Chisamaliro cha Azamba pa Nkhani za Matenda a Bipolar
Pendauluan
Matenda a bipolar ndi matenda a maganizo omwe amadziwika ndi kusintha kwakukulu kwa malingaliro, kuyambira nthawi ya kuvutika maganizo mpaka nthawi ya manic kapena hypomanic. Mwa akazi, matendawa amakhala ndi zovuta zina chifukwa nthawi zambiri amagwirizanitsidwa ndi magawo a moyo wobereka monga mimba, kubereka, kubereka mwana, komanso kuyamwitsa. Pankhani ya chisamaliro cha amayi oyembekezera, matenda a bipolar amafunika kuyang'aniridwa mokwanira komanso mogwirizana chifukwa amatha kukhudza chitetezo cha mayi, mwana wosabadwayo/khanda, komanso mtundu wa chisamaliro komanso mgwirizano wa mayi ndi mwana.
Chisamaliro cha azamba a matenda a bipolar sichimangoyang'ana mbali za mimba ndi kubereka kokha, komanso kuyezetsa thanzi la maganizo, kupewa kubwereranso ku matenda, kutsatira chithandizo, chithandizo cha mabanja, ndi kutumiza chithandizo kwa akatswiri osiyanasiyana komanso kugwirizana. Azamba amachita gawo lofunika kwambiri monga ogwira ntchito zachipatala omwe nthawi zambiri amalankhulana ndi amayi, zomwe zimawathandiza kuzindikira zizindikiro zoopsa zamaganizo msanga.
Chidule cha Matenda a Bipolar
Matenda a Bipolar ali ndi mitundu ingapo, makamaka Bipolar I (yodziwika ndi zochitika zosiyanasiyana za manic) ndi Bipolar II (zochitika za hypomania ndi kuvutika maganizo). Pa nthawi ya mimba, kusintha kwa mahomoni, kugona tulo, kupsinjika maganizo, ndi mbiri ya matenda a maganizo zingayambitse kubwereranso. Chiwopsezo chimawonjezeka nthawi yobereka, pamene mayi amakumana ndi vuto la kusowa tulo komanso kusintha kwa maganizo.
Zizindikiro za kusokonezeka maganizo/kusokonezeka maganizo zimaphatikizapo mphamvu zambiri, kusafuna kugona mokwanira, kulankhula mofulumira, kuganiza mofulumira, khalidwe losakhazikika, komanso kudzidalira kwambiri. Zizindikiro za kuvutika maganizo, kumbali ina, zimaphatikizapo chisoni cha nthawi yayitali, kutaya chidwi, kusokonezeka kwa tulo/chilakolako, kudzimva wolakwa, kuvutika kuganizira, ndi maganizo ofuna kudzipha. Pa milandu yoopsa, zizindikiro zamaganizo (zilombo kapena kuganiza molakwika) zimatha kuchitika, zomwe zingakhale zadzidzidzi zachipatala.
Zotsatira za Matenda a Bipolar mu Obstetrics
Matenda a bipolar angakhudze kutsatira chisamaliro cha amayi apakati, kudya zakudya zopatsa thanzi, kusuta fodya/kumwa mowa, komanso machitidwe oopsa panthawi yamavuto. Panthawi yamavuto, amayi nthawi zambiri amasiya kuchita zinthu zina, samadzisamalira, ndipo amakhala pachiwopsezo cha kusowa zakudya m'thupi kapena kuchepa kwa magazi chifukwa cha kudya zakudya zosayenera. Zotsatira zina zingaphatikizepo mavuto ena okhudzana ndi kubereka monga kusayang'anira bwino mimba, chiopsezo cha kulemera kochepa kwa mwana, komanso mavuto okhudzana ndi ubale wapakati pa nthawi yobereka.
Pa nthawi yobereka, matenda a bipolar amakhala pachiwopsezo chachikulu cha matenda amisala pambuyo pobereka, makamaka kwa amayi omwe ali ndi mbiri ya bipolar I. Matendawa amatha kukula mofulumira ndipo amafunika kutumiza dokotala nthawi yomweyo chifukwa cha chiopsezo chodzivulaza kapena kuvulaza mwana. Chifukwa chake, azamba ayenera kukhala tcheru kwambiri, makamaka m'masabata awiri oyamba pambuyo pobereka.
Mfundo Zokhudza Chisamaliro cha Azamba
Chisamaliro cha azamba kwa amayi omwe ali ndi vuto la bipolar chimatsatira mfundo izi: chitetezo cha amayi ndi makanda, kuzindikirika msanga, kupitiriza chisamaliro, kulankhulana ndi madokotala a matenda amisala, komanso kugwirizana ndi madokotala a matenda amisala ndi azamba. Azamba ayeneranso kusunga chinsinsi ndikupewa manyazi, chifukwa manyazi nthawi zambiri amakhala cholepheretsa amayi kufunafuna thandizo.
Kulankhulana mochiritsira kumachitika pogwiritsa ntchito njira yomvera chisoni, pogwiritsa ntchito mafunso otseguka, kuonetsetsa kuti mayi akumva kuti ali otetezeka, komanso kuti banja lizigwira ntchito limodzi ngati njira yothandizira. Azamba ayenera kuwunika momwe zinthu zilili m'maganizo mwawo, mikangano ya m'banja, nkhanza za m'banja, ndi chithandizo cha zachuma, chifukwa zinthuzi zimatha kukulitsa zizindikiro.
Kuyesa
Kuwunika kwa mimba kumaphatikizapo zinthu zakuthupi ndi zamaganizo. Pathupi, izi zikuphatikizapo zizindikiro zofunika, momwe mayi alili, momwe mwana wosabadwayo alili, zakudya, ndi tulo. Pamaganizo, izi zikuphatikizapo mbiri ya matenda a bipolar, kuchuluka kwa zochitika, zomwe zimayambitsa kubwereranso m'mbuyo, mbiri ya kugonekedwa m'chipatala cha matenda amisala, mbiri ya kudzivulaza, ndi kugwiritsa ntchito mankhwala (monga lithium, valproate, carbamazepine, lamotrigine, kapena antipsychotics). Mzamba ayenera kufunsa za kutsatira mankhwala ndi zotsatirapo zake zilizonse.
Kuyezetsa matenda a maganizo ndi nkhawa kungachitike pogwiritsa ntchito chida chosavuta monga Edinburgh Postnatal Depression Scale (EPDS). Ngakhale kuti EPDS imayang'ana kwambiri pa matenda a maganizo pambuyo pobereka, ndi yothandiza pozindikira zizindikiro za kuvutika maganizo zomwe zimafuna kuunikanso kwina. Kwa anthu okonda kusangalala, azamba amatha kuona zizindikiro monga kupanikizika kwa mawu, kusakhazikika, komanso kuchepa kwa kusowa tulo. Ngati zizindikiro zoopsa monga malingaliro ofuna kudzipha, zilombo, kapena khalidwe losalamulirika zapezeka, azamba amafunika kuyambitsa kutumiza kwadzidzidzi.
Kukonzekera ndi Kulowererapo
Njira zothandizira azamba zimayang'ana kwambiri kupewa kubwereranso kwa matenda, maphunziro, chithandizo, ndi kuyang'anira mosamala. Pa nthawi ya mimba, azamba ayenera kupanga dongosolo lokhala ndi pakati lomwe limaphatikizapo kupita pafupipafupi, kuyang'anira kugona, ndi maphunziro okhudza moyo wathanzi. Amayi amalimbikitsidwa kukhala ndi chizolowezi, kupewa kugona mochedwa, komanso kuthana ndi nkhawa pogwiritsa ntchito njira zopumulira, kuchita zinthu zopepuka, komanso kuthandiza anthu.
Kuphunzitsa odwala mankhwala kuyenera kuchitika mosamala. Mankhwala ena oletsa kusinthasintha maganizo amakhala ndi zoopsa kwa mwana wosabadwayo, monga valproate, yomwe imagwirizanitsidwa ndi zolakwika za neural tube. Azamba sasintha mankhwala, koma amathandiza kuti amayi amvetse kufunika kokambirana ndi dokotala wa matenda amisala komanso dokotala wa ana asanasiye kulandira chithandizo. Kusiya kumwa mankhwala mwadzidzidzi kungayambitse kubwereranso koopsa.
Azamba angalimbikitsenso mabanja kutenga nawo mbali poyang'anira zizindikiro zoyambirira za vuto, monga kusintha kwa tulo, kugwiritsa ntchito ndalama mopupuluma, kapena kuwonjezeka kwachilendo kwa zochita. Mabanja ayenera kudziwa kuti matenda a bipolar ndi matenda, osati vuto la khalidwe.
Chisamaliro cha m'mimba (Kubereka)
Pa nthawi yobereka, azamba ayenera kuonetsetsa kuti pali malo otetezeka komanso osavutikira omwe amathandiza mayi kukhala bwino. Amayi omwe ali ndi matenda a bipolar amatha kukhala omasuka kwambiri ndi nkhawa ndi ululu, choncho njira zothanirana ndi ululu komanso chithandizo chamaganizo ndizofunikira kwambiri. Munthu wobereka naye angasankhidwe pakati pa anthu omwe ali pafupi ndi mayi omwe angathe kutsimikizira ndikumvetsetsa vuto la mayiyo.
Ngati mayi akuwonetsa kusokonezeka kwakukulu, khalidwe losalamulirika, kapena zizindikiro zamaganizo, kubereka kuyenera kuyendetsedwa mogwirizana ndi katswiri ndi gulu la amisala. Nthawi zina, chitetezo ndichofunika kwambiri, kotero chithandizo china chamankhwala chingafunike.
Chisamaliro cha Pambuyo pa Kubereka ndi Kuyamwitsa
Nthawi yobereka mwana ndi nthawi yofunika kwambiri. Azamba ayenera kupita kukaonana ndi dokotala pafupipafupi akabereka, makamaka m'masabata oyamba ndi achiwiri. Kuyang'anira kuyenera kuphatikizapo thanzi la thupi, kupambana kwa kuyamwitsa, njira zogona, komanso thanzi la maganizo. Kusagona mokwanira ndi chifukwa chachikulu chomwe chimayambitsa kubwereranso kwa matenda amisala, kotero azamba angathandize kupanga njira zogona, monga kugawana ntchito zosamalira ndi banja kapena kuyamwa mkaka wa m'mawere kuti mayi apumule.
Ponena za kuyamwitsa, azamba ayenera kuphunzitsa amayi kuti mankhwala ena amisala amatha kulowa mu mkaka wa m'mawere. Chisankho choyamwitsa chiyenera kupangidwa pamodzi ndi mayi ndi dokotala, poganizira ubwino woyamwitsa komanso zoopsa zomwe zingachitike chifukwa cha kugwiritsa ntchito mankhwala osokoneza bongo. Ngati kuyamwitsa sikungatheke, azamba ayenerabe kuthandiza mayiyo, kupewa kudzimva kuti ndi wolakwa, ndikumuthandiza kusankha njira zina zotetezeka zodyetsera ana.
Azamba ayeneranso kuwunika ubale wa mayi ndi mwana. Panthawi ya kuvutika maganizo, amayi angamve ngati sangathe kusamalira ana awo. Njira zina zothandizira zingaphatikizepo chithandizo chothandiza, uphungu woyambira, komanso kutumiza kwa mlangizi wa kuyamwitsa kapena katswiri wa zamaganizo ngati pakufunika.
Zadzidzidzi za Matenda amisala ndi Mauthenga Othandizira
Azamba ayenera kuzindikira zochitika zadzidzidzi, monga kuganiza zodzipha, kuopseza kuvulaza mwana, kusagona konse kwa masiku angapo, kuona zinthu molakwika, kuganiza molakwika, kapena khalidwe lankhanza. Pazochitikazi, njira zazikulu ndikuonetsetsa kuti mayi ndi mwana ali otetezeka, osasiya mayi yekha, kutenga nawo mbali banja, ndikutumiza mayiyo kuchipatala chokhala ndi chithandizo cha matenda amisala nthawi yomweyo. Zikalata zomveka bwino ndizofunikira kuti chisamaliro chipitirire.
Mapeto
Chisamaliro cha azamba cha matenda a bipolar chimafuna njira yonse yophatikiza zinthu zamoyo, zamaganizo, komanso zachikhalidwe. Azamba amachita gawo lofunika kwambiri pofufuza msanga, kuphunzitsa, kuyang'anira, kuthandizira mabanja, komanso kutumiza ana awo nthawi yake. Ndi chisamaliro chophatikizana komanso chopanda manyazi, amayi omwe ali ndi matenda a bipolar amatha kukhala ndi pakati, kubereka, komanso nthawi yobereka bwino komanso kukhala ndi ubale wabwino ndi ana awo. Kugwirizana pakati pa akatswiri ndikofunikira kwambiri pochepetsa chiopsezo chobwereranso ku matendawa komanso kukonza moyo wa amayi ndi mabanja awo.
