Belstaff España Minimally invasive surgery for hyp

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Minimally invasive surgery for hypertensive cerebral hemorrhage post-operative care of patients

Guangdong Jieyang 522000) Surgical treatment of cholesteatoma is the only way, the traditional or modified radical mastectomy radical mastoidectomy, although can remove lesions, but also can cause hearing damage to Sichuan. June 2003 ~ January 2006 in our hospital under the microscope in the surgery with the application of 36 cases of tympanoplasty in cholesteatoma surgery patients, all with successful surgery, postoperative follow-up hearing by the increase in varying degrees, and without any complications, the effect is satisfied with the work of nursing now be summarized as follows. The clinical data of 36 patients, 1 the youngest 14 years old, maximum 52 years, clinical manifestations of long-term or intermittent ear pus, tympanic membrane perforation and hearing loss, temporal bone CT scan showed the attic, the drum or the mastoid sinus with bony destruction area, or soft tissue. Diagnosis: chronic otitis media (cholesteatoma). Intraoperative JJEaN, safety of surgery were sent to ward. 2 with 2.1 preoperative surgical instruments and equipment for microsurgery 2.1.1 drills, microscopes, bipolar coagulation, suction apparatus. 2.1.2 Equipment Preparation () tympanoplasty instruments (including forceps, nasal endoscopic forceps, tonsil dissector, suction head,[link widoczny dla zalogowanych], the organization cut, VII and III of the one handle, toothed short tweezers, etc.); ② micro devices (mastoid retractor, the gun-like small scissors, needles and other challenges); ③ microsurgical drill bit special,[link widoczny dla zalogowanych], curved, straight nose, wires. 2.13 General items for ear surgery dressings (with a towel 6, hole towel bar l), surgical clothing, thread 1, microscope protection cover, article spinning iodine, gelatin sponge, sterile cotton balls, pad, bandages, syringes. 2.1.4 shave the day before surgery the patient for surgery side of the ear before, the rear of the hair, filling the external auditory canal, especially cotton mouth fungus, Tobramycin eye ointment to protect the eyes and painted eyes. Anesthetist with endotracheal intubation to do, and gracefully position, head to the healthy side, affected ear facing up. 2.2 nurses wash their hands with the doctors surgery with 2.2.1 General skin disinfection, sterile shop towels, 2% lidocaine with syringe 1Oml epinephrine solution plus 1% o 6 drops in the ear after local anesthesia temporal In taking over from the temporal muscle close to the last layer of temporal fascia as a graft. Tile in a layer of graft in the gauze, suction pressure in the thin gauze after infiltration with 75% alcohol fixed, and then rinse with sterile saline to keep the fascia is not deformed, sterile gauze on the standby . Moist cotton ball using a little adrenaline surgery to stop bleeding, and connected bipolar coagulation line. 2.2.2 Connect the micro drill, head and wires. When using the general ear surgery incisions, subcutaneous tissue incision, isolation, expansion chamber to open surgery, open attic, it should be connected to the large drill bit and handed surgeon, to clear the mastoid sinus lesions and drums, mastoid bone of the walls and polished, and then switch to 2-3mm of the grinding head, will expand the port entrance of the drum sinus I. Clear out of the lesions on the gauze to be inspected, surgeon will be different according to different conditions tympanoplasty, ossicular chain reconstruction. 2.2.3 Protection of condoms on the microscope with a sterile, rubber band fixed lens, adjust, easy to surgery operation under the microscope carefully to avoid regulation and injured outside the string of the facial nerve. Handed to him the required accuracy of microscopic equipment, pay attention to gentle movements. 2.2.4 will be made of small spherical gelatin sponge, when the operation will cover the graft wall at the top of the external auditory canal, the use of gelatin sponge ball filling the ear canal at the end, then fill the spinning section of iodine, with a doctor stitched the wound. 2.2,5 pad covering the wound, bandage. 2.3 Tour operative cooperation with the nurses adjust drill speed micro-surgery, usually 3600-3700rpm / min, continuous drill no more than 4 hours. And washed with normal saline infusion tube connected to the incision, one to grind out the bone fragments, to better expose the surgical field; the second is to avoid overheating the bit. 3 requirements of clean sterile curved, straight nose, drilling, grinding,[link widoczny dla zalogowanych], electrical, wire fumigated with formalin sterilization method. 4 Precautions and maintenance after each use, should be promptly cleaned curved,[link widoczny dla zalogowanych], straight nose, the bloodstained washed out, and spray with cleaning agents head cavity. Before starting the inspection machine microscope drill head moving sets of: and the sleeve of the two red dots are aligned overlap in the position. If two red dots are not aligned, and definitely not power on. Micro devices are precision instruments, gauze pad immersion cleaning, gently to avoid mutual collision damage.
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