一位壞死性筋膜炎病患於急性期之護理經驗

Nursing Experience of a Patient with Necrotizing Fascitis during Intensive Care

本文是描述一個壞死性筋膜炎病患於加護病房之護理經驗。以Majority Gordon十一項健康功能評估作為指引，結果發現個案的生理及心理健康問題依嚴重性依序為：呼吸道清除功能失效、疼痛、組織完整性受損及身體心像紊亂。透過護理活動之介入，運用同理心、系統性的觀察及評估，提供個案呼吸治療護理促進痰液排出、合宜的疼痛處理、藉由放鬆技巧減緩疼痛、提供傷口護理、並鼓勵正視身體的改變，使得個案朝向有效性的整合。壞死性筋膜炎為罕見疾病，且病程進展快速，對臨床護理人員是一大挑戰，期待藉由本次經驗分享提供照護此類個案之參考。

This case study reported the nursing experience of a necrotizing fascitis patient during intensive care unit admission. Four major nursing problems were found by using Majority Gorden’s functional health assessment guide. In the order of severity, they were ineffective airway clearance, pain, impaired tissue integrity, and disturbance body image. Nursing intervention programs included respiratory care to promote sputum draining, empathy, system assessment, and observation. Pain control was provided by relaxation skill and wound care. The patient was guided to positively perceive his body image and toward an effective integration. Because of the disease is rare, this experience provided nursing staff with a guide to care for similar patients in the future.