Kolorektal ameliyatlar öncesi barsak temizliğinde uygulanan değişik yöntemlerin ve hasta toleransının karşılaştırılması
Küçük Resim Yok
Tarih
1990
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Kolorektal operasyonlarda ameliyat öncesi hazırlık ve an t it> i o tik profilaksi yapılmasının gerekliliği herkes tarafından kabul edilen bir görüştür. Yetersiz bir pre- operatif barsak hazırlığı sonucu ameliyatlardan sonra % 30-60 oranında yara enfeksiyonu ve karın içi abse gibi komplikasyonları meydana getirmektedir. Kolorektal cerra hide preoperatif hazırlığın gerekliliği tartışmasızdır. Bu çalışmada kolorektal ameliyatlar öncesinde me kanik barsak temizleme yöntemlerinden Hintyağı, % 10»luk Mannitol ve Lavman, hasta toleransı ve kolon temizliği açısından kıyaslanmıştır. Araştırma Ege Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, Dokuz Eylül Üniversitesi Genel Cerrahi Anabilim Dalı, Tepecik Sosyal Sigortalar Kurumu 2. Cerrahi Servisi 'ne 13 Kasım 1989 - 16 Mart 1990 tarih leri arasında kolorektal ameliyat olmak için yatmış ve sınırlamalara uyularak seçilmiş 30 hastaya uygulanmıştır. Hastaların toleransı değerlendirilerek hin t yağında daha fazla mide bulantısı, karın ağrısı, kramp, anal ir- ritasyon ve tad duyusu şikayetlerinin olduğu, lavmanda ise daha fazla şişkinlik, karın ağrısı, anal irritasyon oluştuğu gözlenmiştir.74 Mannitolde bu şikayetler çok az seviyede bulunmuş tur. Diğer semptomlarda önemli farklılık görülmemiştir. Hintyağı ve mannitol yönteminde lavman yöntemine oranla daha iyi temizlik olduğu görülmüştür (ideal temiz lik oranı hin t yağında % 80, mannitolde % 70, lavmanda % 60 idi). Barsaklarm hazırlanmasından önceki ve sonraki he matolojik, biokimyasal ve vücut ağırlığı değişikliklerin de hintyağı yönteminde istatistiksel açıdan fark görülme miştir. Mannitol yönteminde potasyum (K) (P<0.10) ve vü cut ağırlığında (P^O.01) anlamlı farklılık oluştuğu gö rülmüştür. Lavman yönteminde kreatinin (P<0.10) ve hema tocrit (P 'Co. 01) düzeylerinde farklılık görülmüştür. Hastanın sıvı elektrolit dengesini etkilememesi ve daha güvenli temizlik oluşturması nedeniyle hintyağı, has tanın rahat tolere etmesi nedeniyle de mannitol kullanımı tercih edilebilir. Bu çalışmada hintyağı ve mannitolün ameliyat öncesi barsak temizliğinde güvenli ve etkin yöntemler oldukları sonucuna varılmıştır
SUMMARY It's commonly agreed that it is necessary to make pre-operative preparations and prophylaxis for colorectal operations. The proportion of the infected cuts and the abscesses in the abdomen due to ineffective pre-operative bowel preparations may vary from 30 % to 60 %0 In this study we compared the pre-operative mechanical bowel cleaning procedures in which castor oil mannitol and enema is used with regard to the patients' tolerance and cleanliness. The research was carried out on the patients hospitalized in at the Departments of General Surgery at the Faculty of Medicine at Ege University and 9 Eylül University and also in the Second General Surgery Service of Tepecik Sosyal Sigortalar Kurumu Hospital to be operated on colorectal between November, 13-1989 and March, l6-1990o After observing the degree of tolerance of the patients it was found out that while castor oil caused nausea, stomachache, cramp, anal irritation and ahsence in the sense of taste, enema caused more distension, stoma chache and anal irrigation» Such complaints were found to be very few in the76 use of mamıital. No significant differences were found in the other symptom s 0 In the processes of castor oil and mannitol the rate of cleanliness was higher than the one in the process of enema. (Ideal cleanliness rate was 80 % for castor oil, 70 % for mannitol and 60 % for enema0 ) No statistical differences were found in hematologic, biochemical and total body-weight variations before or after the bowel preparation procedures... It was also observed that there was a significant difference in the proportions of potassium (P <^0.10).and the total body weight (P<^0e01). In the process of enema there was a difference observed in the levels of creatinin (P^OolO) and hematocrit (P<0.01)o Castor oil can be preferred, for it doesn't affect the balance of liquid electrolyte and provides safer cleanliness. Mannitol can also be preferred as it can be easily tolerated by the patients. The results obtained throughout this study have shown that both the process of castor oil and the process of mannitol are safe and effective in the pre-operative cleaning processes.
SUMMARY It's commonly agreed that it is necessary to make pre-operative preparations and prophylaxis for colorectal operations. The proportion of the infected cuts and the abscesses in the abdomen due to ineffective pre-operative bowel preparations may vary from 30 % to 60 %0 In this study we compared the pre-operative mechanical bowel cleaning procedures in which castor oil mannitol and enema is used with regard to the patients' tolerance and cleanliness. The research was carried out on the patients hospitalized in at the Departments of General Surgery at the Faculty of Medicine at Ege University and 9 Eylül University and also in the Second General Surgery Service of Tepecik Sosyal Sigortalar Kurumu Hospital to be operated on colorectal between November, 13-1989 and March, l6-1990o After observing the degree of tolerance of the patients it was found out that while castor oil caused nausea, stomachache, cramp, anal irritation and ahsence in the sense of taste, enema caused more distension, stoma chache and anal irrigation» Such complaints were found to be very few in the76 use of mamıital. No significant differences were found in the other symptom s 0 In the processes of castor oil and mannitol the rate of cleanliness was higher than the one in the process of enema. (Ideal cleanliness rate was 80 % for castor oil, 70 % for mannitol and 60 % for enema0 ) No statistical differences were found in hematologic, biochemical and total body-weight variations before or after the bowel preparation procedures... It was also observed that there was a significant difference in the proportions of potassium (P <^0.10).and the total body weight (P<^0e01). In the process of enema there was a difference observed in the levels of creatinin (P^OolO) and hematocrit (P<0.01)o Castor oil can be preferred, for it doesn't affect the balance of liquid electrolyte and provides safer cleanliness. Mannitol can also be preferred as it can be easily tolerated by the patients. The results obtained throughout this study have shown that both the process of castor oil and the process of mannitol are safe and effective in the pre-operative cleaning processes.
Açıklama
Anahtar Kelimeler
Hemşirelik, Nursing, Bağırsak-kalın, Intestine-large, Bağırsaklar, Intestines, Kolorektal cerrahi, Colorectal surgery, Lavmanlar, Enema