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Jingdong book

图解耳鼻咽喉·头颈外科手术配合

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图解耳鼻咽喉·头颈外科手术配合

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《图解耳鼻咽喉-头颈外科手术配合》既适合于初入手术室工作的人员,也可供有一定手术室工作经验的人员阅读？既可用于手术室护士的三基三严培训,也可作为手术室教学教师备课的参考书？
Content Description

《图解耳鼻咽喉-头颈外科手术配合》系《图解手术配合丛书》之一,《图解耳鼻咽喉-头颈外科手术配合》共10章？主要包括耳鼻咽喉-头颈外科常见手术与手术配合,基本按照手术用物准备？手术体位？消毒铺巾？手术配合及特殊关注点的顺序予以介绍？重点突出手术配合部分,对手术步骤配以解剖？器械及具体操作的图解,循序渐进,图文并茂？《图解耳鼻咽喉-头颈外科手术配合》作者均来自于临床一线,所介绍的手术方式及术中配合技巧也来源于临床经验的总结,并得到了临床医师的指导？《图解耳鼻咽喉-头颈外科手术配合》强调整体护理观念,关注手术配合技能,为高质量的手术配合提供全面的解决方案？
Catalogue

目录
第一篇 总述
第一章 耳鼻咽喉-头颈外科手术室的特点 (1)
第一节 专科手术室的准备 (1)
第二节 常用专科器械介绍 (5)
第三节 常用专科仪器介绍 (24)
第四节 常用专科物品介绍 (31)
第二章 患者的准备 (33)
第一节 患者术前准备 (33)
第二节 专科常用体位的准备 (33)
第三节 手术野皮肤消毒 (38)
第四节 手术野无菌单的铺置 (40)
第三章 手术配合流程 (47)
第一节 专科手术护士应具备的素质 (47)
第二节 巡回护士工作流程及要点 (47)
第三节 器械护士工作流程及要点 (50)
第四节 专科常见感染手术配合及处理 (51)
第二篇 手 术 配 合
第四章 耳部手术配合 (54)
第一节 耳的局部解剖 (54)
第二节 耳前瘘管切除术手术配合 (60)
第三节 外耳道成形术手术配合 (64)
第四节 外耳道肿瘤切除及植皮术手术配合 (70)
第五节 耳内镜下鼓膜置管术手术配合 (74)
第六节 乳突改良根治术手术配合 (78)
第七节 人工耳蜗植入术手术配合 (83)
第八节 面神经减压术手术配合 (89)
第九节 面神经吻合术手术配合 (94)
第五章 鼻部手术配合 (98)
第一节 鼻的局部解剖 (98)
第二节 鼻内镜手术配合 (100)
第三节 经鼻内镜鼻中隔偏曲矫正术手术配合 (105)
第四节 经鼻内镜视神经减压术手术配合 (109)
第五节 经鼻内镜鼻腔泪囊造口术手术配合 (112)
第六节 经鼻内镜脑脊液鼻漏修补术手术配合 (117)
第七节 经前额进路脑脊液修补术手术配合 (121)
第八节 鼻侧切开术手术配合 (127)
第九节 上颌窦根治术手术配合 (131)
第六章 咽部手术配合 (138)
第一节 咽的局部解剖 (138)
第二节 局麻下扁桃体摘除术手术配合 (139)
第三节 全麻下扁桃体摘除及腺样体刮除术手术配合 (144)
第四节 腭咽成形术手术配合 (150)
第七章 喉部手术配合 (157)
第一节 喉的局部解剖 (157)
第二节 气管切开术手术配合 (161)
第三节 喉裂开肿瘤切除术手术配合 (166)
第四节 喉部分切除术手术配合 (174)
第五节 喉全切除术手术配合 (183)
第六节 下咽喉颈段食管切除及重建术手术配合 (191)
第七节 支撑喉镜手术配合 (199)
第八章 头颈部手术配合 (205)
第一节 颈部的局部解剖 (205)
第二节 腮腺肿瘤切除术手术配合 (210)
第三节 甲状舌管囊肿(瘘管)切除术手术配合 (215)
第四节 咽旁间隙肿瘤切除术手术配合 (221)
第五节 改良性颈清扫术手术配合 (227)
第六节 根治性颈淋巴结清扫术手术配合 (233)
第七节 颈动脉体瘤切除术手术配合 (239)
第八节 颞下窝进路侧颅底术手术配合 (247)
第九章 重建手术配合 (255)
第一节 游离空肠移植重建下咽及颈段食管术手术配合 (255)
第二节 游离皮瓣移植重建下咽及颈段食管术手术配合 (263)
第三节 胸大肌皮瓣移植重建下咽及颈段食管术手术配合 (269)
第四节 胸三肌皮瓣移植修复头颈部皮肤缺损术手术配合 (277)
第五节 气管瘘口修复术手术配合 (282)
第十章 专科常见急诊手术配合 (287)
第一节 外耳道异物取出术手术配合 (287)
第二节 硬质气管镜下气管异物取出术手术配合 (291)
第三节 硬质食管镜下食管异物取出术手术配合 (295)
第四节 鼻腔出血止血术手术配合 (298)
第五节 咽旁脓肿切开引流术手术配合 (300)
参考文献 (305)
Book Abstract

第一篇总述
耳鼻咽喉诸器官因解剖位置较复杂，其上承颅底，下通气管？耳？鼻，左右毗邻眼眶，咽喉与头颈部重要的器官？神经及大血管关系紧密？故现代耳鼻咽喉头颈外科手术不仅包括耳部疾病手术？鼻部疾病手术？咽喉部疾病手术，还包括与口腔颌面部？头颈部(颈动脉？腮腺？甲状腺等)相关疾病？创伤及修复等手术？
第一章耳鼻咽喉-头颈外科手术室的特点
由于耳鼻咽喉诸器官主要结构多居于头部腔道之内，其解剖结构复杂而精细，致使耳鼻咽喉头颈外科手术具有很强的专科特点？而与之息息相关的耳鼻咽喉头颈外科手术室不管是其设计布局？仪器准备还是对人员素质要求，器械？手术的配合流程等也随之具有很强的专科特色？
第一节专科手术室的准备
一？专科手术室的设计
耳鼻咽喉头颈外科手术在一般洁净手术室开展，空气洁净度要求手术区达到10000级，周边区到达100000级(即手术区空气中大于等于0.5μm的尘粒数大于3.5粒/L到小于等于350粒/L;大于等于5.0μm的尘粒数小于等于2.3粒/L)？
耳鼻咽喉头颈外科专科手术室设计一般面积为20~30m2，室温为19~25℃(可调节)，湿度为40%~60%？
二？专科手术室的准备
为满足耳鼻咽喉头颈外科各亚专业手术需要，手术室患者准备？仪器设备等布局各有特点？手术中，主刀医师常在患者头颈部右侧或头顶部操作，麻醉医师则位于患者左侧监护，静脉通道如无特殊需要(如重建手术需肢体供皮时)也建立在麻醉医师位置同侧(通常为患者左侧)？各亚专业手术室准备分类如下所述？
(一)耳科手术室准备
耳科手术时，主刀医师位于患者患侧操作手术，麻醉医师位于患者健侧监测患者生命体征，静脉通道亦建立在患者健侧上肢？如右侧耳部手术时，布局如下(图1-1-1);左侧耳部手术时左右正好相反？
图1-1-1右侧耳部手术手术室
(二)鼻科手术室准备
鼻科手术时，手术医师位于患者头部两侧操作手术，如为鼻内镜手术，头顶放置无菌桌及内镜系统(图1-1-2)？
图1-1-2鼻内镜手术手术室
(三)咽部手术室准备
经口入路咽部手术时，手术医师位于患者头顶部操作手术，于麻醉机对侧(即相对宽敞的一侧区域)放置无菌桌(图1-1-3)？
图1-1-3咽部手术手术室
(四)支撑喉镜手术室准备
支撑喉镜手术时，手术医师位于患者头顶部操作手术，无菌桌至于头部，显微镜？激光仪置于患者右侧区域(图1-1-4)？
图1-1-4支撑喉镜手术手术室
(五)喉切开及头颈部手术室准备
喉切开及头颈部手术时，手术医师位于患者头部两侧操作手术，麻醉医师位于患者左侧监测患者生命体征(图1-1-5)？
图1-1-5喉切开及头颈手术室
(六)重建手术手术室准备
当重建手术，受区和供区手术需同时进行时，需注意无瘤技术原则，准备两套器械及无菌物品，分别放置于两个无菌桌上？如有条件者，两名器械护士配合手术(图1-1-6)？
图1-1-6重建手术手术室
第二节常用专科器械介绍
耳鼻咽喉头颈外科手术特殊器械种类繁多？各亚专业手术器械，或因病变部位或因入路不同等不尽相同，专科器械各有特点？
一？耳科手术常用器械
(一)耳科手术普通器械
1.乳突牵开器常用于耳部？小切口手术剥离手术野(图1-2-1，图1-2-2)？
图1-2-1乳突牵开器 图1-2-2双关节乳突牵开器
2.耳吸引器头(各型)用于清晰手术野，暴露术区？手术医师可根据手术部位深浅等情况选择不同型号且均带有侧孔便于手术医师控制调节吸引力大小的耳吸引器头(图1-2-3)？
图1-2-3耳吸引器头
3.骨膜剥离器用于剥离骨膜(图1-2-4)？
图1-2-4骨膜剥离器
4.剥离子用于探查？游离组织(图1-2-5)？
图1-2-5剥离子
5.乳突刮匙常用于清除病变组织(图1-2-6)？
图1-2-6乳突刮匙
(二)耳科手术显微器械
1.麦粒钳用于耳科显微手术中夹取组织(图1-2-7)？
图1-2-7麦粒钳
2.麦粒剪用于耳科显微手术中离断组织(图1-2-8)？
图1-2-8麦粒剪
3.各型耳探针及耳显微剥

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