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术前准备

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上肢手术前数周及数日内需明确的事项。我们发送的手术详情邮件、医院的在线入院登记、需停用和需继续服用的药物、身体及居所的准备工作，以及最常导致手术推迟的事项。

Updated May 2026
患者术前与外科医生核对检查清单的示意图。
为手术做准备。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

手术能否顺利进行，大部分取决于您抵达医院之前的准备工作。本页面涵盖了手术前数周及数天的安排：我们将向您发送哪些材料、我们需要您提供什么、您可以自行采取哪些措施，以及您在家中应做好哪些准备。手术当天从办理入院到出院回家的流程，详见手术当天页面。

您的术前预约

在手术前，您将在诊室见到我们，以详细讨论手术方案。这是提问的最佳时机，因此请提前将问题记录下来。有用的问题包括：具体将进行什么操作、有哪些替代方案、每周的恢复情况如何、何时可以驾车和上班，以及可能出现哪些风险。

请携带以下物品：

  • 您服用的所有药物的准确清单，并注明剂量：处方药、非处方药、吸入剂、药膏、维生素、鱼油、姜黄及其他任何补充剂。请将其写下来或携带药盒。
  • 您近期获得的任何扫描、X光片或血液检查结果。
  • 参与您治疗的其他医生的详细信息，尤其是心脏病专家或糖尿病专家。
  • 您的健康保险详情，如果您希望的话，还可以带一位陪同人员。

您还将被要求签署一份知情同意书。知情同意是一个沟通过程，而不仅仅是签字。如果有任何不清楚的地方，请明确指出；我们宁愿解释两遍，也不愿让您签署自己不确定同意的内容。

我们发送的电子邮件

一旦您的手术预约成功，接待处将向您发送手术详情电子邮件。这是您将收到的最重要的一份文件，请务必仔细阅读并妥善保存。该邮件将告知您：

  • 哪家医院、哪一天以及您的入院时间，以及抵达医院后应前往的具体位置
  • 您的禁食时间：即在此时间之后不得进食或饮水。如果您的手术仅使用局部麻醉，邮件中会注明您无需禁食
  • 您的麻醉师姓名，以及如果您有关于麻醉或所服用药物的疑问，如何联系他们；对于自费患者，邮件还包含如何咨询其费用的说明
  • 您是否需要过夜住院，还是当天出院；如果是当天出院，您需要有人接送并驾车送您回家
  • 需向接待处支付的任何费用及支付方式
  • 适用于您的药物说明，如果您曾告知我们您正在服用抗凝血药、糖尿病片剂、胰岛素，或注射用糖尿病或减肥药物

该邮件还包含医院在线入院的说明。医院不会主动联系您索取您的详细信息；您需要自行在线填写他们的入院表格，我们附带的说明将指导您完成填写，包括表格所要求的手术项目代码。请在收到邮件后尽快完成此操作，不要等到前一天晚上。表格会询问您的整体健康状况，完整回答至关重要。特别是，请告知他们以下情况：

  • 睡眠呼吸暂停，或伴有日间疲劳的响亮打鼾（参见 睡眠、疼痛与恢复）
  • 心脏起搏器、心脏支架，或任何心脏或肺部疾病
  • 过敏史，包括对药物、敷料、胶带和乳胶的过敏，以及您是否随身携带肾上腺素自动注射笔（EpiPen）
  • 您或您的血亲在麻醉方面曾出现的任何问题
  • 松动牙齿、牙冠或假牙
  • 任何可能怀孕的情况

如果自您预约以来已过去一周，您仍未收到手术详情，或者无法使在线入院流程正常工作，请致电接待处。

药物：哪些需要停用，哪些需要继续服用

大多数药物应照常服用，直至手术当天早晨，仅用少量水送服。少数药物需要做出决定，而该决定取决于您的手术类型及个人情况，因此切勿自行停药或更改药物剂量。适用于您的具体说明位于您的手术详情电子邮件中；如果邮件中未包含相关说明且您认为应当包含，请告知我们。

  • 抗凝药物（血液稀释剂）。 阿司匹林和氯吡格雷（Plavix，以及如DuoCover等复方制剂）应继续服用；请告知我们您正在服用这些药物，以便医疗团队知晓。华法林、利伐沙班（Xarelto）、阿哌沙班（Eliquis）和达比加群（Pradaxa）等抗凝剂需在术前48小时停用，您的电子邮件中会告知最后一次服药的具体日期和时间。请严格遵照执行；这一时间安排在两方面都有重要原因：术中出血风险以及若过早停药导致的血栓风险。 围手术期抗凝药物 页面 解释了这些药物的作用机制以及为何时间控制至关重要。恢复服药前也请先咨询。
  • 口服降糖药 在手术当天早晨不服用。新型被称为SGLT2抑制剂的降糖药（Forxiga、Jardiance、Steglatro）需在术前三天停用，因为它们在禁食期间可能导致血液中酸性物质危险积聚。
  • 胰岛素。 术前一晚照常服用您惯用的长效胰岛素。手术当天早晨服用您惯用晨间剂量的一半，或根据血糖读数进行调整。切勿完全停用胰岛素，并请将您的胰岛素和血糖仪带入医院。
  • 注射用降糖及减重药物 如Ozempic、Wegovy、Mounjaro、Trulicity和Byetta应照常继续注射；请勿停用。改变的是您的禁食要求。这些药物会减缓胃排空，因此常规的禁食时间不足以确保麻醉安全，我们要求您在手术时间前禁食24小时。您的电子邮件中会提供具体时间。参见 GLP-1药物与骨科手术。
  • 非甾体抗炎药及某些补充剂。 布洛芬、萘普生、鱼油、姜黄素、银杏和高剂量维生素E均可能在手术期间导致轻微出血增加。我们将告知您是否需要停用以及何时停用。
  • 常规降压药、心脏药物、甲状腺药物、抗癫痫药及抗反流药物 在手术当天早晨应照常服用，除非另有指示。
  • 抗抑郁药和抗焦虑药 应继续服用。突然停药会使手术前后的日子更加艰难，而非更轻松。

如果您对清单上的任何药物有疑问，请致电诊室，或使用电子邮件中的联系方式联系您的麻醉师。在术前一周通过电话询问这个问题，远比在手术当天早晨的入院登记处询问要容易得多。

为手术做好身体准备

提前几周做好准备，对您的恢复效果会有显著影响。

  • 停止吸烟和使用电子烟。 尼古丁会使皮肤、肌腱和骨骼愈合所依赖的微血管收缩，并增加伤口并发症和愈合缓慢的风险。越早停止越好，但即使仅在最后几周停止也有帮助。请参阅 吸烟与肌肉骨骼愈合。
  • 如果您患有糖尿病，请控制血糖水平。 手术前后几周的高血糖水平会增加伤口感染的风险。如果您的血糖读数出现波动，请立即咨询您的全科医生，而不是等到术后。
  • 均衡饮食。 愈合过程需要蛋白质，而许多患者在手术前的蛋白质摄入量低于实际需求。 促进愈合的饮食指南 页面提供了实用的目标。
  • 在手术前一周减少饮酒，手术前一晚禁酒。酒精会干扰麻醉、镇痛效果以及睡眠。
  • 保持活动。 进行步行，并保持未手术关节的活动。整体健康状况良好可使麻醉更安全，并使术后最初几周更加轻松。

护理即将手术的手臂皮肤：

  • 手术前一周不要刮除手臂上的毛发。 剃须刀会留下微小的切口，细菌可能由此侵入。如果需要去除毛发，将在手术室中由专业人员修剪。
  • 告知我们该手臂上是否有任何切口、划痕、皮疹、粉刺或感染，即使是微小的也要告知。在感染或破损的皮肤上进行手术是不安全的，这也是手术不得不推迟的最常见原因之一。
  • 去除即将手术的手部指甲油和人造指甲。 它们会遮挡甲床，而医疗团队需要观察甲床来检查您的血液循环。
  • 保持皮肤清洁和滋润，并在手术前一个月内避免在该手臂上纹新纹身或打新的穿孔。

做好居家准备

上肢手术后，您将有一段时间只能用单手完成所有事情，且手臂通常需佩戴吊带、石膏或夹板。在入院前布置好家居环境，能显著减少术后的不便。

  • 安排人员接送并陪护。 安排专人送您去医院、术后驾车送您回家，并在术后第一晚陪伴您。这不是可选项。麻醉后您无法自行驾车，且术后夜间不应独自留宿。
  • 规划驾驶事宜。 手术当天您无法驾车，且在手臂佩戴吊带、石膏或夹板期间均不得驾车。肩部手术后，无论哪侧手臂，至少需六周后方可恢复驾驶。肩部及手臂手术后的驾驶 页面列出了不同手术的具体时间线。请在手术日前安排好代驾或无车期间的出行方案。
  • 处理工作事宜。 您需要休假多久，取决于您的工作性质和手术类型。尽早与雇主沟通；重返工作岗位 页面将帮助您规划此次沟通。
  • 储备物资并做好准备。 提前烹饪并冷冻几份餐食。将厨房和浴室中日常使用的物品移至腰部高度，以便单手操作时无需向上伸展或向下弯腰。购买泵式瓶装的洗发水和肥皂；若进行肩部手术，还需购买长柄海绵。
  • 衣物。 选择宽松、前开襟的上衣和一脚蹬鞋。在需要单手穿脱时，提前练习如何单手穿脱衬衫。
  • 睡眠。 肩部手术后，大多数人在最初几周需半卧位睡眠。建议提前准备躺椅或楔形枕头。参见 佩戴手臂吊带时的穿着与睡眠。
  • 儿童、宠物及提重物。 在最初两周内，安排他人协助处理需要双手或强力抓握的事务，如照顾幼童、大型犬、购物、倒垃圾等。
  • 止痛药。 在手术日前取好处方药，确保回家后家中已有药片。术后疼痛管理 页面介绍了如何正确使用这些药物。

在手术前而非手术后，阅读 手部、腕部或肘部手术后的日常生活 和 肩部手术后的日常生活 这些实用页面是值得的。

禁食

您的手术详情邮件中会告知您停止进食和饮水的具体时间。 请严格遵循邮件中的时间；该时间是根据您的入院时间以及您正在服用的药物计算得出的。禁食是麻醉的安全要求，而非形式上的程序，未正确执行禁食是手术当天被推迟的另一个常见原因。 手术前禁食 页面解释了为什么在麻醉状态下空腹至关重要。

手术前一周：核对清单

  • 已收到手术详情邮件，已阅读并保存在可随时找到的地方。
  • 已完成医院在线入院登记，并填写了项目编号。
  • 已列出药物清单，并清楚哪些药物需要停用以及停用的时间。
  • 如果您正在服用华法林、利伐沙班（Xarelto）、阿哌沙班（Eliquis）或达比加群（Pradaxa）：邮件中规定的最后一次服药日期已记录在日程表中。
  • 已安排专人接送您，负责开车送您回家，并陪伴您度过第一晚。
  • 工作单位已知晓您的日期；在您无法驾驶期间，已安排好电梯等辅助设施。
  • 处方药已配齐，冷冻室已备好餐食，家中已调整为适合单手操作的状态。
  • 手臂皮肤完整无损；未刮除体毛；已卸除指甲油。
  • 邮件中规定的禁食时间已记录在手术前一晚您能看到的地方。
  • 如果您患有糖尿病：胰岛素和血糖仪已打包。如果您随身携带肾上腺素自动注射笔（EpiPen）：已打包，以便交给护理人员。

请在手术当天之前致电我们，如果：

  • 您未收到手术详情邮件，或无法完成在线入院手续
  • 您在手术前几天感到不适：感冒、咳嗽、发烧或肠胃不适
  • 我们计划手术的手臂上有切口、皮疹、斑点或任何感染迹象
  • 您不确定是否应服用或停用任何药物
  • 您不小心在禁食时间内进食或饮水
  • 自我们上次见面以来，您的健康状况有任何变化
  • 您只是改变了主意，或希望再次讨论该决定

这些情况都不麻烦。我们更希望在手术前一天收到您的通知，而不是在手术当天早上不得不让您未接受手术就回家。

深入探讨

Advanced reading: the deeper science (optional)

本节面向希望了解术前准备中哪些环节能产生可测量差异的读者。本部分的大多数研究源自髋关节和膝关节置换术，由于患者数量庞大，使得相关问题的研究更为容易；这些经验可迁移至上肢手术，但相关数据不应被直接假定适用。

对话比形式更重要

最有力的发现很简单：术前对手术的预期可以通过事前的沟通加以改变，而预期又会影响术后的满意度。针对髋关节和膝关节置换术前教育课程的随机对照试验表明，结构化的课程改变了患者对康复过程的预期 [1]。此外，一项独立研究显示，关节置换前的正式教育项目与较短的住院时间相关 [2]。

对话的内容至关重要。一项关于专门针对阿片类止痛药的简短术前视频的随机对照试验发现，观看该视频的患者在膝关节置换术后第一周使用的阿片类药物显著减少 [3]。这是一个小干预带来的大效应，这也是为什么我们在您的手术前会花时间讲解如何使用镇痛药物，而不仅仅是讲解手术本身。具体到手部手术，一项系统综述发现术前阿片类药物教育可能有益，但指出相关研究数量较少且质量有限 [4]。

更多技术并不等于更多理解

两项研究为这种热情泼了冷水。在髋关节镜手术患者中，与仅使用标准扫描图像相比，使用患者特异性3D打印髋关节模型进行咨询并未提高患者的理解度或满意度[5]。此外，在一次外科医疗任务旅行中进行的术前课程仅略微提高了患者对关节置换术的了解[6]。实际的解读是，一种简明、从容且允许提问的解释才是干预措施；辅助道具是可选的。

请谨慎选择阅读来源

许多人在就诊前会通过网络搜索进行准备，但所获信息的质量参差不齐。一项针对 YouTube 上关于骨科注射治疗视频的研究发现，其内容不一致，且大部分内容由独立用户而非卫生机构制作 [7]。本维基的存在部分出于此原因。如果您在其他地方阅读到的信息与您在诊室中被告知的内容相矛盾，请在预约就诊时提出，我们将共同核实。

参考文献

[1] Mancuso CA, Graziano S, Briskie LM, Peterson MGE, Pellicci PM, Salvati EA, et al. Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties. Clin Orthop Relat Res. 2008;466(2):424-31. https://doi.org/10.1007/s11999-007-0052-z

[2] Yoon RS, Nellans KW, Geller JA, Kim AD, Jacobs MR, Macaulay W. Patient education before hip or knee arthroplasty lowers length of stay. J Arthroplasty. 2010;25(4):547-51. https://doi.org/10.1016/j.arth.2009.03.012

[3] Maheu AR, Hohmann AL, Cozzarelli NF, Khan IA, Hozack WJ, Ilyas AM, et al. The efficacy of preoperative video-based opioid counseling on postoperative opioid consumption after total knee arthroplasty: a prospective randomized controlled trial. J Arthroplasty. 2024;39(8):S143-7. https://doi.org/10.1016/j.arth.2024.02.027

[4] Babiker-Moore T, Clark CJ, Kavanagh E, Crook TB. The effect of preoperative interventions on postoperative outcomes following elective hand surgery: a systematic review. Hand Therapy. 2024;30(1):19-33. https://doi.org/10.1177/17589983241301449

[5] Childs S, McVicker Z, Trombetta R, Awad H, Elfar J, Giordano B. Patient-specific 3-dimensional modeling and its use for preoperative counseling of patients undergoing hip arthroscopy. Orthop J Sports Med. 2018;6(9). https://doi.org/10.1177/2325967118794645

[6] Solano MA, Ramcharran KK, Jones LC, Sterling RS, Samaroo DR, Khanuja HS. Preoperative patient education class during an orthopedic mission trip: effects on knowledge, anxiety, and informed consent. J Arthroplasty. 2020;35(9):2410-7. https://doi.org/10.1016/j.arth.2020.04.084

[7] Sachs JP, Weissman AC, Wagner KR, Joyce KM, Pickens T, Bi AS, et al. YouTube is an inconsistent source of information on orthobiologics: implications for content quality, reliability, comprehensiveness, and patient decision making. Arthroscopy. 2025;41(10):4225-34. https://doi.org/10.1016/j.arthro.2025.03.062

Reviewed by Dr Kieran Hirpara · 9 September 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies were small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help to lower a patient's length of stay following hip or knee arthroplasty [2].
  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with same-day discharge [3].
  • Patients' preoperative expectations of their recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • Maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust [5].
  • Underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class during a surgical mission trip [6].
  • A pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].

Anatomy & Pathophysiology

  • Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with the unique 'ripple effects' of same-day discharge [3].
  • Preoperative video counseling significantly decreased opioid consumption within the first week after total knee arthroplasty [9].

Investigations

  • A pilot randomized controlled trial is evaluating the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement [7].

Complications

  • Preoperative opioid education showed some indication of favourable outcomes, though the number of studies was small, evidence quality was poor, and data were limited [1].
  • A formal preoperative educational program can help lower a patient's length of stay following hip or knee arthroplasty [2].
  • Patients' preoperative expectations of recovery from total hip arthroplasty (THA) or total knee arthroplasty (TKA) can be modified by preoperative educational classes [4].
  • A pilot randomized controlled trial is evaluating the feasibility and satisfaction of the PREPS program for individuals undergoing shoulder replacement [7].
  • Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction regarding femoroacetabular impingement (FAI) when compared with the use of CT imaging alone [8].

Recovery

  • Preoperative opioid education shows some indication of favourable outcomes following elective hand surgery, though the number of studies was small, evidence quality was poor, and data were limited [1].

Key Evidence

  • [L1] There was some indication of favourable outcomes following preoperative opioid education; however, the number of studies were small, the evidence quality was poor, and data were limited. [1] (10.1177/17589983241301449)
  • [L3] A formal preoperative educational program can indeed help to lower a patient's length of stay. [2] (10.1016/j.arth.2009.03.012)
  • [L5] Enhanced office and staff protocols that are proactive rather than reactive can provide a safe and successful outpatient experience by anticipating potential postoperative pitfalls associated with the unique 'ripple effects' of same-day discharge. [3] (10.1016/j.arth.2019.01.001)
  • [L1] Patients' preoperative expectations of their recovery from THA or TKA can be modified by preoperative educational classes. [4] (10.1007/s11999-007-0052-z)
  • [L5] The author emphasizes that maximizing opportunities to improve communication, learning from others, and treating patients as more than their radiographic findings can help improve patient outcomes and trust. [5] (10.2106/jbjs.24.01274)
  • [L4] On this surgical mission trip, underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class. [6] (10.1016/j.arth.2020.04.084)
  • [L2] This pilot randomized controlled trial will evaluate the feasibility and satisfaction of the PREPS program for individuals undergoing a shoulder replacement. [7] (10.1177/17589983251345393)
  • [L2] Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to FAI when compared with the use of CT imaging alone. [8] (10.1177/2325967118794645)
  • [L1] This study found significantly decreased opioid consumption within the first week after TKA in patients who received preoperative video counseling. [9] (10.1016/j.arth.2024.02.027)

References

[1] The effect of preoperative interventions on postoperative outcomes following elective hand surgery: A systematic review. Hand Therapy. 2024. DOI: 10.1177/17589983241301449

[2] Patient Education Before Hip or Knee Arthroplasty Lowers Length of Stay. The Journal of Arthroplasty. 2010. DOI: 10.1016/j.arth.2009.03.012

[3] Considerations for Office and Staff Protocols for Outpatient Joint Replacement. The Journal of Arthroplasty. 2019. DOI: 10.1016/j.arth.2019.01.001

[4] Randomized Trials to Modify Patients' Preoperative Expectations of Hip and Knee Arthroplasties. Clinical Orthopaedics & Related Research. 2008. DOI: 10.1007/s11999-007-0052-z

[5] What’s Important: Treat the Patient Instead of the Disease. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.24.01274

[6] Preoperative Patient Education Class During an Orthopedic Mission Trip: Effects on Knowledge, Anxiety, and Informed Consent. The Journal of Arthroplasty. 2020. DOI: 10.1016/j.arth.2020.04.084

[7] Preoperative rehabilitation and education program for surgery (PREPS): A pilot randomized control trial protocol. Hand Therapy. 2025. DOI: 10.1177/17589983251345393

[8] Patient-Specific 3-Dimensional Modeling and Its Use for Preoperative Counseling of Patients Undergoing Hip Arthroscopy. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118794645

[9] The Efficacy of Preoperative Video-Based Opioid Counseling on Postoperative Opioid Consumption After Total Knee Arthroplasty: A Prospective Randomized Controlled Trial. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2024.02.027

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