👨‍⚕️ Dr. BOSS 的一般外科衛教室｜Episode 02：腸穿孔手術

👨‍⚕️ Dr. BOSS 的一般外科衛教室｜Episode 02：腸穿孔手術 Dr. BOSS’s General Surgery Health Classroom｜Episode 02: Bowel Perforation Surgery 副標 / Subtitle 👨‍⚕️ Dr. BOSS × 🐨 Koala | 腸穿孔：腸道破洞的緊急處理 👨‍⚕️ Dr. BOSS × 🐨 Koala | Bowel Perforation: Emergency Management of an Intestinal Hole --- 🟦 對話稿 Dialogue（中英對照） Koala： BOSS醫生，腸穿孔是什麼？看起來很嚴重耶！ Doctor BOSS, what is a bowel perforation? It sounds serious! BOSS 醫生： 沒錯，腸穿孔是腸壁出現破洞，導致腸內容物流入腹腔，引起腹膜炎，是外科緊急處理的狀況。 Exactly. Bowel perforation is a hole in the intestinal wall, allowing contents to spill into the abdominal cavity, causing peritonitis. It’s a surgical emergency. Koala： 那通常是什麼原因造成的呢？ What usually causes it? BOSS 醫生： 常見原因包括：腸阻塞長期未處理、嚴重潰瘍、憩室炎破裂、外傷或腫瘤侵蝕。 Common causes include untreated bowel obstruction, severe ulcers, ruptured diverticulitis, trauma, or tumor erosion. --- 🟦 術前準備 Preoperative Preparation（中英對照） 緊急評估 / Emergency assessment 包括生命徵象、血液檢查、腹部影像（X光、CT）確認穿孔位置。 Assess vital signs, blood tests, and abdominal imaging (X-ray, CT) to locate the perforation. 禁食與液體支持 / Fasting & fluid support 禁食並給予靜脈輸液補充水分與電解質。 Keep patient NPO (nothing by mouth) and provide IV fluids for hydration and electrolyte balance. 抗生素 / Antibiotics 術前給予廣效抗生素，防止感染擴散。 Administer broad-spectrum antibiotics preoperatively to prevent infection spread. --- 🟦 手術方式 Surgery Methods（中英對照） 開腹手術 / Open surgery 切開腹腔，清洗腹腔內污染，修補腸穿孔，必要時切除壞死腸段。 Open the abdomen, irrigate the contaminated cavity, repair the perforation, and remove necrotic bowel if necessary. 微創腹腔鏡 / Laparoscopic surgery 適用於局部穿孔且無嚴重感染，可用小切口修補穿孔，恢復較快。 Used for localized perforation without severe infection; small incisions allow faster recovery. 手術目標 / Goals of surgery 控制腹腔感染、修補穿孔、維持腸道功能。 Control intra-abdominal infection, repair perforation, and preserve bowel function. --- 🟦 術後照護 Postoperative Care（中英對照） 抗感染 / Infection control 持續給予抗生素，觀察體溫、白血球與傷口狀況。 Continue antibiotics, monitor temperature, WBC count, and wound condition. 飲食與腸道功能恢復 / Diet & bowel function 初期禁食，隨腸蠕動恢復逐步進食。 NPO initially; gradually advance diet as bowel movement returns. 活動與復健 / Activity & rehabilitation 早期下床走動，促進腸蠕動並降低併發症風險。 Early ambulation to stimulate bowel movement and reduce complications. 長期追蹤 / Long-term follow-up 留意腸道功能、術後疤痕與潛在併發症。 Monitor bowel function, surgical scar, and potential long-term complications. --- 🟦 小知識 Mini Note（中英對照） Koala： 腸穿孔手術後腸道會不會受損很嚴重？ Will bowel function be seriously affected after perforation surgery? BOSS 醫生： 大部分患者腸道功能可以恢復，但嚴重感染或切除腸段可能影響吸收，需要醫師指導飲食與復健。 Most patients regain bowel function, but severe infection or bowel resection may affect absorption, requiring dietary and rehabilitation guidance. --- 🟦 小貼士 Quick Tip 中文：腸穿孔術後務必遵守醫囑，按時服藥、逐步恢復飲食及活動，預防再感染或腸功能障礙。 English: After bowel perforation surgery, follow medical instructions carefully, take medications on time, gradually resume diet and activity, and prevent reinfection or bowel dysfunction.