无菌术石年制a.ppt

无菌术 无菌术的历史 无菌术的概述 手术器械、物品、敷料的灭菌法和消毒法 手术人员和患者手术区域的准备 手术进行中的无菌原则 手术室的管理 古代手术场景 感染非常常见，以至于认为是不可避免的甚至是愈合过程中的必然过程 也有些措施，如火烧，油烫，油膏 手术感染情况 损伤和伤口的治疗：在战场上或伤员家中进行 18世纪后叶及19世纪初，医院建造日益增多，医院内挤满了病人和伤员，“医院病”得以蔓延，其发病率和死亡率令人咋舌 American Civil War（1793 ）：因战伤发生“医院病”而行大腿截肢者，92％死亡 Crimean War（1853 ）：结果相仿 无菌术的发展历程 Heppocrates(460-377BC) 古希腊,化脓性伤口，非化脓性伤口，术前清洁  Pasteur(1822-1895):法，认识到微生物致病（1865） Proof that microbes are reproduced from parent organisms, and do not result from spontaneous generation, came from careful experiments in makeshift laboratories of Frances famed chemist and biologist, Louis Pasteur (1822-1895), at the Ecole Normale, Paris. Behind him are portraies of his father and mother, which he painted during his youth. Mme. Pasteur waits patiently for him to complete an observation. On the table is a replica of the experiment of Lizaro Spalanzani. Pasteur is holding one of his Swan-necked flasks. Joseph Lister (top left 19 year old)?watches in 1846, the first operation in England, under anaesthesia. The surgeon is Robert Liston. In 1867, Lister did the first operation in the world ,under aseptic technique. Joseph Lister (1827-1912) English the originator of antiseptic surgery (1867) 采用石炭酸消毒。一度受到冷落和抵制，但德国人除外。截肢术的死亡率自46％降至15％，奠定了无菌术的基本原则 Ernst von Bergmann (1836-1907) German蒸汽灭菌法--抗菌法演进至无菌法（1877） surgeon and author of a classic work on cranial surgery, (1888; The Surgical Treatment of Brain Disorders). In addition to his contributions to surgery, Bergmann is noted for introducing steam sterilization of instruments and dressings (1886), and in 1891 he introduced aseptic methods to the practice of surgery. Theodor Kocher (1841-1917) German接触污染是伤口感染主要原因 Prof. of Surgery at the University of Berne and pioneer in the development of surgery of the thyroid. He received the Nobel Price in 1909. William S. Halsted (1852-1922) USA戴橡胶手套（1889） prominent American surgeon who introduced the German system of residency training to United States. He also made fundamental contrib