男性輸尿管癌病人接受腹腔鏡手術全期護理經驗－個案報告

Perioperative Nursing Experience of a Male Patient Underwent Laparoscopic Nephroureterectomy because of Ureteral Cancer: A Case Report

鄭素珠(Su-Chu Sheng) ； 邱淑津(Shu-Jin Ciou) ； 凌丰姿(Feng-Tzy Lin) ； 楊式辰(Shih-Chen Yang)

《北市醫學雜誌》 12卷4期 (2015/12) Pp. 385-396

https://doi.org/10.6200/TCMJ.2015.12.4.11

摘要

本文在探討一位因輸尿管癌接受腎及輸尿管全切除，部分膀胱袖切除個案之腹腔鏡手術全期護理經驗。照護期間為2013年7月10日至7月20日，運用手術全期護理及Gordon十一項健康功能型態進行評估與分析，經由直接照顧、身體評估、觀察、會談及傾聽等方式蒐集主客觀資料，確立個案有「焦慮」、「潛在危險性損傷」、「急性疼痛」等健康問題，在手術全期護理過程中，提供有關手術過程的訊息，減輕手術前期個案焦慮；手術中期，提供正確擺位及適當防護，避免手術過程造成神經肌肉損傷；給予PCA自我止痛給藥法、個別性適用之疼痛減輕的方式改善術後疼痛，終讓個案能獲得舒適且安全之手術全期護理。希望藉此照護經驗分享輸尿管癌接受腎及輸尿管全切除，部分膀胱袖切除個案之腹腔鏡手術之照護重點，提供護理同仁重視手術全期護理重要性，並作為日後照顧腎及輸尿管全切除腹腔鏡個案之參考。

關鍵字

輸尿管癌 ； 焦慮 ； 潛在危險性損傷 ； 急性疼痛 ； 手術室全期護理

並列摘要

This report describes a nursing experience of caring a male patient undergone laparoscopic nephroureterectomy because of left ureteral cancer. The Gordon’s 11 Functional Health Patterns was used to evaluate his health status during perioperative nursing period starting from 10th to 20th July 2013. Subjective and objective data were collected by physical assessments, observations, interviews and listening. Anxiety, potentially dangerous injury, acute pain and other health problems were established. Providing information about the surgical procedures during the perioperative nursing period reduced the pre-operative anxiety of the patient; during the middle stage of the nursing period, the patient was correctly positioned and properly protected to avoid neuromuscular damage. PCA method of self-administered pain relief, an individualized pain management approach, was used to improve postoperative pain so that patient was comfort and safe during the perioperative nursing period.

並列關鍵字

ureteral cancer ； anxiety ； risk for injury ； acute pain ； perioperative nursing