一位腦幹中風導致吞嚥障礙患者之護理經驗

Nursing Experience with a Patient with Dysphagia Caused by Brain stem Infarction

本篇報告乃陳述一位中年女性因腦幹中風造成複視、步態欠穩、吞嚥障礙等症狀，筆者於94年9月25日至94年10月2日照護期間，以Gordon十一項健康功能型態評估作為護理評估的引導工具，與個案及家屬開放性會談、利用觀察法及身體評估，蒐集主客觀資料，歸納出個案有三項護理問題：吞嚥障礙、身體心像紊亂、高危險性創傷；而護理活動則依個案個別性讓個案及家屬一起參與護理計畫的擬定，由醫師、護理人員、語言治療師之共同協助使個案能主動參與復健活動，藉由成功之吞嚥訓練來滿足個案身心基本需求，並且安全的由口進食，而免於合併症的產生。

We presented a middle-aged female who suffered from diplopia, gait unsteadiness, and dysphagia caused by brain stem infarction. From September 25th, 2005 to October 2nd, 2005, while receiving nursing care continuously, she was assessed by using Gordon's 11 Functional Patterns. It includes physical assessment, observation, listening and chart review as data collection methods. Three issues were raised and discussed: swallowing impairment, body image disturbance and high-risk trauma. The doctor, nurses, and speech therapist jointly invited the patients and their families to devise care plan and rehabilitation activities. The swallowing training program has proved to be successful and has improved the patient’s intake without complication.