?intraoperative

intraoperative發(fā)音

[intrə'ɔpərətiv]

英：　　美：

intraoperative中文意思翻譯

外科手術(shù)進(jìn)行時(shí)發(fā)生(或遇到, 采取)的

intraoperative常見(jiàn)例句

1 、We present a successful thromboembolectomy under intraoperative transesophageal echocardiography (TEE) monitoring on a woman with massive pulmonary embolism (PE).───摘要在脊椎手術(shù)后并發(fā)肺栓塞的病例是少見(jiàn)的。

2 、Objective: To explore the role of neuronavigation system unite intraoperative ultrasound in the surgical treatment of supratentorial gliomas.───摘要目的：探討神經(jīng)導航結合術(shù)中超聲檢查在幕上膠質(zhì)瘤外科治療的應用價(jià)值。

3 、HT5”SS][WT5”BZ][ST5”BZ]Capsular blook syrdnome (CBS) is a complication of continuous curvilinear capsulorhexis (CCC).Five ceses with intraoperative CBS were reported in this paper.───囊袋阻滯綜合征是連續環(huán)形撕囊術(shù)的一種并發(fā)癥,本文報告5例發(fā)生在術(shù)中的囊袋阻滯綜合征,并對術(shù)中囊袋阻滯綜合征的病因、臨床特點(diǎn)以及預防和處理方法等方面進(jìn)行討論。

4 、Methods Intraoperative TEE was performed in 97 patients with cardiac valve insufficiency.───方法:對97例心臟瓣膜手術(shù)的患者予以TEE術(shù)中監測。

5 、Objective To discuss the significance of intraoperative Doppler monitoring (IDM) in parasellar tumors surgery.───摘要目的探討術(shù)中多普勒監護(IDM)在鞍旁腫瘤手術(shù)中的意義。

6 、The literature related to the control of such hemorrhage is reviewed and a case is presented where a severe intraoperative hemorrhage from the maxillary artery was controlled by ligation of the external carotid artery.───本文回顧文獻上有關(guān)內頷動(dòng)脈出血的控制及一個(gè)經(jīng)由外頸動(dòng)脈結扎來(lái)控制手術(shù)中內頷動(dòng)脈出血的個(gè)案。

7 、To investigate the diagnosis of pancreatic tumors by intraoperative fine needle aspiration cytology(FNAC).───探討術(shù)中細針穿刺細胞學(xué)檢查對胰腺腫瘤的診斷價(jià)值。

8 、The intraoperative and postoperative circulation, hemoglobulin, hematocrit were compared with the preoperative data.───將術(shù)中術(shù)后的循環(huán)變化及血紅蛋白、紅細胞壓積變化與術(shù)前基礎值作比較。

9 、Methods 35 cases endoscopes gastrostomy downlink the preoperative,intraoperative and postoperative care to comfort measures.───方法對35例經(jīng)內鏡下行胃造瘺術(shù)的患者在術(shù)前、術(shù)中和術(shù)后給予舒適護理措施。

10 、Objective: According to intraoperative monitoring of cortical somatosensory evoked potentials(CSEP),reduce injury of spinal cord.───方法:用體感誘發(fā)電位儀對68例脊柱手術(shù)行CSEP監護。

11 、Burra, steroid-sparing is feasible with tacrolimus or cyclosporine A based protocols with mycophenolate mofetil (MMF) and 1 intraoperative dose of steroid.───可以以他克莫司或環(huán)孢菌素A為基礎，聯(lián)合麥考酚酸莫酯，并在術(shù)中給予1次類(lèi)固醇治療。

12 、Methods:The data before,intraoperative and after operation of 39 cases of salpingocyesis treated by laparoscopy and 50 cases by traditional laparotomy were compared and analysed.───方法:將腹腔鏡手術(shù)治療輸卵管妊娠39例與傳統開(kāi)腹手術(shù)50例術(shù)前、術(shù)中和術(shù)后的情況進(jìn)行比較分析。結果:兩組在年齡、停經(jīng)史等方面無(wú)顯差異;

13 、Objective To study the value of the clinical application of intraoperative ultrasound (IOUS) with cool-tip radiofrequency (RF) in carcinoma.───摘要目的探討術(shù)中超聲(IOUS)在冷循環(huán)射頻**中的臨床應用價(jià)值。

14 、Methods Using intraoperative ultrasound in monitoring lithotomy of 55 cases of complex renal stones.───方法在復雜性腎結石術(shù)中實(shí)時(shí)超聲監視。

15 、Abstract：Objective: To gain insight into how nurses work well cooperation at operation with cholecystectomy to treat cholelithiasis depending on the result of intraoperative cholangiogram.───3結果:術(shù)中行膽道膽囊64例,其中均成功置入膽囊導管，獲得滿(mǎn)意顯影效果的有62例,成功率為96.87%。

16 、With the application of intraoperative TEE, we could easily detect the hemodynamic changes of thoracic aorta and find the real causes so as to solve the perfusion abnormalities.───在胸主動(dòng)脈剝離的手術(shù)及心肺循環(huán)下，利用經(jīng)食道心臓超音波可快速地診斷及可有效地提供主動(dòng)脈灌注的情況。

17 、Objective To study the value of selective intraoperative cholangiography during laparoscopic surgery in the treatment of bile duct calculus.───摘要目的：探討對于有膽道相對探查指征的病人行腹腔鏡膽道手術(shù)時(shí)術(shù)中膽道造影的應用價(jià)值。

18 、A Rapid Method for the Intraoperative Diagnosis of Hirschsprung's Disease.───先天性巨結腸的一種術(shù)中快速診斷方法。

19 、Two intraoperative tissue biopsies revealed a yellow-pigmented, rapidly growing Mycobacterial nontuberculous species.The organism was identified as Mycobacterium monacense, a newly described species.───在手術(shù)進(jìn)程中，兩塊活體組織活檢顯示為**，并很快發(fā)展為沒(méi)有結節的分支桿菌，這種生物體被確認為莫娜分支桿菌，一種新近發(fā)現描述的種屬。

20 、Objective To observe the therapeutic efficacy of intraoperative injection of anhydrous alcohol in unresectable pancreatic cancer.───摘要目的觀(guān)察術(shù)中注射無(wú)水酒精治療不能切除胰腺癌的效果。

21 、Influence of "Liberal" versus "Restrictive" Intraoperative Fluid Administration on Elimination of a Postoperative Fluid Load.───術(shù)中“自由的”和“限制性的”液體輸注對于術(shù)后體液排除的影響。

22 、Methods Using normal or self-made skin expander,intraoperative sustained skin expansion was done so as to gain "additional" tissue for covering wound surface.───方法:應用制式擴張器或自制簡(jiǎn)易擴張器進(jìn)行術(shù)中即時(shí)擴張,用擴張出的“額外”皮膚修復各種創(chuàng )面。

23 、Method: 64 cases of cholelithiasis patients with cholecystectomy to therapy the biliary calculi depending on the result of intraoperative cholangiogram were studied by retrospective analysis.───方法：回顧性分析64例采用床邊膽道造影指導膽囊切除術(shù)治療膽石癥的手術(shù)過(guò)程的手術(shù)前護理、手術(shù)中配合的護理體會(huì )。

24 、Objective To discuss the intraoperative techniques and outcome of phacoemulsification through papillary circular synechia.───摘要目的探討瞳孔環(huán)形黏連的白內障超聲乳化術(shù)的手術(shù)技巧及效果。

25 、Methods: To study 76 eases of acute intraoperative encephalocele in severe craniocerebral trauma in order to find out the relationship between the treatment and prognosis.───方法：對76例術(shù)中發(fā)生急性腦膨出的重型顱腦損傷患者，分析術(shù)中處理方法及其與患者預后的關(guān)系。

26 、Both cases were operated under the impression of choledochal cysts, and were found by intraoperative cholangiopancreatography to have dominant dorsal ducts.───在手術(shù)中進(jìn)行膽道胰管攝影發(fā)現皆為背胰管優(yōu)勢。

27 、Intraoperative aortic dissection is one of the complications of aortic cannulation, which is potentially lethal with an incidence of about 0.16%.───摘要手術(shù)中的主動(dòng)脈剝離在心臟手術(shù)是一種少見(jiàn)卻致命的并發(fā)癥。

28 、The power consumption is decreased with SMD mounted chips, making it possible to monitor intraoperative neurosurgery efficiently and to reduce complication as well.───為在神經(jīng)外科手術(shù)中有效地實(shí)行術(shù)中監護提供可能性,可以極大地減小手術(shù)并發(fā)癥。

29 、Abstract The intraoperative posture of 382 patients scheduled for microneurosurgery were analyzed in the present study.───摘要 總結和分析了382例顯微神經(jīng)外科手術(shù)病人的術(shù)中體位護理情況。

30 、The accurate localization of tumors, microsurgical techniques and intraoperative monitoring play an important role in the successful treatment of spinal tumors.───準確的**、精細的顯微外科技術(shù)、術(shù)中電生理檢測是成功治療脊髓脊柱腫瘤的關(guān)鍵。

31 、Purpose: To report a case of intraoperative capsular block syndrome (ICBS), an unusual complication during cataract surgery.───摘要目的：本文報告一例術(shù)中水晶體包囊阻塞癥候群，為白內障手術(shù)中少見(jiàn)之并發(fā)癥。

32 、No intraoperative vitreous bleeding, persisting corneal endothelial decompensation, secondary cataract and surgery-related cystoid macular edema postoperatively were observed in the operated eyes.───所有病例未發(fā)現玻璃體出血、持續性角膜變性、后發(fā)白內障和與手術(shù)相關(guān)的黃斑囊樣水腫。

33 、We have employed intraoperative fluoroscopy with use of an electrocautery cord to assess limb alignment in the supine patient.───本研究以拉直的電烙線(xiàn)為參照，用X線(xiàn)透視的方法對術(shù)中仰臥位患者進(jìn)行下肢對線(xiàn)排列評估。

34 、Methods To analyse 106 patients with hepatolithiasis in intraoperative and postoperative used the choledochoscope to check and removed stones.───方法回顧性分析106例肝膽管結石患者術(shù)中、術(shù)后利用纖維膽道鏡檢查、取石治療的臨床資料。

35 、Methods Ten patients with insulinoma underwent the preoperative-and intraoperative ultrasonographies.The ultrasonographic findings in all patients were analyzed retrospectively.───方法就10例胰島素瘤患者的術(shù)前和術(shù)中超聲應用的情況進(jìn)行回顧性分析。

36 、In the future preoperative and/ or intraoperative measurement of bone density should be available to help the surgeon in more objective decision making to select the optimal implant.───在未來(lái)的術(shù)前和/或術(shù)中測量骨密度可以幫助外科醫生在選擇最佳內植物時(shí)有更多的客觀(guān)決策指標。

37 、It indicated that the completion of preoperative preparation, controling the level of anesthesia, and strenthening the intraoperative manipulation were the keys to improve the intraoperative safty.───提示完善術(shù)前準備，控制**平面，強化術(shù)中管理是提高圍手術(shù)期安全的保證。

38 、There is evidence to suggest that patients who experience intraoperative nerve injury may have preexisting conditions that made the injury unavoidable, even with proper positioning and padding.───有證據表明，手術(shù)當中有神經(jīng)損傷的病人，有可能術(shù)前就有病情，這類(lèi)患者及時(shí)術(shù)中有適當的體位和軟墊，神經(jīng)損傷也不可避免。

39 、Increased intraoperative blood transfusions may be an early warning isgn of massive bleeding after the procedure.───另外，手術(shù)中輸血量的持續增加是日后發(fā)生大量出血的一種警訊。

40 、Methods: Before and after the ulnar nerve relaxations, intraoperative electrophysiological examinations were performed on 25 patients with cubital tunnel syndrome.───方法:對25例肘管綜合征手術(shù)患者進(jìn)行尺神經(jīng)松解前后的電生理術(shù)中監測。

41 、Intraoperative monitoring is a standard of care during carotid endarterctomy, correction of scoliosis, and resection of acoustic nerve tumors.───下面是列出一些目前常用的監測方法有些目前在美國已經(jīng)被認為是醫療的基本標準.

42 、Objective: To discuss the treatment and prevention of acute intraoperative encephalocele in severe craniocerebral trauma.───摘要目的：探討重型顱腦損傷患者術(shù)中急性腦膨出的術(shù)中處理方法和預防措施。

43 、Methods Among 9 cases of obstructing left-sided colonic cancer, one patient was treated with tumor resection and colostomy, the rest 8 patients were treated with intraoperative decompression, lavage, resection and ananstomosis.───方法：對9例左半結腸癌合并腸梗阻的患者，1例行乙狀結腸造瘺，8例行術(shù)中腸道灌洗，一期切除響合。

44 、We need intraoperative staging for the biopsy, extensive dissection of the retroperitoneum, and excision of the mass with wide, clear margins.─── 我們得術(shù)中取病理 廣泛剝離腹膜后腔 切除邊界寬而清晰的腫物

45 、The perforation was due to inadvertent injury of the esophagus that was deformed and distorted by a large calcified lymph node in the mediastinum during intraoperative TEE instrumentation.───其發(fā)生的主要原因是病人縱膈腔中有一大鈣化淋巴結，且手術(shù)中使用經(jīng)食道超音波造成食道被扭曲壓迫所導致。

46 、The existence of micrometastases cannot be detected by routine preoperative imaging studies and intraoperative observations.───常規術(shù)前影像研究及手術(shù)中的觀(guān)察不能檢查到微轉移。

47 、The intraoperative situation of abdominal adhesion and treatment by laparoscopy were summanied retrospecgively in 41cases.───方法回顧41例患者術(shù)中腹腔粘連情況及處理。

48 、Intraoperative Hypothermia for Aneurysm Surgery Trial.───手術(shù)中低溫下動(dòng)脈瘤手術(shù)試驗。

49 、Methods The nursing cares,such as preparation,closely intraoperative cooperation,postoperative measurements and health education,were put into effect in 45 patients undergone TSV25G.───方法對45例表面**下25G經(jīng)結膜無(wú)縫合玻璃體視網(wǎng)膜手術(shù)的患者加強術(shù)前準備、術(shù)中配合、術(shù)后處理和健康指導,分析這些護理措施對手術(shù)療效的影響。

50 、We hope that the adherence to these guidelines will standardize and improve preoperative and intraoperative LN staging and pathologic evaluation of non-small cell lung cancer.───我們希望我們所制定的指導規范能夠使手術(shù)前和手術(shù)中淋巴結分期規范化，同時(shí)幫助提高非小細胞肺癌的病理診斷價(jià)值。

51 、The other critical piece of equipment is intraoperative ultrasound. A variety of intraoperative probes are produced for use in liver ultrasound. The most useful transducers are 5.0 or 7.5 MHz.───儀器另一個(gè)關(guān)鍵組件是手術(shù)中應用的超聲。不同的外科探頭被用于肝超聲探查。最有用的變換頻率為5.0或7.5赫茲。

52 、Methods Intraoperative cholangiography was attempted in 1?466 patients, and was successfully completed in 1382 patients.The success rate was 94.27%.───方法腹腔鏡膽囊切除術(shù)中經(jīng)膽囊管**管行膽道造影共1466例，1382例造影成功，成功率為94.27%。

53 、Methods Analysing the images of the 16 cases delayedintracerebral hematoma after surgical removal of epidural hematoma,intraoperative atate and postoperative clinical symptom.───方法:對本組16例硬腦膜外血腫術(shù)后出現的遲發(fā)性腦內血腫影像學(xué)及術(shù)中、術(shù)后表現進(jìn)行分析。

54 、Objective This study tried to investigate the possible causative factors, clinical manifestations and therapeutic strategy of intraoperative floppy iris syndrome (IFIS).───摘要目的研究虹膜松弛綜合征(IFIS)的發(fā)病機制、臨床表現及應對措施。

55 、It would provide intraoperative amnesia, analgesia, and muscle relaxation and would possess anti-nausea and anti-emetic properties.───它能提供術(shù)中的遺忘、鎮痛、肌松，并且擁有顯著(zhù)的抗惡心嘔吐特性。

56 、We found that the prominent factor in intraoperative cardiac complications was the presence of hypertension (odds ratio = 2.911).───作者發(fā)現術(shù)中心臟并發(fā)癥的首要因素是高血壓（優(yōu)勢比=2.911）。

57 、We used MRI to define the invading level of the tumor, then blocked the main blood supply with angiography plus gelfoam for embolization simultaneously to reduce the amount of intraoperative bleeding.───我們使用核磁共振攝影來(lái)定腫瘤侵犯的程度，并使用血管攝影加上止血芳來(lái)做腫瘤供應動(dòng)脈阻塞，以期降低術(shù)中流血，依腫瘤外緣切除。

58 、Bradycardia during intraoperative device testing is no reason to abort the operation.───在手術(shù)中的裝置測試期間出現心搏徐緩，不是放棄這種手術(shù)的理由。

59 、We present a case of successful removal of adrenal cortical carcinoma with tumor thrombus extension to the right atrium under comprehensive anesthetic care including continuous intraoperative transesophageal echocardiography monitoring.───我們報告此一病例，是應用經(jīng)食道心?超音波于手術(shù)中連續監測，成功且完全的摘除心房?jì)饶[瘤血栓。

60 、Methods:A retrospective study was made on imaging examination or intraoperative frozen section of 8 cases of CRCC.───方法:回顧性分析8例囊性腎癌術(shù)前影像學(xué)檢查或術(shù)中冰凍切片,并進(jìn)行分析。

61 、Abstract: Objective To eveluate the effects of combined intraoperative hepatic arterial chemoembolization (HACE) and postoperative hyperfractional radiotherapy (HRT) for unresectable liver cancer.───文摘:目的觀(guān)察術(shù)中肝動(dòng)脈化學(xué)藥物栓塞聯(lián)合超分割放射治療不能切除肝癌的效果。

62 、However ,the transperitoneal and retroperitoneal approaches were similar in terms of estimated blood loss,hospitalization after operation,intraoperative complications and postoperative complications.───但經(jīng)腹膜和腹膜后方式在估計出血量、術(shù)后住院時(shí)間、術(shù)中并發(fā)癥和術(shù)后并發(fā)癥發(fā)生率上無(wú)明顯差異。

63 、This study was to explore application of combined therapy of intraoperative hypotonic peritoneal chemo-hyperthermia and early postoperative intraperitoneal chemotherapy to gastric cancer.───本研究擬探討術(shù)中即時(shí)低滲溫熱腹腔化療聯(lián)合術(shù)后早期腹腔化療的應用價(jià)值。

64 、Methods 66 patients suffered from malignant bone tumors around the knee were treated with intraoperative microwave heliotherapy in situ (38 cases) and knee prosthesis replacement (28 cases).───方法采用微波原位滅活術(shù)和人工假體置換術(shù)對66例膝關(guān)節周?chē)鷲盒阅[瘤患者行保肢術(shù)，微波原位滅活38例，人工膝關(guān)節置換28例。

65 、This might be caused by injudicious fluid administration after trying to correct intraoperative hypotension due to neurogenic shock.───推斷原因可能是因術(shù)中矯正神經(jīng)性休克造成之低血壓而給予過(guò)量之輸液所造成。

66 、Eliminate intraoperative surprises; extensively extract all the information from the preoperative studies.───手術(shù)前極力找尋所有信息,杜絕手術(shù)中的意外發(fā)現。

67 、This intraoperative movement will be important to measure and adjust for as we proceed to address more detailed aberrations with custom ablations in the future.───如果我們在未來(lái)要進(jìn)一步表述個(gè)性化手術(shù)中像差更多更詳盡的東西，這種手術(shù)當中發(fā)生的運動(dòng)對于測量和調整將是十分重要的。

68 、How do you treat an episode of intraoperative anaphylaxis?───如何治療該手術(shù)中出現的過(guò)敏反應？

69 、Methods:the intraoperative sections were frozen by different temperature and different time.───方法:術(shù)中冰凍切片選用不同的冷凍溫度和時(shí)間。

70 、Intraoperative angiography showed that satisfying management was achieved in 36 of the 38 patients (94.7%), and residue of ophthalmic artery aneurysm was seen in 1 patient which underwent clip adjustment later.───36例(94·7%)經(jīng)過(guò)造影證實(shí)病變處理滿(mǎn)意,1例(9·0%)眼動(dòng)脈瘤夾閉后有殘留,重新調整動(dòng)脈瘤夾;

71 、Methods: The patients with uterine fibroids were done purposeful nursing intervention during the preoperative, intraoperative and postoperative surgery of interventional therapy.───方法：對子宮肌瘤病人介入治療術(shù)前、術(shù)中以及術(shù)后采取針對性的護理干預。

72 、Intraoperative use of sulphan blue dye was associated with almost fatal anaphylaxis in a woman.───手術(shù)中酸性藍試劑與例婦女的致死性過(guò)敏反應相關(guān)。

73 、Intraoperative hemorrhage form innominate artery is very rare and often fatal complications during tracheostomy.───摘要氣管切開(kāi)術(shù)中發(fā)生無(wú)名動(dòng)脈大出血是相當罕見(jiàn)的并發(fā)癥，而且往往有致命性的危險。

74 、Method Diagnosis was made by a combination of clinical presentation,venography and intraoperative venous manometry,and operations for 14 cases who have serious symptoms were performed.───方法結合臨床表現、靜脈造影及術(shù)中靜脈壓力測定，對本病做出診斷，癥狀嚴重者施以相應手術(shù)治療。

75 、Methods The intraoperative situation of abdominal adhesion and treatment by laparoscopy were summarized retrospectively in 92 cases.───方法回顧92例患者術(shù)中腹腔粘連情況及處理。

76 、Method.Iso-C 3-dimensional intraoperative navigation was used to localize osteoid osteomas of the spine in 4 patients.───方法：術(shù)中ISO-C3D導航技術(shù)用于4名患者術(shù)中脊柱骨樣骨瘤的**。

77 、Three patients with a preoperative impression of renal cell carcinoma received nephron-sparing surgery because of intraoperative frozen section which revealed the angiomyolipoma.───三位病患術(shù)前診斷為腎細胞癌因為術(shù)中冰凍切片報告是血管肌脂肪瘤而接受腎臟保留的手術(shù)方式。

78 、Intraoperative fluoroscopy is used routinely in the operating room for a variety of surgical cases.───在很多手術(shù)病例中，常規在手術(shù)過(guò)程中進(jìn)行透視。

79 、Navigating the Fluoroscope's C-Arm Back into Position: An Accurate and Practicable Solution to Cut Radiation and Optimize Intraoperative Workflow.───導航下投射器C形臂復位：一個(gè)準確的、適用的解決投射和優(yōu)化術(shù)中工作的方法。

80 、The intraoperative posture of 382 patients scheduled for microneurosurgery were analyzed in the present study.───總結和分析了382例顯微神經(jīng)外科手術(shù)病人的術(shù)中體位護理情況。

81 、The incidenc of the intraoperative hemorrage, asphyxia neonatorum, birth trauma were significantly higher in the macrosomia group than that in the control group (P───巨大兒組剖宮產(chǎn)及產(chǎn)鉗助產(chǎn)率高，產(chǎn)時(shí)出血多，新生兒窒息、產(chǎn)傷發(fā)生率高。

手術(shù)前自己“洗一洗”切口部位，就能降低手術(shù)后感染的發(fā)生率嗎？

骨科的很多手術(shù)都比較大型，而且大部分手術(shù)都存在內植物放進(jìn)人體體內的過(guò)程。只要是手術(shù)，存在手術(shù)切口手術(shù)后就有潛在發(fā)生感染的風(fēng)險，這就跟坐飛機一樣，發(fā)生的概率很低，但一旦出現就是災難性的。

手術(shù)前黑鍋經(jīng)常用上面坐飛機的例子來(lái)給病人跟家屬舉例講解，以求他們能夠意識到術(shù)后感染的可怕！但事實(shí)上，關(guān)節置換術(shù)后感染的概率要比坐飛機出事的概率要高得多！

東西臟了不能吃，容易拉肚子！那么準備切口的皮膚臟了容易感染，手術(shù)前“洗一洗”自己切口的部位，是不是能夠降低手術(shù)后感染的發(fā)生率呢？

這就提出了這篇科普圍繞的一個(gè)話(huà)題：

到底骨科手術(shù)之前，進(jìn)行的術(shù)前皮膚清洗，是不是會(huì )降低手術(shù)后手術(shù)部位感染及植入物周?chē)腥镜娘L(fēng)險呢？

答案是肯定的！

上面這篇權威雜志的最新文獻指出：骨科手術(shù)前進(jìn)行的術(shù)前皮膚清潔，確實(shí)有助于減少隨后的手術(shù)部位感染（SSIs）和假體周?chē)P(guān)節感染（PJIs）的發(fā)生率！

具體來(lái)說(shuō)，葡萄糖酸氯己定（CHG，也就是醫學(xué)上常用的“洗必泰”）已被證明在預防PJIs/SSIs方面有很好的效果。

1、美國疾病控制中心（Centers for Disease Control）指出：術(shù)前使用抗菌劑進(jìn)行皮膚清潔，可大大減少皮膚微生物的數量1。

很多人可能會(huì )說(shuō)，那么我手術(shù)前就用水多洗洗，用點(diǎn)肥皂，用點(diǎn)沐浴露，應該也能達到消毒的效果吧？

其實(shí)不是！術(shù)前皮膚清潔可使用多種藥劑進(jìn)行，而不只是單純的用水來(lái)洗，因為用水來(lái)洗的話(huà)，效果沒(méi)那么好！來(lái)看看數據：

一項納入700多名患者的前瞻性研究發(fā)現2：使用洗必泰洗澡和擦洗的患者，手術(shù)中傷口微生物培養**率為4%，使用聚維酮碘（另外一種消毒液）的患者為9%，使用肥皂和水洗澡的發(fā)生率高達14%......可見(jiàn)單純用水，肥皂甚至沐浴露，效果還是不可靠呀！

2、培養出微生物那也只是一個(gè)概率問(wèn)題呀，真的對于減少手術(shù)后切口感染及骨科植入物周?chē)腥镜娘L(fēng)險有效果嗎？

對于這個(gè)問(wèn)題，國內外也做過(guò)很多研究，結果眾說(shuō)紛紜，有的有效，有的沒(méi)效，但貌似沒(méi)有說(shuō)會(huì )增加的......下面選取了病例數最多的幾篇研究給大家看看，畢竟是要靠數字說(shuō)話(huà)的嘛！

2016年，老外的一篇研究，納入了3717例接受初次膝關(guān)節置換和翻修手術(shù)（第2次關(guān)節置換手術(shù)）的病人，研究結果發(fā)現：與未接受洗必泰術(shù)前清洗方案的患者相比，入院前使用洗必泰方案的患者，膝關(guān)節置換術(shù)后PJIs的相對風(fēng)險明顯降低?。?.3% vs. 1.9%，將近7倍）3。

另外有人對國外Cochrane數據庫中的10,000多名患者進(jìn)行了系統的回顧，他們也得出結論：手術(shù)前使用洗必泰清洗，總比不洗澡好......然而，這似乎沒(méi)有改變感染的發(fā)生率4！

文獻眾說(shuō)紛紜，有些文獻說(shuō)骨科手術(shù)前進(jìn)行皮膚清潔對減少手術(shù)部位感染和骨科植入物手術(shù)后周?chē)腥居忻鞔_的作用，有些文獻又說(shuō)影響不大！這個(gè)到底要怎么選擇呢？

要知道，目前沒(méi)有任何關(guān)于術(shù)前進(jìn)行皮膚清洗有負面影響的文獻報道；同時(shí)，使用洗必泰消毒引起的皮膚過(guò)敏也非常少。那么，這利大于弊的事，為啥不做呢？

3、既然選擇手術(shù)前好好“洗一洗”手術(shù)部位了，那么應該怎么洗，洗多久才比較合適呢？

還是上面的那一篇文獻為例來(lái)說(shuō)，畢竟人家納入的研究數有3,717例，而且得出來(lái)的結果是：用洗必泰清洗比不清洗有助于減低術(shù)后感染風(fēng)險3。

通過(guò)篩選，這篇文章最初確定了3842例患者，這些患者均是在2007年至2013年期間在同一家醫院，由4名相同的骨科醫生手術(shù)，先后接受了關(guān)節置換手術(shù)（初次置換或者翻修手術(shù)）。

其中，排除了125名在術(shù)后1年隨訪(fǎng)中死亡的患者，最終共獲得3717例研究數，樣本量大可以說(shuō)很有說(shuō)服力了！

根據各個(gè)病人的醫療記錄，對所有病人進(jìn)行再入院或醫院就診的監測，以及時(shí)發(fā)現手術(shù)后感染的跡象。如果隨訪(fǎng)的過(guò)程中發(fā)現有感染的跡象，則根據臨床上常見(jiàn)的診斷感染的診斷學(xué)方法、實(shí)驗室檢查等臨床數據，以確定是否存在感染。

具體清洗方法：

術(shù)前準備很多塊訂制的含有12%洗必泰的用于擦洗的布（Sage Products, LLC, Cary, IL, USA 美國制造），每塊布包含有500毫克葡萄糖酸氯己定（洗必泰）。手術(shù)前叮囑患者不要洗澡，如果病人洗澡了，則要等2個(gè)小時(shí)之后再使用這些布，因為洗澡會(huì )干擾試驗的真實(shí)性。

病人要在手術(shù)前一天晚上用6塊布，其余的6塊在手術(shù)當天手術(shù)前使用。具體擦拭的6個(gè)部位如下：

①脖子，胸口和肚子；

②背部；

③上肢；

④左下肢；

⑤右下肢；

⑥手術(shù)部位；

在這種擦洗過(guò)后，叮囑患者不要洗澡或者使用任何外用藥物自行消毒！

結果得出來(lái)的結論就是：術(shù)前使用洗必泰布消毒方案可降低膝關(guān)節置換手術(shù)后植入物周?chē)腥镜南鄬︼L(fēng)險！

所以，如果手術(shù)前真的要洗澡，洗身體，就按照這種方案，這6個(gè)部位，好好使用洗必泰溶液洗一洗吧！

最后，附上一張“洗必泰”的說(shuō)明書(shū)，希望大家在做關(guān)節置換跟其他放置骨科植入物之前，都可以給自己洗一洗！

參考文獻

1、Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for Disease control and prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control 1999;27:97e132. quiz 133-134; discussion 96.

2、Garibaldi RA. Prevention of intraoperative wound contamination with chlorhexidine shower and scrub. J Hosp Infect 1988;11(Suppl B):5e9.

3、Kapadia BH, Zhou PL, Jauregui **, Mont MA. Does preadmission cutaneous chlorhexidine preparation reduce surgical site infections after total knee arthroplasty? Clin Orthop Relat Res 2016;474:1592e8.

4、Webster J, Osborne S. Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev 2015: CD004985.

好了，今天的科普就到這，如果你有什么意見(jiàn)或者建議，歡迎在評論區給黑鍋留言~寫(xiě)文不易，快快收藏轉發(fā)給需要的那個(gè)TA吧！#小黑鍋說(shuō)科普##清風(fēng)計劃##頭條辟謠#

醫院外科手術(shù)中的燈柄是術(shù)中的污染源之一嗎？建不建議術(shù)中使用？

那個(gè)把兒是一次性的。。。

但是超過(guò)了無(wú)菌區域，所以還是有潛在的感染風(fēng)險的。

但是找護士對燈總歸沒(méi)有自己調的速度和舒服。。。

不過(guò)現在我們用宮腔鏡和腹腔鏡比較多，好多了[呲牙]