...1 HB sag...1...1...5...7...11...12...12...13...14...15...19 TURP...24...26...32...33...35...36...37 I
...40...41...42...47...50...50...52...54...56...58...61...62...63...64...65...69...69...76...80...81...81...83 II
...85...90...93...96...98...99... 103... 105... 108... 110 Fontan... 110... 114... 116... 118... 119... 124... 124... 126... 128... 130... 136... 139 III
... 140... 142... 145... 147... 150... 150... 152... 154... 154... 158... 158... 162... 164... 168... 170... 172... 174... 174... 177... 180... 182... 185 IV
... 187... 188... 190... 190... 190... 191... 193... 193... 194... 195... 195... 196... 198... 198... 200... 201... 202... 204... 206... 207... 208... 209 V
HB sag 1 2 1 200 84 3 1 100 84 4 1 100 84 2 5 1 200 84 6 1 200 84 7 PP +40% 2 23 3 1
1 1.1 1.1.1 1 1.1.2 1 1.2 2
1 5cm 3 4 100 200ml 18G 1 2 4h 40min 4300ml 1.3 1.3.1 40% 0 2.7kPa 1 ( ) 50min 1.3.2 10 30 3
4 1.3cm 0.13kPa(1mmHg) 1 1.3.3 1ml*h -1 /kg 2 2 1
1 5
2 ALCON 0.5% ALCAIN E 20S 15min 15min 1 2 /5min 4 2.8mm ( MEYCO ), Healon 1.5mm 3 9, / Healon 0.3ml 0.01%CARBACHOL( ALCON )0.3 ml 2 U+ 2.5mg 1 60% 2 6
7 Healon BSS 3 3 9/0
Alcon 1 2 U 2.5mg 1 4h 2 50% 0.5ml 0.4ml 1 MIDLABS 20kPa 610 700 /min 1.07 1.33kPa, 2.67kPa 8
2 3 Lander's Woldoff's30 4 15 2 3mm 5 2 10 35% 15% 2% 9
10 75% 1, 2 7.2mm 8.2mm 3
11 (1) (2) 45 o 120 o (3) (4)
12 ( ) + 1 2 ( ) 11 15
3 1 2 1 2 2 3 30cm 4 0.5% 0.25% 0.25% 30 40ml 0.5% (10ml 1 ) 12 13
1 (6 14) 1 5 0.5% 11 15 1 1 14
2 3 () ( ) 1. 2. 3. 15
4. 5. 6. 5 12 6 14 7 17 8 20 9 24 9 34 10 28 11 24 () 1# 4# 7# 10# 1/0 10/0 16
1. 000 0 1 4 7 10 60 cm 70 cm 2. (1) ( ) ( ) 6/0-11/0 1 10 2/0 6/0 10 2/0 6/0 17
(2) 0 9/0 3. 6 20 (1) (2) 1# 2# 0# 1/0 2/0 3/0 4/0 5/0 18
4. ( 1.omm) ( 5mm) ( 6mm) 1cm 1 24 h ( 2000W ) EV1 EV2 90 kpa 1 (1) 19
30 ml/h (2) 18 18 (3) FUL 90 kpa 2 20
21 3 1 2 STORZ 4mm 0 30 70 40min 3 1%
4 5 12 30 75% 1% 20ml 2ml 4 1% 10ml 4 5.1 22
5.2 2 1% 50 70mg 5mg 100 300ml 5.3 23
24 TURP 1 TURP (1) (2) (3) (4) (5) (6) (7) (8) (1) (4% ) (5% ) (2) 2.1% 1.1%1.5% (3) 5% 79% 89% 3% 4%5%
(4) 5% 3% 5% 6% 2 TUR TUR 2 400 7 200ml 2.1 2.1.1 60 70cm 2.1.2 25
2.1.3 2.2 TURP 1 h 1 h TUR 2.3 TUR 1 1.1 C 2.1.2 70 90 26
27 1.3 1.4 1.5 90% 100% 7%
28 1.6 1.7 Charles. Gustilo 1.8%,Gustilo 3.8% Gustilo 9.5% [2] (1) (2)
29 (3) 2 2.1 2.2 (1) (2) (3)
30 (4) ( ) (5) T (6)C (bastista)
1 30min ( ) 2 3 2min 7 17 5cm 3cm 3 3cm 45 2cm 2cm 2cm 2cm 9.1cm 31
3.4cm 4.6cm 1.1 1.4cm 44.3g 2-0Prolene 6.5cm 1.5cm 2-0Prolene 20w/s 4 800ml 30min 2 1 32
33 ( ) 74 2 2 50% 1
45 2 1 5000 PVP 75% 3 2 65 56 /min 50% 60ml 34
1 76 1 2 3 30min 30min 2h 4 6h 3 5min 15 20min 35
5 5 7 2 3 1 3 2 5min 3 3 36
1 1.1 1.2 X 37
38 24h ( ) 2 2.1 2.2 2.3 0.04kPa 0.08kPa 0.03kPa 0.06kPa 1h 10 15min
2.4 2.5 2.6 2.7 39
40 (1)
(2) (3) 1 2 3 4 1 41
42 2 3 4 5 1. (1)
(2) 1) 15 20 2) 3) 4) 5) 43
44 6) 10% 7) 8) 2. (1)
45 (2) 1) ( ) 2) ( 30 ) (X ) 3) 4) 5)
46 6) ( ) 7) 8) 9) 10)
(1) 40% 4ml 2ml 2g 48 72 1 30 (2) 20% 15ml 60 20 70% 1. 1) 47
3 2) 3% 1 1000 84 40% PP 1 100 84 1 100 84 3) 4) 2. 1) 2) ( ) 48
3) 1 100 84 3 1) 100 84 2 1 100 84 2 2) 3 3) 1 2 84 40% PP 2mL PP 1g 3 1 49
4)3 40% 6 4 15 4-0Prolene 20 2 4 1 2 3 50
51 3 30 min 5min 1.5cm ( ) 4 4-0Prolene 3 -
4-0 Prolene 16 4-0Prolene 4-0Prolene ( ) - 3 1 1.1 1h 37 42 1 1h 2 (4 U /100 ml) 10 min 3 52
1.2 5 min 15 20 15 min 2 2.1 1h 15min 2.2 2.3 2.4 37 42 1 h 15 20 15 min 2.5 3 53
1 1 2 12h 1h 0.5h 0.5% 84 KJD1200 22 25 50% 60% 50 m2 2 1 54
90 2 (1) 1 (2) (3) 1 3 45 1 2 min 1 h 10 min 4 2 55
56 10 cm 200 cm 1/3 1/3 1
5 cm 30 WOLF 2 2.1 Odwyer Bobic Gruenwald 2.2 57
2.3 / 1 1.1 ( 60 ) 1.2 (1) (2) (3) 2 58
2.1 (1) ( 155cm) (2) 5cm (3) 90 15 10 15 2.2 (1) 1 1min 59
(2) 15 30 45 60 75 90 2 10 102 37 (3) 2 (4) 2.3 90 60
10 15 1 2 3 18 20 1 2 24cm 4 ( ) 2/0 61
62 0.6 1cm 0.5cm
63 1 2 ( ) +
3 ( ) 1 0.5 2 64
65 3 (75% ) 4 5 1 1 d 2 25 40% 60% 3 40
66 4 5 6 34 30 (Implantable Contact Lens,ICL)
67 1 2 2.1 2.1.1 ICL ICL ICL 2.1.2 0.5%PVP
2.1.3,4% 0.75% 30min 10min 1 1 2.1.4 40min 2.5% 1% 1% (Cyclogyl) 15min 1 2 3 2.2 2.2.1 ICL 1 Mastel 3.2mm 2.3mm 3.2mm ICL ICL 180 Starr Phaco XL 30 BSS 1 2 2.2.2 68
ICL Starr 1. 2. X 3. 1d 4. 1 69
5. 6. 10 7. 1. 2. 3. ( ) 4. 5. 6. 1. 2. 70
3. 3 6 4. () 1. 2. 3. (1) (2) (3) 4. 1. 2. X 3. 4. TAT 71
1. 23o 25o 60% 2. 3. 1 (1) 1-2o C (2) () (3) 1 2S (4) (5) 4. 10 14d 5. 60 100W 30-45cm 24h 2 6. (1) (2) (3) (4) 72
7. 2-3 1. 2. 2 4 3. 5d 3h 14d 50 100g 3h 45d 48h 10 20min 6h 90d 73
4h 1 4, 4 1.1 1 10 min 2 /d 10 min 2 /d 4 8 1.2, 10 min 2 /d 4 8 1.3, 12 74
, 10 min 2 /d 4 8 1.4 6 18 9.3 (two point discrimination 2PD), 10 7 t 2 75
3 (1), (2) (3) 4 (4) (5) 76
1. 2. 3. 4. B X 5. 6. 1d (1) (2) (3) 8 12 7. (1)75% (2) X 8. 77
1. 2. 20 30 10 14d 3. 4. 5. 6. 3-4d 1. 2. 1 3. 4. ( ) 5. 78
79 1. 2. 3. 4. 1d 75% 5. 1d 6. 1. 2. 3. 14h 4. 5. 14d
1 6. 7. 8. lmm 1. 2. 3. 1 4. 5. id () 80
6. 7. 75% 8. 1. 14d 2. 3. 1 4. 5. 6. 2-4 1. 81
2. 3. 4. 1. 2. - 3. 1. 2. 3. 82
1. 2. 3. 30min 1. 2. 26kPa 3. 1. 2. 83
3. 4. 1. 2. 3. 1. 84
2. 3. 4. 5. 6. 7. ( ) 8 30 60 12 16 30 60 12 500 U 1h 2 500 U <20 000 85
U (PT) CCU24h 200 300 g 1 1.1 PT 24h PT 24s + + PT 6h 7 500 U 12 500 U 500ml 4h 16ml/h 4h 17ml/h 8h 19ml/h 2 4 15 20 /min 500ml 5 10 7 500U 12 h 1 0.4ml 6h 0.3ml 12h 1 1 10 1 3 86
PT 1.2 24h 2 CCU S-T T PTCA 2 2.1 1 4 6h 24h 4 6h 2.2 8 87
2.3 24h 24h 8h 24h( ) 48h 48h 72h 3 3.1 32 14 18h 4h 24h 3.2 3.3 2 30min 80min 88
1000ml 500 5 10min 3.4 30min 3h ( ) ( ) ( ) 4 1 30 40 /min 6/0kPa 2mg 40 60mg 89
50 100mg 1 TMLR 3 6 1 90
2-60 /min 1 1 3 1 3 1 1.1 70 80 /min >90 /min 91
50mg 1.2 2.67kPa(20mmHg) 1.3 1 1.18 1.37kPa 1ml/kg 2 8Am 4pm 2 1 T ST 1 4 6h MB (CK-MB) 2 3 6 14h 2h 4h 10ml/kg 92
1h 4 <5ml/h 5 1mg/kg 1.5 3mg/ 1. (1) (2) S-T T 2. (1) T 5 93
94 (2) (3) 1. 2. 30 40 24h 3. 4. 1. 24h
7d 2. 3. 4. 1. 2. 3. 4. 3 95
5 6. 1 1.1 1.2 2 ET UCG 1 CRA 1 1.3 3d 1d () 112 6h 96
2 2.1 1 2 h 1 /h 12 h 1 /4 h 3 d 2.2 72 h 1 12 2.3 97
72 h 3.2.4 800 U 3d 500 ml 100 mg 3d 1 3.2.5 3 d 6 h 1 1 1. 2. 3. 98
1. 2. ( ) 1. 2. 3. 2 4. 5. 6. 7. 1. 99
2. 30 60min1 15 30min 1 3. 20 30 15 16 4. 24h 1. 2. 3. (1) (2) (3) 30% 50% ( ) (4) (5) 100
1. H Ill IV 2. 3. 4. 5. 6. 1. 2. 101
1. 2. 3. - 1. 2. 3. 4. 5. 102
6. 1. 2. 1. (1) (2) (3) 1 5min 15min (4) (5) 2. 3. 103
1. 2. 3. 4. 1. 2. 3. 4. 5. 104
105 1. (1) ( 5 ) (2) (3) T (4) 2. lmin 40 160 3. 10.6kPa 2.6kPa 4.-- 5.
1.- 0 (1) (2) (3) 2. (1) - (2) (3) (4) (5) (6) 24h (7) 3. ( ) 4. 1. 106
2. 3. 4. 300mg/2h WBC WBC QRS Q T 1. 2. 3. 4. 5. 6. 107
1. 2. 1. 2. Zh 3. 4. 2-4L/min 30% 40% 6 SL/min 30%50% 108
109 5. 24h 6. 7. 1. 2. 3. 4.
5. 6. 1. 2. 3. 4. 5. 6. Fontan Fontan 1 45 30 V 2 3 d 110
2 2.1 (SIMV) 8 12 15 ml/kg 6 8 10 ml/kg 3 0.196 0.392 kpa 2.45 kpa 40% 0.05 0.1 mg/kg 1 /2 4 h 0.3 0.6 mg/kg 1 /2 3 h 4 6 h 30 min 1 ph 7.45 7.5 PaO2 10.6 kpa PaCO2 4 kpa 2.2 2 3 h 1 4 6 h 1 3 5 min 1/2 2 3 111
2.3 3 3 Fontan CVP (PLA) 1.6 2.5 kpa 1.0 1.5 kpa 1.0 1.5 kpa PLA 0.5 ml/(kg.h) 2 h (HCT) 35% 40% 4 4.1 112
8 12 kpa 0.5 10 g/(kg.min) 0.5 15 g/(kg.min) 0.1 6 g/(kg.min) CVP 4.2 Fontan 90 140 /min 5 34 35 2 3 d 140 /min 4.3 113
SIMV 0.196 0.392 kpa 4.4 Fontan 1. 2. 3. 3d 114
1.5-2 (1) (2) (3) 1d (4) 1. 2. 2 1 3 4 1 1-2 3. 4. 5. 115
116 1. 2. 39 57.4% (1) 6 (2) 15 30 P R BP
(3) 10kPa (4) O 2 10.6kPa O 2 50 70 100ml+ 16 u 5mg - 4000u 2 14.8kPa O 2 (5) 25ml 3. 30% 2 300ml 3 800ml O 2 117
4. 24 5. 6. 0.25 1% 1. 2. 8kPa 2d 10h 1. 118
2. 3. 1. 3 2 3. 4. 1 1 2 3d 1 3 4 /d,10 20 min/ 119
3d 3 4 /d 2 7 2 3 s 8 12 /min 3 5min, 3 COPD 2 2 2 120
4 CO2 5 COPD 25% 26% 1 SPO2 24 h 15 20 min 1 SPO2<90% SPO2 2 3min 2 4 h 3 5 min/copd 121
122 SPO 2 <90% 3 >100 ml 3 h
4 COPD 60 ml+ 250 mg, 50 2 3 d 5 COPD 2 3 6 123
1. 2. 450 10-14d 3. 4. 5. 30 /min 1. 2. 1. 124
2. 3. 1d 75% 3 1 1. 30% 2. 3. 4. 5. 6. 3 6 1. 125
2 3. 4. (PBMV) 1 1.1 1.2 1.3 1.4 0.1% 1.5 126
10 mg 2 30 min 2.1 2.2 2.3 2.4 2.5 4 2.6 3 3.1 24 h 3.2 4 6 h 127
3.3 CCU 72 h 24 h 1 72 h 3.4 640 U 2 d 3.5 3.6 3.7 1. 2. 128
3. 4. 1d 8 1 id 1 2 3 6 9 200mg 0.5g 4 10% 1000ml 3d 1d 8 1 5. 1 1. 2. 3. 4. 5. 6. 129
130 7. (1) (2) 5-7d (3) (4)
131 1. 2. ( ) 3. 1. 2. 3. 4. (1) 5% 1 2d 2-3h1 100-150ml/ 500-600ml/ 6 (2) (3) 37 (4) (5)
1 : 8 h 20 min 654-2 10mg 2 :Olympus EVIS200 XQ20 500MA X Savary 0.5 2cm Microwasivt Ultraflex 3 : X 2 3cm : Savary 12.8mm 14mm : 3 1 X 132
1 : 2 7,, 38.41 0.71 2 7 3 4 2 1 1 1 2 4 1 1 1 1.1 3 1.2 133
1.3 2 (1) Savary (2) X 8 10 3 3.1 : 1 1 3, 134
1 3.2 : 14mm 3.3 : (30min ) 15 30 3.4 : 135
20 40mg 1 1 1. 2. (1) (2) 1 (3) 1d (4) 3. 4. 5. 6. 3d 3 lh 7. 1. 136
137 2. (1) 4-6 (2) 4h 250ml 100mp (3) 8h (4) (5) 3. (1)
(2) 250ml+ 8 u+ 4000u 2h 5ml (3) (4)2h (5) (6) 20s 3. -784 392Pa(-8 4cmH 2 O) 100ml 3h 4. 20ml lml/kg 138
20ml 2h 2 5. 6. 7. 8. 1 500 ml V 0. 5 g 0.5% 100 ml - 5 mg 500 ml 0.2 g 1.0 g - 5 mg 2 cm 2 139
2 3 7 8 1 /d 12 20 gtt/min, 7d 3 2 4 h 1 2 h 1 1. 2. 3. (1) (2) (3) ( ) ) (4) ( ) 4. 140
141 1. 2. 45o 3. 4. 5. 6. 7. 8. 9. 1. 2.
3. 30min 4. 5. 1. 2. 3. (0.9% 40 8 5 ) 20 /3 / 4. 5. 6. 7. 142
8. 6 9. 10. 1. 18 20 60% 30 2. 3. 4. 15 30. 5. 6. 3 /20 / 4 8 / 7 143
8. 9. 10. 1. 2. 3. 4. 144
5. 6. 1. 2. 3. 4. 5. - 6. 1. 25 60W 40 60cm 2. 145
3. 1 24 30 1 1 2 1 1 3 30 1 4. 500ml 2 6 5. 6. 146
1 4 5 10 2 4 10-15 3 1. 2. 3. 4. 5. (1) (2) (3) 147
(4) 6. 1. 2. 100 /min EKG C O.2mg lh C1d 0.6 1.0mg 3. (1) (2) (3) 148
149 (4) 2-4h 4. (1) (2) 250ml 8u 4000u 5. 6. 1 7. 1. 2. 60 /min
3. 4. 5. 1. 2. 3. EKG CT MRI DSA 4. 5. 6. 150
1. 2. 3. 4. 5. 6. () 7. 1 3 8. 1. B 1 2. 3. 4. 151
1. 2. 2 20 30 3. 4. 5. 6. 7. 152
1. 2. 3. 1. 2. 3. 10min 4. 5. 6. 153
(PICC) B-D PICC 1 1 1 4F( 50 cm, 0.33) 2 1 1 10 cm PICC 10 120 d, 60 d PICC (1) (2) T (3) 1. 154
2. 3. 4. 5. CT MRI DSA 6. 1d 7. 8. 40 500ml 1 20% 250mlX 2 12500u X1 5% NaHCO3 250mlX1 1 U X 5 9. 1 1. 2. 155
156 3. 4. 5. 39 6. 1. 2. 3. B 1 1. 2. 3. ( ) 4.
20 30 3% 1 5. 6. 7. 1d 1. 2. 2 3. 20 30 4. 24 48h 5. 1d 6. 1. 1-2 20 30 157
2. 3. 1 4. 5. ( ) 1. (1) (2) (3) 158
(4) (5) 2. (1) (2) 3d (3) 1 1 2000 (4) () 1 2000 20min (5) 3. (1) 159
5 1 2000 (2) 1 2 0 1 (3) 1 2000 1 2000 1 50 (4) (5) 1. 2. 3. 4. 5. 160
161 1. 2. 20min 40 60 1. 2. ph 3. 4. 5. 6. 7. 8.
1. 2. 3. 1. 2. 3. DIC () () 1. 1 1000 162
163 2. 3. 4. 5. () 1. 2. 3. 2 3 4. 5.
6. 7. 1. 2. 3. 4. 1. 2. 1. 164
2. 3. 4. 1. 2. 3. 1. 2. 3. 165
4. 1. 2. 3. (DIC) 1. 2. 3. 4. 5. 3P 6. 166
1. (1) (2) 2. (1) (2) (3) (4) (5) (6) 1. 2. 3. 4. 167
1. 2. 3. 4. () 1. 168
169 2. 3. 4. 5. () 1. 2. 3. 4. 5. 6.
() 1. 2. 3. 4. 5. 6. 1. 2. 170
3. 1. 2. (1) (2) (3) (4) (5) (6) 3. 1. 2. 3. 171
4. 5. 1. 2. 3. 1. 2. 1. 2. 172
173 3. 1. 2. 3. 4. 5. 1. 2.
3. 3 9/0 Alcon 2 U 2.5mg 1 174
2 50% 0.5ml 0.4ml 1 MIDLABS 20kPa 610 700 /min 1.07 1.33kPa, 2.67kPa 2 3 Lander's Woldoff's 30 4h 175
4 15 2 3mm 5 2 10 35% 15% 2% 75% 1, 176
2 7.2mm 8.2mm 3 1 1.1 1.2 177
178 1.3 300 ml 1.4 2 2.1 2.2 2.3 2.4 3 3.1 3.2 3.3 3.4 0.09g 500mg 0.09g
179 500mg 20% 250ml 4 5 5.1 5.2 5.3 2 2 1.78kPa 1 1.94kPa 1 2.12kPa 1 3.33kPa 0.5% 1 5.4 5.4.1
180 5.4.2 5.4.3 5.4.4 5.5 5.6 2 3 (1)
(2) ( ) (3) (4) 181
(5) (6) 1 182
2 STORZ 4mm 0 30 70 40min 3 1% 4 5 12 30 75% 1% 20ml 2ml 4 1% 10ml 4 183
5.1 5.2 2 1% 50 70mg 5mg 100 300ml 184
5.3 1 A 185
186 B 3 C D 0.2% 2 A 24 24 B C D E F
187 G H 1. (1) 3 4cm 2cm (2) - (3) 2. (1) (2) - 20cm 1/5 (3)
188 (4) (5) (6) ( ) 1 2
1 ( ) 5 7 2 3 1 189
1 2 0.25% 0.5% 3 l 2 4 0.5% 1% 3 2.5ml 4 4 190
1/2 25% 0.3 0.5ml 0.1ml 3 5min 15 20 2 5 1 5% 20% 1 2 3 191
192 0.1% 24h 2 4 5 15 20 6 6.1 6.2 6.3 6.4 1 68
6.5 1. 2. 3d 3. 6cm 10cm 10cm 1. 2. 3. 4. 193
3-6 1. 2. 3. 1. 45 2. 2 3. 4. 1. 2 2. 3 194
1. 2. 10cm 1. 2. 3. 4. 7d 2 2-3 3 l. 2. 3. 2 4. 3d 1 5000 2 195
5. 1d 1. 2. 20 3. 4. 6h 5. 3d 6. 5d 14d 1. 6-8 2.8 2 1. 196
2. 3. 3d 2 4. 1 2 5. 3d 6. 1d 1. 2. 3. 2 5 3 4. 1 5. 12-14d 1. 3 197
2. 1. 2. 30 3. 1. 2. 3. 1 4. 1. 3 2. 1 3. 2 15min 1. 198
2. 2 3. 4. 3d 2 1 5 000 2 3cm 6-8 5. 0.25% 4 6. 1. 2. 1d 45 3. 4. 0. 25% 5. 1d 1 199
2 3 1. 2. 3d 2 1d 3. 1d 8 1. 2. 0.5 1kg 3. 1 4. 2 5 3 5. 200
6. 12d 7. 2 1. 2. 1. 2. 3. 1 1 Zh 1. 2. 3. 201
4. 5. 3-4 1. 2. 3. 1. 2. 202
203 3. 4. () 5. 6. ( ) 1. 7d 2. 1 3. 10d
4. 1. 2. 3. 4. 0.9% 5. 6. () 1. 5% 3d 1 1000 2 2. 1d () 204
205 1. 2. 3. () 4. 5. 6. 1. 3 6 2. 3 3. 30o
15o 1. 2. 3. 1. 2. 3. 1. 2. 6h 3. 206
4. 1. 1 2. 1. 1 2. 4 0.25% 1. 2. 3 3. 207
4. 0.25% 4 5. 1. 0. 25% 2. 3. 1. 2. 3. 3d 2 id 208
4. 3d 8 1. 40 60W 30 40cm 2. 3. 1 4. 2 5 3 5. 3 1. 1 2. 3. 209
210 1. 2. 3. X 4. 5. (1) 0.25% 4 1 (2) (3) (4) 3d 4 (5) (6)
(7) 1. 2. () 3. 4. 3 6 1. ( ) 2. 3. 211
(1) 90o (2) (3) (4) (5) (6) L 90 212