BI 10: K THUT BO QUN BNG, BNG GC V CH KHU PHU

THUT

A. MC TIU BI HC
1. K c tn v nu c c im ca cc loi bng, bng gc
thng dng trong y t.
2. Trnh by c cc bin php k thut chung bo qun bng,
bng, gc v ch phu thut.
B. NI DUNG BI HC

10.1.BO QUN BNG, BNG, GC

BNG- BNG- GC

-L nhng phng tin cn trong cng tc y t

-C tc dng gi vt thng nhim trng, cm mu.

10.1.1. Bng

Trong y t thng c hai loi: bng m v bng ht

10.1.1 Bng m

- L bng c loi sch nha, sp bao quanh cha ty sch cht bo

nn khng thm nc.

- Mu trng ng, s nhn tay, khi p xung th phng ln.

-Dng m np gy xng,t ngoi lp bng ht ca bng cp cu

mu, m khng thm dnh ra qun o, lm vt chn lt trong bao gi.
10.1.1.2. Bng ht

- L bng c loi tp, ty sch cht bo, bng ht c mu trng, thm

nc, s nhp tay.

-Dng thm ht nim dch kh trng, ht mu m, dch

tit ca vt thng.

Bng ht phi
t cc yu cu cht
lng:

- Trng,
khng mi v, trung tnh.
- ng iu, khng ln tp cht.
- Dai si, s khng qu cng, khng m.

10.1.1.3. Cc cht thay th bng

phng chy mu trong phu thut ngi ta dng bng fibrin v

bng gelatin.

Bng gelatin

-Ch t loi gelatin tinh khit

-Mu trng v mm nh bt cao su hoc ging bt bnh m,

-Cng dng ging bng fibrin

Bng fibrin
- Ly t mu ngi hay ng vt
 - Mu vng, xp nh ming bt cao su,
- Tc dng cm mu tt. Sau khi ht mu,
bng fibrin mm v bin thnh mng fibrin,
sau 7- 10 ngy bng tiu ht.
Bo qun: ng gi trong hp st tit trng k

10.1.2. Bng: C tc dng bo v vt thng, chng nhim khun.

Gm: - Bng cun
- Bng c nhn
- Bng dnh

10.2.1.1 Bng cun: gm bng gc, bng vi c nhiu loi kch thc khc
nhau.
Bng gc:
- Lm bng gc tha.
- Dng bng gc vt thng thong.
- Di khong 5- 10m, rng 0,05-0,16m.
 Bng vi:
- Lm bng vi mc v vi phin.
- Chc hn bng gc, bng vi thu hi c c th dng
nhiu ln nhng kn, km co gin.
- Gm cc c: 5x0,1m; 5x0,07m; 2,5x0,05m.

Bng cun c gi ring tng cun hoc ng gi trong 10 cun.

10.1.2.2 Bng c nhn: Thng s dng ph bin cho mi c nhn, cn
gi l bng cp cu.
Gm: Mt cun bng c kch thc 5mx0,05m v 2ming bng gc c kch
thc 0,11mx0,13m .
Bng thng c tm thuc st trng trc hoc c km theo gi bt
sulfamid v mt s phin bng.
Ngoi ra bng c nhn cn c loi nh, tin li c hp v kh trng sn
c bo v bao trong gi cn thn khi dng th mi m ra, trnh xy xt
v lm rch bao gi.
 10.1.2.3. Bng dnh

Dng bng che cc vt thng nh, bo v vt thng ch kh

bng.

10.1.3. Gc

- L loi vi rt tha. Phn bit bng s si ngang, s dc.

- xe ca si nh hng n cht lng gc, se nhiu th bn

chc nhng thm nc km.

Gc y t l gc c se trung bnh.

- Gc ht: gc kh em ty sch h nn c tc dng thm

nc.
- Gc h : gp mc h tinh bt cho cng, dng b bt
thch cao.
Bo qun: ng gi thnh tm hoc thnh cun c kch
thc khc nhau.

10.1.4. Bo qun bng bng, gc

 Bo qun bng , bng, gc cng knh,

chim th tch ln, d b m, d chy, d b mi chut

cn.

Do cn phng m v cc loi cn trng

10.2. Ch khu phu thut

- Ch khu phu thut dng khu vt thng hay tht mch mu.

- Ch khu phi t yu cu v cht lng.

- Mi trng hp phu thut cn mt loi ch khu ring.

- C 2 loi ch khu:

Ch tiu c v ch khng tiu c

10.2.1. Ch khu tiu c trong c th

y l loi ch khu c ch to c bit, i hi v yu cu cht lng
nghim ngt. Chng c c im l tiu c trong c th m khng cn
ct ch sau khi phu thut.

u im
Khng lu vt l trong c th.

Nhc im
Khng bit trc c khong thi gian m si ch cn lc bn chc
nng vt thng.

Nhng loi ch khu c ch to t nguyn liu t nhin hay tng hp

Ch khu c ch to t nguyn liu t nhin
M ng vt
M thc vt
Kim loi
u im
D s dng
Gi tng i r

Khuyt im
L vt l i vi h thng min dch c th
To phn ng ti ch lm bnh nhn au v kh chu

Ch khu c ch to t nguyn liu tng hp

c ch to bng nhng ha cht gn ging cht t nhin

u im
Ch tiu rt chc, to phn ng ph t
Thi gian duy tr lc bn
Thi gian tiu hon ton bit trc chnh xc

Nhc im
Kh s dng

10.2.1.1. Catgut
L ch khu phu thut t tiu c ngun gc t thin nhin

Thnh phn
Thnh phn cha 97-98% collagen nguyn cht thu c t cht nhy ca
rut cu v huyt thanh trong rut b

Cc si t c x l bng mui chromic gip

Tng cng kh nng chng li cc enzyme phn hy
To ra mt lp ph gip si ch bn hn
Ko di thi gian hp th lu hn

Loi ch phu thut ny c th gip vt khu tt trong vng 14-21 ngy

10.2.1.2. Ch gn ui chut
c ch to t gn ui chut trng. Ch gn ui chut c s dng
khu trong phu thut mt.
Bo qun : chr thng c ng gi trong l kn, c cha ethanol pha
thm 1% xanh methylen. Ch phm cn c bo qun nhit lnh.
10.2.2. Ch khng tiu c trong c th
c ch to t nhiu ngun nguyn liu khc nhau:
 ng vt: ch t tm, ch cc.
Thc vt: ch lanh.
Kim loi: ch bc, ch ng, ch thp khng g.
Cht do tng hp: ch polyester, ch nylon, ch polypropylene.
10.2.2.1. Ch t
Ly t hch sinh t ca con tm, em ty trng v tit khun. Bo
qun loi ch ny cn phi trnh m mc. Ch t lu s lm gim
bn c hc nn thng c hn dng l 3 4 nm.

10.2.2.2. Ch cht do tng hp

Nguyn liu chnh sn xut loi ch ny l polyamid hoc
polyester. Ty theo mi nc sn xut, ch tng hp c gi bng
cc tn khc nhau nh: Nilon (Php), Beclon (c), Capron (Nga)
Ch c ch to bng phng php cng nghip nn rt u, sc
chu lc ko cao, chu c nhit d tit trng, khng gin gy
Bo qun loi ny ch cn trnh m mc, trnh nh sang, nhit
bo qun phi n nh. Cn ch l khng nn tch tr qu nhiu v
nu qu lu ch s b bin cht nh: gin, gim bn c hc,
bin mu
 10.2.3. Ch kim loi
Loi ny thng c ch to t cc kim loi nh: bc, ng
thng c dng trong phu thut xng.
Bo qun: Trnh m, trnh tc nhn oxy ha n mn kim loi.