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題 名 | Experience with Early Postoperative Feeding after Abdominal Aortic Surgery=腹主動脈手術後照顧應用早期進食的經驗 |
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作 者 | 柯博仁; 謝宏昌; 劉永恆; 劉會平; | 書刊名 | 長庚醫學 |
卷 期 | 27:3 2004.03[民93.03] |
頁 次 | 頁210-216 |
分類號 | 419.73 |
關鍵詞 | 主動脈瘤; 術後照顧; 早期進食; Early feeding; Abdominal aortic aneurysm; Postoperative care; |
語 文 | 英文(English) |
中文摘要 | 背景:主動脈手術是重大的血管手術之一,在傳統上常在手術後需要一段相當長的住院恢復過程。在主動脈手術之後常會有一時的腸不蠕動情形,造成病人的延後由口進食因而有住院日數過長的現象。本研究回顧了我們在主動脈瘤術後恢復的照顧上應用早期進食情形。 方法:自2002年5月至2003年5月,總共有連續十個腹主動脈瘤的病人接受了常規的開腹主動脈手術。術中皆使用了硬膜上麻醉的輔助。術後照顧皆給予術後早期進食,再加上術後硬膜上止痛給予以及早期的下床復健等等原則來幫助恢復。我們分析了這些病人的術後恢復狀況。 結果:所有的病人皆能在術後一天內就使用清流飲食(平均為術後12.4小時)。幾手所有的病人(9/10)能在術後3天內恢復一般的經口飲食(平均為術後2.2天)。平均的術後住院日數為5.8天。沒有病人死亡或有重大的併發症。 結論:主動脈開腹手術之後給予早期的進食是安全且可行的。在手術時使用輔助性的硬膜上麻醉,術後使用病人主控式止痛,再加上早期的下床活動及復健,可以使得術後給予早期進食成為可能。鄉們認為這樣的主動脈開腹手術後術後恢復照護原則是成功且有效的。 |
英文摘要 | Background: Abdominal aortic surgery is a form of major vascular surgery, which traditionally involves long hospital stays and significant postoperative morbidity. Experiences with transit ileus are often encountered after the aortic surgery. Thus traditional postoperative care involves delayed oral feeding until the patients regain their normal bowel activities. This report examines the feasibility of early postoperative feeding after abdominal aortic aneurysm (AAA) open-repair. Methods: From May 2002 through May 2003, 10 consecutive patients with infrarenal AAA who underwent elective surgical open-repair by the same surgeon in our department were reviewed. All of them had been operated upon and cared for according to the early feeding postoperative care protocol, which comprised of adjuvant epidural anesthesia, postoperative patient controlled analgesia, early postoperative feeding and early rehabilitation. The postoperative recovery and length of hospital stay were reviewed and analyzed. Results: All patients were able to sip water within 1 day postoperatively without trouble (Average; 12.4 hours postoperatively). All but one patient was put on regular diet within 3 days postoperatively (Average; 2.2 days postoperatively). The average postoperative length of stay in hospital was 5.8 days. No patient died or had major morbidity. Conclusions: Early postoperative feeding after open repair of abdominal aorta is safe and feasible. The postoperative recovery could be improved and the length of stay reduced by simply using adjuvant epidural anesthesia during surgery, postoperative epidural patient-controlled analgesia, early feeding, early ambulation, and early rehabilitation. The initial success of our postoperative recovery program of aortic repair was demonstrated. |
本系統中英文摘要資訊取自各篇刊載內容。