一位子宮頸原位癌患者行復腔鏡全子宮切除之手術全期護理

The Perioperative Nursing of Cervical-Intraepithelial-Neoplasia with Laparoscopic Assisted Vaginal Hysterectomy

手術對一般人而言，常會引起害怕與焦慮。筆者是以手術全期護士角色，參與一位子宮頸原位癌行腹腔鏡全子宮切除病患手術前、中、後之護理過程。於護理期間，藉由持續地關懷、傾聽、關心及同理心來鼓勵個案說出其心中感受，以協助解決其手術前、中、後所面臨的問題：對手術的認知不足而造成的焦慮、預防因使用電燒器止血與膀胱截石臥位而造成的潛在危險性傷害、預防因全身麻醉而造成吸入性肺炎以及全子宮切除後病患身體、心理的改變等；並使個案及案夫皆能瞭解因疾病需接受手術的事實，體會存在的生命意義與攜手共進的可貴。

The purpose of this case report is to present how a lead nurse used preoperative, intraoperative and postoperative nursing care for a patient who had cervical-intraepithelial-neoplasia which required laparoscopic assisted vaginal hysterectomy (LAVH). The author applied persistent caring, listening and empathy to encourage the patient to express her feelings and to cope with the consequences of operation, such as anxiety caused by lack of understanding of the operation procedure, prevention of electric burn injury caused by using electrocauterization and lithotomy, prevention of aspiration pneumonia by general-anesthesia, body-image change, and mental distress arising out of the laparocopic assisted vaginal hysterectomy procedure. By providing her and her husband with information about the disease type, complications and prognosis, and the pre-operative, perioperative and post-operative nursing care during the hospitalization period, they recognized and accepted all necessary treatment, examinations, and operation procedures for treating the disease. After the LAVH procedure, the patient and her spouse re-recognized the importance of family support, the value of health, and the meaning of life.