頭頸部癌症病患頸動脈破裂之護理

Mursing Care for the Patient with Carotid Artery Rupture to Head and Neck Cancer Patient

頭頸部癌症病患當發生頸動脈破裂時，往往是無預警的、是非常快速又危急的，嚴重的大出血會造成低血容休克，使得病患生命立即受到威脅、甚至死亡，且在經歷嚴重出血時，大多數病患及家屬情緒是相當恐慌的，因此，護理人員需具備對頸動脈破裂的相關知識，以提供病患及家屬完整的照護。本文主要在探討，當面對可能發生頸動脈破裂之病患的護理，包括事前的準備---「止血車」的設置及熟知頸動脈的解剖位置、破裂機轉，頸動脈破裂的危險因素及症狀與徵象，若一旦事件發生時則需依照病患意願給予「積極急救」或「緩和醫療」的護理等。筆者希望藉由文獻探討及臨床實務經驗，提供護理人員對照護發生頸動脈破裂病患時的參考，期望護理人員除了能在事前作完整的評估及預防外，更能在危急時以機警冷靜的態度作適切的處理，來發揮護理專業的功能。

Carotid artery rupture happens to the head and neck. The attack on the patients can be unpredictable, fast and dangerous. It may cause hypovolemic shock when serious bleeding in the worst situation. It can threaten lives of patients and even cause death. Most patients and their families would panic when facing serious bleeding. Therefore, a nurse is required to possess relative knowledge of carotid artery rupture in order to provide complete care to the patients and their family. The article discusses nursing which includes the dissection area of the carotid artery, the cause of rupture , the critical factors , symptoms of carotid artery, preparation before happening, the installation of the "Emergency carotid precautions Box" , the providing of "Active Emergency Aid" or "The palliative management of carotid artery rupture" under the patients' will while in the situation. Through this article discussion, we hope to provide a reference to nurses for precautionary evaluation and prevention, and further use their nursing profession in a critical situation with alert and calm manners.