一位機械手臂微創冠狀動脈繞道術病人之手術全期護理經驗

Perioperative Nursing Experience of a Patient Who Underwent Robotic-Assisted Coronary Artery Bypass Grafting

陳詠真(Yung-Chen Chen) ； 莊燕妹(Yen-Mei Chuan) ； 林宥均(Yu-Chun Lin) ； 任秀如(Hsiu-Ju Jen)

《志為護理-慈濟護理雜誌》 13卷5期 (2014/10) Pp. 99-107

摘要

描述使用機械手臂摘取雙側內乳動脈行微創冠狀動脈繞道術之手術全期護理經驗。於2011年8月4日至8月12日照護期間，運用Orem理論評估個案健康問題，發現個案有術前焦慮、手術期間潛在危險性擺位傷害、疼痛及知識缺失等問題。手術前期藉由關懷、傾聽，提供心理上支持與相關知識；手術中期提供生理上照護、維持手術無菌及正確姿位擺放；手術後期著重舒緩疼痛、提供合宜環境、教導術後生活飲食習慣及傷口照護等措施。個案能緩解面對手術焦慮，出院後恢復自我照顧能力，以上手術全期護理方式，包含術前教育與心理支持、仔細的術中照顧、術後足夠的傷口衛教，皆有助於接受機械手臂摘取雙側內乳動脈行微創冠狀動脈繞道術之病人迅速恢復。

關鍵字

手術全期護理 ； 機械手臂手術 ； 微創手術 ； 冠狀動脈繞道術 ； Orem理論

並列摘要

This case report described the perioperative nursing experience of a patient who underwent robotic-assisted coronary artery bypass grafting between 4th and 12th August 2011. We evaluated the patient's health problems with Orem theory and identified the following: pre-operative anxiety, potential risk for perioperative positioning injury and insufficient knowledge. The following strategies were implemented: Preoperatively, we provided mental support and related knowledge through caring and listening; intraoperatively, we provided physiological care, proper surgical sterilization, and proper patient positioning; Postoperatively, we focused on pain relief, appropriate resting environment, offer instructions of wound care and diet management. Through these nursing methods, the patient's pre-surgical anxiety was relieved, and resumed self-care ability after discharge. Perioperative nursing, which consisted of preoperative education and mental support, meticulous intraoperative nursing, and provision of sufficient health education postoperatively, would facilitate the patient's speedy recover after robotic-assisted coronary artery bypass grafting.

並列關鍵字

coronary artery bypass graft ； minimally invasive surgery ； Orem theory ； perioperative nursing ； robotic surgery