一位卵巢破裂急行子宮及卵巢全切除手術個案之照護經驗

A Female Patient Ovarian Rupture Undergone Operations of Hysterectomy and Oophorectomy Body Image Disturbance Nursing Experience

何孟蒨(Meng-Chien Ho) ； 鄭碧芬(Pi-Fen Cheng) ； 李依鴻(Yi-Hong Li) ； 王姮樺(Heng-Hua Wang) ； 陳繪竹(Hui-Zhu Chen)

《安泰醫護雜誌》 27卷1期 (2021/06) Pp. 1-16

摘要

本文探討一位38歲女性因卵巢扭轉破裂合併子宮浸潤，經家人緊急送醫後，需即時進行子宮及卵巢切除手術的照護經驗。護理期間為2017年11月17日至11月24日，藉由直接護理、傾聽、觀察、會談及查閱病歷等方式收集資料，運用Gordon十一項健康功能型態進行整體性評估，確立個案有急性疼痛、營養少於身體所需及身體心像紊亂等健康問題。護理期間透過特殊的V形體位擺位、換藥前注射止痛藥等緩解手術後急性疼痛，會同營養師來設計專屬個案喜愛的飲食計畫，讓個案在住院期間得以維持體重，並提供個別性的『骨盆底肌肉運動』影片，及運動步驟執行口訣，增加個案記憶，再利用女性生殖系統圖片、人體模型詳細地說明，藉以幫助個案對於自我概念的否定及心理的疑慮，以降低術後性生活的擔憂，並重拾自信恢復夫妻間的性行為。

關鍵字

卵巢破裂 ； 子宮全切除 ； 身體心像紊亂

並列摘要

The paper explored the nursing experience of a 38-year-old female patient, who had got ovarian torsion and cyst rupture combined with uterine infiltration, and had undergone operations of hysterectomy and oophorectomy immediately after being sent to the hospital by her family.The nursing period was from Nov. 17, to Nov. 24, 2017. The researcher collected information through direct nursing, listening, observation,interviews and checking of her medical records, and then employed Gordon's 11 Functional Heart Pattern Model to perform an overall evaluation. Then the patient was confirmed to have the health problems of acute pain, nutritional deficiencies, as well as physical and body image disturbance. During the nursing period, through the measures of special V-shaped postural position and injection of painkiller before dressing change, her acute pain after the operations was relieved. The researcher,together with the dietitian, designed an individualized diet plan that the case liked in order to help the case maintain her weight during the hospitalization. Besides, the case was provided with a video clip of individualized ＂pelvic floor exercises＂ and taught mnemonic phrases of exercise steps so as to help the case memorize the steps more easily. In addition, a picture of female reproductive system and a human body anatomy model were also used to explain in detail to the case, intending to help the case improve her negative self-concept, and reduce herconcerns and doubts. It was hoped that the case would ease her worries about her sex life after the operations and regain her self-confidence to resume intercourse with her husband.

並列關鍵字

Ovarian rupture ； Hysterectomy ； Body image disturbance