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

10.6142/VGHN.22.2.168

王筱華(Sheau-Hwa Wang)

日本腦炎 ； 急性無力肢體麻痺 ； Japanese encephalitis ； acute flaccid paralysis

榮總護理

22卷2期（2005 / 06 / 01）

168 - 177

繁體中文

日本腦炎和急性無力肢體麻痺，都屬於法定傳染病。日本腦炎病毒感染所導致的急性無力肢體麻痺，不僅對病患本身造成身、心、靈諸多的影響，也增加醫療成本的耗費，更對公共衛生造成衝擊。本文主在描述一位日本腦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驗。透過直接護理、觀察、訪談等方式收集資料，運用Gordon十一項健康功能評估發現有：呼吸道清除功能失效、呼吸器戒斷反應失常、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案之人員有所助益。

Encephalitis and acute flaccid paralysis are both statutory infectious diseases. Acute flaccid paralysis, induced by the Japanese Encephalitis virus infection, not only influences the patient on physiology, mentality and spirituality, but also increases the cost and impacts public health issues. This report describes the nursing experience of a male patient who suffered from respiratory failure and acute flaccid paralysis after a Japanese Encephalitis virus infection. This patient was transferred to our intensive care ward for further treatment because his condition did not improve under initial management. His health problem was based on the Gordon 11 Health- Physiological Scale through the direct care, clinical observation and in terviews. His health problems included ineffective airway clearance, dysfunctional ventilatory weaning response, disability, anxiety, fever, local dermal destruction, selfcare ability deficiency, and altered patterns of urinary elimination. His muscle power was apparently improved by the individual interventions even though he still partially depended on the ventilator before he was transferred to the long-term respiratory care unit. The recovery of muscle power is beneficial to prognosis. Very few adult cases have been reported in the literature review, and therefore we are willing to share this particular experience which might be very helpful.