不同術前機械性腸道準備方式對婦科腹腔鏡良性手術病人之成效探討

Effectiveness of Different Preoperative Mechanical Bowel Preparation Modes in Gynecologic Laparoscopic Surgery Patients

陳秀蓮(Shiu-Lien Chen) ； 莊秋萍(Chiu-Ping Chuang) ； 陳怡仁(Yi-Jen Chen) ； 陳淑芬(Shun-Fen Chen)

《榮總護理》 32卷4期 (2015/12) Pp. 382-391

https://doi.org/10.6142/VGHN.32.4.382

摘要

傳統腹腔鏡手術前的機械性腸道準備方式繁複，造成病人不少的困擾，本研究目的為比較兩種術前機械性腸道準備方式對婦科腹腔鏡良性手術病人症狀困擾程度及手術視野的影響。採類實驗研究設計於2013年7月至201 年6月期間，在北部某醫學中心以接受婦科腹腔鏡良性手術病人為研究收案對象，共收實驗組與對照組各50人，合計100人，對照組採用傳統口服瀉劑加清潔灌腸方式，實驗組則採用飲食調整與口服瀉劑的模式做手術前機械性腸道準備，結果顯示整體症狀困擾分數，兩組有顯著差異(p＜.05)，在噁心、嘔吐、腹脹、肛門口疼痛、疲倦、睡眠干擾、眩暈、虛脫感等各症狀比較，兩組統計達顯著差異(p＜.05)，實驗組比對照組的症狀困擾感受較少；而兩種不同術前腸道準備方式對手術視野的影響比較，則未達統計顯著差異。本研究結果顯示婦科腹腔鏡良性手術病人，採術前飲食調整與口服瀉劑的腸道準備方式，可降低病人術前腸道準備的症狀困擾程度又不影響手術視野，此研究成果可供提升手術病人照護品質之參考。

關鍵字

機械性腸道準備 ； 婦科腹腔鏡手術

並列摘要

Traditional mechanical bowel preparations before laparoscopic surgery are complicated and cause the patient substantial distress. This study compared the effects of two mechanical bowel preparation modes on gynecologic laparoscopic surgery patient symptoms and the surgical field. The study was conducted using a quasi-experimental method in the gynecological ward of a medical center in northern Taiwan from July 2013 to June 2014. Patients were purposively sampled and divided into two groups comprising 50 patients each. Two mechanical bowel preparation methods were used: the patients in the control group received a light oral laxative and bowel clearance on the night before the surgery; whereas the patients in the experimental group maintained a low-residue diet at home 2 days before the surgery and received a clean liquid diet and liquid laxatives on the day before the surgery. The results revealed that the overall discomfort symptom scores signifi cantly differed between the groups (p ＜ .05). In addition, the two groups had significant differences (p ＜ .05) in individual symptoms (nausea, vomiting, abdominal distension, anal port pain, fatigue, sleep disturbances, dizziness, and a sinking feeling). The experimental group experienced less discomfort than did the control group. Furthermore, the results revealed that the preoperative dietary modifi cation and oral cathartic bowel preparation mode can reduce the discomfort of the symptoms of preoperative bowel preparation without affecting the surgical fi eld and promote the quality of surgery patient care.

並列關鍵字

mechanical bowel preparation ； laparoscopic gynecological surgery

參考文獻

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