探討溫水足浴對腸胃道手術後病人腸蠕動之成效

Effect of Warm Footbaths on Bowel Motility in Patients after Gastrointestinal Surgery

10.6142/VGHN.34.2.157

連金延(Chin-Yen Lien)；鄧幼君(Yu-June Deng)；蔡璧玲(Pi-Ling Tsai)；辛文蕙(Wen-Hui Hsin)；洪慧君(Hui-Chun Hung)；王麗玲(Lin-Ling Wang)；林小玲(Shirling Lin)

腸胃道手術 ； 溫水足浴 ； gastrointestinal surgery ； warm footbath

榮總護理

34卷2期（2017 / 06 / 01）

157 - 166

繁體中文

腸胃道手術後常見腸蠕動不佳引發腹脹不適，本研究乃比較溫水足浴介入與否，對腸胃道手術後病人腸蠕動之影響。研究採準實驗性研究設計，利用不同時段收集兩組所須之資料，於2014 年1 月1 日至2014 年12 月31 日，在臺灣北部某醫學中心選擇首次接受腸胃道手術病人89 名進行收案。對照組53 名提供常規照護，實驗組36 名除接受常規照護外，在手術日隔天開始，每日下午定時執行一次溫水足浴，直到病人首次排氣為止。結果顯示手術後首次排氣時間，對照組為87.44(±26.94) 小時，實驗組為73.99(±23.63) 小時，實驗組較對照組提早約13.45 小時，達統計上顯著差異(F = 5.89, p ＜ .05)；手術後首次排便時間，對照組為99.60(±28.62) 小時，實驗組為92.00(±35.03) 小時，未達統計上顯著差異(F =1.21, p = .274)。因此，臨床上可以指導腸胃道手術後病人以溫水足浴法來促進腸蠕動，以期早期排氣，減輕手術後腹脹不適情形。

Abdomen distention is a common cause of poor bowel motility after gastrointestinal surgery. The aim of this study was to evaluate whether warm footbaths can accelerate the recovery of bowel motility after gastrointestinal surgery. This study involved using a quasi-experimental design. A total of 89 patients undergoing gastrointestinal surgery at a medical centre in northern Taiwan were recruited through purposive sampling from January 2014 to December 2014. Participants were divided into either the control (n = 53) or the experimental (n = 36) group. The control group patients received standard care. The experimental group patients received standard care and a warm footbath every day till first flatus. Data were collected from the demographic data, bowel sound assessment, and patient self-record lists. The results indicated that the occurrence of first flatus in the control group was at 87.44(±26.94) hours. First flatus in the experimental group occurred at 74.00(±23.63) hours, with the results for both groups being significant (F = 5.89, p ＜ .05). In addition, the first defecation of the control group occurred at 99.60(±28.62) hours, and the first defecation of the experimental group occurred at 92.00(±35.03) hours; the results were not significant for either group (F = 1.21, p = .274). First flatus occurred approximately 13.45 hours earlier in the experimental group than in the control group. Patients who have received gastrointestinal surgery can be taught that warm footbaths enhance early recovery of bowel function.

1. Abd-Mae-EI-Maebound, K.,Ibrahim, M.,Shalaby, D.,Fikry, M.(2009).Gum chewing stimulates early return of bowel motility after caesarean section.BJOG: An International Journal of Obstetrics and Gynaecology,116(10),1134-1139.
2. Askarpouri, S.,Shoushtari, M.,Saadati, M.(2010).Study of the effect of early feeding, chewing gums, and laxative on ileus in patients who underwent open cholecystectomy.Internet Journal of Surgery,22(2),9p.
3. Behm, B.,Stollman, N.(2003).Postoperative ileus: Etiologies and interventions.Clinical Gastroenterology and Hepatology,1(2),71-80.
4. Bik, C. K.,Jiping, Z.,Yong, H.(2016).Effectiveness of acupuncture in postoperative ileus: A systematic review and Meta-analysis.Journal of Traditional Chinese Medicine,36(3),271-282.
5. Byrne, H.(2009).Gum chewing stimulates early return of bowel motility after caesarean section.BJOG An International Journal of Obstetrics and Gynaecology,117(1),117.
6. Carroll, J.,Alavi, K.(2009).Pathogenesis and management of postoperative ileus.Clinics in Colon and Rectal Surgery,22(1),47-50.
7. Chao, H. L.,Miao, S. J.,Liu, P. F.,Lee, H. H. C.,Chen, Y. M.,Yao, C. T.,Chou, H. L.(2013).The beneficial effect of ST-36 (Zusanli) acupressure on postoperative gastrointestinal function in patients with colorectal cancer.Oncology Nursing Forum,40(2),E61-68.
8. Choi, H.,Kang, S. H.,Yoon, D. K.,Kang, S.G.,Ko, H. Y.,Moon, D. G.,Cheon, J.(2011).Chewing gum has a stimulatory effect on bowel motility in patients after open or robotic radical cystectomy for bladder cancer: A prospective randomized comparative study.Urology,77(4),884-890.
9. Harbaugh, C. M.,Al-Holou, S. N.,Bander, T. S.,Drews, J. D.,Shah, M. M.,Terjimanian, M. N., Englesbe, M. J.(2013).A statewide, community-based assessment of alvimopan's effect on surgical outcomes.Annals of Surgery,257(3),427-432.
10. Hsiung, W. T.,Chang, Y. C.,Yeh, M. L.,Chang, Y. H.(2015).Acupressure improves the postoperative comfort of gastric cancer patients: A randomized controlled trial.Complementary Therapies in Medicine,23(3),339-346.
11. Jang, S. Y.,Ju, E. Y.,Kim, D. E.,Kim, J. H.,Kim, Y. H.,Son, M.,Kim, K. S.(2012).First flatus time and xerostomia associated with gum-chewing after liver resection.Journal of Clinical Nursing,21(15-16),2188-2192.
12. Liao, W. C.,Chiu, M. J.,Landis, C. A.(2008).A warm footbath before bedtime and sleep in older Taiwanese with sleep disturbance.Research in Nursing & Health,31(5),514-528.
13. Massey, R. L.(2012).Return of bowel sounds indicating an end of postoperative ileus: Is it time to cease this long-standing nursing tradition?.Medsurg Nursing,21(3),146-150.
14. Prasad, M.,Matthews, J. B.(1999).Deflating postoperative ileus.Gastroenterology,117(2),489-492.
15. Ren, K.,Qiu, J.,Wang, X.,Niu, F.,Jiang, T.(2012).The effect of a sweet potato, footbath, and acupressure intervention in preventing constipation in hospitalized patients with acute coronary syndromes.Gastroenterology Nursing,35(4),271-277.
16. Saeki, Y.,Nagai, N.,Hishinuma, M.(2007).Effects of footbathing on autonomic nerve and immune function.Complementary Therapies in Clinical Practice,13(3),158-165.
17. Sheeba, C.(2012).The effect of footbath on sleep onset latency and relaxation among patients with cancer.International Journal of Nursing Education,4(2),188-192.
18. Su'a, B. U.,Pollock, T. T.,Lemanu, D. P.,MacCormick, A. D.,Connolly, A. B.,Hill, A. G.(2015).Chewing gum and postoperative ileus in adults: A systematic literature review and meta-analysis.International Journal of Surgery,14,49-55.
19. Takagi, K.,Teshima, H.,Arinaga, K.,Yoshikawa, K.,Hori, H.,Kashikie, H.,Nakamura, K.(2012).Gum chewing enhances early recovery of bowel function following transperitoneal abdominal aortic surgery.Surgery Today,42(8),759-764.
20. Waldhausen, J. H.,Schirmer, B. D.(1990).The effect of ambulation on recovery from postoperative ileus.Annals of Surgery,212(6),671-677.
21. Wang, M.,Gao, Y. H.,Xu, J.,Chi, Y.,Wei, X. B.,Lewith, G.,Liu, J. P.(2015).Zusanli (ST36) acupoint injection for preventing postoperative ileus: A systematic review and meta-analysis of randomized clinical trials.Complementary Therapies in Medicine,23(3),469-483.
22. Widmaier, E. P.、Raff, H.、Strang, K. T.、Widmaier, E.、潘震澤澤(2005)。人體生理學。台北市:合記。
23. Yamamoto, K.,Aso, Y.,Nagata, S.,Kasugai, K.,Maeda, S.(2008).Autonomic, neuro-immunological and psychological responses to wrapped warm footbaths - a pilot study.Complementary Therapies in Clinical Practice,14(3),195-203.
24. Yamamoto, K.,Nagata, S.(2011).Physiological and psychological evaluation of the wrapped warm footbath as a complementary nursing therapy to induce relaxation in hospitalized patients with incurable cancer: A pilot study.Cancer Nursing,34(3),185-192.
25. Yang, H. L.,Chen, X. P.,Lee, K. C.,Fang, F. F.,Chao, Y. F.(2010).The effects of warm water footbath on relieving fatigue and insomnia of the gynecologic cancer patients on chemotherapy.Cancer Nursing,33(6),454-460.
26. Yoon, S. J.,Park, J. K.,Oh, S.,Jeon, D. W.,Yang, J. Y.,Hong, S. M.,Youn, H. J.(2011).A warm footbath improves coronary flow reserve in patients with mild to moderate coronary artery disease.Echocardiography,28(10),1119-1124.
27. Zhang, Z.,Wang, C.,Li, Q.,Zhang, M.,Zhao, H.,Dong, L.,Jin, Y.(2014).Electroacupuncture at ST36 accelerates the recovery of gastrointestinal motility after colorectal surgery: A randomised controlled trial.Acupuncture in Medicine,32(3),223-226.
28. 邱茂良、張善忱、余仲權、周行曉、高鎮五(2004)。針灸學。臺北:知音。
29. 郭素真、沈華詩、石琮瑛、柯莉珊、洪雯玲、周幸生(2013)。比較覺口香糖與早期引水對婦科良性腫瘤術後病人之排氣成效。榮總護理，30(2)，181-190。
30. 陳世銘(2013)。物理治療精選：電療學與熱療學。台北市:禾楓。
31. 章美英、王淑芳、鄧琇介、陳敏修、黃君后、彭台珠(2010)。由中醫護理觀看足浴養生。中西醫結合護理雜誌，1(1)，35-42。
32. 程連心(2007)。腹部術後促排氣兩種方法的探討。時珍國醫國藥，18(6)，1522。
33. 黃君后、王淑芳、林麗美、彭台珠(2012)。探討足浴對經絡能量及自律神經變化之影響。中西醫結合護理雜誌，2，32-43。
34. 董婉君、謝伶瑜(2015)。咀嚼口香糖對降低結腸切除術後腸阻塞之功效。臺灣醫學，19(4)，327-334。
35. 劉長信(2007)。經絡腿足療法。北京:人民衛生。
36. 鄭楊、常宇(2007)。足浴治百病。北京:科學技術文獻。