術後噁心嘔吐照護流程之發展

The Development of Postoperative Nausea and Vomiting Care

噁心嘔吐是手術後常見的併發症，術後嘔吐的出現，易使縫合處產生壓力，導致手術部位的血腫，亦會置病人於吸入性肺炎的危險，其結果不僅降低病人的舒適感及滿意度，亦增加住院天數及費用。臨床常見個案出現術後噁心嘔吐的情形，護理人員除了依醫囑給藥外，對於此症狀的了解及所能提供的措施卻微乎其微，引發筆者匯整國內外相關文獻，合併考量國內醫院目前術後噁心嘔吐治療的現況，發展出術後噁心嘔吐照護流程。本文內容包括引起術後噁心嘔吐的危險因子、預防術後噁心嘔吐的相關藥物和措施、以及術後噁心嘔吐的治療等。最後藉由彙整相關之文獻，整理出目前國內外術後噁心嘔吐的評估及處置趨勢，發展一套適合國內臨床外科情境的簡易照護流程圖，藉以提供臨床醫護人員在面臨術後噁心嘔吐之參考。

Nausea and vomiting is a common post-operative complication that exacerbates patient discomfort and puts tension on suture lines, which may cause hematomas beneath surgical flaps and place patient at risk of aspiration pneumonia. Nausea and vomiting decreases patient comfort and satisfaction and increases hospital stay length and costs. Postoperative nausea and vomiting are common occurrences. Nurses typically give medicine in accordance with doctors’ orders without understanding patient symptoms. Such results in less than optimal holistic care management. This situation encouraged the author to collect references on current international trends related to postoperative nausea and vomiting treatment in the clinical setting. The author further worked to recommend a care management protocol based on findings. This paper describes risk factors of postoperative nausea and vomiting and the related drugs, prevention procedures, and treatment recommendations. Finally, the author developed a simple care flow chart suited for use in internal clinical situations that may provide a valuable reference for medical professionals.