犬胃切开术说课材料.pptVIP

第七节 犬胃切开术 Canine gastrotomy;Ventrodorsal腹背 survey测量 radiograph of the abdomen of a dog with ingested pennies. ;Abdominal radiographs confirmed the presence of an air filled spherical（球形的） structure in the area of the stomach ;Arrows point to the distended abdomen.? This dog is normally very thin. ;This view is of the dog laying on its side under anesthesia.? The ballooning of the abdomen is apparent.;This is the x-ray image of the dog prior to the procedure to relieve the gas distension ; 【preoperative preparation】非紧急手术，禁食24h以上。急性胃扩张—扭转病犬，术前积极补充血容量和调整酸碱平衡。出现休克症状的犬应纠正，快速静脉内输液应有中心静脉压监护，静注林格尔氏液与5％葡萄糖或糖盐水，剂量为80~l00ml/kgbw，静注氢化考地松和氟美松各4~10mg/kgbw，氯霉素50mg/kgbw。在静脉快速补液的同时，经口插入胃管以导出胃内蓄积的气体、液体或食物，以减轻胃内压力。;【anesthesia】全身麻醉，气管内插入气管导管，以保证呼吸道通畅，减少呼吸道死腔和防止胃内容物逆流误咽。 【restrain】仰卧保定。 【operative approach】脐前腹中线切口。 【operative method 1】;Incise abdominal wall on medioventral line ahead navel and abdominal cavity 脐前腹中线切开腹壁，暴露腹腔;Incise peritoneum 切开腹膜;Pull the falciform ligament out of the incision将镰状韧带拉出切口外;Ligate and excise the falciform ligament 结扎后切除镰状韧带;Put sterilized gauge at the sides of wound and apply retractor to the incision. 切口两边衬以纱布后装置牵开器;Pull stomach out of the wound 将胃牵引至创口外;Select incising position between greater and lesser curvature of the stomach with less of blood vessel 在胃大弯和胃小弯之间血管较少处确定切口;Suture 2 traction lines at the two ends of schedualed incision on stomach 在预定切口线两侧装置固定牵引线;Incise stomach wall切开胃壁;Connect the whole stomach wall by continuous suture or Connel suture全层连续缝合或康乃尔缝合;Connect serosa and muscle layer by inverting suture 内翻缝合胃壁浆膜肌层;Close abdominal incision常规闭合腹壁切口;【术后治疗与护理】1.术后24h内禁饲，不限饮水。2.24h后给予少量肉汤或牛奶，术后3天可给予软的易 消化的食物??应少量多次喂给。3.在恢复期间，注意动物水、电解质及酸碱平衡是否 发生了失调，必要时应予以纠正。4.术后5天内每天定时给予抗生素，可首先选用氯霉素 150mg／kg体重，每天二次肌肉注射。5.密切观察胃的解剖复位情况，特别在胃扩张—扭转 的病犬，经胃切开减压整复后，注意犬的症状变 化，一旦发现胃扩张—扭转复发，应立即进行救治;6. a percutaneous经皮的 gastrotomy tube (stomach tube) enabling their owner to force feed kitty小猫 to re-establish consistent nutrition. ;;Laparoscopy腹腔镜检查 was pe