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1、精品文档交流从阑尾炎到最后部分名词解释1.麦氏点：阑尾体表投影在右髂前上棘与脐连线处的中外1/3 交界处称为麦氏点，是阑尾炎手术的标记点。2.肛瘘：肛管或直肠下端与肛门周围皮肤之间形成的慢性感染性管道。3.肛裂：齿状线以下肛管皮肤层裂伤后形成的经久不愈的小溃疡，是一种常见的肛管疾病，多见于青中年人。4.痔：是肛垫病理性肥大和移位，但传统认为是直肠下端黏膜或肛管皮肤下的曲张静脉团。5.Murphy征：检查者将左手平放于病人的右肋部，拇指置于右腹直肌外缘与肋弓交界处，嘱病人深吸气，使肝脏下移，若病人因触及肿大的胆囊引起疼痛而突然屏气，称为Murphy征阳性。6.AOSC：在胆道梗阻的基础上继发的急
2、性化脓性细菌感染。7.牵涉痛：又称放射痛，指在急腹症发生内脏痛的同时，体表的某一部位也出现疼痛的感觉。8.原发性下肢静脉曲张：指单纯涉及隐静脉或浅静脉伸长迂曲成曲张状态。9.血栓闭塞性脉管炎：是一种累及血管的炎症性、节段性和周期性发作的慢性闭塞性疾病。10.颅内压增高：许多颅脑疾病引起的使颅腔内容物体积增加或颅腔容积减少超过颅腔可代偿的容量，导致炉腔内压持续高于200mmH2O，并出现 头痛、呕吐、视神经乳头水肿三大病症。11.脑疝：当颅腔内某一分腔内有占位性病变时，该分腔内的压力高于临近分腔，脑组织由高压区向低压区移动，部分脑组织被挤入颅腔生理腔隙或裂隙，产生相应的临床症状。12.脑震荡：是
3、最常见的轻度原发性脑损伤，为一过性脑功能障碍，无肉眼可见的神经病理改变，但在显微镜下可见神经组织结构紊乱。13.逆行性遗忘：脑震荡的病人清醒后大多不能回忆受伤前及当时的情况。14.中间清醒期：指受伤当时昏迷，数分钟或数小时后意识障碍好转，甚至完全清醒，继而因为硬膜外血肿形成脑受压引起再度昏迷。15.肋骨骨折：是指肋骨的完整性和连续性中断，是最常见的胸部损伤。16.反常呼吸运动：又称 连枷胸，多根多处肋骨骨折，尤其是前侧胸的肋骨骨折时，局部胸壁因失去支撑而软化，可出现反常呼吸运动，表现为吸气时软化处胸壁内陷，呼气时外凸。17.自发性气胸：无外伤、侵入性操作的情况下，肺组织和脏层胸膜自发破裂。18
4、.张力性气胸：胸壁裂口与胸膜腔相通，且形成活瓣，气体随每次吸气时从裂口进入胸腔，而呼气时活瓣关闭，气体只能进不能出，致使胸腔内积气不断增多，压力不断增高19.尿频：排尿次数增多但每次尿量减少。20.尿急：指有尿意就迫不及待地要排出而不能自控，但尿量却很少，常与尿频同时存在。21.排尿困难：尿液不能通畅地排出，变现为排尿延迟、射程短、费力、尿线无力、变细、滴沥等。22.真性尿失禁：膀胱失去控尿能力，膀胱空虚。23.压力性尿失禁：当腹压突然增高尿液不随意地排出，多见于多产的经产妇。24.充溢性尿失禁：膀胱过度充盈，压力增高，当膀胱内压力超过尿道阻力时，引起尿液不断溢出。见于前列腺增生等原因引起的慢
5、性尿潴留。25.急迫性尿失禁：严重尿频、尿急时不能控制尿液而致失禁，见于膀胱严重感染。26.镜下血尿：离心尿沉渣每高倍视野红细胞超过3 个。27.脓尿：离心尿沉渣每高倍视野白细胞超过5 个。精品文档交流28.肾自截：若肾脏高度钙化、输尿管完全闭合，无含菌尿液进入膀胱，症状缓解，尿液恢复正常。29.肾积水：尿液自肾盂排出受阻，使肾内压力升高，肾盂肾盏扩张，肾实质萎缩，造成尿液积聚于肾内。30.TUR综合症：型 TURP的病人，因术中大量的冲洗液被吸收可致血容量急剧增加，出现稀释性低钠血症，病人可在几小时内出现烦躁、恶心、呕吐、抽搐、昏迷，严重者出现肺水肿、脑水肿、心衰等。31.牵引术：利用适当的
6、持续牵引力和对抗牵引力达到整复和维持复位的治疗方法。32.石膏综合征：躯体石膏固定的病人出现持续恶心、反复呕吐、腹胀及腹痛的表现。33.骨折：指骨的完整性或连续性中断。34.骨筋膜综合症：主要是由于骨折部位骨筋膜室内压力增高而致室内肌和神经缺血、水肿、血循环障碍而产生的一系列病理改变，是一组症候群。35.脊髓震荡：属最轻微的脊髓损伤，损伤后脊髓有暂时性的功能抑制，呈驰性瘫痪，损伤部位以下的感觉运动反射及括约肌功能全部丧失，常在数分钟或数小时之内逐渐恢复，最后可完全恢复。36.脊髓半切症：脊髓半横切损伤时，损伤部位以下同侧肢体的深感觉和运动消失，对侧肢体的痛觉和温觉消失。37.关节脱位：指关节面
7、失去正常的对合关系。38.颈椎病：颈椎肩盘退行性变及继发性锥间关节退行性变所致脊髓、神经、血管损害的相应症状和体征。39.寒性脓肿：骨或关节病人出现无红、热、等急性炎症反应。其他重点（填空、选择、简答题）1.急性阑尾炎的最常见病因是阑尾管腔阻塞。2.急性阑尾炎的四种病理类型：急性单纯性阑尾炎、急性化脓性阑尾炎、坏疽性或穿孔性阑尾炎、阑尾周围脓肿。3.急性阑尾炎的转归：炎症消退、炎症局限、炎症扩散。4.急性阑尾炎的临床表现症状：转移性右下腹痛：典型症状胃肠道反应全身表现体征：右下腹压痛：重要体征腹膜刺激症腹部包块5.腹膜刺激症是壁腹膜 受刺激的一种防御反应。6.肛裂三联征：肛裂、前哨痣、肛乳突状
8、肥大。7.肛裂病人的疼痛有两个高峰：排便疼痛 缓解 疼痛8.内痔的临床分度度：无痔块脱出度：排便时有痔块脱出，便后自行回纳度：痔块在腹压增高时脱出，无法自行回纳，需用手辅助度：长期脱出于肛门，无法回纳或回纳后脱出8.直肠癌发病率高于结肠癌。9.左半、右半结肠癌的区别左半结肠 肠腔相对较小，以肠梗阻症状 多见；右半结肠 肠腔较大，以 腹部包块症状 多见11.结肠癌的临床表现文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU
9、1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编
10、码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6
11、 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6
12、ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文
13、档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9
14、T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O
15、6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4精品文档交流排便习惯和粪便性状改变，为首先出现 的症状，表现为血性、脓性、黏液性粪便腹痛：为持续性隐痛或仅为腹部不适、腹胀感腹部包块：较硬肠梗阻：为晚期症状全身症状：病人可出现贫血、消瘦、乏力、低热等全身表现12.直肠癌的临床表现直肠刺激症状黏液血便：最常见粪便变细或排便困难转移症状13.直肠指检 是诊断直肠癌最主要和直接的方法大便隐血试验可作为高危人群的筛查内镜是诊断大肠癌最有效可靠的方法14.大肠癌的手术腹会阴联合直肠癌根治术（Miles 手术）：将乙状结肠近端拉出，于左下腹行永久
16、性人工肛门经腹直肠癌切除术（Dixon 手术）保留肛门15.B超是普查和诊断 胆道疾病 的首选方法，对胆囊结石的诊断准确率高达95以上。16.胆囊结石的临床表现约 30的胆囊结石病人可终身无症状或仅于体检或手术时发现的结石称为静息结石。症状：腹痛：突发的右上腹剧烈绞痛，发生于饱餐，进食油腻食物后消化道症状：伴恶心、呕吐、腹部不适等体征：Murphy 征阳性17.胆道结石：夏科氏三联征，腹痛；寒颤、高热；黄疸AOSC 五联征：三联征休克及中枢神经系统受抑制的表现18.T 管引流目的：引流胆汁和减压；引流残余结石；支撑胆道；经T管溶石或造影护理：妥善固定引流管：应用缝线或胶布将其妥善固定于腹壁保持
17、引流通畅：避免T 管扭曲、折叠、受压，定期挤捏引流管观察引流情况：定期观察并记录引流出胆汁的颜色、量及性状。术后24 小时内引流量约为300-500ml，恢复进食后，每日引流量可有600-700ml 以后逐渐减少至每日200ml 左右。若胆汁引流减少，甚至无胆汁流出，提示引流管阻塞、受压、扭曲、折叠或脱出，应及时找出原因并处理；若引流出胆汁量过多，则提示胆管下端梗阻定期更换引流袋，注意无菌操作拔管指针：大便颜色正常，胆汁减少至200ml 每天左右，透明、金黄色、无脓液。步骤：术后10 天左右，试行夹管1-2 天，病人若无发热、腹痛黄疸等症状，可经T 管作胆道造影，如造影无异常发现，持续开放T
18、管 24 小时，充分引流造影剂后，再夹管2-3 天，无不适可拔管。若胆道造影发现有结石残留，需保留T 管 6 周以上再作取石或其他处理18.胰腺癌和壶腹周围癌临床表现：腹痛：是最常见的首发症状。出现持续且进行性加重的上腹部钝痛、胀痛、可放射至腰背部黄疸：胰头癌黄疸呈进行性加重；壶腹周围癌的黄疸呈波动性消瘦和乏力文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O
19、2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4
20、G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:C
21、W7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF
22、3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1
23、F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码
24、:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6
25、HF3O2V8J1O6 ZU1F4G2J10A4精品文档交流消化道症状19.急腹症病人确诊前4 禁禁吗啡：以免掩盖病情禁食、禁饮、禁导尿、禁灌肠：以免加重消化道负担或造成炎症扩散20.血栓闭塞性脉管炎：吸烟是参与本病发生发展的重要环节临床分期：期：无明显临床症状，仅有患肢麻木、针刺感等。此期患肢动脉已有局限性狭窄病变期：以活动后间歇性破行为主要症状，动脉狭窄程度、范围均超过一期，患肢依靠侧支循环维持血供期：以缺血性静息痛为主要症状，动脉广泛、严重狭窄，仅靠侧支循环无法代偿肢体静息时的血供，组织濒临坏死期：出现指（趾）端发黑、溃疡、干瘪为主要症状，此期，侧支循环血供已经不能维持组织存活21.肢体
26、抬高试验：嘱病人平卧，患肢抬高70-80 度，持续60s，若出现麻木、疼痛、苍白或蜡黄者为阳性，提示动脉供血不足。再让病人下肢自然下垂于床缘下，正常人皮肤色泽可在 10s 内恢复正常，若超过45s 且皮肤色泽不均匀进一步提示患肢动脉存在供血障碍。22.防止颅内压骤然升高休息保持呼吸道通畅避免剧烈咳嗽和便秘及时控制癫痫发作躁动的处理23.脑室引流的处理（1）引流管的位置：引流管开口需高于侧脑室10-15cm（2）引流的速度及量：以每日引流量不超过500ml 为宜，禁忌引流过快，防止脑出血或脑疝（3）保持引流通畅（4）观察并记录脑脊液的颜色、性状、量。正常脑脊液无色透明、无沉渣。脑室引流一般不超过
27、5-7 天（5）严格遵守无菌操作原则（6）拔管：开颅术后脑室引流管一般放置3-4 天。拔管前应先试行抬高引流瓶或夹闭引流管 24h 24.Glasgow 评分法睁眼反应语言反应运动反应自动睁眼 4 回答正确 5 遵命动作 6 呼唤睁眼 3 回答错误 4 定痛动作 5 痛时睁眼 2 吐词不清 3 肢体回缩 4 不能睁眼 1 有音无语 2 异常屈曲 3 不能发音 1 异常伸直 2 无动作 1 意义：最高15 分，表示意识清醒，8 分以下为昏迷，最低3 分。分数越低病人意识障碍越严重。25.小脑幕切迹疝的临床表现颅内压增高的症状：剧烈头痛，进行性加重，频繁呕吐文档编码:CW7E1I3Z9T6 HF3
28、O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F
29、4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:
30、CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 H
31、F3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU
32、1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编
33、码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6
34、 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4精品文档交流意识障碍：随脑疝的进展出现嗜睡、浅昏迷、深昏迷瞳孔改变：初期患侧瞳孔先缩小后增大，晚期健側也出现相应的症状运动障碍：病变对侧肢体肌力减弱或麻痹、病理症阳性生命体征变化26.枕骨大孔疝的临床表现进行性颅内压增高的临床表现：剧烈头痛、频繁呕吐颈项强直或强迫头位生命体征紊乱出现早、意识障碍出现较晚
35、27.颅底骨折的临床表现骨折部位脑脊液漏瘀斑部位可能累及的脑神经颅前窝鼻漏眶周，球结膜下（熊猫眼征）视神经嗅神经颅中窝鼻漏耳漏乳突区面神经听神经颅后窝无乳突部咽后壁少见28.硬脑膜下血肿是最常见 的颅内血肿29.胸腔闭式引流目的引流胸腔积液、积气、积血重建腹压，维持纵隔正常位置促进肺膨胀护理保持管道密闭保持水封瓶玻璃管没入水中3-4cm 搬动病人或更换引流瓶应双钳夹闭引流管若引流管连接处脱落或引流瓶损坏，应立即用双钳夹闭引流管若引流管从胸腔脱落，应立即用手捏闭伤口处皮肤，消毒处理后用凡士林纱布封闭伤口，并协助医生进一步处理严格无菌操作保持引流口处皮肤敷料干结引流瓶应低于胸腔引流口60-100c
36、m 定时更换引流瓶，更换时要注意遵守无菌操作原则保持引流通畅体位：半坐卧位定期挤压胸腔引流管观察和记录一般情况下水柱波动范围为4-6cm 拔管拔管指针：置管引流48-72h，临床观察无引流瓶中五气体溢出且颜色变浅，24h 引流液量少于 50ml，脓液量少于10ml；胸部 X线摄片显示肺膨胀良好无漏气，病人无呼吸困难或气促嘱病人深吸一口气，在其吸气末迅速拔管，并立即用凡士林纱布封闭伤口并加压包扎30.食管癌以胸中段最为所见，其次为胸下段，上段较少；多数为鳞癌典型的临床症状为进行性吞咽困难脱落细胞学检查是食管癌的普查筛选方法31.食管癌病人的围手术期护理文档编码:CW7E1I3Z9T6 HF3O2
37、V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G
38、2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW
39、7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3
40、O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F
41、4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:
42、CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 H
43、F3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4精品文档交流术前护理营养支持：能口服者，进食高热量、高蛋白、丰富维生素的流质或半流质；必要时给予肠内、肠外营养口腔护理呼吸道准备吸烟者嘱病人严格戒烟，至少两周以上消化道准备术前 1 周遵医嘱给予抗菌药物术前 3 天改流质饮食，术前1 天禁食术前 1 日遵医嘱给予100ml 生理盐水加抗菌药物冲洗食管及胃拟行
44、结肠代食管病人，术前 3-5 天口服肠道抗生素，术前 2 天进食无渣流质；术前晚行清洁灌肠或灌肠后禁食禁饮术日晨常规置管心理护理术后护理生命体征监测呼吸道护理密切观察呼吸困难、缺氧、肺炎、哮喘等；及时吸痰，保持呼吸道通畅；术后第1 天鼓励病人深呼吸、吹气球、促进肺膨胀；胸腔闭式引流者，做好相应护理。饮食术后吻合口处于充血水肿期，需禁饮禁食3-4 天禁食期间持续胃肠减压术后 3-4 天待肛门排气、胃肠减压引流量减少后，拔除胃管停止胃肠减压24h 后可进食，术后3 周若病人无特殊情况可以进普食避免吃生冷硬的食物贲门癌、食管癌切除术后，可发生胃液返流入食管，嘱患者饭后2h 需平卧，睡眠时抬高床头食管
45、胃肠吻合术后病人应少食多餐术后胃肠减压术后 3-4 日内持续胃肠减压妥善固定胃管，防止脱出严密观察引流量、性状、气味并准确记录经常挤压胃管胃管脱出后应严密观察病情，不盲目再插入胸腔闭式引流保持通畅：水柱波动随呼吸而动。量的观察：术后早期，血性引流液较多。引流液性质：血性术后前 3 日乳白色乳糜胸食物残渣吻合口瘘食管癌术后并发症吻合口瘘最严重的并发症多发生在术后5-10 天表现：呼吸困难、胸腔积液和全身中毒症状，如寒颤、高热、甚至昏迷处理：嘱病人立即禁食文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU
46、1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编
47、码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6
48、 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6
49、ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文
50、档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9T6 HF3O2V8J1O6 ZU1F4G2J10A4文档编码:CW7E1I3Z9