二十、眼部手术[精品].ppt

【术后护理】 患眼涂布或滴入抗生素眼膏或抗生素眼药水，3~4次/d。 颈部安装颈圈，防止自我损伤病眼。 术后10~14d拆线。 术后数日局部肿胀可逐渐减轻 【术后护理】 患眼涂布或滴入抗生素眼膏或抗生素眼药水，3~4次/d。 颈部安装颈圈，防止自我损伤病眼 术后10~14d拆线。 术后数日内局部肿胀可逐渐减轻 4.尽量不损伤结膜及瞬膜，用青霉素液冲洗创口，3~5min后去除夹钳，灭菌干棉球压迫局部止血。也可剪除增生物后立即烧烙止血，但要用湿灭菌纱布保护眼球，以免灼伤。 5.以青霉素40万IU肌注抗感染。术后也可用新霉素眼药水点眼2~3d。 （四） Excision of Eyelid Tumors Eyelid tumors are common in the dog. The tarsal gland adenoma is the most frequently diagnosed eyelid tumor in the dog. Less commonly found are adenocarcinomas,melanomas，and papillomas. The tarsal gland adenoma, as with most tumors of the canine eyelid,is clinically benign,and surgical excision is usually curative. Cryosurgery using 1iquid nitrogen at -20℃ can also be used to treat these tumors. As the conjunctiva is not involved, it is not removed. Incisions are outlined by dotted lines. The incisions are marked on the patient with a plastic surgery marking pen. The vertical sides of the triangles are 20 per cent longer than the vertical incisions adjacent to the tumor to allow for wound contraction. A square or rectangular incision is made around the tumor. The tumor is dissected off from the base toward the lid margin. The tumor is removed and placed in fixative,and is pinned to a piece of cardboard to allow the ophthalmic pathologist to examine the margins for evidence of tumor. Note：If tumor is present in any margin, excision has been incomplete. The previously marked triangle is elevated and excised. To prevent tension on the wound, the tissues surrounding the triangles and the flap are undermined. The flap is advanced to the margin with no tension on it. Simple marginal sutures of 6-0 silk are placed. Sutures are placed at the corners of the incision to assist in accurate placement of subsequent sutures. Remaining sutures in place 2 mm apart. If the conjunctiva is mobile it is sutured to the skin edge,filling the defect with a simple continuous suture. This helps prevent retraction of the advancement flap. 【术后护理】 全身应用抗生素 局部温敷，以减轻肿胀和疼痛 术后可能发生渗血