一位口腔癌患者接受顏面顯微重建手術之護理經驗

The Nursing Experience of an Oral Cancer Patient Accepting Micro-facial Reconstruction Surgery

温蕙竹(Wen Hui Chu)

《高雄護理雜誌》 35卷1期 (2018/04) Pp. 128-137

https://doi.org/10.6692/KJN.201804_35(1).0011

摘要

本篇個案報告是探討一位口腔癌患者經顏面重建手術後的護理經驗，照護期間自2016年4月18日至4月25日止，使用觀察、會談、病歷查閱與直接評估方式收集資料，並運用Gordon十一項功能性健康型態評估，確定個案問題為口腔黏膜改變、急性疼痛、呼吸道清除功能失效。筆者在照護個案期間，運用同理心並建立彼此信任關係，針對個案的問題，提供口腔護理照護、減輕氣切套管留置和術後頸部傷口疼痛、使用胸腔物理治療，以利呼吸道分泌物排除，提供充份衛教、詳盡的解釋，減少其術後的不安，經護理措施介入後，個案不適情形能獲得改善。期望藉由本文護理經驗過程之分享，以提升口腔癌患者經顏面重建手術後病患之護理照護品質及更適切的護理。

關鍵字

口腔癌 ； 顏面顯微手術 ； 護理照護

並列摘要

This case report was to explore the care of a patient with oral cancer after facial reconstruction surgery care experience during the period from April 18 to April 25, 2016. The data was collected based on Gordon 11 functional health assessment by observation, interview, medical records checking and direct examination. The health problems determined for the case were oral mucosa changes, acute pain, and ineffective respiratory clearance function. During the period of care, the author was empathetic and established a mutual relationship of trust. Based on the caring problems, providing oral care, decreasing the pain of replacement of the tracheal tube, reducing the postoperative pain of the neck, and using chest physical therapy all helped the patient to remove mucus from the airway. Also, providing complete education reduced postoperative insecurity. After the nursing interventions were applied to the case, the discomfort of the patient was ameliorated. Hopefully, through sharing this nursing experience will help to advance the quality of nursing care for oral cancer patients after facial reconstruction surgery.

並列關鍵字

oral cancer ； micro-facial surgery ； nursing care

參考文獻

曾光毅、曾嵩智(2012)．現階段口腔癌的預防與治療．家庭醫學與基層醫療，26(5)，215-224。

王昭淩、李佳倫(2013)．一位口腔癌接受氣管切開術病人的照護經驗．馬階護理雜誌，7(1)．83-93。

胡文郁、陳宛榆、羅淑芬、陳書毓、黃翰心、陳幼貴(2011)．成人癌症疼痛臨床照護指引．腫瘤護理雜誌，11，87-127。

Huang, S., & Liu, H. E. (2008). Effectiveness of cosmetic rehabilitation on the body image of oral cancer patients in Taiwan. Supportive Care in Cancer, 16(9), 981-986.

May, A. H., Hiner, D., & Feldman. (2012). Oral integrity related to head and neck cancer treatment. Perspectives on Swallowing and Swallowing Disorders, 21(1), 28-33. doi:10.1044 /sasd21 .1.28