一位肝硬化合併食道靜脈瘤出血病患的護理經驗

The Nursing Experience of a Patient with Liver Cirrhosis Combined Esophageal Varices Hemorrhage

肝硬化合併食道靜脈曲張出血是肝硬化一個常見的併發症，且致死率頗高，本文為照顧一位肝硬化合併食道靜脈瘤破裂出血患者之護理經驗，筆者於個案住院期間，運用觀察、會談、收集病史及Gordon十一項健康功能型態來評估個案的健康問題，發現有現存性傷害：腸胃道出血、睡眠型態紊亂、腹瀉、焦慮等護理問題，在護理過程中，運用適當的護理措施，例如：症狀護理、疾病相關衛教、主動適時的陪伴和給予心理支持等措施，並運用肝硬化和食道靜脈瘤出血之學理為依據，再配合醫囑的給藥和治療，以解決個案身體不適的症狀。本文藉分享此個案的護理經驗，期盼能提供臨床護理人員對肝硬化合併食道靜脈曲張出血有更深的認識與瞭解，以提升護理專業服務及照護品質。

Esophageal Varices hemorrhage is a common and highly fetal complication of liver cirrhosis. In this article, we addressed the nursing experience of a patient with such complication The author evaluated the hospitalized patient’s condition by way of observation, meeting, history collecting and Gordon’s eleven-item health assessment scale. During the hospitalization period, the patient had suffered from GI tract bleeding, insomnia, diarrhea, and anxiety. Besides offering prescribed medicine, the author relieved the patient’s distress through some ways of nursing intervention, such as symptoms care, education, and psychological support. We hope the experience gained from this case would be a valuable reference for taking care of such cases and contribute to quality- improvement of nursing in the future.