一位海洋弧菌感染導致壞死性筋膜炎之糖尿病個案的護理經驗

Nursing Experience of a Diabetes Mellitus Patient with Vibrio Vulnificus Infection and Necrotic Fasciitis

海洋弧菌，又稱創傷弧菌，除存在溫暖的海域外，也常見於海產，如魚貝類及蝦蟹身上。本文探討一位因處理螃蟹不慎刺傷左手虎口，導致海洋弧菌感染併發壞死性筋膜炎之糖尿病個案的護理經驗。照護期間自2015 年9 月4 日至2015 年10 月13 日，筆者以觀察、會談、身體評估及病歷查閱等收集資料，並運用Gordon 十一項功能性健康型態評估確認個案主要之健康問題有：組織完整性受損、急性疼痛及焦慮。筆者藉避免組織進一步損傷、鼓勵補充高維生素及高蛋白食物，促進個案組織癒合；透過避免牽扯傷口周圍組織、提供疾病相關資訊及宗教支持等，緩解個案疼痛及焦慮。期望此護理經驗能提供日後臨床照顧參考。

Vibrio vulnificus, normally live in warm waters and are commonly stored in the seafood, e.g., fish,shellfish, shrimp, and crabs, etc. The purpose of this article was to explore a nursing experience for adiabetes mellitus patient with Vibrio vulnificus infection and necrotic fasciitis, resulting from beingaccidentally stabbed in the left thumb-index web by crabs. The nursing period was from September 4to October 13, 2015. Gordon's 11 Functional Health Patterns Assessment was used as a tool for nursingassessment. The data were collected through observation, interview, and review of medical records.The major problems identified included impaired tissue integrity, acute pain, and anxiety. By preventingfurther soft tissue damage, offering encouragement to take high vitamin and protein-rich foods, we helpedthe patient’s soft tissue healing. Moreover, we relieved the patient’s pain and anxiety by preventingtissue around wound from being torn, giving information and religious support. Hopefully, this nursingexperience can serve as a reference for clinical care.