一位口腔癌症患者經外科重建手術之護理經驗

Experience of Nursing a Patient with Oral Cancer After Reconstructive Surgery

林靜宜(Ching-Yi Lin) ； 陳淑齡(Shun-Ling Chen)

《弘光學報》 42期 (2003/11) Pp. 25-32

https://doi.org/10.6615/HAR.200311.42.03

摘要

本個案報告主旨在探討一位口腔癌症患者經外科重建手術之護理經驗。筆者採參與觀察及會談收集資料，並運用Gordon's十一項功能性健康型態評估為依據，結果發現其建康問題有：組織完整性受損、睡眠型態紊亂、營養狀況改變／少於身體所需、身體心像紊亂及潛在危險性肺吸入等五項。並依據各項問題提出個別性之護理措施，協助個案術後傷口維持良好血循促進組織癒合，急增加使用鼻胃管進食期間內味覺滿足感，協助表達情緒及重建正像之自我概念。冀望此護理經驗能做為護理同仁日後照顧此類患者之參考。

關鍵字

口腔癌 ； 重建手術 ； 護理經驗

並列摘要

The purpose of this case report is to present the experience of nursing a patient with oral cancer after reconstructive surgery. Nursing assessment was based on the Gordon 11-item Functional Health Pattern. Data was collected by participant observation and interview. Five nursing diagnosis including 1) tissue integrity, impaired 2)sleep pattern disturbance 3)nutrition, altered less than body requirements 4)body image disturbance 5)aspiration potential, were found. Based on item problem to address individual nursing intervention, to assist the wound keeping circulation and promoting tissue healing in post-operation, to increase the sense of taste satisfied in nasal feeding period, to help the patient to express emotion and reconstruct positive self concept. This nursing experience can help nurses to earlier understand the problems of similar cases.

並列關鍵字

oral cancer ； reconstructive surgery ； nursing experience

參考文獻

行政院衛生署(2001)．台灣地區主要癌症死亡原因。行政院衛生署網站。摘自http://www.doh.gov.tw/lane/statist/89/TMCAN89.xls。

李秀芳(1995)．口腔癌患者顯微手術重建術後護理。長庚護理，6(1) ,47-50。

李世一、陳伊呈、萬漢雷(1996)．以游離橈動脈前臂皮瓣重建口腔軟組織缺損。中華民國重建整形外科醫誌，5 (1),24-33。

社斌(1998)．口腔障礙的處理措施。於胡月娟暨海峽兩岸著名學者共同翻譯，玥代內外科護理(pp.1785-1809).台北：華杏。

高壽延、楊政杰、張哲壽(1999)．認識口腔癌。中華牙醫學會訊，139, 41-43。