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

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

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。

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.