一位子宮脫垂行腹腔鏡薦骨陰道固定術病人之手術全期護理

本文述說一位77歲婦女因第四級子宮嚴重脫垂入院接受腹腔鏡薦骨陰道固定手術之手術全期護理。照顧期間為2018年7月11日至7月14日，筆者運用Gordon十一項健康功能進行評估，並藉由會談、實際照護、病歷查閱等蒐集資料，確立病人手術前期有焦慮、手術中期有潛在危險性損傷、手術後期有急性疼痛等健康問題。手術全期護理包括在手術前以數位影片衛教解說手術過程，提供手術成功率，增加個案對手術的認知及手術成功的信心，進而減輕術前焦慮；在手術中期依照標準作業流程確實記錄手術植入用物，並提供正確擺位及適當防護，避免潛在危險性傷害發生；在手術後期依據不同傷口的疼痛程度，選擇不同的止痛方式。期待與護理同仁分享經驗，提升手術全期照護品質。

關鍵字

子宮脫垂；手術全期護理；照護品質；婦女

並列摘要

This article expressed perioperative nursing care of a 77-year-woman who was admitted to the hospital for laparoscopic sacral-colpopexy due to stage IV uterine prolapse. The period of nursing care was from July 11 to July 14, 2018. The author used Gordon's 11 Functional Health Pattern to assess and collect data with interviews, direct nursing care and review of her medical chart. The patient's health problem was anxiety, potential risk of injury, and pain in pre-, intra- and post-operation periods. The perioperative nursing care included providing digital videos to explain the operation process and success rate of the operation to reducing preoperative anxiety during the preoperative period; following the standard operating procedure and strictly recording the surgical implant, providing appropriate patient's positioning to prevent potential intraoperative injury during the surgical period; and selecting various analgesic methods to reduce the different degree of wound pain during the postoperative period. The authors anticipate sharing this experience with nursing colleagues to improve the quality of preoperative nursing care.

並列關鍵字

uterine prolapsed ； preoperative nursing care ； quality of care ； woman

參考文獻

陳威宏(2019)．ERAS術後多模式疼痛治療．台灣醫學，23(2)，212-222。https://doi.org/10.6320/FJM.201903_23(2).0009

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Baines, G., Price, N., Jefferis, H., Cartwright, R., & Jackson, S. R. (2019). Mesh-related complications of laparoscopic sacrocolpopexy. International Urogynecology Journal, 30(9), 1475-1481. https://doi.org/10.1007/s00192-019-03952-7

Hu, T. H., Ker, C. R., ＆Lomg, C. Y. (2020). Urine retention caused by urethral prolapse mimicking uterine prolapse. Taiwanese Journal of Obstetrics and Gynecology, 59(1), 165-166. https://doi.org/10.1016/j.tjog.2019.11.029

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國際替代計量

一位子宮脫垂行腹腔鏡薦骨陰道固定術病人之手術全期護理

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