术前准备及术后处理姚宏伟课件.ppt

1术前准备及术后处理 Perioperative Management 北京大学第三医院普通外科姚宏伟 Dept. of General Surgery, Peking University Third Hospital 2 Purpose 3 Definition: Management before, during & after a surgical operation essful surgery 2. Intra-Op management 1. Pre-Op preparation 3. Post-Op management 4 Key points ? Pre-Operative Preparation ? Post-Operative Management 5 1. Pre-Operative Preparation 6 Aims To achieve the best status for surgeons and patients 7 Principle Individualized preparation & management for different patients & operations Examples Nodular goiter Gastric Carcinoma Acute duodenal perforation with diffuse peritonitis 8术前准备内容:一般性准备 : (1)病人方面(2)医生方面 +体格检查+ 伴随疾病 ( /特殊)化验、检查 、电解质及酸碱平衡监测以及调整 (选择性) :( 1)有胃潴留、幽门梗阻者:胃肠减压管并洗胃(2)结直肠手术:肠道准备 (适应证手术清洁程度分级) 9 1. 营养不良,低白蛋白血症 2. 高血压 3. 非心外科手术合并心脏病者(心衰、心梗) 4. 呼吸道疾病 5. 肝功能异常(代偿期 VS 失代偿期) 6. 肾功能衰竭 7. 糖尿病术前准备内容:特殊性准备 10 Classification of operations 1. Selective operation 2. Restrictive operation 3. Emergency operation(1. 【医】择期手术)