一位腎細胞癌轉移至後腹腔併腸浸潤需攜帶全靜脈營養返家之護理經驗

本文探討一位罹患腎細胞癌術後因後腹腔轉移的患者，在接受腫瘤擴清術後傷口有糞狀物流出，需攜帶全靜脈營養輸液返家，並提供出院準備服務之護理經驗。患者於2009年9月12日至10月23日住院期間，因疾病惡化，出現諸多情緒反應，我們運用Gordon十一項功能性健康型態評估，確認其護理問題有：焦慮、體溫過高、營養狀況差、身體心像紊亂、知識缺失。我們運用溝通及同理心之技巧，建立互信關係，教導病患和家屬學會返家照護事宜，整合醫療相關資源和照護諮詢，克服疾病所帶來的衝擊，使患者能接受身體心像改變的事實，以面對後續照護。

關鍵字

後腹腔轉移；全靜脈營養；身體心像紊亂

並列摘要

The article described a nursing experience of a patient who received debulking surgery for retroperitoneal recurrence after a radical nephrectomy of renal cell carcinoma. The stool leaked from the surgical wound after the operation, and discharge planning was provided with total parenteral nutrition upon discharge. The patient exhibited various emotional reactions induced by rapid disease progression during hospitalization from September 12th to October 23rd, 2009. We used ”Gordon 11 Functional Health Pattern” to evaluate the patient's condition, and several nursing problems were identified, including anxiety, hyperthermia, poor nutrition, body image disturbance, and deficient knowledge. We used communication and empathy skills to establish a relationship of mutual trust, educated the patient and family regarding self-care at home, integrated healthcare-related resources and provided nursing advices aiding the patient in overcoming the impact of the disease, enabling the patient to accept the changes in body image and confront the difficulties in after-care.

並列關鍵字

retroperitoneal metastasis ； total parentaral nutrition ； body image disturbance

延伸閱讀

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陳瑞忻、陳秋月、廖婉君（2015）。照顧一位慢性腎臟病患者接受腹膜透析之護理經驗。臺灣腎臟護理學會雜誌，14(1)，66-80。https://doi.org/10.3966/172674042015031401005
陳春蘭、高綺吟、孫婉娜（2022）。照顧一位腎動脈瘤破裂接受根除性全腎手術病人之護理經驗。馬偕護理雜誌，16(2)，47-58。https://doi.org/10.29415/JMKN.202207_16(2).0005
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一位腎細胞癌轉移至後腹腔併腸浸潤需攜帶全靜脈營養返家之護理經驗

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