一位食道切除個案再次重建之手術全期護理經驗

Perioperative Nursing Experience of Esophageal Reconstruction After Esophageal Resection

史紋綺(Wen-Chi Shi) ； 林春珍(Chun-Chen Lin)

《志為護理-慈濟護理雜誌》 23卷1期 (2024/02) Pp. 128-138

摘要

本文敘述一位69歲男性因食道腐蝕性灼傷切除食道後再次接受重建之手術全期護理經驗。於2020年1月28日至2月8日，經由訪談、傾聽、身體評估及查閱病歷方式收集資料，運用手術全期照護之概念確認主要健康問題為焦慮、潛在危險性手術情境傷害及疼痛等。運用多媒體影音提供正確手術資訊，並傾聽病人感受以緩解焦慮；術中給予正確擺位及防護措施，避免潛在危險性手術情境傷害發生；術後利用非藥物方式緩解病人疼痛，促進早期下床，避免併發症產生。透過團隊合作照護使個案逐漸康復，同時學習返家的自我照護，希望藉此經驗分享面對食道重建手術的個案應先關注心理需求，透過資訊提供讓其瞭解疾病照護重點協助其回歸原有生活。

關鍵字

食道腐蝕性灼傷 ； 食道重建 ； 手術全期護理

並列摘要

The patient of this case study is a 69 year old male who underwent esophageal reconstruction after esophageal resection in 2020 from 28 January to 8 February, Health data was collected throughout interviews, physical assessment and reviewing medical records, and used to determine perioperative nursing care and main health concerns. Identified patient concerns included anxiety, surgical errors and pain. The surgical team provided surgical information to the patient by multimedia and communicated with the patient to reduce the anxiety prior to the surgery. During the operation, carefully following standard operational procedures ensured surgical instruments were correctly positioned and protective measures taken in order to avoid potential surgical errors. Non-medical treatment was used in postoperative care to relieve pain, facilitate the patient getting out of bed and to avoid complications. The surgical team worked cooperatively to helped the patient recovers gradually and to learn self-care for returning home. This case study demonstrates that patient's psychological concerns can be successfully addressed prior to operation. Providing the surgical information and the main focus of patient's disease care will help the patient prepare for return to normal life after the surgery.

並列關鍵字

esophagus corrosive injury ； esophageal reconstruction ； perioperative nursing

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