肺癌併發肋膜積水之病生理變化－－案例分析

Pathophysiological Changes in a Lung Cancer Patient Suffering From Pleural Effusion: A Case Analysis

肋膜積水一直是肺癌病患最常見也是最嚴重的併發症，不管是積水本身引起的呼吸困難、胸痛、咳嗽…，或是一連串檢查、治療及合併症帶來的痛苦，都會嚴重影響病患功能狀態、心理安適，甚至造成生命的威脅。因此，如何維持肺癌併發肋膜積水病患的身心舒適，改善其功能狀態，進而提高生活品質，是照顧此類病患的重點。本文藉由文獻查證，討論肋膜積水的相關病生理學、肺癌併發肋膜積水之病因及影響、臨床評估，最後以一位病患的疾病過程與學理作比較分析，並針對此病患提出個別且適宜的護理處置，期能藉由學理與實務之整合，提供臨床護理人員在照護此類病患的參考，以助提升此類病患的照護品質。

Pleural effusion-perhaps the most common and serious complication among lung cancer patients-causes dyspnea, chest pain, and coughing, leading to a painful series of examinations, treatments, and additional complications. This exerts a strong effect on the functional status and psychological well-being of cancer patients, requiring special treatment responses on the part of nursing professionals. The authors introduce concepts related to pathophysiology, etiology, and the clinical assessment of pleural effusion, using a single case study to compare clinical data with theoretical and empirical knowledge. An individualized nursing intervention developed for this particular case is presented and discussed.