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剖腹產產後護理指導
Instructions for C-Section Delivery Postnatal Care
在平安的剖腹生產後，以下為可能遇到的情形供您參考：
After a safe C-Section delivery, the following are circumstances which you may encounter:
1.寒顫、發抖：
因麻醉藥消退引起，只要保持保暖後，麻醉藥消退完全後能恢復。
1. Chill and shivering: Inducted by the subsiding anesthetics. Simply keep the body warm and it will restore after the anesthetics has fully subsided.
2.惡露變化：產後胎盤剝離後，子宮內分泌物經由陰道排出，前二、三天量較多，顏色鮮紅，腥味重；五、六天後至產後十天量較少，顏色逐漸呈紅褐色，此種情形有時可能維持至二～三星期，完全乾淨需四～六星期。
【若含大量血塊或鮮血湧出，請立即告知護理人員或返診檢查】。
2. Changes in lochia: After the placenta has elevated, the uterine secretion is discharged through the virginal. More amount will be discharged for the first 2~3 days with red color and strong smell.
The secretion will become less in 5~6 days to 10 days after delivery, where the color gradually turns dark color.
This circumstance could last for 2~3 weeks and will become completely clean in 4~6 weeks(in the event of large blood chunks or surging blood, please immediately notify the nurses or return for revisit).
3.會陰沖洗：
二天內由護理人員每天為您沖洗並檢查傷口及子宮收縮狀況，其餘時間請家屬協助3-4小時換產墊，以保持清潔及乾爽，大小便後以沖洗器裝開水自行洗。
3. Perineal Douche: The nurses will rinse and check your wound as well as uterine contraction on the first two days after delivery. The family members should help the maternal woman change the pad in every 3~4 hours to keep the perineal clean and dry. Rinse with the flusher filled with drinking water after urination and bowel movement, as shown in Figure 1.
4.傷口疼痛：可為您打止痛藥(少量止痛藥不致成癮，請您放心！)。
4. Wound pain: We can inject painkiller for you (small painkiller will not become addictive. Do not worry).
4. Wound pain: We can inject painkiller for you (small painkiller will not become addictive. Do not worry).
5.進食(包括飲水)：由護理人員告知後才可進食。
5. Food (including water): Eat after notified by nurses.
6.導尿管小便紀錄：每500cc傾倒後，由家屬紀錄，以了解腎臟功能恢復狀況。依醫囑為您拔除，請於6-8小時內應自然解小便。
6. Records of urinary catheter: Family shall record the every 500cc of pouring out to understand the restoration of kidney functions. The catheter will be removed according to medical order. Please urinate naturally in 6~8 hours.
7.活動：請儘早在身體狀況可負荷範圍內翻身活動以促進早日排氣及增加血液循環，使得傷口早日癒合。
7. Activity: Please turn the body around within the bearable scope of physical condition soon to promote early gas discharge and enhance blood circulation, so that the wound will heal soon.
8.束腹帶使用方式：
固定於傷口上方，避免過度壓迫傷口，並保持束腹帶與腹部呈二指寬之距離，可避免活動時牽扯傷口引起疼痛可將您的束腹帶束於衣服外。
8. Use of binder: Fix the binder on top of the wound to avoid excessively pressing the wound. Keep the binder in distance of 2 fingers from the abdomen to avoid the pain triggered by pulling the wound during activity, so your binder will be used on the close.
9.傷口：保持乾燥儘量不要弄濕以免感染。
9. Wound: keep dry and do not dampen to avoid infection.
10.飲食：採漸進式飲食，以免造成腸負荷不良而導致腹瀉。
10. Diet: Gradually eat to avoid gastrointestinal burden and diarrhea.
一般可由流質→軟質→普通飲食。
Generally from liquid →soft→regular food
1.流質食物：如水、果汁、米湯等。
2.軟質食物：如稀飯等易消化食物。
3.普通食物：指一般食物。
注意油膩湯類及易產氣食物暫勿食用，以免腹脹及腹瀉。
如：牛奶、地瓜、豆漿及豆類食品。
1. Liquid food: i.e. water, juice, and rice porridge.
2. Soft food: i.e. rice porridge and other digestive food.
3. Regular food: refers to the average food.
Do not eat greasy soup and other gas-producing food to avoid abdominal distention and diarrhea, i.e. milk, yam, soybean milk, and beans.
※酒類食品：產後一週內暫勿食用，若需進食酒類食品請酌量，以免影響傷口癒合及子宮收縮。
※Alcohol food: Avoid eating such food in one week after the delivery.
Please take moderate amount of alcohol based food to avoid affecting wound healing and contraction.
※生化湯：產後一週內暫勿食用，因生化湯是一種子宮收縮劑，若子宮收縮疼痛厲害，請暫時停止食用等待疼痛緩解後才食用。
※Shenghua Soup:
Do not take this medicine in one week after delivery.
Shenghua soup is a type of contracting agent and severe contraction will cause extreme pain. Please suspend taking the medicine after the pain is alleviated.
11.安全問題：
產後身體比較虛弱，第一次下床時需有家屬陪伴，以免暈厥而發生意外傷害。
11. Safety issues:
The body is weak after giving birth and requires the company of family when getting off the bed for the first time to avoid injury due to passing out.
12.產後性生活：一般只要產後夫妻雙方做好溝通，心理建設完全，且傷口已沒有任何不舒服的感覺即可開始。
12.Postnatal sex life: In general as both couple communicates after delivery with mental readiness, while the wound no longer feels discomfort, then the couple may begin the sex life.
◎產婦出院須知
Instructions for Maternal Women Discharged from the Hospital
1.返家後傷口自我照顧方法：返家後傷口不需換藥，但請不要弄濕傷口。
1.Self-care method for wound upon returning home: No need to change medicine after returning home. But do not dampen the wound.
2.會陰部沖洗：大小便後，以煮過的溫開水由前往後沖洗(陰道口→肛門口)，
並保持乾爽即可。
2. Perineal Douche: After urination and bowel movement, use lukewarm drinking water to rinse from front to back (virginal →anus) in addition to keeping it dry.
藥物：出院時醫師會依照您的復原狀況而開藥，依照藥袋上指示服用即可。
Medicine: The physician will prescribe medicine according to your recovery condition at discharge from the hospital. Follow the instructions on the medicine bag for administration.
出院後如有下列情形，請立即返院檢查：
1.陰道大量出血或有惡臭的分泌物。
2.持續發燒及腹瀉。持續性腹部疼痛或陰部疼痛。
3.乳房發生紅腫疼痛的硬塊。
In the event of the following conditions after discharge from the hospital, please return to the hospital for examination:
1. Massive vaginal bleeding or odorous secretion.
2. Continuous fever and diarrhea. Continuous abdominal pain or vaginal pain.
3. Rash, swollen and painful blocks on the breast.
返院檢查：依醫師約定時間返院作產後檢查，並做子宮頸抹片檢查，關於節育方法可與醫師商討。
Return to hospital for examination: Return to the hospital for postnatal examination according to the time scheduled by the physician in addition to taking Papanicolaou test. Discuss with the physicians for birth control measures.
◎產後運動：
1.產後腹肌鬆弛，做合宜運動可助肌肉收緊，保持身材促進產後子宮復舊。
2.依個人情形，選擇適宜的運動，尤其是手術生產者，應請教醫師。
3.最好在早晨或晚上按時施行，需每天做至產後兩個月為止。
4.做時先解小便，躺在硬板床上，起初切忌勉強或太累，次數應漸漸式增加做完運動應適當休息。其方法如下：
◎Postnatal Exercises:
1. Postnatal loose abdominal muscles. Do proper exercises to tighten the muscles, maintain body shape and promote postnatal uterine restoration.
2. Choose proper exercise depending on individual situation. Consult with a physician for surgical delivery.
3. Exercise in the morning or at night every day until two months after the delivery.
4. Urinate first before exercise.
Lie down on the hardboard bed. Do not exercise excessively or too tired.
The number of exercises should be gradually added with proper rest, as shown in the following method:
胸部運動：產後第三天開始
(1)平躺仰臥，全身肌肉放鬆手腳伸直，用腹部緩緩吸氣，儘量擴張胸部。
(2)收縮小腹，將氣緩緩吐出。
(3)屏氣繼續收縮小腹，下背部緊緊貼住床面再放鬆共做五次。
Chest exercise: starting from the third day after delivery.
(1) Lie down, relax the muscles of the whole body and straighten the arms and legs. Breathe through the abdomen and try to expand the chest.
(2) Hold in the abdomen and slowly breathe out the air.
(3) Hold the breath and continue to hold the abdomen.
Have the lower back adhere at the bed and relax. Do total 5 laps.
乳部運動：產後第三天開始
(1)仰臥床上，雙臂向左右伸展至與肩部對齊，伸直平放。
(2)將兩手慢慢上舉合攏，再慢慢回復原位。
(3)共做五次。
Breast exercise: starting from the third day after delivery
(1) Lie on the bed, stretch the arms out and align with the shoulder, straighten and place flat.
(2) Put the two hands upward and close, then slowly put the hands back to the original position.
(3) Follow the diagram and do 5 laps.
頸部運動：產後第七天開始
(1)仰臥床上，全身放平，手腳伸直，手掌貼身邊。
(2)將頭仰起，盡量向前彎，使下巴貼近胸部，再復原共做10次。
(3)做此動作時，不可牽動身體其他部份。
Neck exercise: Starting from the seventh day after delivery.
(1) Lie on the bed and flatten the body. Straighten the arms and legs with palm stay close to the body.
(2) Lift the head and try to bed forward so the chin stays close to the chest, and then restore. Do 10 laps.
(3) This motion should be pull any other parts of the body.
腿部運動：產後第十天可開始。(會陰縫補者須延至二週後開始)
(1)平躺仰臥，手腳伸直。
(2)先將左右腳輪流向上舉起，膝部須挺直，腳尖伸直各做五次。
(3)然後同時將雙腳舉起。
(4)注意用腹肌操作，不要利用手力。
Legs exercise: Starting from the tenth day after delivery (however persons with sewn perineal may not start until after 2 weeks).
(1) Lie flat and straighten the arms and legs.
(2) Lift both legs in turn. Straighten the knees;
the tip of toe straight and do 5 laps.
(3) Lift both legs up.
(4) Use abdominal muscles for operation and do not use the force of hands.
臀部運動：與腿部運動同
(1)仰臥床上，手腳伸直，手掌貼身邊。
(2)將一腿舉起，使足部貼近臀部，大腿靠近腹部，再伸直放回床面，另一腿作同樣動作，左右兩腿各做五次。
Hip exercise: The same as leg exercise.
(1) Lie on the bed, straighten the arms and legs with palm place close to the body.
(2) Lift one leg so the foot stays close to the hip.
The thigh stays close to the abdomen, then stretch and place back
on the bed.
Do the same motion with the other leg. 5 laps per each leg.
收縮陰道運動：產後半個月開始
(1)仰臥床上，雙手伸直平貼床面，兩腳彎曲分散與肩同寬，腳跟後縮，將臀部抬離床面。
(2)兩膝合併同時收縮臀部肌肉，保持此姿勢1-2分鐘。
Virginal contracting exercise: starting from half month after delivery
(1) Lie on the bed, straighten the arms and flatten to the bed.
Bed the two legs separately to the same width as the shoulder.
Pull up the heels and lift the hip off the bed.
(2) Put the two knees together while pull up the hip muscles.
Keep this position for 1~2 minutes.
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