照顧一位行多項泌尿科手術的患者之手術全期護理經驗

本文敘述一位79歲男性，因前列腺肥大、腹股溝疝氣、輸尿管、膀胱結石等疾病，入院行經內視鏡前列腺汽化術、腹腔鏡疝氣修補術、輸尿管鏡輸尿管結石取石術及膀胱鏡膀胱結石碎石術之手術全期護理經驗。護理期間自2018年12月10日至12月15日，筆者運用手術全期護理模式，透過觀察、訪談及查閱病歷等部份照護的方式收集資料，對個案進行身體、心理及社會各方面的評估，發現個案有，手術前期：焦慮，手術中期：潛在危險性手術全期擺位傷害、潛在危險性熱的傷害，手術後期：特定知識缺乏等健康問題。筆者針對其健康問題擬定護理計劃，藉由提供多元化的手術全期護理資訊，配合圖文及影像的說明協助個案理解手術過程、提供正確擺位及適當防護，避免手術過程造成皮膚損傷；利用陪伴傾聽、轉移注意力及放鬆等技巧協助個案緩解手術所產生的焦慮；提供術前及術後照顧相關的知識，以增進術後自我照顧能力協助早日恢復正常的生活。希望藉由此經驗分享，提供日後照護多項手術病人之全期臨床護理照護之參考。

關鍵字

內視鏡手術；前列腺；手術全期護理

並列摘要

This case report describes the preoperative nursing experience of a 79 year-old male patient who received photo-selective vaporization of Prostate, laparoscopic herniorrhaphy, Uretero-Reno-Scopic Lithotripsy (URSL), Endoscopic cystolitholapaxy due to Prostatic hypertrophy, Right inguinal hernia, Right ureteral calculi and Bladder stones The period of care was from 2018.12.10 to 2018.12.15. The author used Gordon's 11 function health patterns and perioperative nursing techniques to evaluate the patient's physical, psychological and social conditions, and data was collected via direct observation, individual interview and medical charts review. Health issues included preoperative: anxiety regarding the surgery, and concern about post procedure infections; mid-surgery: potential injuries/position and instrument related; and post-surgery: lack of specific knowledge/postoperative wound care. The author created a nursing plan targeted to the patient's concerns through the use of emotion-sharing, accompanying and listening, and attention divergence and relaxation techniques, so the patient's anxiety and postoperative pain were relieved. Knowledge regarding postoperative care and self-care abilities were also taught to help the patient return to daily living. In sharing this report, it is hoped to provide a clinical experience for similar cases in the future.

並列關鍵字

Endoscopic surgery ； Benign prostate hypertrophy ； Preoperative nursing

參考文獻

江松輯(2018)．八自由度內視鏡機器人運動模型建立與鏡頭視角控制．［未發表之碩士論文］．臺灣大學機械工程學研究所學位論文．華藝線上圖書館。

方玉瑤(2011)．良性前列腺肥大症．人醫心傳－慈濟醫療人文月刊，12，72-74。https://doi.org/10.30151/ MH.201112.0016

林嘉禾、林光明、蘇世斌(2011)．攝護腺肥大症之雷射手術治療．家庭醫學與基礎醫療，26(2)，83-86。https://doi.org/10.6965/ FMPMC.201101.0083

林錦城(2013)．前列腺肥大症(Benign Prostatic Hyperplasia)的實際治療體會．北市中醫會刊，19(2)，29-36。https://doi.org/10.6718/TJCMb.201309_19(2).0006

任秀如(2012)．手術全期護理．醫療品質雜誌，6(3)，27-30。https://doi.org/10.30160/JHQ.201205.0006

國際替代計量

照顧一位行多項泌尿科手術的患者之手術全期護理經驗

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