围手术期处理英语摘要.ppt

Perioperative period Definition not well established Importance directly related to the outcome of surgery itself Composition preoperative preparation postoperative management Preoperative Preparation The principle Different preparation for different operation The classification of operations according to the characteristics of operations Preoperative Assessment Essential steps in preoperative assessment and preparation History taking Physical examination Collating pre-admission information about diagnosis Arranging any further diagnostic investigation Making special preparations for the particular operation Investigating any intercurrent or occult illness suggested by medical clerking Essential steps in preoperative assessment and preparation Discussing the operation with the patient and his family and obtaining signed consent Marking the operation site Making arrangements for the operation with the operating theatre staff Arranging and informing the anaesthetist Prescribing medication prophylactic antibiotics etc. Planning rehabilitation and convalescence General Preparation Specific Preparation Perioperative management The general principle of perioperative management Establish good diabetic control before operation Given insulin as a continuous intravenous infusion during the operative period Given an infusion of dextrose throughout the operative period to balance the insulin given and to make up for lack of dietary intake The general principle of perioperative management Add potassium to the dextrose infusion Monitor blood glucose and electrolytes frequently throughout the operative and early postoperative period Post-operative Management Management of postoperative complaint The main postoperative complications: Atelectasis Chest infection Aspiration pneumonitis Pneumonia Management of postoperative complications Wound healing and suture removing Classification of incision clean