協助一位小腦橋腦角腫瘤病患脫離呼吸器之照護過程

The Nursing Care Experience of a Cerebellar-Pons Angle Tumor Patient to Wean Ventilator

本文是探討一位小腦橋腦角腫瘤行開顱手術，術後住加護病房期間，發現個案不易脫離呼吸器的原因，除本身疾病因素之外，營養不良是造成呼吸肌肉耐受性不足的重要因素；此外，個案面臨肢體活動障礙及心理層面的無望感等問題。運用Gordon 十一項功能性健康型態評估，確立個案有：1. 營養狀況改變：少於身體需要；2. 呼吸機戒斷反應功能失常；3. 身體活動功能障礙；4. 無望感等健康問題，並給予相對應的護理措施，進而緩解個案身體不適症狀及心理狀態的調適。期望藉由本文能提供臨床護理人員協助此類個案脫離呼吸器，減少使用呼吸器之機率，以獲得良好的生活品質。

This paper discussed the reasons a patient couldn't wean ventilator while staying at intensive care unit after Craniotomy of Cerebellar-Pons Angle Tumor. Besides the affection of Cerebellar-Pons Angle Tumor, malnutrition was also one of the important reasons which caused intolerance of respiratory muscle. Further, the patient encountered impaired physical mobility and psychological hopelessness in this case. We evaluated his condition of psychological, social and spiritualstatus by using 11 types of functional health, and found that the patient had the following condition: 1. Altered nutrition: Less than body requirement; 2. Dysfunctional ventilator weaning response; 3. Impaired physical mobility; 4. Hopelessness. According to different problems, we gave countermeasure to alleviate physical and psychological ail of the patient. The purpose of this article is to offer the clinical nursing staff the way to assist patients in taking off life-support machine or to reduce the ratio of depending on the life-support machine, so the patient can get better life quality.