口服药物法行肠道准备在肝叶切除术中应用的效果.doc

口服药物法行肠道准备在肝叶切除术中应用的效果 解放军护理杂志2007年1O月,24(1OB) 口服药物法行肠道准备在肝叶切除术中应用的效果 周丽平,王志红 (第二军医大学东方肝胆外科医院 ,陈月芳 肿瘤综合治疗科,上海2OO438) 摘要:目的研究肝脏手术适宜简便的术前肠道准备方法.方法将330例肝切除术患者,随机分为口服乳果糖 组170例,口服硫酸镁组160例.使用统一的调查问卷调查服药后耐受性,服药后排便次数,术中及术后并发症情 况,术后胃肠道功能恢复情况等.结果硫酸镁组有35例因呕吐,腹胀等原因未能全部服完硫酸镁液,服药后不 良反应硫酸镁组明显高于乳果糖组(Plt;O.01).服药后排便,乳果糖组9O%在3次以下,有15例未排便而再次行 肠道准备(开塞露4Oml纳肛),而硫酸镁组有86.9的病例大便次数在3次以上,其中≥6次者达47.5.两组患 者术后肠道功能恢复天数,胃肠道并发症发生率无明显差别(Pgt;O05).玷论对于肝切除术前肠道准备,乳果 糖综合效果优于硫酸镁.护理人员在此过程中,应做好用药指导及效果观察. 关键词:肝叶切除术;肠道准备;乳果糖;硫酸镁 中图分类号:R472.91文献标志码:A文章编号:10O8—9993(2007)1OB一0004--03 OutcomesofCatharticBowelPreparationforHepatectomy:AComparison ZHOULi-ping,WANGZhi—hong,CHENYue-fang(Depa~mentofComprehensiveTreatment.Eastern HepatobiliarySurgeryHospital,SecondMilitaryMedicalUniversity,Shanghai200433,China) Abstract:ObjeaiveTosearchforasimplemethodforbowelpreparationbeforehepatectomy.Methods Atotalof330patientswhohasundergonehepatectomyinourdepartmentwererandomlydividedinto groupD(orallytakenDuphalac,一170)andgroupM(orallytakenMagnesiumSulfate,It/一160).T0l— erance,defecationtimes,postoperativecomplicationsandrecoveryofgastrointestinalfunctionofpatients wereinvestigatedbyunifiedquestionnairesurvey.ResultsThirty-fivepatientsingroupMdidnotcom— pletethestudyduetovomitingandabdominaldistensiorLAdversereactionoccurredmorefrequentlyin groupMthaningroupD(Pd0.01).Therewere90ofpatientsingroupDdefecatedlessthan3 times;15patientswhodidnotdefecateweresubjectedto40mlGlycerineEnemaintotheanus. Therewere86.9ofpatientsingroupMdefecatedover3timesand47.5patientsdefecated0一 ver6times.Nosignificantdifferencewasfoundinpostoperativecomplicationsandrecoveryof gastrointestinalfunctionbetweenthetwogroups(Pgt;0.05).ConclusionDuphalacissuperiorto MagnesiumSulfateinbowelpreparationbeforehepatoectomy.Nursingstaffshouldgivebetter drugadministrationguidanceandobservationoftheoutcomes. Keywords:hepatectomy;bowelpreparation;duphalac;magnesiumsulfate INursJChinPLA,2007,24(10B):4—6I 肝叶切除术是处理肝脏外科疾病的重要手 段L1].因肝脏外科疾病多合并不同程度肝功能损 害,胃肠道功能障碍[2],如术前肠道准备不充分,