肾内科常见手术操作（Common surgical procedures in nephrology）.doc

肾内科常见手术操作（Common surgical procedures in nephrology） Operation 1: internal arteriovenous fistula operation 1. patients were supine position, left upper limb abduction, routine sterile sterile sterile towel. 2. according to the preoperative localization (between the cephalic vein and radial artery), the left forearm hand root longitudinal incision about 3cm long, cut the skin, subcutaneous layer, separating the cephalic vein and radial artery, avoid the anterior nerves. 3. free head vein and radial artery were about 2cm, stripped of adventitia and ligated vascular branch. The distal end of the cephalic vein was ligated and proximal heparin water was used to expand the cephalic vein. Trim the end of the cephalic vein for anastomosis. The sharp knife cut the radial artery, the anastomosis was about 0.8cm, and the 7-0 proline line underwent continuous end to side anastomosis. The anastomosis showed no oozing of blood, the patency of the anastomosis was good, the blood flow was good, the cephalic vein could touch the pulse and the blood vessel tremor. 4., the wound fully hemostatic, close the wound, wound external application, surgery, dressing, complete. Operation two: renal biopsy was used to record the pathological condition of the patients and to guide the treatment. This afternoon, the patients underwent B-ultrasound guided biopsy of the kidney in the B ultrasonic room. The patient was instructed to urinate before surgery. Select the right kidney biopsy is lower, the back of the needle, the conventional disinfection shop towels, with 2% lidocaine local anesthesia, placement of guide, 18G biopsy gun along the guide needle tip to the renal capsule, trigger kidney biopsy gun biopsy needle is lower, then, drawing satisfaction, repeated 1 times after operation the renal biopsy, divided into three parts respectively in light and electron microscopy, fluorescence microscope tube to save pathology. The patient had no obvious discomfort, and the lathe was back to the ward. Pa