接受異體週邊血液幹細胞移植個案之護理經驗

The Nursing Experience of an Adolescent Receiving Allogeneic Peripheral Blood Stem Cell Transplantation

隨著骨髓移植技術逐漸成熟，異體週邊血液幹細胞移植已成為嚴重再生不良性貧血之最佳療法。本文探討嚴重再生不良性貧血新發病青春期個案，接受異體週邊血液幹細胞移植治療相關措施與具體的後續照顧之護理經驗。護理期間筆者應用Gordon 十一項功能性健康型態，評估移植過程中發生潛在危險性感染、噁心、知識不足、身體心像紊亂與害怕等五項健康問題。護理過程中，除提供生理照護外，更扮演著諮詢者與教育者的角色，建立信任的護病關係，鼓勵分享情緒，瞭解對移植、身體改變與長時間隔離的感受，更不斷的指引正向思考，使個案順利完成週邊血液幹細胞移植治療。本文希望藉由分析青春期個案接受週邊血液幹細胞移植的生理、心理及靈性需求的結果，提供未來照顧類似個案之參考。

Due to recent developments in the technology of bone marrow transplantation, AllogeneicPeripheral Blood Stem Cell Transplantation (APBSCT) has become the best therapy for severeaplastic anemia. The article describes the nursing experience of an early diagnosis adolescent withsevere aplastic anemia who had received APBSCT. During the period of nursing care, we utilizedthe method of Gordon's 11 functional health styles to evaluate potential for risk of infection,nausea, knowledge deficit, body image disturbance and fear. In addition to providing physicalcare, we also acted as a consultant and educator. Due to the trust between the patient and us, weencouraged the patient to freely share feelings, after which we gave support. In order to performAPBSCT smoothly, we realized the feelings of the patient towards bone marrow transplantation,physical change and long-term isolation and offered the patient positive thinking alternatives. Byanalyzing the demands of physiology, psychology and spirit in an adolescent receiving APBCST,we hope the article offers an important reference for future cases.