Bariatrik Cerrahide Hemşirelik Bakımı

Obezite, yağ dokusunun vücutta fazla miktarda artması sonucu ortaya çıkan ve giderek yaygınlaşan ciddi bir sağlık problemidir. Obezite prevelansı dünya genelinde her yaş grubunda artış göstermektedir. Obezite sıklığındaki bu artış obeziteye bağlı kronik hastalıkların görülme sıklığını da artırmaktadır. Bu yönüyle obezite kronik hastalıklar için bir risk etmeni olarak kabul edilmektedir. Beden Kitle İndeksi 30'un üzerinde olan kişiler obez, 40'ın üzerinde olan kişiler ise morbid obez olarak adlandırılmaktadır. Bariatrik cerrahi obezitede kalıcı kilo verilmesini sağlayan etkili bir tedavi yöntemidir. Bariatrik cerrahi ameliyat teknikleri üç farklı tipte uygulanmaktadır. Bu teknikler; gıda alımını kısıtlayan, besin emilimini azaltan (malabsorpsiyon), hem malabsorpsiyon hem de gıda alımını kısıtlayan ameliyatlardır. Bariatrik cerrahide ameliyat öncesi ve sonrasında, obez hastaların eşlik eden hastalıklarının bulunması nedeniyle hasta bakımının önemi artmaktadır. Bu dönemde bariatrik cerrahi adayı olan hastaların bakımında yaşanabilecek riskleri azaltan, komplikasyon gelişmesini önleyen ve iyileşmenin en kısa zamanda olmasını sağlayan özel hemşirelik uygulamaları yer almaktadır. Bu makalede, obez hastaların ameliyat öncesi ve sonrası hemşirelik bakımı ele alınmaktadır. Ayrıca bariatrik cerrahi, komplikasyonlar ve hastaların yaşayabilecekleri güçlükler incelenecektir

Nursing Care in Bariatric Surgery

Obesity is caused by increased amounts of fatty tissue in the body and increasingly common serious health problem. The prevalence of obesity is increasing in all age groups throughout the world. This increase in the rate of obesity increases the incidence of obesity-related chronic diseases. In this respect, obesity is considered a risk factor for the chronic diseases. People who are more than 30 Body Mass Index called as obese and people who are over 40 called morbidly obese. Bariatric surgery is an effective treatment providing in permanent weight loosing for obesity. Bariatric surgery techniques are applied as three different types. These techniques include; limit food intake, reduce nutrient absorption (malabsorption), and restricting food intake and malabsorption surgeries. In bariatric surgery, patient care is becoming increasingly important at before and after surgery due to the presence of concomitant diseases in obese patients. During this period, there are special nursing practices which include reducing the risks in the care of patients who are candidates for bariatric surgery, preventing the development of complications and supplying the recovery from illness as soon as possible. In this article nursing care of obese patients before and after surgery is to be discussed. In addition, bariatric surgery, complications and difficulties in live patients are to be examined.

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1.Antipatis V.J., Gill T.P.: Küresel Bir Sorun Olarak Obezite. In: International Textbook of Obesity. Ed: Björntorp P. 1. Baskı, s. 1-22, And Danışmanlık, İstanbul, 2002.
2.Grindel ME, Grindel CG. Nursing Care of the Person Having Bariatric Surgery. MEDSURG Nursing 2006;15:129-145.
3.Arterburn DE, Maciejewski ML, Tsevat J. Impact of Morbid Obesity on Medical Expenditures in Adults. Int Obes 2005;29:334-339.
4.Global Database On BMI [online]. WHO. 2004 [Erişim:01.Mart.2011]. Elektronik adresi:http://www.who.int/bmi/index.jsp?introPage=intro_3.html.
5.Woodward BG, A Complete Guide to Obesity Surgery. Victoria-CANADA:Trraford;2003.
6.Barth MM, Jenson CE, et al. Postoperative Nursing Care Of Gastric Bypass Patients. AmJ Crit Care 2006; 15:378-387.
7.Szarka LA, Foxx-Orenstein AE. Obezitenin Değerlendirmesi Ve Tedavi. Clinical Gastroenterelogy And Hepatology 2006; 1 : 117-124.
8.Ersöz Gülçelik N, Gürlek A, Usman A. Obezitenin Medikal Tedavisi. Hacettepe Tıp Dergisi 2007;37 :212-217.
9.Colquitt JL, Clegg AJ, Loveman E, Royle P, Sidhu MK. Surgery For Morbid Obesity. The Cochrane Database Of Systematic Reviews 2005; 4: 1-84.
10.Gibbons LM, Sarwer DB, Crerand CE, Fabricatore AN, Kuehnel RH, Lipschutz PE, et al. Previous Weight Loss Experiences Of Bariatric Surgery Candidates: How Much Have Patients Dieted Prior To Surgery?. Obesity 2006; 14: 70-76.
11.McMahon MM, Sarr MG, Clark MM, Gall MM, Knoetgen J, Service FJ, et al. Clinical Management After Bariatric Surgery: Value of a Mutidisciplinary Approach. Mayo Clin Proc 2006;81(10):34-45.
12.Dzıurowicz-Kozlowska A, Lısık W, Wierzbıckı Z, Kosieradzkı M. Heath-Related Quality Of Life After The Surgical Treatment Of Obesity. Journal Of Physiology And Pharmacology 2005; 6: 127-134.
13.Chang KH, Condon ET, O'Connor EJ, McAnena OJ. Sustained Weight Loss And İmprovement Of Quality Of Life After Laparoscopic Adjustable Gastric Banding For Morbid Obesity: A Single Surgeon Experience İn İreland. Ir J Med Sci 2010;179: 23-27.
14.Snow V, Barry P, Fitterman N, Qaseem A, Welss K . Pharmacologic And Surgical Management Of Obesity İn Primary Care: A Clinical Practice Guideline From The American College Of Physicians. Ann İntern Med. 2005; 142:525-531.
15.McMahon MM, Sarr MG, Clark MM, Gall MM, Knoetgen J, Service FJ et al. Clinical Management After Bariatric Surgery: Value of a Multidisciplinary Approach. Mayo Clin Proc 2006;81 (10):34-45.
16.Gallagher Camden S. Shedding Health Risks with Bariatric Weight Loss Surgery. Nursing 2009;39:34.
17.Grindel ME, Grindel CG. Nursing Care of the Person Having Bariatrics Surgery. Medsurg Nursing 2006;15(3):129-45.
18.Bozbora A. Obezite. 1. Baskı. İstanbul: Medikal Yayıncılık İstanbul Tıp Fakültesi; 2008. 371-6.
19.Mac Lellan K. Management of Pain: A Pratical Approach for Health Care. Wigens L,editors. United Kingdom:Nelson Thornes Ltd;2006.
20.Erdil F, Özhan Elbaş N. Cerrahi Hastalıkları Hemşireliği. 4. Baskı. Ankara: Hacettepe Üniversitesi Hemşirelik Yüksekokulu; 2001. 97-137.
21.Burke KM, LeMone P, Mohn-Brown E. Medical-Surgical Nursing Care. 2. Edition. Philadelphia: W.B. Saunders Company; 2007.
22.Story SK, Chamberlain RS. A Comprehensive Review of Evidence-Based Strategies to Prevent and Treat Postoperative İleus. Dig Surg 2009;26:265-275.
23.Harrington L. Postoperative of Patients Undergoing Bariatric Surgery. Medsurg Nurs 2006;15(6):357-63.
24.Khwaja HA, Bonanomi G. Bariatric Surgery: Techniques, Outcomes and Complications. Current Anaesthesia&Critical Care 2010;21:31-38.
25.Gregory J. Pain Management and Orthopaedic Care. İn : Kneale J, Davis P, 2nd ed.,Churchill Livingstone editors. Orthopaedic and Trauma Nursing. Philadelphia: 2005;140-164.
26.Medina A, Scott PG, Ghahary A, Tredget EE. Pathophysiology of chronic nonhealingwounds. J Burn Care Rehabil 2005;26:306-19.
27.Şendir M, Acaroğlu R, Kaya H et al. Evaluation of Quality of Sleep and Effecting Factors Hospitalized Neurosurgical Patients in Turkey. Neurosciences Journal 2007;12(3):226-31.
28.Başoğlu ÖK, Yürekli BS, Taşkıranlar P, Tunçel Ş, Yılmaz C. Ege Obez Okulu Anket Çalışması: Obezite ile Obstrüktif Apne Sendromu Semptomları ve Gündüz Uykululuk İlişkisi. Ege Journal of Medicine 2011;50(2):111-17.
29.Poulose BK, Griffin MR, Moore DE, Zhu Y, Smalley W, Richards WO, et al. Risk Factors For Post-Operative Mortality İn Bariatric Surgery. Journal Of Surgical Research 2005;127:.1-7.
30.Tessier DJ, Eagon JC. Surgical Management Of Morbid Obesity. Curr Probl Surg 2008;45:68-137.
31.Fujioka K, Follow-up Of Nutritional And Metabolic Problems After Bariatric Surgery. Diabetes Care 2005; 28: 481-484.
32.Bult MJF, Dalen TV, Muller AF. Surgical Treatment of Obesity. European Journal of Endocrinology 2008;158:135-145.
33.Eid I, Birch DW, Sharma AM, Sherman V, Karmali S, Complications Associated With Adjustable Gastric Banding for Morbid Obesity: A Surgeon's Guide. Can J Surg 2011;54:61-66.
34.Wittgrove AC, Clark Wesley G. Laparoscopic Gastric Bypass, Rox-en-Y-500 Patients:Technique and Results, with 3-60 Month Follow-up. Obesity Surgery 2000;10:233-239.