一位糖尿病急性併發症病患之護理經驗

Nursing Experience of a Diabetes Mellitus Patient with Acute Complications

糖尿病是一種常見的慢性代謝異常疾病，在台灣盛行率約1.5%，40歲以上的國人約5~10%罹患此疾病，在國外研究糖尿病併發症發生率為14~34%，而糖尿病併發症是病患致死及發生殘缺或喪失勞動力的主要原因之一(曾，2000 ; Centers for Diseases Control Diabetes in Managed Care Work Group, 2001)。本個案為一位48歲的男性病患，因糖尿病併發視網膜剝離入院手術治療，於住院手術期間卻引發糖尿病急性併發症而造成生命徵象不穩定的狀況，轉入加護病房治療。病患住加護病房期間，筆者運用羅氏適應理論評估發現個案有：自主性換氣失能、體液容積失衡、腹瀉、皮膚完整性受損、潛在高危險性感染及焦慮等護理問題，經給予個別性之護理，病患成功脫離危險期並轉出加護病房，故希望藉由此次對糖尿病併發症病患在加護病房照護之經驗，提供日後其它同仁之參考。This case study demonstrated the nursing experience of a 48-year-old male patient, who had to receive surgical intervention for his diabetic retinal detachment, while suffering from acute critical diabetic complications during his hospitalization. Due to his condition deteriorating, he was transferred to intensive care unit (ICU) for further treatment. In ICU, we used the Roy's Model to evaluate the patient and noted that the patient had the problems of inability to sustain spontaneous ventilation, fluid imbalance, diarrhea , impaired skin integrity , high risk infection, anxiety and strain on the caregiver. We provided the nursing interventions to help him out of critical illness. Hence, we would like to provide our nursing experience in dealing with the diabetic complications.