Topics What is a stomal therapy nurse? 4 A guide to eating and drinking if you have an ileostomy 8 A guide to eating and drinking if you have a colost

Transcription

1 造口护理信息中文版 Information on caring for a Stoma in Chinese 造口护理信息中文版 Chinese

2 Topics What is a stomal therapy nurse? 4 A guide to eating and drinking if you have an ileostomy 8 A guide to eating and drinking if you have a colostomy 14 A guide to managing constipation 18 Caring for my colostomy 22 Caring for my ileostomy 26 Caring for my urostomy 30 Healthy bowel habits 36 Hints for a patient with a stoma 40 Peri-anal skin care 44 2 Topics

3 主题 什麼是造口治療護士? 5 迴腸造口手術後的飲食指南 9 結腸造口手術後的飲食指南 15 管理便秘指南 19 照顧我的結腸造口 23 照顧我的迴腸造口 27 照顧我的尿道造口 31 健康的排便習慣 37 給有人工造口病人的建議 41 Н 肛門周圍皮膚護理 45 Topics 3

4 What is a stomal therapy nurse? (1) A stomal therapy nurse: Is a registered nurse Specialises in Stomal Therapy Nursing Cares for people who are preparing for or have had surgery, resulting in the creation of a stoma Educates people in the pre and post operation periods, to manage their stoma and will discuss any issues important to you and your family Is located in most major hospitals and community nursing services Cares for people requiring wound, drain tubes, breast and continence care. Information about Stomas What is a stoma? A stoma is an artificial opening created by surgery The stoma creates as an opening into the body to allow body waste to come out, for example, urine or faeces The most common type of stoma is an opening into the large or small bowel A stoma may be permanent or temporary. Why do people need a stoma? Trauma to the bowel Cancer Congenital abnormalities Inflammatory bowel conditions Damage caused by radiation Protection of an anastamosis (the joining of two pieces of bowel). 4 What is a stomal therapy nurse? - Page 1 of 4

5 什麼是造口治療護士? (1) 造口治療護士.. 是一名註冊護士 專業於造口治療護理 照顧為要建立一個造口正作準備或已經做過手術的人士 教導手術前後期間的人管理他們的造口, 並且會討論對您或您的家人的任何重要問題 服務大部分較大醫院與社區護理服務處 照顧那些需要對傷口 引流管 胸部與失禁護理的人 關於造口的資訊 什麼是造口 造口是手術建立的一個人造開口 造口創建一個開口通道進入體內, 讓體內的廢物排出, 例如小便和大便 最常見的造口類型就是一個進入大腸或小腸的開口 造口可以是永久性的也可以是臨時性的 人們為什麼須要造口? 腸道創傷 癌症 先天性異常 腸道發炎情況 放射線造成損害 接合處的保護 ( 兩段腸道接合處 ) What is a stomal therapy nurse? - Page 2 of 4 5

6 What is a stomal therapy nurse? (2) Who has a stoma? Anyone from a newborn baby to the very old Australia has over 25,000 people with a stoma A person with a stoma is not a different person, but they have a different way of going to the toilet A stoma should not keep people from enjoying a family life, social activities, or a sport or business life. Types of Stoma Colostomy An opening into the large bowel (or colon) May be temporary or permanent. Ileostomy An opening into the small bowel (or ileum) May be permanent or temporary. Urostomy (Ileal Conduit) A stoma made from a piece of small bowel (ileum) to divert urine A permanent stoma. 6 What is a stomal therapy nurse? - Page 3 of 4

7 什麼是造口治療護士? (2) 誰有造口? 任何人, 從新生嬰兒到非常年老的長者 澳大利亞有超過 25,000 人有造口 有造口的人與別人沒有不同, 不過他們上廁所的方法不一樣 造口不會妨礙人們享受家庭生活 社交活動 體育或商業活動 造口的類型 結腸造口 進入大腸 ( 或結腸 ) 的開口 可以是永久性的或臨時性的 迴腸造口 進入小腸 ( 或迴腸 ) 的開口 可以是永久性的或臨時性的 人造尿道口 ( 迴腸導水管 ) 利用一段小腸 ( 迴腸 ) 建立一個造口來疏導尿液 永久性的造口 What is a stomal therapy nurse? - Page 4 of 4 7

8 A guide to eating and drinking if you have an ileostomy (1) This information about your diet is a Guide Only. You do not have to change what you eat because you have a stoma You may now be able to eat foods you had trouble with before surgery Every person will react, to each food type, differently If your faeces remain watery speak to your Doctor or Stomal Therapy Nurse. You may require medication to thicken the faeces After your operation the ileostomy will start to work with a fluid output. This will later become a thick paste. Foods that may cause gas Cucumber Peas Beans Orange juice Onions Eggs Cabbage Yeast Mushrooms Baked beans Ham Chewing gum Fizzy drinks Broccoli Cauliflower Low calorie sweets and lollies How can I reduce gas Eat your food slowly Chew with your mouth closed and avoid gulping your food Don t eat too much food at the one time Eat regular meals, skipping meals is more likely to increase gas Foods that may produce odour Cheese Beans Onions Cabbage Fish Asparagus Chewing gum Eggs Garlic Lentils Ham 8 A guide to eating and drinking if you have an ileostomy - Page 1 of 6

9 迴腸造口手術後的飲食指南 (1) 這裡的飲食資訊只是一個 指南 您不須要因為有一個造口而改變飲食 您現在也許可以吃您在手術前有問題的食物 每一個人對所吃食物種類有不同反應 如果您的糞便一直含過多水份, 告訴您的醫生或迴腸造口治療護士, 您可能需要服用藥物來使糞便變厚 在施行手術後, 迴腸造口開始會有流質排泄物, 不過以後會變成濃厚膏狀 可能會造成排氣的食物 黃瓜 青豆 豆類 橙汁 洋蔥 蛋類 卷心菜 發粉 蘑菇 烤豆 火腿 口香糖 起泡飲料 西蘭菜 椰菜花 低卡洛里甜食及糖果 如何減少排氣? 吃東西時將速度放慢 咀嚼食物時將嘴閉上, 避免狼吞虎嚥一次不要吃太多食物按時進餐, 省過一餐很可能增加排氣 可能會產生臭氣的食物 乳酪 豆類 洋蔥 卷心菜 魚 蘆筍 香口膠 蛋類 大蒜 扁豆 火腿 A guide to eating and drinking if you have an ileostomy - Page 2 of 6 9

10 A guide to eating and drinking if you have an ileostomy (2) Foods that may reduce odour Yoghurt Cranberry juice Buttermilk Fresh parsley Stewed or grated apple (no skin) Foods to help thicken your stomal faeces Pasta Pumpkin Dumplings Custard Tapioca Pancakes Pretzels Rice Bananas Toast Mashed potato Apple sauce Uncooked corn flour Marshmallows Jelly babies Smooth peanut butter White bread (not fresh) Fresh grated apple (no skin) Foods that may cause a blockage A large amount of highly fibrous food may have difficulty passing through your stoma. This can cause a blockage in the small bowel It is advisable not to eat these foods or only eat in small quantities. Mango Mushrooms Peas Pineapple Rhubarb Celery Coconut Popcorn Nuts Corn Coleslaw Figs Some sausage casings Breads / buns with seeds Dried fruits ** Take special care with all these foods 10 A guide to eating and drinking if you have an ileostomy - Page 3 of 6

11 迴腸造口手術後的飲食指南 (2) 可能會減少臭氣的食物 酸奶 小紅梅汁 脫脂奶油 新鮮香菜 煮爛或碾碎蘋果 ( 去皮 ) 使糞便變厚的食物 意粉 南瓜 水餃 蛋奶凍 木薯粉 薄煎餅 椒鹽脆餅 米飯 香蕉 烤麵包 搗碎的馬鈴薯 蘋果汁 未煮玉米粉 棉花糖 豆形軟糖 無仁花生漿 白麵包碾碎新鮮蘋果 ( 不是新鮮的 ) ( 去皮 ) 可能會造成阻塞的食物 大量高纖維食物可能很難通過迴腸造口, 這樣會造成小腸阻塞建議您不吃這些食物, 或者只吃少量 芒果 蘑菇 青豆 鳳梨 大黃根 芹菜 椰子 爆米花 果仁 玉米 卷心菜沙拉 無花果 某些香腸腸衣 有種子的麵包或包類 乾果 ** 特別注意所有這些食物 A guide to eating and drinking if you have an ileostomy - Page 4 of 6 11

12 A guide to eating and drinking if you have an ileostomy (3) What should I do if a blockage occurs? Don t eat food but continue to drink fluids Have a warm bath and take an appropriate pain reliever Rest with a hot water bottle on your abdomen Massage your abdomen in a clockwise motion Never take laxatives If pain continues, or you vomit or there is no faeces call an ambulance. Should I drink fluids? Drink regularly throughout the day Aim to drink 8 glasses (not all water) of fluid per day. Include soups, jellies, ice cream, half strength fruit juice, tea, sports drinks (not suitable for people with diabetes due to sugar content) Increase your fluid intake on hot days Do not drink a lot of fluid before a meal Replace lost salts by drinking sports drinks A banana a day will assist to keep your potassium levels normal If you have a continuous watery output from your stoma, drink plenty of fluids to prevent dehydration and speak to your Doctor. 12 A guide to eating and drinking if you have an ileostomy - Page 5 of 6

13 迴腸造口手術後的飲食指南 (3) 如果發生阻塞該怎麼辦? 停止進食但繼續喝液體 洗熱水澡, 服用適當的止痛藥 把熱水袋放在肚子上休息 以順時鐘的方向按摩腹部 絕對不可以吃瀉藥 如果疼痛不止, 或者嘔吐, 或者沒有糞便, 呼叫救護車 我應該喝液體嗎? 每天有規律地喝液體 每天的目標是喝 8 杯液體 ( 不必都是水 )..包括湯 果膠 雪糕 半濃果汁 茶, 運動飲料 ( 由於糖份過高, 不適於糖尿病患者 ) 熱天時增加液體攝取量 進食前不要飲用過多液體 喝運動飲料代替失去的鹽份 每天一根香蕉能幫助您保持正常鉀含量 如果造口持續流出水狀物, 喝大量的液體來防止脫水, 並且去看醫生 A guide to eating and drinking if you have an ileostomy - Page 6 of 6 13

14 A guide to eating and drinking if you have a colostomy (1) You do not have to change what you eat because you have a stoma You may now be able to eat foods you had trouble eating before surgery Every person will react, to each food type, differently. Foods that may cause gas Cucumber Peas Beans Orange juice Onions Eggs Cabbage Yeast Mushrooms Baked beans Ham Chewing gum Fizzy drinks Broccoli Cauliflower Low calorie sweets and lollies How can I reduce gas Eat your food slowly Chew with your mouth closed and avoid gulping your food Don t eat too much food at the one time Eat regular meals, skipping meals is more likely to increase gas Foods that may produce odour Cheese Beans Onions Cabbage Fish Asparagus Chewing gum Eggs Garlic Lentils Ham Foods that may reduce odour Yoghurt Cranberry juice Buttermilk Fresh parsley Stewed or grated apple (no skin) 14 A guide to eating and drinking if you have a colostomy - Page 1 of 4

15 結腸造口手術後的飲食指南 (1) 你不須要因為有一個造口而改變飲食 你現在可能可以吃你在手術前有問題的食物 每一個人對所吃的食物種類有不同反應 可能造成排氣的食物 黃瓜 豆角 豆類 橙汁 洋蔥 蛋類 卷心菜 發粉 蘑菇 烤豆 火腿 口香糖 起泡飲料 綠花菜 ( 白 ) 花菜 低卡洛里甜食及糖果 如何減少排氣? 吃東西時將速度放慢咀嚼食物時將嘴閉上, 避免狼吞虎嚥一次不要吃太多食物按時進餐, 省過一餐很可能增加排氣 可能產生臭氣的食物 乳酪 豆類 洋蔥 卷心菜 魚 蘆筍 口香糖 蛋類 大蒜 扁豆 火腿 可能減少臭氣的食物 酸奶 小紅梅汁 脫脂牛奶 新鮮香菜 煮爛或碾碎蘋果 ( 去皮 ) A guide to eating and drinking if you have a colostomy - Page 2 of 4 15

16 A guide to eating and drinking if you have a colostomy (2) Foods to help thicken your stomal faeces Pasta Pumpkin Dumplings Custard Tapioca Pancakes Pretzels Rice Bananas Toast Mashed potato Apple sauce Uncooked corn flour Marshmallows Jelly babies Smooth peanut butter White bread (not fresh) Fresh grated apple (no skin) What do I do if I am constipated? If you become constipated, try the following: Eat prunes, cabbage or fresh fruit Take a gentle stool softener Aim to drink 2 litres (6 to 8 glasses) of fluid per day If 2 to 3 days pass with no bowel action, speak to your Doctor or Stomal Therapy Nurse. What should I do if I have diarrhoea? If diarrhoea (runny or fluid stomal faeces) occurs, treat as you did before you had a colostomy. Speak to your Doctor if it continues for more than 2 to 3 days. You may need to change to a drainable pouch while you have diarhhoea. This will prevent frequent pouch changes that can affect your skin. Speak to your Stomal Therapy Nurse. 16 A guide to eating and drinking if you have a colostomy - Page 3 of 4

17 結腸造口手術後的飲食指南 (2) 使糞便變厚的食物 意粉 南瓜 水餃 蛋奶凍 木薯粉 薄煎餅 鹹餅乾 米飯 香蕉 烤麵包 搗碎的馬鈴薯 蘋果汁 未煮玉米粉 藥蜀葵 豆形軟糖 無仁花生漿 白麵包碾碎新鮮蘋果 ( 不是新鮮麵包 ) ( 去皮 ) 如果我便秘怎麼辦? 如果便秘, 試試以下辦法.. 吃乾梅 卷心菜或新鮮水果 服用溫和的糞便軟化藥 每天至少喝兩升 (6 至 8 杯 ) 液體 如果 2 到 3 天還沒有排便, 告訴你的醫生或者造口治療護士 如果腹泄怎麼辦? 如果發生腹泄 ( 拉肚子或液狀造口糞便 ), 用你沒有結腸造口之前的辦法處理 如果超過了 2 至 3 天, 告訴你的醫生 如果腹泄的話, 你可能須要換一個可排水的造口袋, 這樣就可以不用經常更換造口袋, 因為經常換會影響你的皮膚 告訴你的造口治療護士 A guide to eating and drinking if you have a colostomy - Page 4 of 4 17

18 A guide to managing constipation (1) Constipation is when your faeces is harder, drier and more difficult to pass than usual. What causes constipation? Lack of fibre in your diet Not drinking enough fluids Lack of exercise Change in lifestyle eg. travel If you ignore the need to go to the toilet Some medications and medical conditions. How can I regulate bowel actions? Eat regular meals. Chew your food thoroughly and slowly Increase the amount of fibre in your diet Drink 2 litres (6 to 8 glasses) of fluid per day Exercise daily, when possible. 18 A guide to managing constipation - Page 1 of 4

19 管理便秘指南 (1) 便秘是您的糞便又硬 又乾 比平常難排出 造成便秘的原因是什麼? 飲食中缺少纖維 喝的液體不夠 缺乏運動 生活方式改變, 例如旅行 如果須要上廁所但是您不理會 某些藥物或醫療情況 如何可以有規律的排便? 按時用餐 咀嚼食物時要徹底而緩慢 在您的飲食中增加纖維含量 每天喝兩升液體 (6 至 8 杯 ) 可能的話, 每天做運動 A guide to managing constipation - Page 2 of 4 19

20 A guide to managing constipation (2) How much fibre should I eat? Eat between 30 to 40 grams of fibre each day Fibre is found in fresh fruit, vegetables and grains. How much fluid should I drink? A hot drink, first thing in the morning, may help to open your bowel You should drink 2 litres (6 to 8 glasses) of fluid per day Vary your fluid intake with water, milk, soups, fruit and vegetable juices. Should I take laxatives? Laxatives (stool softeners) are sometimes needed if the other suggestions do not work Some laxatives can increase constipation if not used correctly. Speak to your Doctor or Stomal Therapy Nurse for more information. 20 A guide to managing constipation - Page 3 of 4

21 管理便秘指南 (2) 我應該吃多少纖維? 每天吃 30 至 40 克纖維 纖維可以在新鮮的水果 蔬菜及穀類中找到 我應該喝多少液體? 每天早上第一件事是喝一杯熱水, 可以幫助打開您的腸道 您應該每天喝兩升液體 (6 至 8 杯 ) 變換您喝的液體, 例如水 牛奶 湯 水果與蔬菜汁 我應該吃瀉藥嗎? 如果其他方法無效的話, 有時候須要吃瀉藥 ( 糞便軟化劑 ) 如果使用不當, 有些瀉藥會增加便秘 請教您的醫生或者造口治療護士來得到更多資訊 A guide to managing constipation - Page 4 of 4 21

22 Caring for my colostomy (1) How should I change my pouch? Equipment To change your pouch you will need the following things: A bowl of warm water A washcloth or something similar A pouch with a hole cut out, if needed New pouch A plastic bag for the rubbish Anything else you may need such as barrier wipes or adhesive remover wipes (These are special types of wipes). 1. It may be best to change the pouch first thing in the morning, before breakfast, as it is less active then 2. Take off the dirty pouch, by peeling it way from the skin 3. If you wish, you may shower when you take the pouch off 4. Clean the skin with a wash cloth and warm water. Dry the skin well 5. Apply the clean pouch to the skin, as you have been taught. 22 Caring for my colostomy - Page 1 of 4

23 照顧我的結腸造口 (1) 應該如何更換我的造口袋? 裝備 更換造口袋須要以下事物.. 一盆溫水 一條毛巾或類似的東西 如果需要的話, 一個剪開一個洞的袋子 新造口袋 一個裝垃圾的塑膠袋 其他您也許需要的東西, 例如皮膚保護抹紙或清除黏性的抹紙 ( 這些是特別類型的抹紙 ) 1. 最好是在大清早, 早餐之前更換造口袋, 因為那時段它的活動較少 2. 取下髒袋, 方法是將它從皮膚上揭下來 3. 如果您願意, 您可以在取下髒袋時淋浴 4. 用毛巾和溫水清洗皮膚, 把皮膚全擦乾 5. 按照教導的方法把新袋安上去 Caring for my colostomy - Page 2 of 4 23

24 Caring for my colostomy (2) Hints Your base plate (two piece) can remain in place for up to 3 to 4 days, providing it does not leak Your pouch can be changed daily When you go out, always take a spare pouch with you. Also take a plastic bag for the rubbish and anything else you may need. How should I dispose of the dirty pouch? Empty the contents of the pouch into the toilet Put the dirty pouch into a plastic bag and tie it off You can use freezer bags and nappy bags. They are cheap Wrap the pouch in a newspaper and place it in the rubbish bin Do not burn this rubbish. When should my stoma be checked? Your Stomal Therapy Nurse should check your stoma within 2 to 6 weeks after discharge from hospital or earlier if problems occur. How can I order supplies? Always keep two weeks of supplies You will receive a new order form from the Ostomy Association with each delivery. You may order your supplies monthly or as required. 24 Caring for my colostomy - Page 3 of 4

25 照顧我的結腸造口 (2) 建議 您的底座貼環 ( 兩片 ) 可以留在原處 3 至 4 天, 只要不漏就可以 您的袋子可以每天更換 外出時, 一定要帶一個備用袋 另外帶一個塑膠袋裝垃圾, 還有別的您也許需要的東西 如何丟棄我的髒袋? 把袋子排空, 髒物丟進廁所 把髒袋放進塑膠袋然後紮好 您可以使用冷凍袋和尿片袋, 這些東西很便宜 把髒袋用報紙包好丟進垃圾桶裡 不要用火燒掉這個垃圾 應該什麼時候檢查我的造口? 您的造口治療護士應該在您出院後 2 至 6 周之內檢查您的造口, 如果有問題的話就要提早 我如何訂購補給品? 時常保持兩個星期的存量 每次補給品送到之後會得到一張 (Ostomy Association) 造口協會 給您的新定貨單 您可以按需要或按月訂購補給品 Caring for my colostomy - Page 4 of 4 25

26 Caring for my ileostomy (1) How should I change my pouch? Equipment To change your pouch you will need the following things: A bowl of warm water A washcloth or something similar A pouch with a hole cut out, if needed New pouch A plastic bag for the rubbish Anything else you may need such as barrier wipes or adhesive remover wipes (These are special types of wipes). 1. It may be best to change the pouch first thing in the morning, before breakfast, as it is less active then 2. Take off the dirty pouch, by peeling it way from the skin 3. If you wish, you may shower when you take the pouch off 4. Clean the skin with a wash cloth and warm water. Dry the skin well 5. Apply the clean pouch to the skin, as you have been taught. 26 Caring for my ileostomy - Page 1 of 4

27 照顧我的迴腸造口 (1) 應該如何更換我的造口袋? 裝備 更換造口袋須要以下事物.. 一盆溫水 一條毛巾或類似的東西 如果需要的話, 一個剪開一個洞的袋子 新造口袋 一個裝垃圾的塑膠袋 其他您也許需要的東西, 例如皮膚保護抹紙或清除黏性的抹紙 ( 這些是特別類型的抹紙 ) 1. 最好是在大清早, 早餐之前更換造口袋, 因為那時段它的活動較少 2. 取下髒袋, 方法是將它從皮膚上揭下 3. 如果您願意, 您可以在取下造口袋時淋浴 4. 用毛巾和溫水清洗皮膚, 把皮膚全擦乾 5. 按照教導的方法把新袋安上去 Caring for my ileostomy - Page 2 of 4 27

28 Caring for my ileostomy (2) Hints Your base plate (two piece) can remain in place for up to 3 to 4 days, providing it does not leak Your pouch can be changed daily When you go out, always take a spare pouch with you. Also take a plastic bag for the rubbish and anything else you may need. How should I dispose of the dirty pouch? Empty the contents of the pouch into the toilet Put the dirty pouch into a plastic bag and tie it off You can use freezer bags and nappy bags. They are cheap Wrap the pouch in a newspaper and place it in the rubbish bin Do not burn this rubbish. When should my stoma be checked? Your Stomal Therapy Nurse should check your stoma within 2 to 6 weeks after discharge from hospital or earlier if problems occur. How can I order supplies? Always keep two weeks of supplies You will receive a new order form from the Ostomy Association with each delivery. You may order your supplies monthly or as required. 28 Caring for my ileostomy - Page 3 of 4

29 照顧我的迴腸造口 (2) 建議 您的底座貼環 ( 兩片 ) 可以留在原處 3 至 4 天, 只要不漏就可以 您的袋子可以每天更換 外出時, 一定要帶一個備用袋 另外帶一個塑膠袋裝垃圾, 還有別的您可能需要的東西 如何丟棄我的髒袋? 把袋子排空, 髒物倒進廁所 把髒袋放進塑膠袋然後紮好 您可以使用冷凍袋和尿片袋, 這些東西很便宜 把髒袋用報紙包好丟進垃圾桶裡 不要用火燒掉這垃圾 應該什麼時候檢查我的造口? 您的造口治療護士應該在您出院後 2 至 6 周之內檢查您的造口, 如果有問題的話就要提早檢查 我如何訂購補給品? 時常保持兩個星期的存量 每次補給品送到之後會得到一張 (Ostomy Association) 造口協會 給您的新定貨單 您可以按需要或按月訂購補給品 Caring for my ileostomy - Page 4 of 4 29

30 Caring for my urostomy (1) How should I change my pouch? Equipment To change your pouch you will need the following things: A bowl of warm water A washcloth or something similar A pouch with a hole cut out, if needed New pouch A plastic bag for the rubbish Anything else you may need such as barrier wipes or adhesive remover wipes (These are special types of wipes). 1. It may be best to change the pouch first thing in the morning, before breakfast, as it is less active then 2. Take off the dirty pouch, by peeling it way from the skin 3. If you wish, you may shower when you take the pouch off 4. Clean the skin with a wash cloth and warm water. Dry the skin well 5. Apply the clean pouch to the skin, as you have been taught. Hints Your base plate (two piece) can remain in place for up to 3 to 4 days, providing it does not leak Your pouch can be changed daily When you go out, always take a spare pouch with you. Also take a plastic bag for the rubbish and anything else you may need. 30 Caring for my urostomy - Page 1 of 6

31 照顧我的尿道造口 (1) 應該如何更換我的尿道造口袋? 裝備 更換造口袋須要以下事物.. 一盆溫水 一條毛巾或類似的東西 如果需要的話, 一個剪開一個洞的袋子 新造口袋 一個裝垃圾的塑膠袋 其他您可能需要的東西, 例如皮膚保護抹紙或清除黏性的 ( 這些是特別類型的抹紙 ) 1. 最好是在大清早上, 早餐之前更換造口袋, 因為那時段它的活動較少 2. 取下髒袋, 方法是將它從皮膚上揭下 3. 如果您願意, 您可以在取下髒袋時淋浴 4. 用毛巾和溫水清洗皮膚, 把皮膚全擦乾 5. 按照教導的方法把新袋安上去 建議 您的底座貼環 ( 兩片 ) 可以留在原處 3 至 4 天, 只要不漏就可以 您的袋子可以每天更換 外出時, 一定要帶一個備用造口袋 另外帶一個塑膠袋裝垃圾, 還有別的您也許需要的東西 Caring for my urostomy - Page 2 of 6 31

32 Caring for my urostomy (2) How should I dispose of the dirty pouch? Empty the contents of the pouch into the toilet Put the dirty pouch into a plastic bag and tie it off You can use freezer bags and nappy bags. They are cheap Wrap the pouch in a newspaper and place it in the rubbish bin Do not burn this rubbish. How do I manage overnight? You can connect an overnight drainage bag to your pouch. This will ensure less disruption to your sleep When the overnight drainage bag is connected, make sure the pouch tap is open and the overnight drainage bag tap is closed Ensure the drainage bag does not pull on the pouch Place the drainage bag over the side of the bed, in a bucket on the floor A strap to hold the tube to your leg is available. This is used to help stop the tube from twisting while you sleep. The strap is free from the Ostomy Association. 32 Caring for my urostomy - Page 3 of 6

33 照顧我的尿道造口 (2) 如何丟棄我的髒袋? 把袋中排空, 髒物丟進廁所 把髒袋放進塑膠袋然後紮好 您可以使用冷凍袋和尿片袋, 這些東西很便宜 把髒袋用報紙包好丟進垃圾桶裡 不要用火燒掉這個垃圾 夜間如何處理? 晚上您可以在造口袋上連接一個夜間排尿袋, 這將確保您的睡眠受到較少的打擾 連接了夜間排尿袋之後, 要確定打開造口尿袋的塞子, 把夜間排尿袋的塞子封閉 確定夜間排尿袋不會拉扯造口尿袋 把夜間排尿袋放在床邊地上的水桶裡 有一種帶子可以把導管固定在腿上 用這個方法來防止導管在您睡覺的時候纏繞在一起 這種帶子可以向 (Ostomy Association) 造口協會 免費索取 Caring for my urostomy - Page 4 of 6 33

34 Caring for my urostomy (3) How can I clean my overnight drainage bag? In the morning, disconnect your overnight drainage bag from the urinary pouch and empty it into the toilet Wash your overnight drainage bag as you have been taught by your Stomal Therapy Nurse Replace the overnight drainage bag with a new one each week. How can I order supplies? Always keep two weeks of supplies You will receive a new order form from the Ostomy Association with each delivery. You may order your supplies monthly or as required. 34 Caring for my urostomy - Page 5 of 6

35 照顧我的尿道造口 (3) 如何清潔我的夜間排尿袋? 在早上, 把您的夜間排尿袋從尿袋上分離, 將裡面的尿液倒進廁所裡 按照造口治療護士教的方法清洗夜間排尿袋 每一個星期更換一個新的夜間排尿袋 我如何訂購補給品? 時常保持兩個星期的存量 每次補給品送到之後會得到一張 (Ostomy Association) 造口協會 給您的新定貨單 您可以按需要或按月訂購補給品 Caring for my urostomy - Page 6 of 6 35

36 Healthy bowel habits (1) The aim of maintaining health bowel function is to support regular defaecation (opening bowels). There are a number of important things you need to consider for healthy bowel function and the following suggestions can help: How much fibre should I eat? Between 30 to 40 grams of fibre every day and it can be found in fresh fruit, vegetables and grains. How much fluid should I drink? Drink fluid for your stool to be soft and easy to pass. Drink 2 litres or 6 to 8 glasses of fluid a day, unless your Doctor has advised you otherwise Caffeine is found in tea, coffee, coke and fizzy drinks. Caffeine can dehydrate you. 36 Healthy bowel habits - Page 1 of 4

37 健康的排便習慣 (1) 保持健康排便功能的目的是幫助按時通便 ( 打開腸道 ) 為了有健康的排便功能, 有一些重要的事情您須要考慮, 下列建議會有幫助.. 應該吃多少纖維? 每天吃 30 至 40 克纖維, 纖維可以在新鮮水果 蔬菜及穀類中找到 我每天應該喝多少液體? 多喝液體可以軟化您的糞便因而容易排出 除非您的醫生另有建議, 否則每天喝兩升或 6 至 8 杯的液體 茶 咖啡 可樂和起泡飲料含有咖啡因, 咖啡因可以使您脫水 Healthy bowel habits - Page 2 of 4 37

38 Healthy bowel habits (2) How much exercise should I do? Exercise stimulates your bowel and helps it to work better If you are not able to stand or walk, try simple exercises in your chair. Going to the toilet To pass your bowel motion you must feel a strong urge to go to the toilet If you ignore the urge to go to the toilet you may become constipated Do not strain Ensure that the toilet is private with no interruptions Do not rush as you may not empty your bowel properly. How should I sit on the toilet? The correct position on the toilet is the same as a squatting position. Your knees should be higher than your hips. You can do this by placing your feet on a small foot stool or phone book. Then you should lean forward and rest your elbows on your knees. 38 Healthy bowel habits - Page 3 of 4

39 健康的排便習慣 (2) 每天應該做多少運動? 運動能夠刺激腸道, 幫助腸道更好地工作 如果您不能站立或行走, 在椅子上試做一些簡單的運動 上廁所 要排解糞便, 您必須感到一種上廁所的迫切感 如果您對上廁所的迫切感不加理會, 您可能會變成便秘 不可用力排糞便 確保廁所是私人地方, 不受干擾 不要匆忙, 因為您可能沒有恰當地排空您的糞便 應該如何坐在馬桶上? 在馬桶上的正確姿勢應該與蹲下姿勢相同 膝蓋應該高過臀部 把雙腳放在小凳子上或電話薄上就可以做到這個姿勢, 然後向前傾, 把手放在膝蓋上 Healthy bowel habits - Page 4 of 4 39

40 Hints for the patient with a stoma (1) How do I care for my stoma? Your stoma will change in size in the weeks after your surgery Measure your stoma every week during this time so that your pouch fits properly Your stoma may move in and out sometimes. This is normal If you have sore, red and itchy skin, speak to your Stomal Therapy Nurse If you see any big changes in the length of the stoma or if you see a lump under your stoma, speak to your Doctor or Stomal Therapy Nurse soon. What should I do before going to the hospital? Ensure that you know the name and telephone number of your Stomal Therapy Nurse Speak to your Stomal Therapy Nurse before going to hospital When being admitted to hospital, take your own supplies from home to use in the hospital. How do I order and look after my supplies? Learn the name, size and type of pouch and skin products you are using, to make ordering easy Order your supplies regularly in case of delays. In this way you will not run out Collect all your supplies and information sheets and keep them in a cool and dry place, away from direct sunlight. 40 Hints for the patient with a stoma - Page 1 of 6

41 給有人工造口病人的建議 (1) 我如何照護我的造口? 您的造口的大小在手術後幾個星期內會改變 這段時間每星期都量一下造口的大小, 這樣您的袋子才可以恰當地配合 您的造口有的時候會移進又移出, 這很正常 如果皮膚酸疼 發紅或發癢, 告訴您的造口治療護士 如果您看到造口的長度有任何的大改變, 或者如果您看到造口下方有息肉, 告訴您的醫生或造口治療護士 到醫院之前我應該做什麼? 確定您知道造口治療護士的名字和電話 在去醫院之前告訴您的造口治療護士 送進醫院時, 從家裡帶著您自己的用品在醫院裡使用 如何訂購及料理我的應用品? 學習袋子的名稱 大小和牌子 和您使用的護膚用品, 使訂購容易方便 按時訂購補給品以免延誤, 這樣您就不會缺貨 把您的應用品與說明書收集一起, 放在涼爽乾燥的地方, 避免陽光直射 Hints for the patient with a stoma - Page 2 of 6 41

42 Hints for the patient with a stoma (2) How can I get rid of smells in my pouch? You can put deodorant drops in your pouch if smells are a problem. Drops can be ordered from your Ostomy Association. What will I need when I travel overseas? Always carry an emergency stoma care kit with pouches, wipes and a plastic rubbish bag with you When travelling take some drainable pouches and some thickening medication in case of diarrhoea Ask the Ostomy Association for a Travelling Ostomy Card Carry some of your supplies with you in your hand luggage and some in your suitcase. This is important particularly if your suitcase is lost For security reasons, do not carry scissors in your hand luggage. Carry them in your suitcase When you go overseas, take more supplies than you expect to need. How should I empty and clean my open end pouch? Should be emptied when a third to a half full You can empty the pouch into a container or directly into the toilet Your pouch does not require rinsing, but if you want to do so, use a plastic sauce bottle to flush in water via the drainable end. You can shower or bathe with your pouch ON or OFF. Do this before breakfast when your stoma is less active. 42 Hints for the patient with a stoma - Page 3 of 6

43 給有人工造口病人的建議 (2) 如何除去袋中的異味? 如果有異味的問題, 在袋內滴幾滴除臭劑 除臭滴劑可以向您的 (Ostomy Association) 造口協會 訂購 出國旅行時需要什麼? 隨身攜帶一個緊急造口護理包, 裡面有造口袋 抹片與一個塑膠垃圾袋 旅行時帶一些排水造口袋與一些糞便增厚藥, 以備腹泄時使用 向 造口協會 索取一個 旅行造口卡 分別在手提行李和行李箱中帶一些您的應用品, 如果您的行李箱弄失, 這是尤其重要的 為了安全的理由, 切勿在您的手提行李中攜帶剪刀, 把剪刀放在行李箱裡 出國的時候多帶一些比您預期所需的應用品 我應該怎樣排空並清洗我的開口造口袋? 在滿了三分之一或一半的時候就應該排空 您可以把袋中物傾倒在容器中或直接倒進廁所 您的造口袋並不須要清洗, 不過假如您想要洗的話, 使用一個塑膠醬汁瓶, 將水通過排水末端部分灌入沖洗 在淋浴或用澡盆洗澡時, 您的造口袋可以仍在身上或已被移離 在早餐之前洗澡, 因為這個時候您的造口活動比較少 Hints for the patient with a stoma - Page 4 of 6 43

44 Hints for the patient with a stoma (3) How should I change my pouch? Give yourself plenty of time to change your pouch Do not wait for your pouch to leak before you change it Wash the stoma and surrounding skin with warm water, then dry the skin The hole in the base plate or pouch should show no more than 2mm of skin. You may have sore skin or leaks if the hole is too large. The stoma may be damaged if the hole is too small If you shower or bathe with your pouch off, wash around the stoma with water and a clean washcloth Do not use bath oils, talcum powder or creams as they will stop the pouch sticking to your skin. Unscented soap and warm water is the best way to clean around the stoma You may notice a trace of blood when cleaning the stoma. This is normal Keep the hairs around the stoma trimmed or shaved. Hold a tissue over the stoma while shaving. This will protect the stoma Clothes pegs are ideal for holding your clothes away from the pouch whilst you are changing it. How do I remove sticky residue? To remove sticky residue from your skin, use an adhesive remover wipe. 44 Hints for the patient with a stoma - Page 5 of 6

45 給有人工造口病人的建議 (3) 我應該如何更換造口袋? 給自己充份的時間更換造口袋 不要等到造口袋開始漏袋時候才更換 用溫水清洗造口和周圍的皮膚, 然後把皮膚擦乾 在底部貼環內或袋內的洞口不應該看到超過 2 毫米的皮膚 如果洞口太大, 您的會覺得皮膚酸疼或洩漏, 如果洞口太小, 造口也許會損壞 如果在淋浴或用澡盆洗澡的時候造口袋不在體上, 用乾淨的布和水清洗造口周圍 洗澡的時候不要使用泡澡油, 滑石粉或洗澡膏, 因為這些東西會使您不能把袋子貼在皮膚上 使用不加香料的肥皂和溫水是清洗造口周圍的最好的方法 在清洗造口的時候您或會注意到微量血跡, 這是正常的 造口周圍的毛髮要整修或剃掉, 剃毛髮的時候在造口上蓋一張面紙 這樣可以保護造口 更換造口袋的時候, 曬衣夾可以非常合適的把您的衣服從造口袋夾開 我怎麼樣去掉黏渣? 可以用清除黏性抹片來擦去您皮膚發黏的殘渣 Hints for the patient with a stoma - Page 6 of 6 45

46 Peri-anal skin care (1) Particular attention and care is required to the skin around the anal areas as some people can experience skin irritation. This is caused by leakage of mucous or frequent loose stools and is usually temporary. After bowel surgery, it may take 6 to 12 months for regular bowel function to return. How can I prevent skin irritation? Keep the peri-anal skin as dry as possible, by cleaning and drying after each bowel action Avoid using hard toilet paper and substances that may cause burning or irritation (e.g. some scented soaps) Use nappy wipes or unscented cleansers to clean the peri-anal area after each bowel action Avoid vigorous wiping or rubbing. Pat the skin dry For painful and sore peri-anal skin, use a hand-held shower to cleanse the skin before gently drying 46 Peri-anal skin care - Page 1 of 4

47 肛門周圍皮膚護理 (1) 肛門周圍的皮膚須要特別的注意和照顧, 因為有些人會出現皮膚過敏的體驗 造成過敏的原因是黏液漏出或經常大便稀薄, 不過通常都是暫時性的 做過腸部手術後, 大概須要 6 至 12 個月才能恢復正常的排便功能 如何防止皮膚過敏? 盡量保持肛門周圍的皮膚乾燥, 在每次排便結束後清洗並擦乾 避免使用硬廁所紙及會可能導致燒灼或過敏的物質 ( 例如一些添加香料的肥皂 ) 每次排便後使用尿布抹片或不加香料的清潔劑清洗肛門周圍的地方 避免用力擦拭或揉搓, 把皮膚輕輕拍乾 對於疼痛和與一碰就痛的皮膚, 可以用手拿淋浴龍頭清洗皮膚, 然後輕輕擦乾 Peri-anal skin care - Page 2 of 4 47

48 Peri-anal skin care (2) Apply a barrier cream to the peri-anal area after cleaning. There are special creams available for this purpose. Discuss this with your Stomal Therapy Nurse or Continence Advisor Use a nappy liner in a pad. This will prevent the need to frequently change the continence pad For small amounts of leakage, use a make-up remover pad, folded in half and inserted into the buttock crease, against the anus. This is a cheaper option Wear cotton underwear, not nylon Certain foods may cause irritation and should be avoided e.g. spicy foods. Discuss this with a Dietician, as different foods, affect people, in different ways If the cause of the peri-anal irritation is from diarrhoea or a loose bowel action, you may take an anti diarrhoeal. Speak to your Doctor about this. 48 Peri-anal skin care - Page 3 of 4

49 肛門周圍皮膚護理 (2) 清洗完之後在肛門周圍皮膚擦一點護膚膏, 市面上有一種為這個目的而製造的特別軟膏, 與您的造口治療護士或失禁顧問討論這件事 在護墊裡面放一個尿布襯墊, 這樣就不須要經常地更換失禁護墊 少量瀉露的話, 使用卸妝片, 對摺並對著肛門插入屁股的摺縫 這是一個便宜的選擇 穿棉質內褲, 不要穿尼龍的 某些食物會導致過敏, 應該避免食用, 例如..辛辣的食物 與營養師商量, 因為不同的食物對人有不同的影響 如果造成肛門周圍過敏的原因是腹瀉或者 Peri-anal skin care - Page 4 of 4 49

50 如需使用您的语言, 通过电话传译与我们沟通, 请致电 ( 国语 ) 和 ( 广东话 ) 电话传译服务免费 To speak to us in your language with the help of a telephone interpreter, please call our National Language Line on for Mandarin and for Cantonese. The telephone interpreter is free of charge to you Bolton Clarke is the brand name for a group of companies being RSL Care RDNS Limited ACN , Royal District Nursing Service Limited ACN and RDNS HomeCare Limited ACN