一位妊娠中期行子宮肌瘤切除術患者之手術全期護理經驗

A Nursing Experience of a Pregnant Woman Who Underwent Myomectomy

陳瓊如(Chiung-Ju Chen) ； 王秀禾(Hsiu-Ho Wang)

《若瑟醫護雜誌》 7卷1期 (2013/08) Pp. 95-105

摘要

本篇旨在描述一位妊娠中期行子宮肌瘤切除術患者之手術全期護理經驗，護理期間為2010年7月14日至23日，運用生理、心理、社會、靈性及發展層面為評估架構，經由會談、觀察、身體評估及查閱病歷方式收集資料，確立個案的主要護理問題為焦慮、高危險性手術情境的傷害、潛在危險性傷害及高危險性感染。經由術前訪視，藉由傾聽、關懷病人並提供手術訊息；術中持續性監測生命徵象並提供生理照護、維持手術過程之無菌狀況及協助手術姿勢正確擺位；術後護送個案至恢復室，立即給予胎心音監測，觀察手術合併症徵象等護理措施介入後，個案能緩解面對手術焦慮，於手術後無手術傷口及管路感染發生，且無流產徵象發生，並能於術後9天康復出院，電訪追蹤個案於妊娠38週計畫性剖腹產下健康胎兒。期望藉由此護理經驗，提供臨床護理同仁在照護此類病患之參考。

關鍵字

妊娠中期 ； 子宮肌瘤切除術 ； 手術全期護理

並列摘要

The article described the nursing experience of a pregnant woman who underwent myomectomy. During the period of 2010/07/14-07/23. Use of the physical, psychological, social, spiritual, and the development dimension to the assessment framework. Data were collected through using observation, interviewing accompanied with physical examination. The researcher found that the patient had four major health problems: anxiety, distorted body image, the damage of high-risk surgical situations, the potential risk of injury and high risk of infection. Through as the preoperative visit, by listening to the care of patients and provide message; intra operative continuous monitoring of vital signs and provided health care, maintain the sterile condition of the surgical procedure and assist the surgical posture correct position; postoperative escort cases to the recovery room. Immediately, provided nursing intervention, such as recorded the fetal heart beat, observing surgical complications. The case can in reducing potential anxiety, post-operative surgical wound and tube infection and non abortion signs, and after 9 day was discharged, telephone interviews to track cases of healthy fetus at 38 weeks of pregnancy plan Caesarean. By this nursing experience provide clinical nursing staff to reference in the care of these patients.

並列關鍵字

second trimester ； myomectomy ； perioperative care