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<!--bt end--> <div class=time>08-03-07 17:05:02　　　www.39.net　　　39</div> <!--time end--> <div class=key>关键è¯ï¼š<a href='/List.aspx?chid=18&Keyword=%e6%89%8b%e6%9c%af&FieldName=tagnamestr' target='_blank'>手术</a></div> <!--key end--> <div class=daodu></div> <!--ad end--> <div class=geyan><label><span>å¥åº·è°šè¯­</span></label></div> <!--geyan end--> <div class=concent fang=08-03-07 17:05:02> <br> <img border="0" src="../../Files/Shoushu/200812715104229677801.jpg" > 1-1ã€€åˆ‡å£ <img border="0" src="../../Files/Shoushu/200812715104234377802.jpg" > 1-2　横行切开ç¬?2肋床 <img border="0" src="../../Files/Shoushu/200812715104239077803.jpg" > 1-3　显露è‚åŽåŒ? <img border="0" src="../../Files/Shoushu/200812715104242177804.jpg" > 1-4　脓肿å上，å‘上分ç¦? <img border="0" src="../../Files/Shoushu/200812715104245377805.jpg" > 1-5　脓肿å下，沿肾上æžå‘å‰å‘下分ç¦? <img border="0" src="../../Files/Shoushu/200812715104250077806.jpg" > 1-6　试验穿刺 <img border="0" src="../../Files/Shoushu/200812715104253177807.jpg" > 1-7ã€€è„“è…”å¼•æµ å›?　åŽä¾§è…¹è†œå¤–膈下脓肿切开引æµæœ? <p>[适应è¯]</p><p>å³è‚上åŽé—´éš™è„“è‚¿ã€å³è‚下间隙脓肿以åŠè…¹è†œå¤–间隙脓肿å‡å¯é‡‡ç”¨å³åŽä¾§è…¹è†œå¤–切开引æµæœ¯ã€‚对于左è‚下åŽé—´éš™è„“肿，å¯é‡‡ç”¨å·¦åŽä¾§è…¹è†œå¤–脓肿切开引æµæœ¯ã€?/p><p>[麻醉]</p><p>局麻或全麻ã€?/p><p>[手术步骤]</p><p>1.体ä½ã€€å·¦ä¾§å§ä½ï¼Œå¥ä¾§åœ¨ä¸‹ï¼Œç¨å‘å‰æ–œ15°左å³ã€‚用沙袋垫起腰部，在ç¬?腰椎棘çªå¤„作一标志ã€?/p><p>2.切开　从胸<sub>12</sub>è…?sub>1</sub>椎棘çªå¹³é¢ä¹‹é—´å‘è…‹åŽçº¿ä½œä¸€æ–œè¡Œæˆ–弧行切å£[å›?-1]。切开皮肤ã€çš®ä¸‹ç»„织ã€æ‹‰å¼€èƒŒé˜”肌和下åŽé”¯è‚Œï¼ˆå¿…è¦æ—¶å¯ä»¥åˆ‡æ–­ï¼‰ï¼Œæ˜¾éœ²å¹¶åœ¨éª¨è†œä¸‹åˆ‡é™¤éƒ¨åˆ†ç¬¬12肋骨。在剥离骨膜时，注æ„肋骨上缘和内é¢ï¼Œä»¥å…æŸä¼¤èƒ¸è†œã€‚切除肋骨åŽï¼Œåœ¨å¹³ç¬¬1腰椎棘çªå¹³é¢åˆ‡å¼€ç¬?2肋骨内é¢éª¨è†œï¼Œç¼æ‰Žè‚‹é—´è¡€ç®¡ï¼Œæ˜¾éœ²æ·±å±‚的膈肌，将膈肌在脊柱的附ç€éƒ¨åˆ‡å¼€ï¼Œå³ä¸ºè‚¾å‘¨å›´è„‚肪囊的上区[å›?-2ï½?]。将肾周围脂肪作é’性分离，å³è§è‚¾åŒ…膜的åŽå£ã€?/p> <p>3.引æµã€€ç”¨æ‰‹æŒ‡æŽ¢æŸ¥è„“肿部ä½ï¼Œå¦‚为è‚上间隙，脓肿å上，å¯ç”¨æ‰‹æŒ‡å°†è…¹è†œä»Žè†ˆé¢å‰¥ä¸‹ï¼Œå‘上分离[å›?-4]；如为è‚下肾å‰ï¼Œå¯åœ¨è‚¾ä¸Šæžä¹‹å‰å‘下分离[å›?-5]。然åŽï¼Œå†è¯•éªŒç©¿åˆº[å›?-6]，如抽得脓液，å³å¯æ²¿ç©¿åˆºé’ˆåˆ‡å¼€ã€‚切开åŽç”¨æ­¢è¡€é’³åˆ†ç¦»è„“腔，å†ä»¥ç¤ºæŒ‡ä¼¸å…¥è„“腔分开纤维隔，以利充分引æµã€‚脓腔内放入2ï½?æ¡é¦™çƒŸå¼•æµï¼Œå¦‚脓腔较大，则å¯ç”¨è½¯èƒ¶ç®¡å¼•æµ[å›?-7]ã€?/p> <p>[术中注æ„事项]</p><p>术中如果å‘现胸膜破裂，有空气进入胸腔，å¯å…ˆç”¨çº±å¸ƒåŽ‹ä½ï¼Œç„¶åŽç¼åˆè£‚å£ã€‚如无呼å¸å›°éš¾æˆ–气胸ä¸ä¸¥é‡ï¼Œå¯ä¸äºˆå¤„ç†ï¼Œæœ¯åŽèƒ¸è…”内气体会被å¸æ”¶ï¼›å¦‚果呼å¸æœ‰å›°éš¾ï¼Œåˆ™åº”予处ç†ã€?/p><p>[术åŽå¤„ç†]</p><p>1.气胸的处ç†ã€€å¦‚胸膜æŸä¼¤ï¼Œæœ¯åŽæœ‰æ°”胸，气体较多，åˆæœ‰å‘¼å¸å›°éš¾è€…，应抽出气体ã€?/p><p>2.ä½™åŒå‰ä¾§è…¹è†œå¤–引æµæœ¯</p> </div> <!--concent end--> <div class=next> <p><a href="http://www.whrenai.com/ssdq/ptwk/70355.html">å‰ä¾§è…¹è†œå¤–膈下脓肿切开引æµæœ?/a></p> <p><a href="http://www.whrenai.com/ssdq/ptwk/70357.html">手掌皮肤缺æŸä¿®å¤æœ?/a></p> </div> <!--next end--> <div class=fanhui><a href="http://www.whrenai.com"><img src="http://images.whrenai.com/news_images/back.gif" width="180" 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