穴位按壓促進腹部手術後之胃腸道功能

Acupressure for the Improvement of Gastrointestinal Function after Abdominal Surgery

約有10%-30%的腹部手術患者，會出現術後腸阻塞（postoperative ileus，POI），POI是一種暫時性胃腸道活動功能障礙，會導致術後恢復延遲、延長住院天數及增加醫療費用的支出，如何促進腹部手術後胃腸道功能，為臨床重要照護議題。常用來預防及治療POI的方法包括：早期下床活動、術後盡早拔除鼻胃管、早期進食、假性進食或胃腸蠕動促進劑，但POI仍然是一項艱鉅的臨床挑戰，因此，有必要找到更有效、方便和經濟的治療方法。穴位按壓是一種非侵入性治療、安全、隨時可以操作、不需要有醫囑、護理人員可以執行的獨立性護理措施。本文介紹腹部手術之POI的生理病理機轉，及以穴位按壓應用在促進腹部手術患者術後胃腸道功能的相關概念，以提供臨床護理人員照護腹部手術患者另一個選擇的措施。

About 10%-30% of patients who underwent abdominal surgery suffer from postoperative ileus (POI), which is a transient dysfunction of gastrointestinal. POI can delay postoperative recovery, prolong hospital stay, and increase the medical expenses. Improving the recovery of gastrointestinal function in patients after abdominal surgery is an important issue. Methods commonly used to prevent and treat POI include early ambulation, removing the nasogastric tube as soon as possible after surgery, early feeding, sham feeding, or administering prokinetic agents. However, POI remains a difficult clinical challenge. Therefore, a more effective, convenient, and economical method should be developed for treatment of POI. Acupressure is a non-invasive and safe treatment that can be operated at any time. This method is an independent nursing measure that can be implemented by nursing staff without medical order. This paper introduces the pathophysiology mechanism of POI in abdominal surgery and related concepts on acupressure to improve postoperative gastrointestinal function in patients undergoing abdominal surgery and provide clinical nursing staff with an alternative measure.