一位肝癌病人接受肝葉切除術的手術全期護理經驗

A Perioperative Nursing Experience for a Hepatoma Patient with Hepatectomy

本文描寫一位中年女性肝癌病人接受肝葉切除的手術全期護理經驗。自2012年2月2日至2012年2月10日止，以生理、心理、靈性及社會等四大面向對個案進行整體性的護理評估，確立個案主要健康問題有焦慮、潛在危險性手術情境傷害、潛在危險性感染、健康尋求行為等健康問題。手術前協助個案面對手術及疾病的不確定感，降低其焦慮不安程度；手術中運用手術室護理人員之專業知識及技巧，預防潛在危險性手術情境的傷害和感染，使其安全渡過手術全期；手術後確認個案身心各方面的恢復狀況，持續關懷個案及家屬，教導出院後自我照顧及尋求資源的方法，令個案能夠有勇氣去面對肝切除手術後陸續而至的相關照護問題，最終成為可以現身說法分享癌症治療經驗的病友。

This article probes into the perioperative nursing experience for a hepatoma patient with hepatectomy. The nursingperiod started on February 2, 2012 and ended on February 10, 2012. A holistic nursing assessment was conducted fromthe aspects of physical, psychological, spiritual and social integrity, and identified that the patient had the followinghealth problems: anxiety, potential risk for intraoperative injury, potential risk for infection, and health seeking behavior.In the preoperative phase, the patient was helped to face the operation and the uncertainty of the disease to loweranxiety. In the intraoperative phase, the use of professional knowledge and skills prevented the case from potentiallysurgical injury and infection so that the patient could safely make through. In the postoperative phase, the recovery ofthe patient’s physical and mental conditions was confirmed after surgery; the patient and her family were continuouslysupported; and she was taught about the methods of self-care and resource-seeking after discharging so that she couldhave the courage to deal with the health problems after surgery and moreover eventually become a wardmate of cancerpatients to share her own experience.