0

0o%intee #i 0ep%in0e%ie

pa$ient((i.

A#i#tenta me0i$a9 o'#e%&9

#i notea9 $aitatea; o%a%(

#omn((i; g%a0( 0e

#ati#fa$e%e a $eo%ate

ne&oi.

nto$me#te (n p%og%am 0e

o0i:n9 $o%e#p(n9to%

o%gani#m((i.

A0mini#t%ea9t%atament

me0i$amento#

a in0i$atia

me0i$((i.

Pa$ient( 'enefi$ia9 0e (n

#omn $aitati& #i

$antitati&

$o%e#p(n9to%.

1,


19/33

Ne&oia 0e a #e

mi#$a; 0e a a&ea

o '(n9 po#t(%9.

Difi$(tate n a

#e mi#$a 0ato%at9

0(%e%io%a'0ominae;

t(mefa$tiei

%egi(nii

a'0ominae.

Pa$ient( #9 ai'9

ton(# m(#$(a% #i

fo%t9 m(#$(a%9 p9#t%at9.

Pa$ient( #9 fie

e$:ii'%at p#i:i$.

A#i#tenta me0i$a9

#(p%a&eg:ea9 pe%manent

pa$ient( pent%( a n( #e%9ni.

Panifi$9 (n p%og%am 0e

e+e%$itii #i 0e me%# n

f(n$tie 0e $apa$itatea #a.

La in0i$atia

me0i$((i

a0mini#t%ea9t%atament(

p%e#$%i#.

n (%ma

me0i$atiei

a0mini#t%ate0(%e%ea #-a

0imin(at n

inten#itate #i e#te

p%eent ton(#(

m(#$(a%. Ne&oia 0e a-#i

mentine

tempe%at(%a

$o%p((i n imite

no%mae.

Defi$itate 0e a-#i

p9#t%a

tempe%at(%a

$o%p((i n

imite no%mae

0ato%it9

inte%&entiei

$:i%(%gi$ae.

Pa$ient( #9-ti

mentin9

tempe%at(%a

$o%p((i n imite

fiioogi$e.

Pa$ient( #9 fie

e$:ii'%at

:i0%oee$t%oiti$.

A#i#tenta me0i$a9

aie%i#e#te n$9pe%ea; a#ig(%9

m'%a$9minte ee%9;

#$:im'9 0e# ene%ia 0e pat

#i $o%p.

A#i#tenta me0i$a9 mentine

igiena teg(menteo%;

mo0ifi$a%e me0i((i

am'iant $( fa$iita%ea

mentine%ii tempe%at(%ii n

A0mini#t%ea9

me0i$atia

%e$oman0at9

0e me0i$;

antite%mi$e #i

anti'ioti$e.

Pa$ient( #i

mentine

tempe%at(%a

$o%p((i n imite

fiioogi$e.

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20/33

imite fiioogi$e.

A#i#tenta me0i$a9 notea9

tempe%at(%a n foaia 0e

o'#e%&atie 0e 2 o%i pe i. Ne&oia 0e a #e

m'%9$a #i

0e'%9$a.

Difi$(tate #i

in$apa$itate 0e a

#e m'%9$a #i

0e'%9$a

0ato%ate

inte%&entiei

$:i%(%gi$ae.

Pa$ient( #9

$(noa#$9

impo%tanta

#ati#fa$e%ii ne&oii

0e a #e m'%9$a #i

0e'%9$a.

Pa$ient( #9 fie

e$:ii'%at p#i:i$.

A#i#tenta me0i$a9 e0($9

pa$ient( p%i&in0 impo%tanta

&e#timentatiei n

i0entifi$a%ea pe%#onait9tii.

A#i#tenta me0i$a9 e+pi$9

eg9t(%ie 0int%e tin(ta

&e#timenta%9; imagine #i

#tima 0e #ine.

oi$it9 pe%#oanei #9 #e

m'%a$e; &o%'in0(-i $ae;

0i#tin$t; $( %e#pe$t #i

%9'0a%e; %e#pe$tn0 %itm(

a$e#t(ia.

A0mini#t%ea9

t%atament

p%e#$%i#.

Pa$ient( #e

poate m'%9$a #i

0e'%9$a #ing(%;

e e#te e$:ii'%at

p#i:i$.

Ne&oia 0e a e&ita

pe%i$oee.

Impo#i'iitatea

0e a e&ita

Pa$ient( #9

'enefi$iee 0e (n

A#i#tenta me0i$a9

#(pine#te pa$ient( n

A0mini#t%ea9

a in0i$atia

n (%ma

ng%ii%io%

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pe%i$oee 0in

$a(a 0(%e%ii; a

an+iet9tii.

Pie%0e%ea #timei0e #ine; a

imaginii 0e #ine.

me0i( 0e

#ig(%ant9 fe%it 0e

a$$i0ente #i

infe$tii;Pa$ient( #9-#i

#ati#fa$9 ne&oie

n f(n$tie 0e

#ta%ea 0e #9n9tate

#i g%a0( 0e

0epen0ent9.

#ati#fa$e%ea ne&oio%

o%gani#m((i.

A#ig(%9 (n me0i( 0e

p%ote$tie p#i:i$9 a0e$&at#t9%ii 0e 'oa9 a pa$ient((i.

n$(%aa9 pa$ient( #9

$om(ni$e $( $ei 0in (%; #9-

#i e+p%ime emotiie; f%i$a #i

opiniie.

me0i$((i (n

t%atament

me0i$amento#.

a$o%0ate

pa$ient(

'enefi$iea9 0e

(n me0i( 0e#ig(%ant9; e#te

e$:ii'%at p#i:i$

#i #i #ati#fa$e

ne&oie n f(n$tie

0e #ta%ea #a 0e

#9n9tate.

21


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II.3.P!an e /ng%i0i%e $a n%.3

C)!ege%ea ate!o%

N(meH T

P%en(meH V

V%#taH *! ani

InatimeH 1;* m

4%e(tateH 2 g

Lo$aitateaH C(%atee

P%ofe#iaH pen#iona%

Ante$e0enteH


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ta%e 0e n(t%itieH 0e#:i0%ata%e

Teg(menteH a$ope%ite $( t%an#pi%atii %e$i




7i$at; #pinaH in imite no%mae

i#tem ne%&o#H o%ientat tempo%o-#patia

Apa%at (%o-genita H oe %enae i'e%e

PARAETRII 5I-IOLO6ICI PREOPERATOR

E+amina%i pa%a$!ini$e 1*.7".271' anaie 0e a'o%ato%; %a0iog%afiea'0ominaa


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#e &a efe$t(a toaeta $a&it9tii '($ae; #e &a n0ep9%ta p%otea 0enta%90a$9 e#te p%eent9

#e &a int%o0($e o #on0a 7oe pent%( (%ma%i%ea 0i(%eei>

#e &o% monta 2 inii &enoa#e; #e &o% a0mini#t%a #o(tii pe%f(a'ie$a0(te.

P%egati%ea !o$a!a

#e #pa9 pieea 0e pe a'0omen; #i %egi(nea 0in (%; in#i#tan0(-#e a pi(%i #i om'ii$>

#e %a0e $( g%ia pioitatea>

#e 0einfe$teaa pieea $( anti#epti$ Fe+H a$oo; 'eta0ineG.Ing%i0i%i!e po#tope%ato%ii pana !a in#ta!a%ea (o!na&)!)i in pat

p%egati%ea $ame%ei F25-22CG; ae%i#it9>

p%egati%ea mate%iaeo% in &e0e%ea %eanima%ii po#tope%ato%ii>


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Ne&oia

f(n0amenta9

Diagno#ti$ 0e

n(%#ing

O'ie$ti&e Inte%&entii p%op%ii Inte%

0ee Ne&oia 0e a

%e#pi%a; 0e a

a&ea o '(n9

$i%$(atie.

Difi$(tate 0e a

%e#pi%a 0ato%it9

0(%e%ii #i

an+iet9tii

manife#tat9 p%in

0i#pnee;

:ipoten#i(ne

a%te%i9.

Pa$ient( #9

p%einte o

%e#pi%atie $(

f%e$&ent9 no%ma9;

#9 fie e$:ii'%at

$i%$(ato%.

A#i#tenta me0i$a9

monito%iea9 f(n$tiie

&itae #i e notea9 n foaia

0e tempe%at(%9.

A#i#tenta me0i$a9

(%m9%e#te 0i(%ea; #$a(n(;

efe$t(ea9 mi#$9%i a$ti&e #i

pa#i&e ae mem'%eo%.

A#i#tenta me0i$a9(mee#te ae%( 0in #aon;

a0mini#t%ea9 o+igen pe

ma#$9; n&at9 pa$ient( #9

fa$9 gimna#ti$9 %e#pi%ato%ie;

La i

me0i

a0mi

'%on

e; an

(%m

efe$t


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ee%9. Ne&oia 0e #e

mi#$a; 0e a a&ea

o '(n9 po#t(%9.

Defi$itate 0e a

#e mi#$a

0ato%it9 0(%e%ii;

an+iet9tii.

Pa$ient( #9 #e

poat9 mi#$a #ing(%

#i #9 n( p%einte

e#$a%e 0e 0e$('it.

A#i#tenta me0i$a9

in#taea9 pa$ient( n pat

%e#pe$tn0 poitiie

anatomi$e ae $o%p((i;

a#ig(%9 igiena teg(menteo%;

efe$t(ea9 e+e%$itii pa#i&e

#i a$ti&e; ma#ea9 %egi(nie

p%e0i#p(#e a e#$a%e.

A(t9 pa$ient( n

#ati#fa$e%ea $eo%ete ne&oif(n0amentae.

A0

a in

me0i

antia

#o(t

pe%f

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0o%mi; 0e a #e

o0i:ni.

Difi$(tate n a

0o%mi; a #e

o0i:ni 0ato%it9

Pa$ient( #9

'enefi$iee 0e

$onfo%t fii$ #i

A#i#tenta me0i$a9 mentine

$on0itiie ne$e#a%e

#omn((i; n&at9 pa$ient(

La i

me0i

a0mi


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a'0omina9;

g%et(%i;&9%#9t(%i.

Pa$ient( #9 fie

e$:ii'%atn(t%(tiona #i

&oemi$ n 0e$(%

0e 2-3 ie.

Pa$ient( #9-#i

mentin9 g%e(tatea

$o%po%a9 optim9.

ate%a; p%oteea9 ene%ia

$( m(#ama #i ae9; a(t9 pa$ient( n timp(

&9%#9t(%io%.

E+po%ea9 g(#t(%ie #i

o'i$ei(%ie aimenta%e.

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a#(p%a %egim((i aimenta%

n meneine%ea #9n9t9tii.

E+po%ea9 p%efe%intee

pa$ient((i a#(p%a

aimenteo% pe%mi#e #i

inte%i#e.

e%&e#te pa$ient( $(

me0i

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pe%f

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#9%(


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NURSIN6UL EVENTRAŢIILOR

i a noi n ţa%9 $a n o%i$e at o$; pa$ient( &ine a #pita pent%( ng%ii%i8i pent%( o'#e%&aţii $ini$e; a$e#t ($%( t%e'(in0 #9 fie f9$(t n #pita 8i; fiin0 n%eaţie 0i%e$t9 $( $ompe+itatea #(fe%inţei; att pa$ient(; $t 8i famiia ne$e#it9$on#(taţii n $eea $e p%i&e8te %egim( 0e &iaţ9; imita%ea efo%t(%io%; ng%ii%ea

pan#amenteo% et$.

n toate #pitaee; $a 8i n $eeate (nit9ţi me0i$ae; am'(ato%ii #a($a'inete; a#i#tent( me0i$a t%e'(ie #9 a#ig(%e toate #e%&i$iie me0i$ae 0e $a%e

pa$ient( a%e ne&oie #(' n0%(ma%ea me0i$((i $(%ant .

Pa%ti$ipa%ea a#i#tentei mei$a!e !a e+amen)! $!ini$A#i#tenta me0i$a9 pa%ti$ip9 a e+amen( $ini$ a 'ona&((i. Ea &a

%eaia 0e a n$ep(t (n $imat 0e nţeege%e nt%e me0i$ 8i 'ona&. Va p%eg9ti p#i:i$ 'ona&(; ini8tin0(-; e+pi$n0(-i $( #oi$it(0ine 8i fe%mitate n $e$on#t9 e+amen( 8i impo%tanţa (i . a(t9 #9 #e 0e'%a$e; $( m(t ta$t 8i fineţe;

pent%( a n( p%o&o$a mi8$9%i in(tie 8i 0(%e%oa#e. Ea a%e g%i9 $a n timp(e+amin9%ii geam(%ie #9 fie n$:i#e 8i #9 n( #e $i%$(e p%in $ame%9. Pent%( a ţine#eama 0e #imţ( p(0o%ii 'ona&((i; ea &a ioa pat( (n0e a%e o$ e+amen( $((n pa%a&an. A#i#tenta me0i$a9 &a a0($e n poiţia a0e$&at9 e+amin9%ii. Ea &a


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a$e#to% ng%ii%i $ompetente pe%#oaneo% a $9%o% #ta%e o ne$e#it9; ţinn0 $ont 0ene&oie afe$ti&e; #pi%it(ae 8i fii$e 8i n o'#e%&a%ea 8i $om(ni$a%ea $9t%e $eiaţimem'%i ai e$:ipei 0e ng%ii%e a $on0iţiio% $e e+e%$it9 (n efe$t impo%tant a#(p%a#9n9t9ţii pa$ient((i. Ro(%ie a#i#tentei me0i$ae $on#ta( n F1!GH

%o 0e ng%ii%e p%omo&a%ea igienei #pitai$e8ti o%gania%ea 8i ge#tiona%ea ng%ii%io% p%eg9ti%ea 8i pe%fe$ţiona%ea ee&eo% a#i#tente me0i$ae; a#i#tenteo%

me0i$ae 0e'(tante 8i $a0%eo% a(+iia%e e0($a%ea #anita%9 a pa$ienţio% 8i pe%#oaneo% #9n9toa#e; a&n0 $a #$op p%omo&a%ea #9n9t9ţii; p%e&eni%ea m'on9&i%io%; a(to%( &in0e$9%ii8i %e$(pe%a%e.

Ce!e mai impo%tante p%o$e)%i e n)%#ing

Ne&oia pa$ienţi!o% imo(i!iaţin o%i$e #it(aţie n $a%e mo'iitatea pa$ient((i e#te afe$tat9; n(%#a a%e

%o( 0e a-i ameio%a #ta%ea 0e 0epen0enţ9 a#tfe $%eat9; moti&n0 pa$ient( 8ia(tn0(- #9-8i n0epinea#$9 ne$e#it9ţie f(n0amentaeH aimentaţie; e+$%eţie;toaet9 et$. Pent%( #it(aţiie n $a%e imo'iia%ea &a fi 0e #$(%t9 0(%at9; #p%iin(


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La pa$ient( 'ona&; att 'oaa; $t 8i t%atament( pot 0ete%mina omo0ifi$a%e a #t9%ii 0e $on8tienţ9; ($%( $a%e &a p(tea 0($e a p%o0($e%ea 0ea$$i0ente; a#tfe $9 att pa$ient(; $t 8i famiia t%e'(ie info%maţi a#(p%a

po#i'iit9ţio% (no% efe$te #e$(n0a%e ae t%atamenteo% a0mini#t%ate; a#tfe n$ta$e8tia #9 poat9 e&ita %ea$ţii nea8teptate. n $a( 'ona&io% imo'iiaţi #e &o% (a toate m9#(%ie 0e #ig(%anţ9 pent%( p%e&eni%ea a$$i0enteo% n $(%#(t%an#po%t((i> 0e a#emenea %(0ee #a( apa%ţin9to%ii &o% fi n&9ţate an(mitete:ni$i 0e imo'iia%e; p%e$i9%i 8i te:ni$i 0e mo'iia%e $a 0e e+emp( 0(8( a

toaet9 F1*G.n an(mite #e%&i$ii 0e #9n9tate 0in E(%opa 8i Ame%i$a; 0a% 8i a noi 0e$ţi&a ani 0e ie; #-a( 0e&otat an(mite #t%($t(%i $a%e in$(0 e$:ipe 0e me0i$i8i n(%#e $a%e a#i#t9 pa$ient( 0(p9 e+te%na%ea 0in #pita; a 0omi$ii( a$e#t(ia;0(p9 (n p%og%am 'ine #ta'iit. A#tfe pan#amentee (no% p9gi ope%ato%ii #a(

p(ngie 0e $oo#tom9 #(nt #$:im'ate a 0omi$ii( pa$ient((i 0e $9t%e a$e#te#t%($t(%i.

P%e&eni%ea $omp!i$aţii!o%Ca( $e mai $a% e#te $e a (n(i pa$ient imo'iiat a pat; a$e#t ($%(

p(tn0 0($e a apa%iţia (no% p%o'eme #e%ioa#e; p%e$(m H1. E#$a%e 0e 0e$('it; p%o0(#e 0ato%it9 p%e#i(nii e+e%$itate 0e g%e(tatea

$o%p((i a#(p%a oneo% $(tanate afate n %apo%t 0i%e$t $( p%oeminenţee o#oa#eHfe#ee; %egi(nea om'o#a$%at9; %egi(nie #$ap(a%e>


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CONCLU-II

1. E&ent%aţia po#tope%ato%ie e#te (na 0int%e $ee mai g%a&e afe$ţi(ni ae pe%ete(ia'0omina; $a%a$te%iate p%int%-o mo%'i0itate %i0i$at9 8i o 0(%at9 ma%e 0e#pitaia%e.

2. Cei mai p%e0i#p(8i a apa%iţia e&ent%aţiei po#tope%ato%ii #(nt pa$ienţii 0e #e+ma#$(in.

3. Pa$ienţii $ei mai afe$taţi 0e e&ent%aţii po#tope%ato%ii a( &%#ta $(p%in#9 ninte%&a( *5-)5 0e ani 8i p%o&in 0in me0i( %(%a.


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;I;LIO6RA5IE

1. Titi%$9 L. U%genţe me0i$o-$:i%(%gi$ae; E0it(%a Be0i$a9; 6($(%e8ti; 25552. Titi%$9 L 8i $oa'. Te:ni$i 0e e&a(a%e 8i ng%ii%e a$o%0ate 0e a#i#tenţi

me0i$ai; &o.II. E0it(%a Viaţa Be0i$a9 Romnea#$9; 255*3. Boe# C. Te:ni$a ng%ii%ii 'ona&((i; E0it(%a Be0i$a9; 6($(%e#ti; 255*". Boe# C. Ca%tea a#i#tent((i me0i$a. Te:ni$a ng%ii%ii 'ona&((i. E0iţia a

VII-a; E0. Be0i$a9; 255*.!. Titi%$9 L. 6%e&ia% 0e e+po%a%i f(n$tionae 8i ng%ii%i #pe$iae a$o%0ate

'ona&((i. E0it(%a Viaţa Be0i$a9 Romnea#$9; 255,*. Titi%$9 L. 4:i0 0e n(%#ing - $( te:ni$i 0e e&a(a%e 8i ng%ii%ie


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EVENTRATII

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Transcript of EVENTRATII