课件：外科病人营养补液.ppt

引 流 材 料—橡胶引流管 普通引流管 用于乳腺、甲状腺、胸腔、腹腔及盆腔手术后，放入时应标记深浅度，并作妥善固定，必要时可接负压引流装置 引 流 材 料—橡胶引流管 双套管引流管 为一个套管包含有较粗吸出管及较细滴入管的复合套管，多用于腹腔手术后。吸出管可使渗出物流出，并可接负压吸引装置，滴入管可进入气体减少周围组织对引流管的贴附、堵塞，并可滴入液体或抗生素液，以便冲洗脓腔或局部用药 引 流 材 料—橡胶引流管 T型管 多用于胆管或输尿管手术引流，根据实际情况，选择适当的T型管，将其两臂各剪短成长2cm，管口剪成斜面，或将两臂剪成半环形 引 流 材 料—橡胶引流管 蕈状导管 常用于膀肮、腹腔引流不易脱位和移位，不易被软组织和脓块堵塞。 水囊导尿管 由排尿管和水囊管组成，用于膀肮引流尿液。使用时无菌操作下经尿道插入膀胱，然后经水囊注入生理盐水5~20ml ，此时尿管即不会脱出。 引流的注意事项 a. 防止压迫损伤 b. 应放在距引流区最近、最直的通路上，腹腔手术后一般另作切口引出 c.脓肿引流时，引流物填塞松紧适度，换药间隔时间适当 d.橡胶引流管引流:根据病情需要决定拔管时间 引流的并发症及预防 引流物掉入腹腔 感染 引流管道的感染 瘘的形成（吻合口瘘和腹壁外瘘） 切口疝 引流伤口出血 Summary Nutrient substances consist of carbohydrate, fat, protein and electrolytes, trace elements, vitamins. The metabolism of nutrient substances may be changed by trauma and infection. Several criteria are used to evaluate nutritional status. Both enteral nutrition and parenteral nutrition have advantages and disadvantages. As long as the condition permitted, enteral nutrition should be used. Measures should be taken to avoid and tackle with the adverse effects and complications associated with nutrition supplement. The principles of fluid supplementary should be mastered to restore the body fluid balance of the patient. Dress changing is necessary for the well healing of wounds and incisions. The indications and interval of dressing changing should be understood and the proper material should be used. Systematic application of antibiotics is sometimes necessary. The procedure of dress changing should be familiar with. Drainage is a way to extract the content of organs, body or tissue cavities out of body or to another place. Drainage can be initiative or passive. The purpose, principles of drainage should be understood. Proper drainage should be adopted in different conditions. The correct way to avoid and cope with complications of drainage should be known. * * * * 外科病人的液体治疗 什么情况下需要液体治疗？ ——内环境失衡 内环境——细胞外液 体液60%：内40%外20%间液15%血浆5% 第三间隙：消化液、关节液1~2% 外科病