炎症性肠病Chapter 14 Inflammatory bowel disease
学习目标
1.了解疾病中对排便的观察
2.掌握饮食指导及保留灌肠的注意事项
3.掌握以下词汇
bloody purulent stool 脓血便
left lower abdomen 左下腹
barbecue 烧烤，烤肉
retention enema 保留灌肠
left lateral decubitus 左侧卧位
sigmoid colon 乙状结肠
Wang Ming in bed #25 is a patient diagnosed with inflammatory bowel disease.He has had recurrent bloody purulent stool for 2 years.The symptoms have worsened recently, with bowel movements occurring 4 to 9 times a day, accompanied by dull pain in the lower left abdomen and no fever.Wang fang is his primary nurse.She is talking with Wang Ming and giving him a health instruction.
Wang Fang: Good morning, Wang Ming.It is a nice day today.You don't look very well, what's up?
Wang Ming: Thank you for your care.Yes, last night I lost control ofmyself.I ate some barbecue and had diarrhea later.
Wang Fang: Oh, I am so sorry to hear that.If you lose control of your mouth and stomach, it is very difficult to manage your inflammatory bowel disease.Starting from tonight, we will give you medication for retention enema as directed by the doctor.
Wang Ming: Can you tell me what food I can eat? How should I cooperate with you to preserve the enema? I will take your advice seriously this time.
Wang Fang: Ok, Wang Ming.First, you should have a good rest.I suggest you choose a diet rich in calorie, protein and vitamin, but low in residue and fat.Retention enema allows the drug to work directly on the intestinal mucosa locally, which has very good therapeutic effects.A disposable sputum suction tube will be used for enema, as it can reduce your discomfort.
Enema medication will be used at 37 to 38℃, which is closest to human gut temperature.Second, when we inject the enema solution into your body, the volume will not exceed 200 mL each time, so that you won't feel like going to the bathroom, which serves the purpose of retention enema.In addition, when we perform enema,you need to maintain a left lateral decubitus position, so that the medication can directly reach the sigmoid colon.Finally, you need to go to the bathroom before enema is applied, so that the retention time will be longer.
Wang Ming: Ok, thank you so much.I will keep your advice in mind.
译文
25床王明是一位炎症性肠病患者，他反复出现黏液性血便2年，近来症状加重，大便每日达4～9次，伴有左下腹隐痛，无发热，他来到医院，王芳是他的责任护士，她正在对王明进行健康教育。
王芳：早上好，王明，今天是美好的一天，我看你今天气色有点不太好，怎么了？
王明：谢谢你的关心，是的，昨晚我实在是没忍住，吃了点烧烤，后面就腹泻。
王芳：哦，我很抱歉听这些，如果你没办法管住你的嘴和胃，那么很难控制你的炎症性肠病。从今天晚上开始，我们将遵医嘱对你进行药物保留灌肠。
王明：你能不能告诉我什么食物能吃。我应该如何配合你们进行保留灌肠呢？这次我一定认真听从你的意见。
王芳：好的，王明，首先你要保持良好的休息，我建议你多吃高热量、高蛋白质、高维生素、少渣少油饮食，保留灌肠可以使药物直接作用于局部肠道，具有良好的治疗效果。首先在选择灌肠器械的时候我们会选择一次性吸痰管，这样可以减轻你的不适感。使用37～38℃的灌肠药物，这样最接近人体肠道温度。其次在给你注入灌肠液的时候一次不能超过200 mL，这样不会使你产生便意，以达到保留灌肠的目的。我们在灌肠的时候你要保持左侧卧位，这样可以使药物直接到达乙状结肠，最后希望你灌肠前去下卫生间，这样灌肠液保留的时间将会更持久。
王明：好的，非常感谢你，我会认真牢记你的建议。