肝硬化病人之臨床護理問題

The Nursing Problems of the Patients with Liver Cirrhosis

肝硬化合併症在台灣是一重要死因(林、簡，2000)，台灣地區每年約有4000人死於肝硬化，在臨床上對肝硬化的治療卻只能提供消極性的症狀治療或侵襲性的手術治療，目前唯一能根治的方法為肝臟移植(胡，2001a)。肝硬化為慢性病之一，臨床上的問題是長期而多樣性的，不僅帶給病患痛苦及困擾，也帶給家屬在照顧上極大的心理負擔與經濟壓力。本文藉由文獻探討肝硬化之病因、合併症及治療，提出9個常見之臨床護理問題及相關護理措施，並呼籲護理人員除了需評估病患之病況變化及身體症狀外，更需依病患接受之各種檢查、治療、合併症給予適當的衛教與護理計劃，同時亦應評估並協助解決病患與家屬的心理或經濟問題，以減少病患症狀困擾與家屬的負擔和壓力，如此才能發揮真正的護理功能，提供以病人為中心的整體性護理。

The complication of liver cirrhosis is one of the important causes of death in Taiwan, where in about 4000 people died from liver cirrhosis every year. The management for liver cirrhosis clinically can only relieve symptoms or provide invasive surgery. The only way to cure liver cirrhosis is by liver transplantation, but few patients have this chance. Liver cirrhosis is one of the chronic diseases inducing long-term and various problems. It not only bring patients discomfort, but also causes family caregivers burdens: both mental and economical stresses. According to the literature about liver cirrhosis, nine nursing problems and relative nursing interventions were provided. Besides, the results also suggest that all the nurses should not only assess patients' physical problems, but also provide nursing care plans according to patients' examinations, cures and complications. The mental and economic problems of patients and family caregivers also should be assessed and solved in order to decrease the physical symptoms of the patients and mental stresses of the families. In this way, nurses can provide holistic and patient-centered nursing cares.