常用外科手術(shù)器械及其使用課件

第六章手術(shù)基本操作技術(shù)手術(shù)種類繁多，范圍、大小和復(fù)雜程度不同，但基本操作技術(shù)是相同的手術(shù)順利完成，一定意義上取決于基本操作的熟練程度及其理論的掌握理論指導(dǎo)下的不斷實踐，是唯一的正確途徑。穩(wěn)、準(zhǔn)、巧、輕、快是基本要求。整理課件第六章手術(shù)基本操作技術(shù)手術(shù)種類繁多，范圍、大小和復(fù)雜程度內(nèi)容提綱第一節(jié)常用外科器械及其使用第二節(jié)顯露第三節(jié)止血第四節(jié)縫合第五節(jié)拆線第六節(jié)打結(jié)第七節(jié)引流整理課件內(nèi)容提綱第一節(jié)常用外科器械及其使用整理課件（一）種類4、6、8號刀柄配19~24號刀片。3、5、7號刀柄配10、11、12、15號刀片專用手術(shù)刀，如眼科刀等。高頻電刀。第一節(jié)常用外科器械及其使用一、手術(shù)刀整理課件（一）種類第一節(jié)常用外科器械及其使用一、手術(shù)刀整理課件Sharpscalpelwithdisposable10號小圓刃11號角形尖刃12號號彎形尖刃15號小圓刃3號刀柄8號刀柄整理課件Sharpscalpelwithdisposable1Handles整理課件Handles整理課件HandlesBladesBlades#10,11,12,15fitthe#3handle,#22,#23fitthe#4handle,commonlyusedforlargeanimals.整理課件HandlesBladesBlades#10,11,DisposableScalpel整理課件DisposableScalpel整理課件Electrosurgicalscalpel整理課件Electrosurgicalscalpel整理課件（二）手術(shù)刀的使用裝刀片法取刀片法視頻026整理課件（二）手術(shù)刀的使用裝刀片法取刀片法視頻026整理課件裝刀片整理課件裝刀片整理課件ThreebasicgripsforholdingthescalpelPencilgripFingertipgripPalmgrip整理課件ThreebasicgripsforholdingScalpels整理課件Scalpels整理課件Thescalpelisheldwiththumb,middleandringfingerwhiletheindexfingerisplacedontheupperedgetohelpguidethescalpel.Longgentlecuttingstrokesarelesstraumatictotissuethanshortchoppingmotions.整理課件ThescalpelisheldwiththumbThescalpelshouldneverbeusedina"stabbing"motion整理課件Thescalpelshouldneverbeus二、

surgicalscissors組織剪剪線剪Commonlyusedsurgicalscissors整理課件二、surgicalscissors組織剪剪線剪CommClassificationbytypeofpointsAlltypesofscissorscanhavebluntorsharpblades(A:Sharp:Sharp,B:Blunt:Blunt).整理課件ClassificationbytypeofpoinAlltypescanhaveeitherstraightorcurvedblades整理課件AlltypescanhaveeitherstraMayoandMetzenbaum整理課件MayoandMetzenbaum整理課件Mayoscissors(B)areusedforcuttingheavyfasciaandsutures.

Metzenbaumscissors(A)aremoredelicatethanMayoscissors.

Metzenbaumscissorsareusedtocutdelicatetissuesandscissorshavealongerhandletobladeratio.整理課件Mayoscissors(B)areusedfor執(zhí)剪的方法剪線的方法視頻027

整理課件執(zhí)剪的方法剪線的方法視頻027整理課件三、

tissueforcepsA.DifferenttissueforcepsB.PencilgripforthumbforcepinuseC.Palmedpositionforthumbforcepbeingcarried整理課件三、tissueforcepsA.DifferenttThumbforcepsareheldlikeapencil

整理課件ThumbforcepsareheldlikeaThumbForcepsarenotheldlikeaknife

整理課件ThumbForcepsarenotheldlik鑷子在手術(shù)中的使用視頻028

整理課件鑷子在手術(shù)中的使用視頻028整理課件四、止血鉗五、持針鉗HemostaticforcepsNeedleholder整理課件四、止血鉗五、持針鉗HemostaticforcepsNe持針鉗在手術(shù)中的應(yīng)用整理課件持針鉗在手術(shù)中的應(yīng)用整理課件ClassificationbysizeandshapeandsizeoftipsHemostaticforcepsandhemostatsmaybecurvedorstraight.整理課件ClassificationbysizeandshaKellyHemostaticForcepsandMosquitoHemostatsBotharetransverselyserratedMosquitohemostats(A)aremoredelicatethanKellyhemostaticforceps(B).整理課件KellyHemostaticForcepsandMMosquitohemostats(A)haveasmaller,finertipComparisonofKellyandMosquitotips整理課件Mosquitohemostats(A)haveaCarmalt視頻029

整理課件Carmalt視頻029整理課件Mayo-HegarHeavy,withmildlytaperedjaws.Nocuttingblades.整理課件Mayo-HegarHeavy,withmildlyOlsen-HegarIncludesbothneedleholdingjawandscissorsblades.Thedisadvantagetohavingbladeswithintheneedleholderisthesuturematerialmaybeaccidentallycut.整理課件Olsen-HegarIncludesbothneed六、surgicalneedles1.needlepoint2.needlebody3.needlelength4.needlediameter5.needlechordlength6.needleridusABCB.conventionalcuttingC.reversecuttingA.Theshapeofthepointandbodyofnocutting整理課件六、surgicalneedles1.needlepoi七、retractorRibretractorAbdominal~Perineal~整理課件七、retractorRibretractorAbdomiSennBladesateachend.Bladescanbeblunt(delicate)orsharp(moretraumatic,usedforfascia).整理課件SennBladesateachend.BladeHohmanLeverstissueawayfromboneduringorthopedicprocedures.整理課件HohmanLeverstissueawayfromWeitlanerEndscanbebluntorsharp.Hasraketips.Ratchettoholdtissueapart.整理課件WeitlanerEndscanbebluntorGelpiHassinglepointtips.Ratchettoholdtissueapart.整理課件GelpiHassinglepointtips.Ra創(chuàng)鉤在手術(shù)中的應(yīng)用視頻030

整理課件創(chuàng)鉤在手術(shù)中的應(yīng)用視頻030整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件創(chuàng)鉤的使用整理課件八、towelforcep視頻031

整理課件八、towelforcep視頻031整理課件九、tissueforceps整理課件九、tissueforceps整理課件Forceps:consistoftwotinesheldtogetheratoneendwithaspringdevicethatholdsthetinesopen.Forcepscanbeeithertissueordressingforceps.Dressingforcepshavesmoothorsmoothlyserratedtips.Tissueforcepshaveteethtogriptissue.Manyforcepsbearthenameoftheoriginatorofthedesign,suchasAdsontissueforceps.整理課件Forceps:consistoftwotinesRatTooth:ATissueForcepsInterdigitatingteethholdtissuewithoutslipping.Usedtoholdskin/densetissue整理課件RatTooth:ATissueForcepsIntAdsonTissueForcepsSmallserratedteethonedgeoftips.TheAdsonstissueforcepshasdelicateserratedtipsdesignedforlight,carefulhandlingoftissue整理課件AdsonTissueForcepsSmallserrAllis:AnIntestinalTissueForcepsInterdigitatingshortteethtograspandholdbowelortissue.Slightlytraumatic,usetoholdintestine,fasciaandskin整理課件Allis:AnIntestinalTissueFoBabcock:AnIntestinalTissueForcepsMoredelicatethanAllis,lessdirectlytraumatic.Broad,flaredendswithsmoothtips.

Usedtoatraumaticallyholdviscera(bowelandbladder).

整理課件Babcock:AnIntestinalTissueSpongeForcepsSpongeforcepscanbestraightorcurved,canhavesmoothorserratedjaws.Usedtoatraumaticallyholdviscera(bowelandbladder).整理課件SpongeForcepsSpongeforcepsc十、腸鉗整理課件十、腸鉗整理課件DoyenIntestinalForcepsNon-crushingintestinaloccludingforcepswithlongitudinalserrations.Usedtotemporarilyoccludelumenofbowel整理課件DoyenIntestinalForcepsNon-crPayrPylorusClampsAcrushingintestinalinstrument.Usedtooccludetheendofboweltoberesected.整理課件PayrPylorusClampsAcrushingThethumbandringfingerareinsertedintotheringsofthescissorswhiletheindexandmiddlefingerareusedtoguidetheinstrument.Theinstrumentshouldremainatthetipsofthefingersformaximumcontrol.整理課件ThethumbandringfingerareThisisthewrongwaytoholdthescissors.Theringfingershouldbeinsertedint