口腔癌實行皮瓣重建手術之手術全期護理

Application of Perioperative Nursing on Oral Cancer Undergoing Flap Reconstruction Surgery

蕭夢漩(Meng-Hsuan Hsiao) ； 吳如香(Ju-Hsiang Wu)

《志為護理-慈濟護理雜誌》 20卷1期 (2021/02) Pp. 103-112

摘要

本文探討一位口腔癌病人行皮瓣重建手術之手術全期護理經驗，於2017年10月26日至11月10日，透過術前訪視、術中照護及術後衛教，以訪談及觀察方式收集資料，以Gordon十一項健康型態評估進行資料分析，確立病人主要健康問題：1.手術前期－焦慮；2.手術中期－潛在危險性壓瘡；3.手術後期－身體心像紊亂。藉由術前訪視，協助病人面對疾病及術前準備過程，減輕其焦慮，術中維護病人安全及術後訪視評估病人需求，陪伴其渡過外觀改變衝擊時期，經由家屬的支持與陪伴，增強病人自信心。透過連續照護模式經驗分享，落實手術全期護理，提供照護此類病人之參考，以提升手術全期護理照護品質。

關鍵字

口腔癌 ； 頭頸部重建 ； 手術全期護理

並列摘要

The objective of this article is to describe the perioperative nursing experience of a patient with oral cancer undergoing flap reconstruction surgery. From October 26, 2017 to November 10, we collected the data of the patient according to Gordon's 11-itemed functional health patterns with resect to preoperative visits, intraoperative care, postoperative education, observation, and visiting methods. As a result, we were able to determine the patient's main health problems over the course of care. In the preoperative phase, the major problem was anxiety. During the operative phase, the major nursing problem was the potential risk of pressure sores. In the postoperative nursing care phase, the major problem was the body image disorder. Preoperative visits assist patients in facing the disease. Preoperative preparation process aims to reduce their anxiety and maintain the patient's safety during operation. Postoperative visits aims to assess the patient's needs, accompany them through the period of change in appearance, encourage family support and companionship to enhance the patient's self-confidence, share experiences through continuous care mode, and implement the perioperative nursing methods for overall care. This study can serve as a reference for nursing similar patients and to improve the quality of the perioperative nursing.

並列關鍵字

Head and neck reconstruction ； Oral Cancer ； Perioperative nursing

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