日本腦炎併發急性無力肢體麻痺患者之照護經驗

Nursing Experience of Caring for a Patient with Japanese Encephalitis Acute Flaccid Paralysis

日本腦炎和息性無力肢體麻痺，都屬於法定傳染病。日本腦炎病毒感染所導致的急性無力股體麻痺，不僅對病怠本身造成身、心、靈諸多的影響，也增加醫療成本的耗費，是對公共衛生造成街擊。本文主在描述一位日本屆炎合併呼吸衰竭及急性無力肢體麻痺患者，在外院治療無進展，轉至本院加護病房的護理經睡。透過直接護理、觀察、訪談等方式收集資料，運用Gordon+一項健康功能評估發現有:呼吸道清除功能失放、呼吸器成斷反應失常、身體活動功能障礙、焦慮、體溫過高、皮膚完整性受損、自我照顧能力缺失、及排尿型態改變等健康問題。經提供個別化的護理措施後，雖然個案未能成功脫離呼吸器，即轉到長期呼吸照顧機構，但使個案在住院期間肌肉力量能明顯恢復，並對預後不致無望，實屬不易。此護理經驗，期望能與護理同仁分享，和對往後照顧此類似個棄之人員有所助益。

Encephalitis and acute flaccid paralysis are both statutory infectious diseases. Acuteflaccid paralysis, induced by the Japanese Encephalitis virus infection, not onlyinfluences the patient on physiology, mentality and spirituality , but also increases thecost and impacts public health issues. This report describes the nursing experienceof a male patient who suffered from respiratory failure and acute flaccid paralysisafter a Japanese Encephalitis virus infection. This patient was transferred toour intensive care ward for further treatment because his condition did not improveunder initial management. His health problem was based on the Gordon 11Health- Physiological Scale through the direct care , clinical observation and interviews. His health problems included ineffective airway clearance, dysfunctional ventilatoryweaning response, disability, anxiety, fever , local dermal destruction, selfcareability deficiency , and altered patterns of urinary elimination. His musclepower was apparently improved by the individual interventions even though he stillpartially depended on the ventilator before he was transferred to the long-termrespiratory care unit. The recovery of muscle power is beneficial to prognosis. Veryfew adult cases have been reported in the literature review, and therefore we arewilling to share this particular experience which might be very helpful.