题名

應用足三里穴位按摩改善結腸切除術後病人腹脹感之護理經驗

并列篇名

Using Acupressure to Improve Abdominal Bloating in a Hemicolectomy Patient: A Nursing Experience

DOI

10.6224/JN.62.5.96

作者

曾怡菱(Yi-Ling Tseng);許春宏(Chun-Hung Hsu);曾惠珍(Hui-Chen Tseng)

关键词

穴位按摩 ; 足三里穴 ; 腹部手術 ; 腹脹 ; 護理經驗 ; acupressure ; Zusanli (ST-36) ; abdominal surgery ; bloating ; nursing experience

期刊名称

護理雜誌

卷期/出版年月

62卷5期(2015 / 10 / 01)

页次

96 - 102

内容语文

繁體中文

中文摘要

本文係照顧一位住院接受右半結腸切除術之結腸癌病人,在術後運用雙側足三里穴位按摩方案,促進腸蠕動及緩解腹脹感之護理經驗。於2014年11月13日至11月23日照護期間,以直接照顧、會談、觀察、身體評估方式進行整體性護理評估,確認個案主要有焦慮、急性疼痛、術後腹脹之舒適情況改變的健康問題。除了給予手術前後護理指導、緩解傷口疼痛及預防感染措施之外,在術後第一天至第四天提供足三里穴位按摩方案改善其術後腹脹,個案在術後第二天即排氣與恢復腸蠕動,術後第四天主訴已無腹脹感並感覺按摩後心情放鬆有助於睡眠,出院前教導個案穴位按摩技巧,返家一週後追蹤亦未再出現腹脹不適。希望藉由此次照護經驗分享,提供護理人員應用此穴位按摩方案於腸道手術後腹脹病人照護之參考,以減少個案術後腹脹引發的合併症。

英文摘要

This article describes a nursing experience applying the protocol of bilateral Zusanli (ST-36) acupressure to reduce abdominal bloating in a colon cancer patient who had undergone a right hemicolectomy. The period of care was between November 13 and November 23, 2014. Data were collected through direct care, interviews, observation, and physical assessment. The main health problems of the patient included anxiety, surgical wound pain, and abdominal bloating. We provided pre- and postoperative routine nursing care, wound pain management, and the protocol of Zusanli (ST-36) acupressure for reducing abdominal bloating. Results of care recorded the first passage of flatus and intestinal motility during the second postoperative day, with no complaints of bloating from the fourth postoperative day. The subject exhibited a relaxed mood and slept soundly following each acupressure session. Furthermore, the subject reported experiencing no abdominal bloating during the week following discharge, during which he continued to follow the acupressure protocol. This article provides support via an instance of nursing care for the effectiveness of the Zusanli (ST-36) acupressure in improving abdominal bloating and thus reducing the complications of hemicolectomy surgery.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Beard, T. L.,Leslie, J. B.,Nemeth, J.(2011).The opioid component of delayed gastrointestinal recovery after bowel resection.Journal of Gastrointestinal Surgery,15(7),1259-1268.
  2. Chao, H. L.,Miao, S. J.,Liu, P. F.,Lee, H. H.,Chen, Y. M.,Yao, C. T.,Chou, H. L.(2013).The beneficial effect of ST36 (Zusanli) acupressure on postoperative gastrointestinal function in patients with colorectal cancer.Oncology Nursing Forum,40(2),E61-E68.
  3. Ernst, E.,White, A. R.(2001).Prospective studies of the safety of acupuncture: A systematic review.The American Journal of Medicine,110(6),481-485.
  4. Iyer, S.,Saunders, W. B.,Stemkowski, S.(2009).Economic burden of postoperative ileus associated with colectomy in the United States.Journal of Managed Care Pharmacy,15(6),485-494.
  5. Lemmens, V. E. P. P.,Janssen-Heijnen, M. L. G.,Houterman, S.,Verheij, K. D. G. W.,Martijn, H. M.,van de Poll-Franse, L.,Coebergh, J. W. W.(2007).Which comorbid conditions predict complications after surgery for colorectal cancer?.World Journal of Surgery,31(1),192-199.
  6. LeMone, P.,Burke, K. M.,Bauldoff, G.(2011).Medical-surgical nursing: Critical thinking in patient care.Upper Saddle River, NJ:Pearson/Prentice Hall.
  7. Senagore, A. J.(2007).Pathogenesis and clinical and economic consequences of postoperative ileus.American Journal of Health-System Pharmacy,64(20, Suppl. 13),S3-S7.
  8. Siegel, R.,DeSantis, C.,Virgo, K.,Stein, K.,Mariotto, A.,Smith, T.,Ward, E.(2012).Cancer treatment and survivorship statistics, 2012.A Cancer Journal for Clinicians,62(4),220-241.
  9. Stewart, D.,Waxman, K.(2010).Management of postoperative ileus.Disease-a-Month,56(4),204-214.
  10. Story, S. K.,Chamberlain, R. S.(2009).A comprehensive review of evidence-based strategies to prevent and treat postoperative ileus.Digestive Surgery,26(4),265-275.
  11. Sun, Y.,Song, G.,Yin, J.,Chen, J.,Chen, J. H.,Song, J.,Chen, J. D.(2010).Effects and mechanisms of electroacupuncture on glucagon-induced small intestinal hypomotility in dogs.Neurogastroenterology and Motility,22(11),1217-1223, e1318.
  12. Takahashi, T.(2006).Acupuncture for functional gastrointestinal disorders.Journal of Gastroenterology,41(5),408-417.
  13. 馬素華, S. H.(2005)。穴位按壓法於護理臨床實務之應用。護理雜誌,52(4),5-10。
  14. 馬惠文, H. W.,張曼玲, M. L.,林綽娟, C. J.(2007)。以系統性文獻回顧檢視穴位按壓在護理實務的應用。護理雜誌,54(4),35-44。
  15. 高震, Z.(2001)。經穴能量系統的本質及刺激傳導機理。中國針灸,3(21),161-163。
  16. 陳淑如, S. R.,鄭綺, C.(2001)。「腸脹氣」相關因素、定義性特徵之建立及臨床測定的初探。新臺北護理期刊,3(1),55-65。
  17. 楊怡婷, Y. T.,梁金銅, J. T.,賴逸儒, I. R.,陳佳慧, C. C. H.(2014)。腹部手術後胃腸活動障礙。台灣醫學,18(2),244-250。
  18. 葉倩菁, C. C.,王九華, C. H.,馬素華, S. H.(2007)。穴位療法作用的可能機轉。護理雜誌,54(4),5-9。
  19. 衛生福利部(2015,6月17日).民國103年死因結果摘要表.取自http://www.mohw.gov.tw/cht/DOS/DisplayStatisticFile.aspx?d=49777&s=1 [Ministry of Health and Welfare, Taiwan, ROC. (2015, June 17). 2014 statistics of causes of death. Retrieved from http://www.mohw.gov.tw/cht/DOS/DisplayStatisticFile.aspx?d=49777&s=1]
  20. 盧燕, Y.,樊艷艷, Y. Y.(2003)。按摩足三里穴促進腹部手術後胃腸功能恢復的研究。解放軍護理雜誌,20(5),13-14。
  21. 賴東淵, T. Y.,許昇峰, S. F.(2005).中醫學概論.臺北市=Taipei City, Taiwan, ROC:華杏=Farseeing.
被引用次数
  1. 黃靜宜,黃頌儼,林幸雅,吳美雯(2023)。穴位按壓對大腸直腸癌病人手術後腸蠕動之成效。腫瘤護理雜誌,23(1),25-35。