一位甲狀腺癌病人術後喉返神經損傷之護理經驗

Nursing Experiences of a Thyroid Cancer Patient with Postoperative Injury in Recurrent Nerve

本文主要在探討一位甲狀腺癌病人因腫瘤壓迫呼吸道須接受甲狀腺全切除術，術後喉返神經損傷之護理經驗，護理期間自2012年1月5日至2012年1月9日，筆者藉由紙筆溝通、觀察並運用Gordon十一項健康功能型態進行評估確立個案有呼吸道清除功能失效、急性疼痛及焦慮等問題。護理期間，維持個案生理舒適，提供呼吸器治療，增加呼吸器使用的護理指導、解決疼痛、給予心理支持，降低焦慮之護理措施，使其面對甲狀腺癌術後喉返神經損傷導致急性呼吸道阻塞所帶來的衝擊。經由護理此個案，深刻體會護理人員在照護時，唯有適切地給予個別性及整體性的護理措施，深入了解所面臨的身心問題，方能發揮護理獨特性功能。

This article described the nursing experiences of a thyroid cancer patient who received total thyroidectomy with postoperative injury in recurrent nerve due to upper airway compressed by the tumor. The author assessed the patient by clinical observations, interviews, data collections, and the eleven-item Gordon Functional Health Measure during the caring period (Jan 5, 2012 ~ Jan 9, 2012). The patient was diagnosed suffering from some problems, such as ineffective airway clearance, acute pain, and anxiety. Nursing care included maintaining comfort level, providing respirator treatment and instruction for respirator use, relieving pain, and reducing anxiety through psychological support. The author helped the patient face the impact of acute airway obstruction with postoperative injury in recurrent nerve. The uniqueness of nursing role can only be achieved by providing individualized and comprehensive nursing care and understanding the physical and psychological needs of patients.