一位主動脈剝離病患手術前後之護理經驗

本文在探討一位因升主動脈剝離病患手術前後之護理經驗。藉由觀察、筆談、手勢及病歷查閱方式收集資料，運用Gordon十一項功能性健康型態進行護理評估，確立個案有「組織灌流改變」、「急性疼痛」、「焦慮、」及「健康維護能力改變」護理問題。護理過程中，採集中護理、密切監測生命徵象並控制血壓，以確保有足夠的組織灌流；在疼痛方面，教導個案轉移注意力、支托傷口的技巧及胸骨固定帶使用並給予止痛藥物使用，以減緩疼痛；提供個案主動脈剝離手術相關完整的護理指導，由醫師說明疾病治療與處置、預後和相關注意事項，增強個案對疾病與手術的認知及恢復的信心，減輕焦慮；提供疾病、飲食衛教與教導調整生活飲食型態，強調規則服藥與戒菸的重要性，提升個案對疾病自我照顧、知識，預防疾病復發，為返家自我照護做準備。

關鍵字

主動脈剝離；手術；護理經驗

並列摘要

The main purpose of this case report is to explore the experience of caring a patient with aortic dissection before and after surgery. Gordon's Functional Health Patterns were applied to assess the problems. The identified problems consisted of altered tissue perfusion, acute pain, anxiety, and changing of ability change of health promotion. During the nursing period, the patient was provided with centralized nursing care, closely monitoring of vital signs and control of blood pressure, in order to ensure a dequate tissue perfusion. The patient was also trained for skills to avoid wounds torn, distraction techniques and pain control was performed. Patient's anxiety was palliated by providing health education and the information of postoperative care. The education about disease, diet and adaptation of life and dietary pattern was provided with emphasizing the importance of regular medication and cigarette cessation and enhancing the knowledge on daily self-care, and eventually to prevent subsequent disease recurrence.