一位罹患古漢氏症併發乳糜胸病人之加護照護經驗

Nursing Experience of a Gorham's Disease Patient with Chylothorax in Intensive Care Unit

劉雅云(Ya-Yun Liu) ； 林俐君(Le-Gin Lin)

《榮總護理》 30卷2期 (2013/06) Pp. 214-220

https://doi.org/10.6142/VGHN.30.2.214

摘要

本文係探討一位古漢氏病（Gorham's disease）併發乳糜胸病人在加護病房之護理經驗。護理期間筆者運用觀察、會談、身體評估及實際照護等技巧，利用Gordon十一項功能性健康型態評估工具收集資料，確立其健康問題有：營養改變／少於身體所需、高危險性感染、氣體交換障礙、睡眠型態紊亂及焦慮。本文藉與病人建立良好護病關係與信任感，運用護理專業知識提供適當護理措施及心理支持，協助其改善身體症狀之不適且成功脫離呼吸器，最終順利轉出普通病房後出院。

關鍵字

古漢氏病 ； 乳糜胸 ； 脫離呼吸器

並列摘要

This article describes a nursing experience in an intensive care unit with a patient who suffered from Gorham's disease accompanied by Chylothorax. Data were collected through observation, conversation, physical examination, and actual care according to Gordon Functional Health Assessment guide. The nursing diagnosis identified included altered nutrition: less than body requirements, infection, impaired gas exchange and anxiety. Good nurse-patient relationship and trust were maintained, professional knowledge, skills and mental support were provided to successfully help the patient improve physical symptoms of discomfort and the weaning of the ventilator. The Patient was transferred to a general ward and then discharged.

並列關鍵字

Gorham's disease ； Chylothorax ； weaning ventilator

參考文獻

呂珮菁(2009)．一位肺炎合併呼吸衰竭脫離呼 吸器個案之護理經驗．澄清醫護管理雜 誌，5(4)，55-61。

宋瑞萍、鍾淑媛、盧璧珍(2006)．照顧一位 罹患淋巴血管平滑肌增生併發乳糜胸婦 女之護理經驗．護理雜誌，53(4)，96- 105。doi: 10.6224/JN.53.4.96

郭敏勇、周佳滿、陳厚全(2008)．以胸腔鏡 肋膜沾黏術成功治療一合併兩側乳糜胸 之Gorham 氏症病童．中台灣醫學科學雜 誌，13(1)，43-47。

賴怡樺、施富金(2009)．成功脫離呼吸器之影 響因素與護理．榮總護理，26(4)，382- 387。

Brodszki, N., Länsberg, J. K., Dictor, M., Gyllstedt, E., Ewers, S. B., Larsson , M. K., & Eklund, E. A. (2011). A novel treatment approach for paediatric Gorham–Stout Sy n d r ome wi t h c h y l o t h o r a x . Ac t a Paediatrica, 100(11), 1448-1453. doi: 10.1111/j.1651-2227.2011.02361.x