Title Razlike u sestrinskoj skrbi nakon kolecistektomije s obzirom na kiruršku tehniku Title (english) Differences in nursing care after cholecycectomy with regard to surgical technique Author Klara Kuprešanin Mentor Marijana Neuberg (mentor)Committee member Marijana Neuberg (predsjednik povjerenstva)Committee member Ivana Herak (član povjerenstva) Committee member Željko Jeleč (član povjerenstva)Granter University North Defense date and country 2020-09-10, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Akutni kolecistitis, tj. akutna upala žučnjaka jedna je od najzastupljenijih komplikacija simptomatske kolelitijaze. Statistički podaci pokazuju nam kako 10% ukupnog stanovništva ima žučne kamence i kako je bolest nešto češća u žena, posebice u dobi od 30 – 40 godina. Na učestalost i pojavnost žučnih kamenaca utječe genetika, način prehrane, rasa, ali i geografski prostor. Žučni kamenci mogu biti kolesterolski, pigmentni i mješoviti od kojih su kolesterolski žučni kamenci nešto više zastupljeniji na našim područjima. Jedan od najčešćih znakova žučnih kamenaca je jaka bol koja se pojavljuje u desnom gornjem dijelu trbuha, a koja se obično širi u leđa i pod desni pazuh. Bol je uglavnom praćena mučninom i povraćanjem. Najbolja metoda za dijagnosticiranje žučnih kamenaca u žučnom mjehuru je ultrazvuk. Ostale pretrage uz pomoć kojih dokazujemo prisutnost žučnih kamenaca su kolescintigrafija, RTG abdomena, CT, MR, ERCP te oralnom kolecistografijom. Do akutnog kolecistitisa nerijetko dolazi uslijed opstrukcije cističnog kanala žučnim kamencem ili njegovom opstrukcijom radi pojave edema. Tada se javlja djelomični ili potpuni prekid pražnjenja žuči, a zastojna žuč u organizmu u većini slučajeva dovodi do infekcije. Zlatni standard u liječenju žučnih kamenaca i akutnog kolecistitisa je laparoskopska kolecistektomija koja ima niz prednosti u odnosu na otvorenu klasičnu kolecistektomiju. Laparoskopskom kolecistektomijom postiže se brži oporavak, blaža postoperacijska bol, smanjena učestalost primjene analgetika, kraći boravak u bolnici i ljepši estetski rezultat. Od neizmjerne je važnosti dobra prijeoperacijska priprema bolesnika za kirurški zahvat.
Medicinska sestra/tehničar započinje psihološku pripremu bolesnika od trenutka kada se postavi indikacija za kirurško liječenje. Provodi fizičku pripremu bolesnika koja uključuje provođenje edukacije, uzimanje materijala za dijagnostičke pretrage, pripremu probavnog sustava i prehranu. Nakon kirurškog zahvata sudjeluje u pacijentovom oporavku. Pomaže bolesniku pri ustajanju, previja kiruršku ranu te prati mogući razvoj poslijeoperacijskih poteškoća i komplikacija koje često mogu zateći bolesnika nakon kirurškog zahvata. Prije samog izlaska iz bolnice, vrlo je važno da medicinska sestra objasni bolesniku i članovima njegove obitelji važnost pridržavanja žučne dijete, način i vrstu uzimanja poželjnih namirnica te o aktivnostima koje bolesnik mora provoditi kod kuće.
Abstract (english) Acute cholecystitis, i.e. acute inflammation of the gallbladder is one of the most common complications of symptomatic cholelithiasis. Statistic data shows that 10% of total population has gallbladder stones and that the condition is more common in females, especially between 30 and 40 years of age. The development and occurence of gallbladder stones is affected by genetics, diet, race, but also geographical location. There are more types of gallbladder stones, such as cholesterol gallstones, pigment gallstones or mixed gallstones. Cholesterol gallstones are more common in our area. One of the most common signs of gallbladder stones is severe pain in the upper right part of the belly, which usually spreads towards the back and under the right armpit. The pain is usually followed by nausea and vomiting. The best method of diagnosing gallbladder stones in the gallbladder is ultrasound. Other methods of diagnosing gallstones are cholescintigraphy, abdominal x-ray, CT, MRI scan, ERCP and oral cholecystography. Acute cholecystitis is usually caused by the obstruction of the cystic canal with gallstones or it's obstruction because of aedema. A partial or complete emptying of the gallbladder happens, and the stagnant bile within the organism leads to an infection. The golden standard in treating gallstones and acute cholecystitis is laparoscopic cholecystectomy which has many advantages over an open classic cholecystectomy. With laparoscopic cholecystectomy, faster recovery, less post-surgery pain, lower application of analgetics, shorter hospital stay and a better aesthetical result are achieved. It is of utmost importance that the patient is well prepared for the surgery beforehand.
A nurse begins to prepare the patient for the surgery psychologically from the moment a surgery is deemed necessary. They also carry out physical preparation of the patient which includes education, taking material for diagnostic tests and preparing the digestion system and diet. After the surgery, they participate in the patient's recovery. They help the patient to stand up, bandages the surgical wound and tracks possible post-surgery complications that a patient can experience. Before checking out of the hospital, it is very important that the nurse explains the importance of gallbladder diet, the type and kind of foods to consume and the required patient's activities to the patient and their family.
Keywords
žučni mjehur
žučni kamenci
prijeoperacijska priprema
laparoskopska i klasična kolecistektomija
žučna dijeta
Keywords (english)
gallbladder
gallbladder stones
pre-surgery preparation
laparoscopic and classic cholecystectomy
gallbladder diet
Language croatian URN:NBN urn:nbn:hr:122:586196 Study programme Title: Nursing Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-11-12 15:00:51
