— 生理適應 · EASY · MCQ —
一位腹部手術後 24 小時的病人。哪項評估結果最能暗示發生麻痺性腸阻塞？
A client is 24 hours postoperative following an abdominal surgery. Which assessment finding is most suggestive of a paralytic ileus?
- ASlight abdominal tenderness輕微腹部壓痛
- BAbsence of bowel sounds in all quadrants✓ 正解四個象限均無腸鳴音
- CA blood pressure of 110/70 mmHg血壓 110/70 mmHg
- DPassing small amounts of flatus排出少量氣體
— Explanation · 中文詳解 —
麻痺性腸阻塞（Paralytic Ileus）常發生於腹部手術後，原因包括手術刺激、麻醉藥物作用及交感神經反應，導致腸道平滑肌蠕動功能暫時性喪失。臨床評估中，腸鳴音（Bowel sounds）消失是腸道功能尚未恢復的關鍵表徵，若伴隨腹脹、噁心或無法排氣，需暫停進食並維持禁食狀態，以防腸穿孔或吸入性肺炎。
Paralytic ileus commonly develops after abdominal surgery due to surgical manipulation, anesthetic effects, and sympathetic response, all of which transiently impair intestinal motility. Absent bowel sounds in all quadrants is the key finding indicating that intestinal function has not yet returned; if accompanied by distention, nausea, or inability to pass flatus, oral intake must be held to prevent perforation or aspiration.