- 期刊
運用達文西手術系統行冠狀動脈繞道手術於一位病人之手術全期護理經驗
Nursing experience for a patient undergoing coronary artery bypass surgery using the Da Vinci surgical system
摘要
本文描述一位病人採用達文西手術系統行冠狀動脈繞道手術，於術前面臨重大手術衝擊而產生焦慮不安及術後疼痛之護理經驗。筆者自2018年10月20日術前探訪病人，10月22日手術期間直接照護，術後10月23日至11月1日查閱病歷及陸續探訪病人，以及出院後電訪。護理期間經由訪談、身體評估及病歷收集資料，運用Gordon十一項功能性健康型態評估，結果顯示病人有手術前焦慮、手術中潛在危險性傷害及手術後急性疼痛等健康問題。運用手術全期護理與病人及家屬建立良好的護病關係，手術前訪視藉由傾聽、同理心與關懷病人，提供手術前指導手冊與心理支持以減輕病人焦慮；手術期間提供保護性軟墊維持病人姿勢擺放，避免機器手臂碰撞及長時間手術引發潛在危險性傷害；手術後查閱病歷及至病房探訪，適時教導病人減輕疼痛之技巧，提供病人手術室整體性與連續性的照護，以協助病人手術後早日回復日常生活，期待藉此經驗分享能提供手術室護理人員照護此類病人之參考。
並列摘要
This article describes a male patient who underwent coronary artery bypass surgery with the Da Vinci surgical system to remove the left internal mammary artery and the left hand radial artery. He experienced anxiety in anticipation of major surgery, and had severe postoperative pain. The author visited the patient on October 20, 2018 before the surgery and took care of the patient during the operation on October 22. After the surgery, the author visited the patient from October 23 to November 1 and after discharge. Through interviews, physical assessments, and medical records collected during the treatment, Gordon's 11 functional health assessments were used to identify pre-operative anxiety, potential risk of injury during surgery, and post-operative pain. The author established a good relationship with the patient and his family during pre-operation visits by providing instruction manuals and relieving anxiety by listening to concerns. Protective cushions were provided to maintain patient posture during surgery. Avoiding robotic arm collisions and prolonged surgery reduced the risk of potentially dangerous injuries. After surgery, the patient was taught pain relief techniques and provided with continuous care to assist in returning to daily life as soon as possible after surgery. This article shares this experience to provide reference for operating room staff to care for bypass surgery patients.
參考文獻
延伸閱讀
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