一位心肌梗塞合併左心室破裂患者行心室輔助器置入之加護護理經驗

Intensive Nursing Experience of a Patient with Ventricular Assist Device Implantation Who Suffered from Myocardial Infarction Associated with Left Ventricular Rupture

10.6142/VGHN.28.4.347

陳靜儀(Ching-Yi Chen)；鐘貴春(Kwei-Chun Chung)

心室輔助器 ； 肺部復健 ； 哀傷 ； ventricular assist device ； activity intolerance ； grief

榮總護理

28卷4期（2011 / 12 / 01）

347 - 353

繁體中文

本文為照護一位急性心肌梗塞患者，因左心室破裂，行左心室修補術及左心室輔助器置入之加護經驗。照護期間2009年1月20日至3月10日，筆者藉由觀察、會談、身體評估、病歷檢閱等方式，運用Gordon十一項健康功能型態進行評估，發現病人有心輸出量不足、低效性呼吸型態、活動無耐力及預期性哀傷四個健康問題。護理過程中除依據心室輔助器照護原則給予臨床生理照護以度過術後急性期，另透過呼吸訓練、肢體活動及增加身體活動能力等復健活動，使其能成功脫離呼吸器及降低肺部合併症的發生。再利用主動關心及傾聽的態度，並提供個案及家屬心室輔助器之照護經驗，協助家屬及病人以多面向的思考，共同面對生命的難關。

This article provided the intensive nursing experience of a patient with acute myocardial infarction complicated with left ventricle rupture to undergo emergent left ventricle repair and left ventricular assist device (VAD) implantation. During the nursing period from January 20 to March 10 in 2009, by assessing the patient's Gordon 11 health functions with direct nursing, observation, interview with family members, and physical assessment, the author identified the patient's major health problems as low cardiac output, ineffective breathing pattern, activity intolerance, and anticipatory grief. Besides applying clinical physical care according to the principle of VAD and VAD nursing methods, we also helped the family and patient to think from multi-aspects in order to overcome the life crisis together.