外科学-总论英文课件：Perioperative Management.ppt

Thank you Let’s begin. Today we are discussing the topic is perioperative management. It is very important. If some of you become a surgeon. The main work of residency is perioperative management. * * * * * * * * * * * * * * * * * * * * * * Perioperative period Definition not well established Importance directly related to the outcome of surgery itself Composition preoperative preparation postoperative management 1. Elective surgery 2. Restrictive surgery 3. Emergent surgery Preoperative Preparation The principle Different preparation for different operation The classification of operations according to the characteristics of operations Preoperative Preparation The relationship between the classification of operations and preoperative preparation Elective surgery making full preparations for operation Restrictive surgery making full preparations for operation as sooner as possible Emergent surgery Operation is first To confirm the diagnosis To assess the risk of operation To assess the general condition and function of important organs To evaluate the patients endurance to the operation and risk of operation Preoperative Assessment Psychological preparation talk frankly and appropriately to patients and his family General Preparation Physiological preparation Adaptive exercise Transfusion Prevention of infection Gastro-intestinal tract preparation (pyloric obstruction) Maintenance of fluid, electrolyte and nutrition General Preparation Malnutrition and dysfunction of immune system Risk— Malnutrition dramatically decreases the patients endurance to the operation increases the morbidity and mortality Preparation — Preoperative nutritional support is more valuable Specific Preparation(1) Hypertension Risk— At high risk of perioperative cardiac failure , post