一位行肝動脈栓塞後併有肝膿瘍個案之護理經驗

Nursing Experience of a Patient with Liver Abscess After Implementation of Hepatic Arterial Embolization

本文主要描述一位接受肝動脈栓塞治療後出現肝膿瘍合併症，因治療過程不如個案預期，引起個案對治療進展感到失落和不確定的護理經驗。護理期間自2007年3月5日至2007年3月28日藉由會談、觀察、身體評估、實際照護等方式，以Gordon十一項健康功能型態進行護理評估；分析歸納個案有急性疼痛、焦慮等護理問題。在照護過程中以增加身體舒適感的方法，緩解栓塞治療後併發症引起之疼痛及發燒不適；以主動關懷、同理心、支持、接受等技巧提供個案個別性、連續性護理與諮詢，讓個案情感得以表達與宣洩，協同家屬參與個案照護計劃，使能主動參與治療及護理活動，並減輕情緒困擾及確定不確定感來源，增強個人的自信心面對個人的健康問題等。藉此護理經驗的分享，期望提供日後護理同仁照顧類似病患時的參考。

This article concerns one patient who suffered from liver abscess complications during hepatic arterial embolization. The direction of the treatment process was unanticipated by the patient and this led to him feeling lost and uncertain. The nursing care duration extended from March 5th, 2007 to March 28th, 2007. The author collected data by interview, observation, physical assessment and the care was guided by Gordon's 11 functional health status method in order to identify the patient's major health problems. There were three main nursing problems that were identified; these were acute pain, hyperthermia and anxiety. Nursing intervention was able to provide comfort by alleviating the patient's pain and fever after embolization. In addition, active caring, empathy and support were provided using available skills to give individual continuous nursing. Furthermore, it was possible to use consultation to allow the release of emotional expression. Coordination with the family allowed their participation in the patient’s care plan. This helped the patient to become involved in his own treatment and nursing, which reduced the mood swings and helped to remove sources of uncertainty. As a result there was an enhancement of self-confidence, which helped the patient to face his health problems. It is hoped that colleagues will be able to use this nursing experience as a reference and in the future this will help with the nursing of similar cases.