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來源文獻資料
摘要
外文摘要
引文資料
題名:
以系統性文獻回顧檢視術前機械性腸道準備對結直腸手術病人之臨床效益
書刊名:
榮總護理
作者:
張瑛瑛
/
林麗英
/
張麗銀
作者(外文):
Chang, Ying-ying
/
Lin, Lih-ying
/
Chang, Li-yin
出版日期:
2012
卷期:
29:3
頁次:
頁234-242
主題關鍵詞:
計畫性結直腸手術
;
機械性腸道準備
;
手術部位傷口之感染
;
Elective colorectal rectal surgery
;
Mechanical bowel preparation
;
Surgical site infection
原始連結:
連回原系統網址
相關次數:
被引用次數:期刊(
2
) 博士論文(0) 專書(0) 專書論文(0)
排除自我引用:
2
共同引用:0
點閱:2
計畫性結直腸手術病人術前機械性腸道準備(Mechanical Bowel Preparation, MBP)仍被視為常規處置,不僅喝瀉劑,亦要執行經肛門之清潔灌腸,造成病人身體不適。國外學者不建議MBP做為結直腸手術前的必要常規,這樣的建議是否適用於本土病人尚無定論。為瞭解術前是否接受MBP對計畫性結直腸手術病人之臨床效益。全面文獻搜尋共有20篇相關之隨機控制型研究(RCT),符合條件有4篇RCT研究,經過文獻品質評析後,使用RevMan 5.0軟體進行4篇文獻之綜合分析(Meta-analysis),勝算比1.74,95%信賴區間為1.18-2.56,然Cochrane之綜合分析結果顯示術前是否接受MBP對病人手術部位感染率無顯著差異。此實證資料可以提供醫護團隊臨床照護決策的參考,考慮MBP的利益與風險,納入病人的感受,做出最適當的醫護處置,簡化繁瑣的處置流程,以提昇照護品質。
以文找文
Preoperative mechanical bowel preparation is still regarded as a routine procedure before an elective colorectal surgery. It includes not only taking certain laxatives in solution form, but also performing a cleansing enema, which causes suffering to the patients and their family. This also increases the burden to the nurses' already busy work load and having to repeatedly observe the content and color of the fecal material. Since 1992, many randomized controlled trials show that by not performing preoperative mechanical bowel preparation, it does not increase surgery-related complications, including leakage of the intestinal anastomosis, intra-abdominal abscess formation, or wound infection. By searching the best evidence in the literature and using critical appraisal, the authors tried to find the best decision-making process; through the use of database from hospital records, efforts were made to understand the clinical orders for intestinal preparation before colorectal surgeries and, through nursing records, more was learned about the distressing symptoms of patients' enema. Expectively, by application of international standards, empirical verification of evidence information, and constant communication and cooperation within the medical team, we are able to provide more sophisticated quality of service for the benefit of patients, their families and clinical staff in order to achieve a win-win outcome.
以文找文
期刊論文
1.
Bucher, P.、Gervaz, P.、Soravia, C.、Mermillod, B.、Erne, M.、Morel, P.(2005)。Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery。British Journal of Surgery,92(4),409-414。
2.
Eskicioglu, C.、Forbes, S. S.、Fenech, D. S.、McLeod, R. S.(2010)。Preoperative bowel preparation for patients undergoing elective colorectal surgery: A clinical practice guideline endorsed by the Canadian。Society of Colon and Rectal Surgeons. Canadian Journal of Surgery,53(6),385-395。
3.
Fa-Si-Oen, P.、Roumen, R.、Buitenweg, J.、van de Velde, C.、van Geldere, D.、Putter, H.、Croiset van Uchelen, F.(2005)。Mechanical bowel preparation or not? Outcome of a multicenter, randomized trial in elective open colon surgery。Diseases of the Colon & Rectum,48(8),1509-1516。
4.
Fry, D. E.(2011)。Colon preparation and surgical site infection。American Journal of Surgical Pathology,202(2),225-232。
5.
Guenaga, K. F.、Matos, D.、Wille-Jorgensen, P.(2011)。Mechanical bowel preparation for elective colorectal surgery。Cochrane Database of Systematic Reviews,9,CD001544。
6.
Hughes, E. S.(1972)。Asepsis in large-bowel surgery。Annals of the Royal College of Surgeons of England,51(6),347-356。
7.
Jung, B.、Pahlman, L.、Nystrom, P. O.、Nilsson, E.(2007)。Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic resection。British Journal of Surgery,94(6),689-695。
8.
McCoubrey, A. S.(2007)。The use of mechanical bowel preparation in elective colorectal surgery。Ulster Medical Journal,76(3),127-130。
9.
Nichols, R. L.、Condon, R. E.(1971)。Preoperative preparation of the colon。Surgery, Gynecology & Obstetrics,132(2),323-337。
10.
Pena-Soria, M. J.、Mayol, J. M.、Anula, R.、Arbeo-Escolar, A.、Fernandez-Represa, J. A.(2008)。Single-blinded randomized trial of mechanical bowel preparation for colon surgery with primary intraperitoneal anastomosis。Journal of Gastrointestinal Surgery,12(12),2103-2109。
11.
Pena-Soria, M. J.、Mayol, J. M.、Anula-Fernandez, R.、Arbeo-Escolar, A.、Fernandez-Represa, J. A.(2007)。Mechanical bowel preparation for elective colorectal surgery with primary intraperitoneal anastomosis by a single surgeon: Interim analysis of a prospective single-blinded randomized trial。Journal of Gastrointestinal Surgery,11(5),562-567。
12.
Scabini, S.、Rimini, E.、Romairone, E.、Scordamaglia, R.、Damiani, G.、Pertile, D.、Ferrando, V.(2010)。Colon and rectal surgery for cancer without mechanical bowel preparation: Onecenter randomized prospective trial。World Journal of Surgical Oncology,8,35。
13.
Shawki, S.、Wexner, S. D.(2008)。Oral colorectal cleansing preparations in adults。Drugs,68(4),417-437。
14.
Watanabe, M.、Murakami, M.、Nakao, K.、Asahara, T.、Nomoto, K.、Tsunoda, A.(2010)。Randomized clinical trial of the influence of mechanical bowel preparation on faecal microflora in patients undergoing colonic cancer resection。British Journal of Surgery,97(12),1791-1797。
15.
Zmora, O.、Mahajna, A.、Bar-Zakai, B.、Hershko, D.、Shabtai, M.、Krausz, M. M.、Ayalon, A.(2006)。Is mechanical bowel preparation mandatory for leftsided colonic anastomosis? Results of a prospective randomized trial。Techniques in Coloproctology,10(2),131-135。
16.
Zmora, O.、Mahajna, A.、Bar-Zakai, B.、Rosin, D.、Hershko, D.、Shabtai, M.、Ayalon, A.(2003)。Colon and rectal surgery without mechanical bowel preparation: A randomized prospective trial。Annals of Surgery,237(3),363-367。
其他
1.
行政院衛生署(20110901)。民國99年臺灣地區主要癌症死亡原因,http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=11468&level_no=1&doc_no=77184。
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