一位吞噬球缺乏症導致蜂窩性組織炎學齡前期兒童之護理經驗

Nursing Care of a Preschool-Age Child With Cellulites Induced by Phagocyte Deficiency

吞噬細胞是免疫系統中發炎反應的第一線細胞，也是幫助傷口癒合的重要物質之一。當免疫力較低的幼兒患有吞噬細胞缺乏症，會使其免疫功能受到極大阻礙，即便是微小的傷口，都會快速的造成全身感染反應、傷口不易癒合，需要住院接受治療。而治療過程常帶給病童極大的壓力，嚴重地影響病童身心安適、甚至家庭的適應過程。本文乃運用學齡前期兒童的發展特性及Dr. Schultz等人提出的“TIME”準則進行傷口評估，促進傷口癒合，進而縮短住院時間。護理過程中教導家屬（媽媽）正確的居家換藥技巧，以降低再入院率，也是照顧此類病童的重點。本文藉由相關文獻查證，並以一位吞噬細胞缺乏症的學齡前期兒童發生蜂窩性組織炎之傷口護理過程，與學理做比較分析，並提出符合病童的獨特性護理，希望能藉此文提供臨床護理同仁在照護吞噬細胞缺乏症病童時之重要參考。

Phagocyte, the first inflammatory response of the immune system, is an important component of the wound healing process. For children with low immunity who suffer from phagocyte deficiency, even a small wound will result in a rapid response to systemic infection, poor wound healing, and hospitalization for treatment. Such treatments often bring enormous pressure to bear on the child, with serious impacts on his or her psychological well-being as well as on that of the family. This paper applies the concept of preschool-age child development and “TIME” criteria proposed by Dr. Schultz to assess pathological changes in poor healing wounds in order to promote wound healing and shorten necessary hospitalization times. Teaching the primary caregiver (oftentimes the patient’s mother) adequate at-home wound dressing skills to reduce re-admission rates is also a main focus of nursing care. This article integrates related articles in the literature with a case analysis by reporting on an individualized nursing intervention for a child with cellulites induced by phagocyte deficiency. It is hoped that recommendations provide a valuable clinical reference for nursing colleagues to care for children suffering from phagocyte deficiency.