Ngoại khoa thực hành

CHƯƠNGà.àKIẾN THỨCàCƠàBẢN
1. VÔ KHUN NGOI KHOA
2. VÔ TRÙNG TRONG NGOI KHOA
3. VN CHUYI B 
4. GÂY TÊ
5. GÂY MÊ
6. CHUN B C M
7. 
8. QUÁ TRÌNH LIN V
9. KIM VÀ KÌM KP KIM KHÂU PHU THUT
10. CÁC LOI NG THÔNG VÀ NG D
11. CÁC THAO TÁC PHU THUT
12. CÂN BN GII
13. CP CU NGNG TIM PHI
14. CM MÁU TM THI
15. KHÁM CH NÃO
16. NG
17. TA, TK TR
18. TI
19. G
CHƯƠNGà.àKỸ NĂNG
20. 1-K N THN TRONG PHÒNG M:
21. 2-K N THN TRONG PHU THUT:
22. 3-CÁC K U THUT NÂNG CAO:
CHƯƠNGà.àPHẪU THUẬT
23. PHU THUT CT GAN TRÁI
24. K THUT TÌM VÀ X LÝ TÚI THOÁT V BN
25. PHU THUT MILES
26. PHU THUT HELLER QUA NI SOI
27. K THUT LÀM HU MÔN NHÂN TO
28. PHU THUT CNG MT RN GAN

29. PHU THUT CT KHI TÁ TU BO TN MÔN V
30. PHU THUT CT TÚI MT NI SOI
31. PHU THUT CT TOÀN B D DÀY
32. PHU THUT CT THN KINH X
33. PHU THUT CT RUT THA NI SOI
34. PHU THUT CT RUT THA
35. PHU THUT CT GAN PHI
36. PHU THUT CI TRÀNG XÍCH-MA NI SOI
37. PHU THUT CI TRÀNG PHI NI SOI
38. PHU THUI BIÊN
39. PHU THUNG MCH CH BNG
40. DI
41. PHU THUT TUYN GIÁP
42. PHU THUT CT THU GIÁP
43. PHU THUT CT THC QUN KHÔNG M NGC
44. PHU THUT IVOR LEWIS
CHƯƠNGà.àBỆNH LÝ NGOẠI Ổ BỤNG
45. B
46. THNG D DÀY - TÁ TRÀNG
47. THOÁT V BN
48. CHNG KÍN
49. VIÊM RUT THA CP
50. CH CA
51. I TRÀNG
52. K TRC TRÀNG
53. HI CHNG TC RUT
54. VIÊM TY CP
55. XOI TRÀNG
56.  DÀY
57. SA TRC TRÀNG

58. SI NG MT CH
59. SNG MT
60. THOÁT V BN
61. THOÁT V NGHT
62. THOÁT V SAU M
63. 
64. VIÊM RUT THA CP
65. 
66. NG MT NGOÀI GAN
67. U TY
CHƯƠNGà.ààPHẪU THUẬT LỒNG NGỰC
68. CHC
69. VIÊM M MÀNG PHI
70. ÁP XE PHI
71. GIÃN PH QUN
72. K PH QUN
73. U TRUNG THT
74. HP VAN 2 LÁ
75. 
76. N VÚ
CHƯƠNGà.àCHẤNàTHƯƠNGàCHỈNH HÌNH
77. GÃY H NG CHÂN
78. 
79. 
80. GÃY C 
81. U TRÊN 
82. 
83. NG TAY
84. V
85. 

86. PHU THUT TÁI TO DÂY CHNG CHÉO SAU
CHƯƠNGà.àBỎNG NGOẠI KHOA
87.  BNG
88. DIN TÍCH -  SÂU TNG
89. LÂM SÀNG SC BNG
90. U TR SC BNG
91. BNG HOÁ CHT
92. BN
93. BNG NG HÔ HP
94. BNG CHIN TRANH
95. X TRÍ VNG K U
96. THI K II CA BNG
97. THI K SUY MÒN CA BNG
98. THUU TR TI CH BNG
99. THUU TR BNG
100. PHU THUU TR BNG
101. NH NHÂN BNG
102. U TR BNG  TR EM
CHƯƠNGà.àTHẬN-TIẾT NIỆU
103. CHN
104. TU QUN
105. CH
106. V NIU ÐO
107. CH
108. CHO
109. CHN KÍN
110. SI NIU
111. SNG TIT NIU
112. U BÀNG QUANG
113. I LÀNH TÍNH TIN LIT TUYN

114. CN LÂM SÀNG CHN TIT NIU
115. VIÊM THN  B THN CP
116. VIÊM BÀNG QUANG CP
117. VIÊM NIO CP
118. VÀI KHÁI NIM V GHÉP THN
CHƯƠNGà.àGÂYàMèàHỒI SỨC
119. C V GÂY MÊ HI SC
120.  CÁC THUC MÊ
121. CH
122. THU
123. THUC GI
124. THUC GI
125. CH TOÀN B
126. THUC MÊ HÔ HP
127. THUC AN THN
128. VÔ CM TRONG PHU THUT  BNG
129. T NI KHÍ QUN KHÓ
130. GÂY TÊ TY SNG - NGOÀI MÀNG CNG
131. I
132. I THN KINH CÁNH TAY
133. GÂY TÊ THN KINH GIA
134. GÂY TÊ THN KINH TR
135. GÂY TÊ THN KINH TR
136. GÂY TÊ THI
137. HN CH TRUYN MÁU TRONG NGOI KHOA
138. GÂY TÊ TY SNG  TR EM
139. PHI HP THUC TÊ VI CÁC THUC H TR TRONG GÂY TÊ CC B
140. CHUN B C M NH NHÂN SAU M
141. QUN LÝ BNH NHÂN CH NÃO  TUY
142. CH TRUNG TÂM

143. T NG NI KHÍ QUN
CHƯƠNGà.àNGOẠI KHOA THỜI CHIẾN
144. 
145. CM MÁU TM THI
146. C NH TM TH
147. 
148. SC CH
149. NHIM KHUN VN TRANH
150. HÔ HP NHÂN TO
151. CT CT CHI CP CU
152. VN MM
153. VP
154. VT SNG-TY SNG
155. VA KHÍ
156. VT BNG DO NHIM CHC QUÂN S
157. X 
158. X U CHC
159. X U VU BNG
160. X U CH NÃO
161. TCH MÁU NGOI VI
162. T
163. HI CHNG VÙI LP
164. THM HA VÀ CÔNG TÁC PHÒNG CHNG
165. CHT
166. CHT
167. CHNG
168. U TR VT BNG BNG THUC NAM
TÀI LIỆU TRA CỨU

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CHƯƠNGà.àKIẾN THỨCàCƠàBẢN


1. VÔàKHUẨNàNGOẠIàKHOá



khoa.




-  

- 





nh











-  



0




- 

0

- 

-   


 
- C- NH
4
:

4




-  


- 

-  có clo:




- 
- 

- 





- 180
0
C)



- 
- 
0

C) nên


- 20 


- 





0



- 







 



1 kg/cm
2

(1 atmotphe) = 120
0
C.
2 kg/cm
2
(2 atmotphe) = 134
0
C.
3 kg/cm
2
(3 atmotphe) = 145
0
C.

2

1,5 - 2 kg/cm
2

2



- 2 kg/cm
2
- 60



- 

- 55
0
 60 - 80
0
trong



 





 


- 
- 


0
C.
- 

0
C.
- 



Coban chlorur : 20g.
Axit chlohydric 30% : 10ml
 : 88ml.

- 



- 
 :





 




- 0 - 180
0
C trong vòng 40 - 60

- 

0
C trong vòng 15 phút.

0

C trong vòng 30 phút.
 
0
C trong vòng 40 - 60 phút.
- 
0
C trong vòng 15 phút.
- 
- 
- 

2. VÔàTRÙNGàTRONGàNGOẠIàKHOA






- 

-



tràn vào.
- 
- 


-  trùng.









- 



 
- 










- 

và 
này.
- , bao trùm


- 


- 70%) trong vòng 20





- 



- 
- 



- 





-  



-  




3. VẬNàCHUYỂNàNGƯỜIàBỊàTHƯƠNG

.àĐạiàươg.



 





.





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


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







 












- 
-  

Hình 1
- 


- 


..àBàgàgườiàịàthươgàtàlưgà(hình2):

- 

-  

- 

- 






 









- 
- 
- 
- 
-  
- 
- 
 - 


- 

- 

- 
- 

4. GÂY TÊ




nhân.


- 
- Gây tê vùng (regional anesthesia).
2.1. Gây tê 
- 


- 
tê lên b

- 


- 
- 


- 




. Chi trên 90 phút.

2.2. Gây tê vùng (regional anesthesia):




- Gây t
- 
- 
- 
- 
- 


- 


-

chúng k
- 

- 
- 

- 
- .
- 


- 
- 
- 
- 



4.1. Phân 


- 
- 

- 
- 









1/100.000 - 1/200.000 (1 - 


- 
- 
- Gây tê các ngón tay, ngón chân.

4.2.1. Cocain:

- 
- 
- - 200mg.
- 
4.2.2. Novocain (procain):
- 
- - 45

axit para aminobenzo
- 

- 
- 
- 1%.
4.2.3. Chloroprocain (nescain):
- 
- - 
- 75 phút khi 
- -
3%.
- - 
4.2.4. Tetracain (pontocain):
- 

- 

- - 6

- 
4.2.5. Lidocain (xylocain, lignocain):
- 
- 
trung bình (60 - 90 phút khi - 



- 
4.2.6. Mepivacain (carbocais):
- 
- 

- 

4.2.7. Prilocain (citanest):
- 
- 


- 
 

- 
- 
4.2.8. Marcain (bupivacain, sensoreain):

- 
- 

- 

- - - 0,3mg/kg).
4.2.9. Etidocain (duranest):
- 

- 
- - 
- 
- 
4.2.10. Dibucain (nupercain):
- 
-15mg).
4.2.11. Ropivacain (naropin):
- 
- Tác d
- 





- 
- 
- 
- - 
- 

- 
-  
- 
- 






- 

- , co

- 

- 
hoàn toàn.
- 
- 
- 

- 

. Thiopental.
n.
- 
- 

- 

- 
- .
- Corticoid: depersolon, prednisolon.
- Calcigluconat.

- 

- 
T
- 
- 

tê vào nhan

- 

- 
m- 
- 




5. GÂY MÊ















th
- 
- 

- 


 - 






 








2.1.2. 
 - 



























.àCàgiaiàđoạàủaàgàà(theo Guedel).




- 

- 
- 
- 
- 
- 




- 


 

- 

- 



 

- 

- 





- 






- 





2


- 


 

...àGiaiàđoạàI 
- 
- 
- 


- - 

- 
- 
- 
- 
...àGiaiàđoạàII 
- 
- 


- 
- 

- 

- 
3...àGiaiàđoạàIII 
- 
1
:
- 
- 
- 
- 
- 
- 
2
:
- 

- 
- 
- - 
- 
3
:
- 

- 
-  
- 
4
:
- 

- 
- 
- 

4


...àGiaiàđoạàIV 

 




ông còn



Các




Da


gây mê
ng


Than
h khí

n
 
ch
Mi

t
Gâ
n
gó
t

t,
nôn


Biên


h

t áp



I (giai





-
-
-
-
-
-
Khôn
g

và



khi

hít
vào
Nhan
h
Bình

ng
Bình

Bình

ng

II (giai

thích)
-
-
-
-
-
±
Khôn
g

và





trên

Bình

Giãn
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)

III

III
1

-
-
-
-
-
-

Nha
nh
và 
n


trên

trên
Bình

ng
Bình

Co

III
2

±
-
-
-
-
-

trên

trên


trên
Bình

ng
Bình

Co

III
3

-
-
-
-
-
-

trên
Cân

và


trên
Bình

ng
Bình


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