照顧一位接受體外循環維生系統治療之照護經驗

Caring for a Patient with ECMO: A Case Report

徐盈真(Ying-Chen Hsu) ； 林妍雯(Yen-Wen Lin) ； 張瓊櫻(Chiung-Ying Chang)

《高雄護理雜誌》 27卷1期 (2010/05) Pp. 84-95

https://doi.org/10.6692/KJN-2010-27-1-8

摘要

本文為照顧本院第一例肺部損傷併發急性呼吸窘迫症的患者，接受體外循環維生系統治療之照護經驗。筆者於96年7月8日至96年7月23日照護期間，運用觀察、回顧病歷及訪談家屬的方式收集病史，以身體檢查及羅氏適應模式為評估指引分析資料並確立護理問題，問題有：氣體交換障礙、潛在危險性損傷、焦慮等。護理過程中發揮重症護理角色功能，維持個案生命徵象的穩定，並使用體外循環維生系統治療，使得病患確實改善肺部的損傷情形及氣體交換功能障礙的問題，進而脫離呼吸器的使用；後續針對病患和家屬之心理層面給予協助，以減輕其疑惑改善焦慮問題，及出院後復健照護的衛教。期許本文對護理人員在照護此類病患時，能提供完整的照護經驗參考。

關鍵字

急性呼吸窘迫症 ； 體外循環維生系統 ； 氣體交換障礙 ； 潛在危險性損傷 ； 焦慮

並列摘要

The aim of this article explores a nurse's experience related to a 21 year-old young man, suffered from lung injury with acute respiratory distress syndrome, receives ECMO (Extra-Corporeal Membrane Oxygenation) treatment. During the period of July 8-23, 2007, the author occupies observation, history review as well as direct interviews with the subject and his family members to gather information. The nursing diagnoses, impaired gas exchange, risk for injure and anxiety, are examined and settled via applying physical assessment and the Roy adaptation model. Within hospitalization, the nurse carries out the obligation of critical care and manages ECMO in order to maintain the subject’s life from improving lung injury, advancing gas exchange, in addition, weaning from a ventilator. Concerning relieving the anxiety and resolving perplexity, the mental support and health education associated with rehabilitation after being discharged from hospital are provided to the subject also his relatives. This experience may bring a reference of an ECMO patient's total care plan to ICU nurses.

並列關鍵字

Acute respiratory distress syndrome ； ECMO ； impaired gas exchange ； risk for injure ； anxiety