一位福尼爾氏壞疽術後患者的護理經驗

Experience of Providing Nursing Care to a Patient with Fournier's Gangrene

本文描述一位小兒麻痺症男性患者，因福尼爾氏壞疽術後執行術後傷口合併結腸造口手術之過程。護理期間於2015年11月25至2015年12月14日，運用會談、觀察、傾聽、身體評估等方式，運用Gordon十一項評估健康功能評估工具，發現急性疼痛、組織完整性受損及焦慮等三項健康問題。了解小兒麻痺患者在中年階段的發展，照護期間除整體性評估及持續性護理外，增加個案糖尿病疾病認知照護技能降低感染發生，運用團隊合作共同介入照護，讓患者在術後傷口合併結腸造口照護中學習及增加對自己的疾病認知，使個案能順利接受自己外觀的改變，勇於面對，進而轉為為主動學習自我照護能力，達到生理、心理、靈性的臨床照護。（志為護理，2019; 18:3, 103-113） In this article, we report the case of a male patient with poliomyelitis who developed a postoperative wound and underwent colostomy for Fournier's gangrene. During the treatment period from November 25th, 2015, to December 14th, 2015, we applied Gordon's 11 health assessment tools, including interviews, observation, listening, and physical assessment, and discovered that acute pain, organizational integrity and anxiety And so on three health problems. The mechanisms underlying the development of diabetes in middle-aged patients with poliomyelitis require elucidation. During the care period, in addition to the overall assessment and continuous care, patients should be provided with information regarding diabetes care to reduce infection and a team cointervention should be implemented to enable patients with postoperative wound combined with colonostomy care to acquire relevant knowledge and increase their awareness of the disease. This can help patients to successfully accept changes in their appearance, develop the courage to confront the implications of their disease, and take the initiative of acquiring self-care abilities to achieve proper physical, psychological, and spiritual clinical care. (Tzu Chi Nursing Journal, 2019; 18:3, 103-113)