医学论文发表:手术配合常规消毒铺单
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① routine disinfection of a single shop, take the abdominal incision, the left around the navel, skin incision, abdominal white line, separating the rectus abdominis, the peritoneal incision. ② Equipment nurses prepare for the big forceps, right angle clamp, scissors cut retroperitoneal comprehensive, free ureter, urinary catheter, a line hanging wire, remote offUreter, instrument nurse to prepare the guide wire dipped in paraffin oil into the ureteral stent, then gloves, forceps, measured by theurine.③ 器械护士准备长电刀头于膀胱顶部正中切开腹膜,钝性分离腹膜与膀胱,分别钳夹左右侧膀胱上动脉,并切断,准备结扎。准备钳夹,吊线结扎,切断左右输精管。沿Denonvilier’s后膜分离至前列腺尖部。分离并钳夹切断膀胱左右侧韧带,递线缝扎止血。④ 于前列腺浅静脉丛深部粗丝线横行贯穿缝扎,并电刀切断前列腺耻骨韧带至尿道。手指触及尿道及内置导尿管。切断尿道及导尿管,钳夹并提起导尿管近端,行膀胱前列腺逆向切除。器械护士准备强氧化离子水冲洗创面。⑤分离乙状结肠系膜,截取乙状结肠约20cm,器械护士准备肠钳及Koeker钳切断乙状结肠,并准备小圆针l号线二层缝合法端端吻合乙状结肠,恢复连续性。游离乙状结肠自吻合口下方引至盆腔。器械护士准备l%呋喃西林冲洗肠腔。⑥ 保留系膜对侧正中1.5cm结肠带及两端外侧之5cm结肠带,其余结肠带予以剔除达弧形。于保留之正中结肠带处,戳孔,切除约0.5cm 肠壁全层。储尿囊中置多侧孔F26造瘘管一根。自尿道置F24三腔导尿管一根,器械护士准备3/0可吸收线自尿道断端外进里出。至尿道戳孔处里通外出,缝合4针,将导尿管引至储尿囊中;器械护士准备5ml盐水打入气囊内。牵引至膜部尿道,收紧吻合线,完成尿道储尿囊吻合。⑦分别于储尿囊断端残留结肠带处纵行切开至黏膜下层,于近尿道端黏膜戳孔,引入输尿管断端,递3/0可吸收线吻合储尿囊输尿管,按Leader—better法缝合肌肉,包埋输尿管,并减张缝合。⑧输尿管支架管及储尿囊造楼管倒戳孔引出体外。于储尿囊下面(背面)及上面(腹侧)倒置一多孔负压引流管,并戳孔引出体外,荷包缝合储尿囊两端。⑨ 探查有无活动性出血,器械护士准备清查器械、敷料数目。缝合腹膜,间断缝合前腹膜及储尿囊。缝合腹直肌前鞘、皮下、皮肤。
来源:医学论文发表网
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