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題名:Enema Prior to Labor: A Controversial Routine in Taiwan
書刊名:The Journal of Nursing Research
作者:曾雅玲 引用關係施怡如鄧玉貴邱靜瑜黃美瑤
作者(外文):Tzeng, Ya-lingShih, Yi-juTeng, Yu-kueiChiu, Ching-yuHuang, Mei-yao
出版日期:2005
卷期:13:4
頁次:頁263-270
主題關鍵詞:常規灌腸分娩人性化生產Routine enemaLaborHumanized birth
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:0
  • 共同引用共同引用:10
  • 點閱點閱:30
縱使爭議性不斷,灌腸卻仍為台灣許多醫療院所分娩準備的常規項目。由於普遍施行會陰切開術,預防糞便污染造成會陰傷口感染即成為贊成維持此項常規的主要理由。因此本研究旨在比較有無常規灌腸對產婦與新生兒產後住院期間的感染率、胎頭下降時間、產程時間、產後開始排便時間及會陰傷口裂開的差異,以作為是否繼續執行此項常規之參考。研究對象為534位至台灣中部某醫學中心生產之低危險姙娠婦女。其中前6個月264位產婦依原有常規執行灌腸,後6個月270位產婦則未施予灌腸。記錄並比較二組產婦及新生兒於生產及產後住院期間感染、產程進展及產後排便等變項之差異。結果發現無論有無灌腸,產婦與新生兒在產後住院期間皆未出現感染徵象、胎頭下降所需的時間亦無顯著差異。雖然灌腸組在第二產程的時間較非灌腸組短,且有統計上的差異,但二組在第一、三產程及總產程的時間長度方面則無顯著差異。此外,在產後排便的時間方面,未灌腸的產婦並未延遲其產後排便時間,或增加會陰傷口裂開的機率。依據本研究之結果生產過程並無常規執行灌腸的必要;但由於受到研究設計之限制,建議未來的研究可採隨機臨床試驗,以提昇結果的推論性。
While taking an enema to induce labor is a controversial issue worldwide, in Taiwan it remains a routine procedure in many hospitals in preparation for birth. Episiotomy is also a prevalent procedure performed during the birthing process. Some physicians believe that enemas help reduce the risk of feces contamination of the episiotomy incision and, therefore, are justified as a routine procedure. This study compared the neonatal infection rates, times to appearance of fetal head, times to first post-labor bowel movement, and rates of episiotomy dehiscence of women receiving a pre-labor enema against those who did not. A total of 534 women classified with low-risk pregnancies were recruited from a medical center in central Taiwan and assigned randomly into one of two groups for a six-month period. The first group (264 subjects) received routine enema procedures prior to delivery in the first 6 months. The second group (270 subjects) did not receive enemas. Study results revealed no significant difference between enema and non-enema groups in terms of infection rates in mothers or infants or in terms of average time to fetal head appearance. While labor duration was the same for the two groups in the first and third stages of labor, the enema group experienced a relatively shorter second stage. No significant difference was observed in times to first post-labor bowel movement or episiotomy dehiscence rates. The results of this study indicate that the administration of enemas as a routine practice prior to labor is not substantiated by medical necessity. However, limitations of the research design suggest that a randomized clinical trial be adopted in the future to explore further the scientific validity of study results.
期刊論文
1.郭素珍(20050600)。人性化生產。護理雜誌,52(3),21-28。new window  延伸查詢new window
2.Wagner, W.(2001)。Fish Can't See Water: The Need to Humanize Birth。International Journal of Gynecology & Obstetrics,75,25-37。  new window
3.Drayton, S.、Rees, C.(1984)。They Know What They're Doing。Nursing Mirror,159(5),4-8。  new window
4.Cuervo, L. G.、Rodriguez, M. N.、Delgado, M. B.(2004)。Enemas during Labour。The Cochrane Database of Systematic Reviews,17(4)。  new window
5.Goer, Henci(2004)。Humanizing Birth: A Global Grassroots Movement。Birth,31(4),308-314。  new window
6.Johnston, R. A.、Baltimore, S. R. S.(1992)。Is the Usual Method of Preparing Patients for Delivery Beneficial or Necessary?。American Journal of Obstetrics & Gynecology,4,645-650。  new window
7.Kantor, Herman I.、Rember, Robert、Tabio, Pablo、Buchanon, Ronald(1965)。Value of Shaving the Pudendal-perineal Area in Delivery Preparation。Obstetrics & Gynecology,25(4),509-512。  new window
8.郭素珍(2002)。母親親善生產的創始-第一個同意倡導改善母嬰服務的聯盟。助產雜誌,45,1-6。  延伸查詢new window
9.Lopes, M. H.、Silva, M. A.、Christoforo, F. F.(2001)。The Use of Intestinal Enema in Labor Preparation: Analysis of Advantages and Disadvantages。Revista Latino-americana de Enfermagem,9(6),49-55。  new window
10.Romney, M. L.、Gordon, H.(1981)。Is Your Enema Really Necessary?。British Medical Journal,282(6272),1269-1271。  new window
11.Romney, M. L.(1982)。Nursing Research in Obstetrics and Gynaecology。International Journal of Nursing Studies,19(4),193-203。  new window
12.Rutgers, S.(1993)。Hot, High and Horrible. Should Routine Enemas Still Be Given to Women in Labour?。The Central African Journal of Medicine,39(6),117-120。  new window
13.Whitley, Nancy、Mack, Esther(1980)。Are Enemas Justified for Women in Labor?。The American Journal of Nursing,80(7),1339-1339。  new window
14.Yeh, Peter S.(2002)。Childbirth in Taiwan is Certainly Overmedicalised。British Medical Journal,325(7355),105-106。  new window
圖書
1.Enkin, M.、Keirse, M.、Neilson, J.、Crowther, C.、Duley, L.、Hodnett, E.、Hofmeyr, J.(2000)。A guide to effective care in pregnancy and childbirth。Oxford:Oxford University Press。  new window
2.Wertz, Richard W.、Wertz, Dorothy C.(1989)。Lying-in: A History of Childbirth in America。New Haven:Yale University Press。  new window
3.Dickason, Elizabeth J.、Silverman, Bonnie L.、Kaplan, Judith A.(2001)。Maternal - Infant Nursing Care。Maternal - Infant Nursing Care。St. Louis, MO。  new window
4.World Health Organization(1997)。Care in Normal Birth - A Practical Guide。Care in Normal Birth - A Practical Guide。Geneva, Switzerland。  new window
 
 
 
 
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