Application in nursing of adhesive intestinal obstruction after abdominal surgery
Adhesive intestinal obstruction after abdominal surgery is a kind of adhesion reaction
caused by the obstruction of the intestinal contents of the patient after abdominal surgery,
which makes the intestinal contents unable to flow normally in the patient's intestines [1].
This is also a common type of intestinal obstruction. Once it occurs, timely treatment and
nursing work must be carried out to reduce the adverse effects of the disease and
promote effective recovery of patients after surgery.
1 Materials and methods
1.1 General data The patients selected in this study were 86 patients with adhesive
intestinal obstruction after abdominal surgery who were treated in our hospital from April
2014 to April 2015, with 43 cases in each group. There were 42 males and 44 females.
The age ranged from 19 to 74 years old, with an average age of (45.00±10.09) years old.
There was no significant difference in the general clinical data of the two groups of
patients (P>0.05), which was comparable.
1.2 Methods The control group adopted conventional nursing, and the nursing group
adopted comprehensive nursing intervention as follows.
1.2.1 Intestinal artificial movement care[2] After the patient's surgery, vital signs and other
indicators gradually return to normal and stable. At this time, the nursing staff needs to
perform passive movement care for the patient's intestines according to the patient's
intestinal function recovery. Under the premise that the patient's body allows, guide the
patient to perform upper limb bending, straightening, lifting, pulling and other exercises,
and insist on doing 15 to 20 times/time, 2 to 3 times/day. At the same time, during the
exercise, the nursing staff needs to adjust and guide the patient's breathing, so that the
patient can breathe through the nose when lying flat, exhale slowly, and count while
exhaling. Usually, a popping sound is made when counting to 7 numbers[3]. The exercise
is completed every 4 hours every day. After each breathing exercise, the body and mind
need to be relaxed as much as possible. At the same time, the lower limb function
exercise needs to be strengthened, and the patient needs to be correctly guided to get
out of bed and move around after the operation, and the amount of activity needs to be
gradually increased. For patients who cannot get out of bed, the nursing staff needs to
assist the patient to complete the body exercise in bed, and perform auxiliary exercises
such as turning over and patting the back, so as to further strengthen the patient's body
exercise, improve physical fitness, and recover soon.
1.2.2 Abdominal massage care After surgery, strengthening abdominal massage care for
patients is also a very important nursing work. Patients can be correctly guided to
perform abdominal massage care, alternating clockwise and counterclockwise massage,
and persist in doing so twice a day. Patients can choose to perform abdominal massage
once in the morning and once in the evening. During the entire abdominal massage
process, the intensity of the massage needs to be well controlled. Abdominal massage
lasts for 20 minutes per time and the massage operation lasts for 1 week[4]. During the
massage process, nursing staff must control the intensity of the massage, adjusting from
light to heavy and then from heavy to light to avoid causing discomfort to the patient.
1.2.3 Gastrointestinal decompression care[5] Use a negative pressure suction device to
decompress the patient's gastrointestinal tract to ensure that the patient breathes
smoothly. At the same time, the changes in the drainage fluid need to be observed.
Starting from 3 days after surgery, enema can be used to stimulate the patient's anus.
1.2.4 Psychological care Surgical trauma can cause pain in the patient's incision, and
analgesics can hinder the patient's intestinal motility. Therefore, when carrying out
nursing work, nursing staff must actively explain to patients some adverse symptoms that
may be caused after surgery, and actively explain to patients the knowledge of the
disease, so that patients can maintain a smooth mood and actively cooperate with
medical care to improve the efficacy of nursing.
1.3 Statistical processing This study used SPSS 19.0 statistical software for processing,
and the inter-group comparison was performed using t test () or χ2 test (%), and P<0.05
was considered statistically significant.
2 Results
2.1 Comparison of gastrointestinal function recovery time and adhesive intestinal
obstruction incidence between the two groups of patients The gastrointestinal function
recovery time and adhesive intestinal obstruction incidence of the nursing group were
(8.05±2.00) d and 2.33% (1/43), respectively, and the gastrointestinal function recovery
time and adhesive intestinal obstruction incidence of the control group were (25.40±2.04)
d and 13.95% (6/43), respectively. There was a significant difference between the two
groups (P<0.05), which was statistically significant.
2.2 Comparison of adverse reaction incidence between the two groups of patients The
adverse reaction incidence of the nursing group was 11.63%, including 2 patients with
insomnia and dreaminess, 1 patient with puncture site injury, and 1 patient with dysuria.
The adverse reaction incidence of the control group was 32.56%. In addition to the above
symptoms, there were 2 patients with pressure sores. There was a significant difference
between the two groups (P<0.05), which was statistically significant.
3 Discussion
Abdominal surgery is gradually becoming more widely used in clinical practice, but it
often causes patients to suffer from adhesive intestinal obstruction after surgery. Once
adverse symptoms occur, it will hinder the patient's recovery process and cause patients
to experience abdominal pain, nausea and vomiting. In view of this, it is necessary to
carry out nursing intervention work in a timely manner in clinical practice to achieve
effective prevention and nursing intervention of the patient's condition, further improve
the patient's cooperation and satisfaction with medical care, shorten the gastrointestinal
function recovery time, reduce the incidence of adverse reactions, and achieve early
recovery.
