N h i m m u c di ch th eo doi c a c t h o n g so c a n thiet de p h a t hi en va xir ly kip thdi c a c bi en c o x a y ra tao dieu k i e n c h o sir t h a n h c o n g ciia phdu thuat.
1. T h e o doi tim m a c h
- T h e o doi d i e n tarn d 6 de p h a t hi en m o t so bi en c h t i n g k h o n g d a c hieu nhu: n hi p tim c h a m d o p ha n x a va loan nhip. Ph a n tich d o a n ST de pha t hien n h u n g thoi d i e m thieu m a u c u c bo c o tim la n h u n g tien bo ldn tir khi co m o n i t o r va c o the c h o biet n h u n g t h o n g tin b a n g c a c h t h e o doi tu d o n g . N h u n g sir t h e o doi n a y c o the bi nhidu d o d a o die n, m a y m o c va t ha y doi true di en tim do sir ha n c h e di d o n g ciia c o h o a n h .
- T h e o doi h u y e t ap: s u t h a y doi h u y e t a p c o the nhi du va m a n h , n h a t la khi b o m C 0 2 va o 6 b u n g sir d o h u y e t ap tu d o n g la m o t yeu to an t o a n va ich lgi t r ong q u a trinh phdu thuat.
2. D o o x y m a c h m a u
D o do ba o h o a o x y t r o n g m a u d o n g m a c h ( S a 0 2) phai d u g c t h uc h i e n mo t c a c h he t h on g, khi c o s oc h o a c h a than nhiet nhidu se a nh h u d n g d e n su do n a y h o a c khi c o sir bat t h u d n g ve h u y e t sdc to.
3. D o n h i e t do
D o h a y c o sir ha t h a n n hi et t r o n g m o noi soi n e n c u n g c a n phai d o n hi e t do c h o b e n h n h a n c o the dat d a y do n hiet do d m u i h au , true t r a n g q u a he t h o n g m on i t or .
4. D o t ac d u n g c u a d a n c o
T hdi gian m d noi soi t h a y doi t h e o loai b e n h ly va c a n phai c o d a n c o tot t r o ng q u a trinh m o de d a m b a o t h o n g khi tot, p hd u t h u a n lgi n en c a n c o m o n i t o r th eo doi tac d u n g ciia d a n c o n o c o th6 c h o p h e p sir d u n g d a n c o an toan va biet d u g c d a n c o ton d g n g sau phdu thuat.
5. C a p n o g r a p h i e
N gu d i ta sir d u n g m a y n a y de do n o n g do C 0 2 t r ong he t h o n g ga y me. N o la 1 p h u o n g tien k h o n g the th ay the d u o c de diSu c h i n h c h e do t h d phu hop, t rong khi P a C 0 2 th ay ddi do b o m C 0 2 lam ta ng a p lire t r o ng 6 b u n g . A p lire r ieng pha n c u a C 0 2 t rong khi t h o ra (P|.T C 0 2 ) c u n g c o the s u y ra P a C 0 2. T r o ng thuc te P, ., C 0 2 k h o a n g 30 m m H g la mo t c o n so c o the: c h a p n h a n duoc .
Su c h e n h lech gi ua P a C 0 2 va P n C 0 2 da d u o c n g h i e n curu va x ac d inh khi m d noi soi. N h u n g t ha y doi chi so V a / Q do thay ddi a p lire t r ong o b u n g va tu the da lam tha y doi sir c h e n h lech c u a P a C 0 2 va P h;, C 0 2 , g an d a y B r a mp to n va W a t s o n d a chuTig m i n h s u k h a c n ha u phu t h u o c v a o ky t huat g3y me ( me toa n the’ h o a c te ngoai m a n g c u n g ) . Vdi n h u n g y e u to c o m a c h t rong m d c u n g c o the t ha y ddi gia tri c u a C 0 2 t hd ra c u n g n h u ha n c h e sir tai hap thu.
Tr u dc moi tha y doi vS h uy et d o ng , sir ta ng P, , C 0 2 la mo t da u hieu s d m c u a tac m a c h do khi.
6. C a c trirong h o p d a c biet
Dd i vdi t r u o n g h o p d u n g m o n i t o r c o dat c a t h e t e r ( c a t h e t e r Swan G a n z ) co the ly giai tinh t r an g h uye t d o n g k h o n g dn dinh, c o the’ ma t bu t r o n g t r u o n g ho p m d noi soi do di6u kien tran khi' m a n g b un g ( g i am t rd v i c u a m a u tTnh ma c h , g i a m luu lu on g tim va tang sue c an m a c h m a u he t h on g ).