一位二度接受角膜移植病人之手術全期護理

Peri-operative Nursing for a Patient Undergoing Second Corneal Transplantation

吳雪紅(Hsueh-Hung Wu) ； 劉永芳(Yung-Fang Liou) ； 闞秋萍(Chiou-Ping Kan)

《源遠護理》 1卷3期 (2007/11) Pp. 72-81

https://doi.org/10.6530/YYN.2007.1(3).08

摘要

本文描述一位60歲女性接受角膜移植病人，第一次角膜移植後由於自我照顧知識不足，當發生排斥、感染而未及時就醫，導致移植手術失敗。筆者以手術全期護理人員角色參與個案第二次角膜移植，護理期間自2006年3月22日至2006年3月28日。利用訪談、觀察與個案及家屬建立信任感，依據Gordon十一項功能性健康型態進行整體性的護理評估，確立個案有焦慮、睡眠型態紊亂、潛在危險性感染、知識缺失等護理問題。於照護期間術前藉由護理指導以減輕焦慮，術中則以維護安全、遵守無菌原則避免感染為照護主旨，術後則以指導用藥及自我照顧知識以改善個案睡眠品質等。筆者依據所呈現的問題提供適當的護理措施後，個案能主訴焦慮減輕、了解自我照顧事項及住院期間睡眠障礙有明顯改善、出院後無感染現象等。希望將此護理經驗與大家分享，作為日後照護此類病人之參考，協助病人能正向的面對疾病進而提昇護理品質。

關鍵字

角膜移植 ； 手術全期護理

並列摘要

The purpose of this case report was to describe the peri-operative nursing experience in caring a patient who experienced tissue rejection and infection from her first corneal transplant related to lack of self-care and was undergoing her second corneal transplant surgery. The author used the Gordon's 11-item functional health patterns to assess patient's health problems including: (1) anxiety, (2) disturbed sleep patterns, (3) potential risks for infection, and (4) lack of knowledge. Through the preoperative period, the author provided health education to reduce patient's anxiety. The objectives of intraoperative care were safety and asepsis. The post operative care focuses on the correct use of medications, provision of self-care and the improvement of sleep quality.

並列關鍵字

perioperative ； corneal transplant