一位已婚女性接受小陰唇肥大整形術之手術全期護理經驗

A Perioperative Nursing Care Experience of Caring a Married Woman with Labia Minora Hypertrophy undergoing Plastic Surgery

本篇描述一位已婚女性因小陰唇肥大導致長期反覆陰道感染，嚴重影響性生活型態選擇整形手術之手術全期護理經驗。護理期間自2020年2月26日、3月2、4、5日及3月11日自門診諮詢到術後追蹤，藉由觀察、會談、身體評估及電訪收集資料，依手術全期護理理論為架構，進行整體性評估，確立護理問題為：身體心像紊亂、焦慮、潛在危險性手術全期擺位傷害、急性疼痛、性生活型態失常等健康問題，運用傾聽、主動關懷等技巧，手術前電訪提供詳細手術流程及注意事項，增加對手術的了解以減輕焦慮；手術中給予適當姿勢擺位、提供生理照護及避免潛在危險性損傷；手術後提供個別性照護運用薰衣草舒壓精油搭配穴道式按摩，緩解術後急性疼痛問題。誘導說出對自我身體心像感受與夫妻間的親密關係，鼓勵個案重建信心，協同先生參與治療陪伴，提升術後的性生活滿意度。個案於門診諮詢時，與醫師討論溝通時無實際輔助工具，故對術式選擇仍顯得疑惑，不了解切除方式及過程，此為照顧此個案之限制。因此，建議增設會陰部模型工具輔助，以利諮詢時有輔助工具可以協助解說，並針對問題可立即澄清，以維持良好的醫護關係，並達到最佳的照護品質。

This article describes the case of a married woman who experienced recurrent vaginal infections due to hypertrophic labia minora, which significantly impacted her daily life. It also outlines the perioperative and post-operative nursing care provided. Nursing care was delivered on February 26, March 2, 4, 5, and 11, 2020, including clinic inquiries and post-operative follow-up. Based on a thorough evaluation combining peri-operative nursing, observation, communication, physical examination, and telephone follow-ups, the following nursing care problems were identified: body image disturbance, anxiety, potential risk of injury due to surgical positioning, post-operative pain, and abnormal sexual life. To address these issues, we built trust with the patient through attentive listening, expressing concern, and providing detailed information about the surgical procedure and precautions during preoperative telephone consultations. This approach helped the patient understand the operation and alleviate surgical anxiety. For intraoperative care, we ensured correct positioning to prevent possible injury. Post-operatively, we used lavender essential oil massage to relieve pain. We also supported the patient in rebuilding confidence and enhancing the intimate relationship with her husband to improve sexual satisfaction. During clinic consultations, the patient lacked practical aids for discussion with the physician, resulting in confusion about the choice of surgery and the resection procedure. This limitation affected the care provided. To address this, we recommend incorporating a perineal model as a tool to better explain, discuss, and clarify questions during consultations. This approach would help maintain a strong relationship between doctors, nurses, and patients, and contribute to achieving the highest quality of care.