一位因牙周病治療引發感染性心內膜炎術後患者之護理經驗

The Nursing Experience of a Patient with Infective Endocarditis Related to Receive Periodontal Treatments

林宸瑀(Chen-Yu Lin) ； 張瑀玲(Yu-Ling Chang) ； 吳心煦(Hsin-Hsu Wu) ； 林月娥(Yueh-E Lin)

《長庚護理》 28卷4期 (2017/12) Pp. 709-719

https://doi.org/10.3966/102673012017122804012

摘要

本文探討一位因牙周病治療引發感染性心內膜炎病患，經二尖瓣修補及清除贅生物術後之護理經驗。護理期間為2015年5月1日至2015年6月12日。運用Gordon十一項評估，透過系統性的觀察、溝通、治療性會談等方式收集資料，分析歸納個案主要的問題有：現存性感染、危險性活動無耐力及焦慮等護理問題。藉由同理心、心理支持和放鬆技巧，協助個案表達其情緒感受，在術後介入個別性的術後復健照護促進個案術後能恢復日常的活動機能，提升返家生活品質。因牙齒疾病導致感染性心內膜炎的臨床照護複雜，護理人員不但應該處理生理問題，還應注重心理層面的需求。本護理經驗期能與護理人員分享並作為日後照護此類案例分析的參考。

關鍵字

牙周病治療 ； 感染性心內膜炎病患 ； 現存性感染 ； 危險性活動無耐力 ； 焦慮

並列摘要

This paper described the experience of nursing a patient who suffered from infective endocarditis related to periodontal treatments after repairmen of the mitral valves and resection of the vegetation. The nursing period was from 5/1/2015 to 6/12/2015. This study implemented the Gordon's 11 function health patterns as an assessment method and collected information by systemic observation, communication, and therapeutic interviews. As a result, infection, risk for activity intolerance, and anxiety were identified as nursing problems of the patient. By applying sympathy, mental supports, and relaxation skills to encourage the patient to express emotion, so the patient can have correct concepts about the disease and positive attitudes toward the illness. The individualized rehabilitation was intervened to assist the patient regain the abilities to daily life and improve the quality of life as the patient returned home. Providing care for patients with infective endocarditis related to dental treatments is a challenged process. Nursing staff should not only focus on the physical needs but also pay attention to psychosocial perspectives of the patients. This nursing experience is expected to share with nurses who care for similar patients in the future.

並列關鍵字

periodontal disease treatment ； infective endocarditis ； infection ； activity intolerance ； anxiety

參考文獻

王培子、黃純德、顏雅音、黃曉靈、康沛倫、馬光遠、謝耀東(2011)。牙周相關疾病與冠狀動脈疾病風險的相關性之研究。台灣口腔醫學科學雜誌。27(2)，94-107。

高佳霙、謝育整、蔡森蔚、陳彥文、余幸澄、丁紀台(2010)。運用心臟復健計畫改善心肌梗塞患者生活品質。醫療品質雜誌。4(2)，87-92。

郭思妤、陳秀玲(2014)。照顧一位行冠狀動脈繞道手術後病人之護理經驗。高雄護理雜誌。31(1)，62-72。

陳秀玲、蔡秀蘭、陳婉宜(2012)。心臟外科病人藥物指導完整性之改善專案。長庚護理。23(1)，63-72。

黃文德、朱柏齡(2009)。血液透析患者之感染性心內膜炎。腎臟與透析。21(1)，6-10。