一位初診斷口腔癌病人行廣泛切除手術之照護經驗

Nursing Experience of a Patient with Initial Diagnosis of Oral Cancer Undergoing Extensive Resection

黃靜宜(Ching-Yi Huang) ； 陳繪竹(Hui-Zhu Chen) ； 黃詩婷(Shi Ting Huang) ； 王姮樺(Heng-Hua Wang) ； 鄭碧芬(Pi-Fen Cheng)

《高雄護理雜誌》 37卷2期 (2020/08) Pp. 120-131

https://doi.org/10.6692/KJN.202008_37(2).0011

摘要

本文為一位中年男性因罹患口腔癌，行廣泛切除術併皮瓣修補之照護經驗。護理期間為2017年9月25日至10月3日，運用Gordon十一項健康功能型態評估方法，發現個案因初次罹患口腔癌，在手術後有急性疼痛、口腔黏膜改變及身體心像紊亂等健康問題。護理期間藉由中西醫合併即時緩解個案手術後疼痛；提供個別性的『口腔復健計劃』，在住院期間即時恢復溝通能力；引導個案表達對身體外觀改變之感受，尋求相關支持團體及跨領域醫療團隊服務，以恢復個案身體心像，讓個案能早日重返家庭及融入社會生活。建議往後可提供口腔癌皮瓣術後照護資訊，幫助同仁制定護理計畫及措施，讓病人出院後有更完善的治療，藉照護此纇病人經驗分享，提升個別性護理品質。

關鍵字

口腔癌 ； 口腔黏膜改變 ； 身體心像

並列摘要

This case report explores a 50-year-old man with right-lateral-modified neck lymph node dissection and skin flap repair experience due to oral cancer. In the caring process, Gordon's 11-item functional health assessment tool was used. Based on results of the health assessment, the patient's health problems were identified as the following: acute pain, impaired oral mucous membrane, and body image disturbance. Postoperative pain was immediately relieved by a combination of Chinese and Western medicine, and an individual ＂oral rehabilitation plan＂ was applied to restore communication ability during hospitalization and guide the patient to express feelings about the change in physical appearance, while relevant support group and cross-domain medical team services input was sought to encourage the patient to accept the altered body image and reaffirm their self-worth, thereby allowing the patient to return to the family and integrate into social life as soon as possible. In sharing the experience of this patient, the unit hopes that this information of postoperative care of oral cancer flap patients could be developed and implemented in the future to also assist colleagues in developing such care plans and measures to allow patients to have better treatment after discharge to improve the quality of individual care.

並列關鍵字

oral cancer ； impaired oral mucous membrane ； body image change

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