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剖腹產之快速復原照護路徑

Fast-Track Surgery for Elective Cesarean Section

摘要


著醫學發展日進千里,許多常規臨床上的照護也已有重大改進。最近,對選擇性剖腹產婦女相關部門的整合,以「快速恢復手術方式」改良手術前、後的照護,冀望能使患者早日康復出院。除手術前對患者的評估與諮詢、避免灌腸、減少空腹時間,手術中維持正常體溫、輸液量、適當麻醉,手術後早進食、良好的止痛、盡快拔除導尿管、減少點滴注射、預防噁心和嘔吐、早下床等嶄新的照顧方式,希望在不會增加手術罹病率情形下,也許能讓患者縮短住院時間。

並列摘要


A major challenge in healthcare is to incorporate innovation into routine clinical practice. Recently, fast-track surgery for elective cesarean section entails a multidisciplinary approach of perioperative care to permit earlier discharge from the hospital. Patient education and information, no bowel enemas, minimizing starvation times, maintaining normothermia, early feeding, adequate analgesia, early removal of urinary catheter, fluid management, postoperative nausea and vomiting prophylaxis, and early enforced ambulation are all essential. A significant reduction in length of hospital stay can be achieved without increase of perioperative morbidity.

參考文獻


Kehlet H: Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 1997;78:606-17.
deGroot JJA, van Es LEJM, Maessen JMC, et al: Diffusion of enhanced recovery principles in gynecologic oncology surgery: is active implementation still necessary? Gynecol Oncol 2014;134:570-5.
Nilsson L, Wodlin NB, Kjolhede P: Risk factors for postoperative complications after fast-track abdominal hysterectomy. Aust N Z J Obstet Gynaecol 2012;52:113-20
Lucas DN, Gough KL: Enhanced recovery in obstetrics- a new frontier? Int J Obstet Anesth 2013;22:92-5.
Nanavati AJ, Prabhakar S: Fast-track surgery: Toward comprehensive peri-operative care. Anesth Essays Res 2014;8:127-33.

被引用紀錄


陳宛柔、張怡惠(2023)。一位後天免疫缺乏症候群經產婦之照護經驗領導護理24(2),117-129。https://doi.org/10.29494/LN.202306_24(2).0009

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