一位罹患月經性氣胸病人接受胸腔鏡切除術之護理經驗

A Nursing Experience of Caring a Patient Undergoing Thoracoscopic Resection for Menstrual Pneumothorax

本文為描述一位罹患月經性氣胸的女性病人，經歷三次胸腔鏡切除手術後之照護經驗，筆者照護期間為2018年1月13日至1月19日，運用Gordon十一項功能性健康型態評估，使用觀察、會談及身體評估收集個案資料，確立個案健康問題有疼痛、低效性呼吸型態、焦慮。個案因手術後放置胸腔引流管導致傷口疼痛影響呼吸，針對術後疼痛緩解給予護理措施，加強胸腔物理治療，教導Triflow、拍痰等訓練，改善低效性呼吸型態問題。筆者主動關心、傾聽，建立良好護病關係，醫療團隊合作且由家屬的陪伴減輕焦慮，藉此護理經驗能提供臨床護理人員日後照護類似個案之參考。

This report described the nursing experience of care a female patient suffering from catamenial pneumothorax (i.e. pneumothorax occurring in conjunction with menstrual periods) and having experienced three times of thoracoscopic surgery. During the care period from January 13 to 19, 2018, the author utilized Gordon's eleven functional health patterns assessment tool to collect information through observation, interview, and physical assessment. The patient had three main health problems, including pain, ineffective breathing pattern, and anxiety. Her wound was painful due to placement of post-operation thoracic drainage tube that subsequently affected her breathing. In order to relieve her postoperative pain, active nursing care was given. To improve the breathing pattern, the patient received intensive chest physical therapy, education about using Triflow, and training about chest care. We actively cared about and listened to the patient to establish a good nurse-patient relationship. With the cooperation of the medical team and accompany of the family, her anxiety was relieved. By sharing this nursing experience, we intend to provide a reference for clinical caregivers who will care similar patients in the future.