【正文】 my in which an opening is made through the abdominal wall into the peritoneal cavity is done to detemine the cause of an acute abdomen. If the cause of acute abdomen can be surgically removed (., inflamed appendix) or surgically repaired (., ruptured abdominal aneurysm), then surgery is considered definitive therapy.剖腹探查就是經由腹壁開口觀察腹膜腔，以確定急腹癥的病因。 Goals 護理目標 The patient will have a satisfactory level of pain control, relief of nausea and vomiting, normal bowel sounds within 72 hours, absence of fever, and lungs clear to auscultation.病人對疼痛控制、惡心嘔吐緩解感到滿意，72小時內腸鳴音正常，不發(fā)燒，肺部聽診無雜音。急腹癥病人術前準備包括CBC計數(shù)、血型和交叉配血、凝血化驗。 2. Increased use of laparoscopic procedures has reduced the risk of postoperative plications related to wound care and altered GI motility. These procedures generally result in shorter hospital stays. 腹腔鏡檢查減少了發(fā)生與傷口護理和胃腸道運動減少相關的術后并發(fā)癥的危險，可以縮短住院時間。毛鼻胃插管的目的是排空胃部分泌物和氣體，防止胃擴張。護囑中通常寫明，必要時用20至30 ml生理鹽水沖洗插管。 4. Parenteral fluids are administered to provide the patient with fluids and electrolytes until bowel sounds return. Occasionally, ice chips may be ordered because they relieve a dry mouth. 在腸鳴音恢復前，非腸道補液可為病人體內液體和電解質。 5. Although nausea and vomiting are not unmon after abdominal surgery, these problems are often selflimiting. Observation is important in determining the cause. Antiemetics such as promethazine, prochlorperazine, or trimethobenzamide may be ordered. 盡管腹部手術后惡心嘔吐并不常見，即使出現(xiàn)也常常是可以自己控制的。也可以開一些止吐藥，如異丙嗪、丙氯拉嗪）或曲美芐胺等。 they are due to swallowed air and impaired peristalsis resulting from immobility, manipulation of abdominal contents during surgery, and side effects of anesthesia. The resulting pain can be so unfortable that medications to stimulate peristalsis, such as bethanechol or neostigmine methylsulfate, may be given. A rectal tube or moist heat on the abdomen may be effective in relieving distention. The physician should be informed of abdominal distention and rigidity. As intestinal activity increases, distention and gas pains gradually decrease. 剖腹術后出現(xiàn)腹用及腹痛也是常見的癥狀，這是由吞咽空氣及運動不能引起腸蠕動受損、手術期間腹內容物處理、麻醉副作用等造成的。肛管或腹部濕熱敷可有效緩解腹脹。因為隨著腸動增加， 腹脹和脹痛也會逐漸增加。 Patient Teaching 病人宣教 1. Patient teaching for discharge begins when the patient returns from the OR. Instructions to the patient and family should include any modifications in activity, care of the incision, diet, and drug therapy. 在病人從手術室返回時就應開始病人出院宣教。 2. Small, frequent meals that are high in calories should be taken initially, with a gradual increase in food intake as tolerated. 開始時可少量多餐，食用一些高卡食物，在許可情況下再逐漸增加攝食量。 4. The patient should be aware of possible plications after surgery and should notify the physician immediately if vomitting, pain, weight loss, incisional drainage, or changes in bowel function occur. 病人應了解可能的術后并發(fā)癥，應在出現(xiàn)下列情況時應立即通知醫(yī)生：嘔吐、疼痛、體重下降、切口滲液或腸道功能發(fā)生變化。本和標是一個相對概念，主要說明病證各種矛盾的主次關系。在復雜多變的病證中，常有標本主次的不同。 急則護其標：當標病甚急，可危及病人生命或影響本病治療時，護理上應采取應急措施，解決其標的問題。若不解決標的問題，不但病人疼痛難受，而且影響本的治療，造成血壓更高。哮喘患者一旦哮喘發(fā)作，護理上應給端坐位、給氧和其它止喘的護理。如做好精神情志的調 攝、加強鍛煉以增強體質、適當?shù)氖逞a等。臨床應用時應視病情變化適當掌握。 （1）調養(yǎng)身體，提高正氣抗邪能力：要提高正氣，關鍵要增強體質。遺篇”為了防止疾病的發(fā)生，必須注意精神的調攝、身體的鍛煉、飲食起居護理、避免過度疲勞和適當?shù)乃幬镱A防等方面。中醫(yī)認為精神神志活動，與人體的生理、病理變化有密切的關系。如過喜傷心、暴怒傷肝、過思傷脾、恐懼傷腎等。而心情舒暢、精神愉快，則使氣機通暢，氣血和平，有利于疾病康復。上古天真論》中說的：“恬惔虛無，真氣從之，精神內守，病安從來。 ② 加強身體鍛煉。說明經常進行身體鍛煉，能增強體質，減少疾病的發(fā)生。 ③ 生活起居護理。如《素問” ④ 藥物預防。遺篇早在明清時代，人痘接種法已得到推廣。近年來中草藥預防疾病有了很大發(fā)展，取得很好效果。 （2）防止病邪的侵害：要做好未病先防除了采用以上四方面措施外，還應防止病邪的侵害，因病邪是導致疾病發(fā)生的重要條件。C. 艾滋病肝系病癥中醫(yī)護理要點中醫(yī)的肝系病癥與現(xiàn)代醫(yī)學肝病概念不同，可出現(xiàn)頭痛、眩暈、煩悶不寐、脅痛耳鳴、黃疸，以及痙攣等諸多表現(xiàn)，在艾滋病人可見于HIV神經癥狀，EB病毒感染或帶狀皰疹病毒感染等。，如芹菜、海蜇、白蘿卜等。，可采用體針、耳針、頭