照顧一位口腔癌患者於重建顯微手術後之護理經驗

Nursing Experience of Caring for a Patient with Buccal Cancer Post Microsurgery

台灣地區口腔癌之病患人數有逐年上升之趨勢。其手術治療方式也由早期的單純病灶切除，進步至目前的立即顯微重建手術。本文以一第四期口腔癌接受立即顯微重建手術之病患為對象。筆者於加護單位中以護理過程為指引，運用Gordon's十一項功能性健康型態進行護理評估，自89年6月至7月間藉直接護理、觀察和會談收集資料並分析得個案於加護單位中面臨諸如：組織灌流改變：有關周邊血管；呼吸道清除功能失效；疼痛；營養狀況改變：少於身體需要；家庭運作過程改變及身體心像改變等護理問題。文中詳述各護理問題之相關措施與評值。分享此護理經驗可提供此類病患照護之參考，進而提昇照護品質。

The incidence and prevalence of patients diagnosed as buccal cancer increased gradually. The focus of surgery for buccal cancer has changed from tumor resection to immediate reconstruction microsurgery. A patient diagnosed as stage IV buccal cancer and treated with immediate reconstruction microsurgery was selected in this report. Data were collected by recording direct nursing care, observation, and interview processes. Nursing problems such as tissue perfusion altered: peripheral, ineffective respiratory clearance, comfort altered, pain, nutrition altered: less than required, family process altered, and body image altered were identified by a Gordon 11-item health assessment. This particular experience can be used as a reference of caring for this specific group of patients.