臨床執(zhí)業(yè)醫(yī)師考試大綱復(fù)習(xí)外科學(xué)名師輔導(dǎo)講義

1、臨床執(zhí)業(yè)醫(yī)師考試大綱復(fù)習(xí)外科學(xué)名師輔導(dǎo)講義第十七篇 外科學(xué)第1章 無(wú)菌術(shù)考綱要求滅菌、消毒概念和方法。手術(shù)洗手方法和原則。不同手術(shù)區(qū)消毒范圍和原則。手術(shù)中的無(wú)菌原則。 復(fù)習(xí)要點(diǎn) 一、滅菌消毒概念和方法1無(wú)菌術(shù)無(wú)菌術(shù)包括滅菌法、消毒法、操作規(guī)則及管理制度。2滅菌法滅菌法化學(xué)方法應(yīng)用甲醛、環(huán)氧乙烷、戊二醛等溶液進(jìn)行滅菌，可殺滅一切微生物 電離輻射用于藥品、抗生素等的滅菌紫外線用于空氣的滅菌高溫最常用物理方法滅菌法是指殺滅一切活的微生物。包括物理方法和化學(xué)方法。3消毒法 消毒法又稱抗菌法，是指殺滅病原微生物和其他有害微生物，但并不要求清除或殺滅所有微生物。二、無(wú)菌操作原則 2手術(shù)區(qū)域皮膚消毒方法 對(duì)

2、嬰兒、面部皮膚、口腔、肛門、外生殖器等部位，不能用碘酊消毒，應(yīng)選用刺激性小的消毒劑，如0.75%吡咯烷酮碘。在植皮時(shí)，供皮區(qū)的消毒可用70%酒精涂擦23次。涂擦皮膚消毒劑時(shí)，一般由手術(shù)中心部向外周涂擦。如為感染性傷口、肛門部、結(jié)腸造瘺口等部位手術(shù)，則應(yīng)自手術(shù)區(qū)域外周向切口部涂擦。已接觸污染部位的藥液紗布，不應(yīng)再返擦清潔處。3無(wú)菌操作原則 （1）手術(shù)人員無(wú)菌區(qū)的規(guī)定 手術(shù)人員肩以下、腰以上、腋中線以前的區(qū)域?qū)儆跓o(wú)菌區(qū)域。（2）手術(shù)野無(wú)菌區(qū)的規(guī)定 手術(shù)臺(tái)緣以上、麻醉架及托盤以內(nèi)的區(qū)域。（3）同側(cè)手術(shù)人員的換位 一人先退后一步，背對(duì)背轉(zhuǎn)身達(dá)另一位置，以防觸及對(duì)方不潔區(qū)。（4）器械的傳遞 不準(zhǔn)從手術(shù)人

3、員背后傳遞器械及用品。（5）術(shù)中如手套破損或接觸到有菌的地方，應(yīng)立即更換手套 前臂或肘部碰到有菌?？键c(diǎn) 題少。參考答案1b 2bc29c91afe4ced1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afedd1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af95ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9d1b6c8795ad9c9

4、1afe4ced1b6c8795a1afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced

5、1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91d1b6c

6、8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced1d91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c871afe4ced1b6c8795ad9

7、1afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4

8、ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8791afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1

9、b6c8795ad29c91afc91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c879

10、5ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795a

11、d29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced15ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8

12、795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced195ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4c

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14、1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af795ad9c91fe4ced1b6c8795add1b6c8795ad9c91afe4c

15、ed1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af29c91af4ced1b6c8795ad1b6c8795ad9c91afe4ced1b6c8795ad91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad29c91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c9d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af1afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd1bd1b6c8795ad9c91afe4ced1b6c