一位愛滋病剖腹產婦女行非預期子宮切除之手術全期護理經驗

Perioperative Nursing Experience of an AIDS and Caesarean Woman with Unexpected Hysterectomy

本文探討一位27歲愛滋婦女37週剖腹產下一名男嬰，術中胎盤無法娩出，接受非預期性子宮切除術之護理經驗。護理問題有焦慮、潛在危險性傷害、疼痛及身體心像改變。術前訪視建立信任關係、傾聽與心理支持、提供疾病資訊，有效減輕擔憂嬰兒遭受感染之焦慮；術中透過整合醫療共照，使個案生命免於遭受威脅；術後運用藥物及非藥物止痛，有效改善疼痛；提供子宮切除資訊、增加嬰見膚觸機會、予案夫心理支持，使接受身體心像改變。由手術全期護理過程，協助個案及家屬渡過非預期性手術之衝擊，藉此成功經驗分享供參考。

This article discusses the case of a 27-year-old woman with AIDS who had a caesarean section less than 37 weeks of pregnancy. Because her placenta could not be delivered, she had to receive an unexpected hysterectomy. She experienced anxiety, potential risk for injury, pain, and changes in body image. Before the surgery, we needed to show concern and establish a relationship of trust, listen and provide spiritual support, and provide information related to her condition. We effectively reduced anxiety over having a baby infected with HIV. During the operation, we prevented the baby being infected by integrating medical treatment. We applied medicine and non-medicine techniques to ease the patient's pain. We provided the patient with hysterectomy information, increased the baby's chance of skin touch, gave spiritual support to her husband, and helped them accept the changes of body image. Using perioperative nursing procedures, we helped the case and her family members cope with the stress of an unexpected operation. Overall, this nursing consultation experience was successful.