運用肺部復健運動計畫照顧一位食道切除術後個案之護理經驗

Nursing Experience of Applying Pulmonary Rehabilitative Exercise on a Patient Undergoing Esophagectomy

本文為協助一位食道癌術後個案，於加護病房透過早期肺部復健運動計畫，有效預防術後肺部合併症的護理經驗。護理期間為2010年12月13至24日，採Gordon十一項功能性健康型態評估，確立問題有低效性呼吸型態、急性疼痛、焦慮、營養少於身體所需。因此筆者與個案及家屬建立信任的護病關係，運用個案熟悉的生活喜好及舒適擺位，舒緩焦慮及轉移疼痛；亦早期提供腸道營養、結合個案全家與醫療團隊，共同設計及執行肺部復健訓練計畫，以預防術後肺部合併症。期藉此經驗分享，能提供日後護理人員照護此類個案之參考。

The article describes a nursing experience of caring for a post-operative patient who underwent an sophagectomy. An early pulmonary rehabilitation exercise plan effectively prevented the patient from post-surgery pulmonary complications in an intensive care unit. The nursing care period was from December 13 to 24, 2010. The author applied Gordon's 11 Functional Health Patterns and identified the following problems: ineffective breathing pattern, acute pain, anxiety, and a deficit of nutrition. The nurse built a trusting relationship with the patient and the patient's family. The patient's anxiety was relieved and the pain was alleviated by repositioning the patient and adjusting lifestyle preferences to maximize comfort. Early enteral nutrition was also initiated. A pulmonary rehabilitative training plan was designed and performed by the care team to prevent post-operative pulmonary complications. This article may serve as a reference for nurses who care for similar patients in future.