手术室护理工作流程

手术室护理工作流程 目 录 手术室护理常规操作流程图 外科洗手流程图„„„„„„„„„„„„„„„„„„2 洗手护士工作流程图„„„„„„„„„„„„„„„„3 巡回护士工作流程图„„„„„„„„„„„„„„„„5 手术标本去向流程图„„„„„„„„„„„„„„„„7 手术室接病人流程图„„„„„„„„„„„„„„„„8 手术室送病人流程图„„„„„„„„„„„„„„„„9 一般器械清洗流程图„„„„„„„„„„„„„„„„10 感染器械清洗流程图„„„„„„„„„„„„„„„„11 手术室输血流程图„„„„„„„„„„„„„„„„„12 手术风险评估流程图„„„„„„„„„„„„„„„„13 手术安全核查工作流程„„„„„„„„„„„„„„„14 手术部位识别标示流程图„„„„„„„„„„„„„„15 腹腔镜胆囊切除手术配合常规流程图„„„„„„„„„16 腹股沟斜疝修补手术配合常规流程图„„„„„„„„„17 阑尾切除术手术配合常规流程图„„„„„„„„„„„18 肾切除术手术配合常规流程图„„„„„„„„„„„„19 输尿管切开取石术手术配合常规流程图„„„„„„„„20 前列腺电切术手术配合常规流程图„„„„„„„„„„21 全子宫切除术手术配合常规流程图„„„„„„„„„„22 卵巢囊肿剔除术手术配合常规流程图„„„„„„„„„23 腹腔镜下输卵管切除术手术配合常规流程图„„„„„„24 股骨下端骨折切开复位术手术配合常规流程图„„„„„25 人工全髋关节置换术手术配合常规流程图„„„„„„„26 内固定取出术手术配合常规流程图„„„„„„„„„„27 开颅手术手术配合常规流程图„„„„„„„„„„„„28 脑室—腹腔分流术手术配合常规流程图„„„„„„„„29 室间隔缺损修补术手术配合常规流程图„„„„„„„„30 二尖瓣瓣膜置换术手术配合常规流程图„„„„„„„„31 鼻中隔偏曲矫正手术配合常规流程图„„„„„„„„„32 支撑喉镜下声带息肉摘除术手术配合常规流程图„„„„33 直肠癌根治术手术配合常规流程图„„„„„„„„„„34 混合痔切除术手术配合常规流程图„„„„„„„„„„35 肛瘘切除术手术配合常规流程图„„„„„„„„„„„36 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 2 1、外科洗手流程图 更换洗手衣，修剪指甲，清除指甲下的污垢 取适量清洁剂按七部洗手法洗手，清洁双手、前臂和上臂1/3 用清洁小毛巾擦干(自手指往上擦至肘部) 进入手术间后取适量消毒液抹擦双手 指尖、指腹、指缝、指侧、手掌、手背、手腕、前臂、 上臂1/3(肘关节上约10cm) 反复交替分段(手、前臂、上臂)抹擦, 时间共约3分钟 必要时重复第3步 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 3 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 2、洗手护士工作流程图 术前一日 手术前 备 齐 次 日 开包准备台上了解手术步骤 核对病人 建立静脉通道 手 术 物 品 物品 一次性物品 器械敷料 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 4 手术后 手术前 协助包扎整理污敷保存病理清洗器械清点台上主动配合核对手术整理台上整理台上伤口 料 标本 打包 用物 手术监控物品物品 部位 无菌操作 皮手关关肤术闭闭 缝开体体合始腔腔 完前 前 后 毕 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 5 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 3、巡回护士工作流程图 术前一日 手术前 备齐次日手术物品 术前访视病人 与病房再次核 检查层检查设配合麻放置体护士交对手术流面板 备仪器 醉医生 位 接病人 部位 一次性物品 检查仪器设备 了解病情 心理护理 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 6 手术中 手术后 交 关手协助协助观察术接整理术后四个时间 术间填写各添加台医生记保存点清点台中动态病室内 访视 层流包扎账 类格 上物品 标本 上的物品 发展 人 系统 伤口 静监补指手关关缝观病控术脉伤充导 术闭闭皮察人口无病中穿室保开体体肤病情 用物愈菌洁刺内 始腔腔前 情 药 品 合 操物工部前 前 后 位 作 品 作 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 7 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 4、手术标本去向流程图 术中标本 术中冰冻 术后病检 洗手护士 〔巡回护巡回护士值班护士 病理科和病理科和 士〕保留 与手术室和手术室 手术室工巡回护士手术室工 福尔马林工人查对工人查对 人查对签密封保存 人查对签固定 签名 签名 名 名送检 密封登记 签名 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 8 5、手术室接病人流程图 接病人 术日到科室接病人查对 术日到科室接病人查对 术日到科室接病人查对 固保科室、床号、约 定证姓名、性别、束麻醉实施前三三方共同执行 对病年龄、诊断、病方共同执行安安全核查工作 接人手术名称、手人 全核查工作 明确标示部位 车安术部位、腕带 身 全 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 9 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 6、手术室送病人流程图 送病人 离开手术室前三方通知工人送病人 护送病人回病房 共同执行安全核查 工作 保证 病人固定对交接 交接各种管交接皮 接车身 液体 道 肤情况 安全 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 10 7、一般器械清洗流程图 流动水刷洗 多酶浸泡2—5分钟 流动水刷洗 擦干 按伤情合理安排 必要时除锈并清洁 按伤情合理安排 润滑剂浸泡30秒 检查器械功能及完整性 按伤情合理安排 打包挂牌 按伤情合理安排 送消 按伤情合理安排 按伤情合理安排 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 11 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 8、感染器械清洗流程图 一般感染器械 特殊感染器械 含氯消毒剂浸泡30分钟 含氯消毒剂浸泡30分 初洗 包装 高压灭菌 流动水刷洗 擦干 必要时除锈并清洁 检查器械完整性及功能 打包挂牌 送消 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 12 9、手术室输血流程图 输 血 术前了在血库查巡回护士血袋保留解血型 对 与麻醉医24小时无 生共同查特殊后处 对 理 科室姓 血型RH 输血单 采血日 血液有 血袋是 交叉配名性别因子和与血袋期和失无血块否破损 血年龄住血量 上的编效日期 或溶血 有无凝院号 码一致 集 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 13 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 10、手术风险评估流程图 术前由手术医生、麻醉医生、巡回护士按手术风险评估对 病人进行风险评估 手术持续 麻醉分级 手术类别 手术切口清洁时间 程度 评估后三方各自签名 手术医生根据风险评估内容确定最终手术风险评分 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 14 11、手术安全核查工作流程 麻醉开始前由手术医生、麻醉医生、巡回护士按麻醉实施前的 手术安全核查标准对病人进行安全核查 手术开始前由手术医生、麻醉医生、巡回护士按手术开始前的 手术安全核查标准对病人进行安全核查 术后患者离开手术室前，再次由手术医生、麻醉医生、巡回护 士按手术安全核查标准对病人进行安全核查 填写好手术安全核查表后，三方确认无误后签名 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 15 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 12、手术部位识别标示流程图 经治医生术前为手术患者切口位置进行标示 经治医生与患者或家属共同确认及核对切口标示 手术室工作人员接患者时查看手术患者切口位置标示 麻醉医生为患者麻醉前查看手术患者切口位置标示 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 16 13、腹腔镜胆囊切除手术配合常规流程图 仰卧位，常规消毒皮肤，铺巾 准备腹腔镜物品，连接腹腔镜系统 切开第一切口，气腹针插入，形成气腹，用11mm穿刺鞘穿刺， 置镜探查。 切开第2、3切口，依次穿刺。 取头高脚低位、向左倾斜30?，暴露胆囊。 暴露胆囊三角，钛夹(生物夹)钳夹胆囊动脉及胆囊管，离断胆 囊管及胆囊动脉。 切除胆囊，电钩止血。 胆囊抓钳夹胆囊颈部，取出胆囊。 检查手术野，清点物品数目，拔除穿刺鞘，取回内镜及器械。缝合 切口，腔镜敷贴覆盖。 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 17 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 14、腹股沟斜疝修补手术配合常规流程图 常规消毒皮肤,铺巾，切开皮肤、皮下组织，电刀止血 甲状腺拉钩牵开显露腹外斜肌腱膜及外环 分离皮下脂肪组织及筋膜 在外环的外上方切开腹外斜肌腱膜，潜行分离，剪开腱膜，显露并分离髂腹股沟神经及髂腹下神经 显露精索及疝囊。用弯血管钳提起疝囊，切开疝囊，勿伤及内容物。手指裹以纱布，将疝囊周围组织分开 高位结扎疝囊，作内荷包缝合，收紧荷包，剪去多余疝囊 修补内环，4号线缝合膜横筋膜，修补腹股沟管 小圆针4号线缝合腹外斜肌腱膜，清点用物，常规逐层缝合，敷贴覆盖伤口 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 18 15、阑尾切除术手术配合常规流程图 常规消毒皮肤，铺巾，取右下腹麦氏切口，逐层进腹，保护皮肤切口 用长平镊、卵圆钳找出阑尾，用皮肤钳提起阑尾， 依次切开阑尾系膜，4号线结扎 用小圆针4号线在阑尾根部作荷包缝合，阑尾根部用4号线结扎 手术刀涂以碘酊切断阑尾，碘酊、酒精、盐水棉球依次消毒阑尾残端 包埋阑尾残端，扎紧荷包线，作褥式缝合 检查腹腔有无出血，清点物品，关腹 更换干净的器械，逐层缝合 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 19 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 16、肾切除术手术配合常规流程图 常规消毒皮肤，铺无菌单。取腰部切口，探查肾脏 用盐水纱布推开腹膜，打开肾周筋膜，用手分离肾周围脂肪，递拉钩显露肾脏 钝性剥离肾周围脂肪及粘连处，出血点扁桃腺钳夹住4号线结扎，直至显露。找 到输尿管，用阑尾钳夹住输尿管，带肾蒂处理完后再切断 将肾脏及上段输尿管全部分离清楚，用3把肾蒂钳夹住肾血管，在肾蒂钳处切断，结扎并缝扎残端。取下肾蒂钳 纱垫保护好切下的肾脏，分离输尿管，用2把血管钳夹住，周围以湿纱垫保护，切断 将离体肾脏放入弯盘内，结扎输尿管残端，缝合 清点物品，冲洗伤口。放置引流管，常规逐层缝合，敷贴覆盖伤口 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 20 17、输尿管切开取石术手术配合常规流程图 常规消毒皮肤，铺无菌单。取腰部切口，逐层进入，显露输尿管 明确结石位置，递两把阑尾钳固定结石 切开输尿管，取石钳取出结石 导尿管冲洗，输尿管导管探查输尿管有无结石，上双J管 5—0可吸收线缝合输尿管 必要时在输尿管切口旁放引流管 清点用物后，逐层缝合切口，无菌辅料覆盖 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 21 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 18、前列腺电切术手术配合常规流程图 取截石位，常规消毒会阴部，铺巾 连接电视成像系统，冷光源，等离子电切机，3L袋 检查电切镜和配件的性能，连接导光纤维，调节亮度、电凝电切功率 润滑电切镜镜鞘后，经尿道置入电切镜，进行电切工作 电切完毕按关闭各种仪器设备 经尿道置入三腔气囊导尿管，接3L袋持续膀胱冲洗 撤除敷料及用物，恢复患者平卧位，收集标本送检 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 22 19、全子宫切除术手术配合常规流程图 平卧位，常规消毒腹部，铺巾 切开皮肤后，电刀止血逐层进腹，润手后，探查盆腔 依次钳夹离断两侧圆韧带、阔韧带、主韧带、宫骶韧带，结扎残端 保护子宫直肠陷凹，于阴道穹隆处切除全子宫 一块酒精纱布放入阴道残端内，碘酒、酒精、生理盐水依次消毒残端，用可吸收 缝线封闭残端 止血后，冲洗腹腔，清点器械敷料后，常规关闭腹腔 取出阴道纱布，收集标本送检 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 23 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 20、卵巢囊肿剔除术手术配合常规流程图 平卧位，常规消毒腹部，铺巾 切开皮肤后，电刀止血逐层进腹，润手后，探查盆腔 拉出囊肿，钝性分离囊肿壁，取出囊肿，3/0可吸收线缝合残端 止血后，检查对侧卵巢及子宫 冲洗腹腔，清点器械辅料后，常规关闭腹腔，收集标本送检 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 24 21、腹腔镜输卵管切除术手术配合常规流程图 平卧位，常规消毒腹部，铺巾，准备腹腔镜物品，连接腹腔镜系统 切开第一切口，形成气腹。取头低脚高位，用11mm穿刺鞘穿刺，置镜探查盆腔 依次切开第2、3切口，并穿刺。于患侧输卵管峡部处切除患侧输卵管，电凝止血 止血后，检查患侧卵巢、对侧附件及子宫 冲洗腹腔，清点器械辅料后，常规关闭腹腔，收集标本送检 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 25 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 22、股骨下端骨折切开复位术手术配合流程图 常规消毒皮肤，铺巾，逐层切开皮肤及皮下组织，切开髂胫束逐层游离股外侧肌分离至股骨 切开骨膜，拉钩牵开显露外侧骨折端，复位，骨折内固定 生理盐水冲洗，清点器械、敷料数目 1-0可吸收线缝合至皮下组织 三角针缝合皮肤，对合皮肤后敷料覆盖 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 26 23、人工全髋关节置换术手术配合常规流程图 取侧卧位，常规消毒皮肤，铺巾，逐层切开皮肤及皮下组织 分离臀大肌、臀中肌、臀外侧肌、切开关节囊，牵开暴露髋关节 取出病变股骨头，暴露髋臼，进行髋臼置换、股骨假体柄置换后复位检查，同时 检查关节紧张度和活动范围 放置引流管并固定，清点物品 1-0可吸收线缝合关节囊、肌层、皮下组织，三角针缝合皮肤后覆盖切口并包扎 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 27 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 24、内固定取出术手术配合常规流程图 据手术部位而定 消毒皮肤、铺巾 切开皮肤，逐层进入，显露内固定处 用厂家专用器械取出钢板、螺钉等固定用物 冲洗切口，清点物品后缝合，无菌敷料覆盖 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 28 25、开颅手术手术配合常规流程图 平卧位或侧卧，固定头部，常规消毒铺巾 切口周围皮肤注入生理盐水，切开，双极电凝、头皮夹止血 切开帽状腱膜，将头皮瓣掀起，盐水纱垫保护 用骨膜剥离器剥离骨膜，头皮牵开器牵开，电钻钻孔，骨腊止血，在两孔间用线锯或开颅锯锯断，去骨瓣减压，用咬骨钳修颅骨边缘，剪开脑膜，明胶海绵压迫止血，尽可能将肿瘤或血肿全部清除 检查伤口，取出棉片，放置引流管后逐层缝合，包扎伤口 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 29 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 26、脑室-腹腔分流术手术配合常规流程图 仰卧位，头偏向一侧，常规消毒铺巾 切开头皮、皮下、帽状腱膜，双极电凝止血，骨膜剥离器剥离骨膜 电钻钻孔，骨腊止血，脑室穿刺，置入导管 剑突下正中切口，电刀逐层切开，直达腹膜，递金属通条做隧道，7号丝线将导管绑扎金属通条头端，置入脑室腹腔分流管 清点用物关腹，覆盖切口，缝合头部切口并覆盖 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 30 27、室间隔缺损修补术手术配合常规流程图 平卧位，常规消毒铺巾，术野贴手术贴膜 切皮后用电刀止血，电动胸骨锯开胸后骨腊止血，胸骨开胸器，暴露手术野，切开、悬吊心包 建立体外循环，阻断主动脉，切开右心房房壁，心内探查，暴露心室修补缺损:用涤纶片或心包补片 缝合右心房切口:4-0 或5-0 滑线，带垫片连续缝合，拔除上、下腔静脉和主动脉插管，停止体外循环 安放胸腔引流管、缝合心包，胸骨穿钢丝、关胸，可吸收线缝合肌肉、皮肤，覆盖敷料 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 31 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 28、二尖瓣瓣膜置换术手术配合常规流程图 仰卧位，常规消毒铺巾，术野贴手术贴膜 切皮、电动胸骨锯开胸，开胸器暴露手术野，切开、悬吊心包 建立体外循环，阻断主动脉，切开房间隔探查二尖瓣 切除病变二尖瓣，用测瓣器测量后放置人工二尖瓣瓣膜并缝合 探查人工二尖瓣开闭情况，缝合房间隔及右心房 拔除上、下腔静脉和主动脉插管，停止体外循环 安放胸腔引流管、缝合心包，关胸，可吸收线缝合肌肉、皮肤 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 32 29、鼻中隔偏曲矫正手术配合常规流程图 表麻麻醉:用肾上腺素、丁卡因棉片填塞鼻腔 常规消毒皮肤，铺无菌单。取出表面麻醉棉片 在鼻镜下用刀在鼻中隔前段—“L”型切口,切开软骨膜,用粘膜剥离子分离骨膜,显 露出白色软骨及弯曲部分 在原切口稍后切开鼻中隔软骨，分离对侧软骨膜。用鼻粘膜撑开器分别插入鼻中隔两侧粘膜下 用鼻中隔回旋刀切除鼻中隔软骨， 鼻中隔咬钳咬除筛骨垂直板及梨骨的偏曲部分 检查鼻腔内有无出血，清除骨片取出鼻粘膜撑开器 双侧鼻腔内填塞凡士林油纱条，压迫止血使粘膜复原 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 33 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 30、支撑喉镜下声带息肉摘除术手术配合常规流程图 颈过伸平卧位，肩下垫海绵垫，头下垫海绵圈 常规消毒皮肤，铺无菌单 病人张口，用纱布保护上列牙齿或上唇。术者左手持直接喉镜，右手拇指和中指推开上唇。将喉镜沿舌背正中或左侧送入喉咽 暴露喉腔，看到声门后，根据息肉或肿物的大小，形态，部位选用不同的喉钳，将息肉或肿物摘除 如有出血，则局部用肾上腺素棉片按压止血 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 34 31、直肠癌根治术手术配合常规流程图 膀胱截石位,臀部垫高10cm，常规消毒腹部切口，铺巾，贴膜护皮 取下腹部左旁正中切口(自耻骨联合至脐上) 剪开乙状结肠外侧腹膜及腹膜反褶处，分离乙状结肠系膜 分离直肠后壁及直肠旁的疏松结缔组织，分离直肠前壁 切断直肠两侧侧韧带，结扎直肠中动、静脉，断肠系膜下血管，切断乙状结肠，冲洗盆腔，缝闭盆底及盆腹膜，必要时盆腔内留置引流管 清点用物，逐层缝合腹壁切口，覆盖伤口 会阴部切口:消毒肛周皮肤，温盐水冲洗肠管 放置骶前引流管并固定(必要时放置肛管)，覆盖敷料 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 35 贵 阳 中 医 学 院 第 一 附 属 医 院 No.1 hospital attached to Traditional Chinese Medical College of Guiyang 32、混合痔切除术手术配合常规流程图 截石位，常规消毒皮肤，铺无菌单 局部注射麻药加强麻醉 皮肤钳钳夹暴露痔核，切除痔核 缝扎、结扎止血完毕后，塞入凡士林，覆盖伤口 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly 36 33、肛瘘切除术手术配合常规流程图 截石位，常规消毒皮肤，铺无菌单 探查瘘管方向及内口、递探针从外口插入内口穿出 沿瘘管内、外之间的皮肤及粘膜切开，直至瘘管壁全部切除， 递有齿镊、23号刀片切开，组织剪、蚊式钳剥离瘘管壁 圆针4号线全程缝合，三角针1号线缝合皮肤，凡士林纱布塞入，覆盖切口 road, are the structural road traffic within the city. In addition, suitable for high speed, and high-speed, S206, S307, also serve inner-city traffic. Outbound traffic: existing highways (suitable for high-speed, and high speed), darts (S206, S307) and Yi wei road, and so on. After years of constant development, road conditions have been greatly