照護一位大腸癌術後吻合處滲漏病人之護理經驗

A Nursing Experience in Care of a Patient with Anastomosis Leakage after Colectomy

10.6142/VGHN.202009_37(3).0011

劉筱涵(Xiao-Han Liu)；阮薰慧(Hsun-Hui Juan)

大腸癌 ； 吻合處滲漏 ； colon cancer ； anastomosis leakage

榮總護理

37卷3期（2020 / 09 / 01）

313 - 319

繁體中文

本文描述一位初罹患大腸癌手術病人，因出現滲漏合併症而延長住院天數，協助緩解焦慮情緒，勇敢面對後續治療之護理經驗。護理期間為2017年5月3日至5月23日，運用Gordon十一項功能性健康型態評估，藉由直接照護、會談、觀察、查閱病歷等收集資料，確立病人有急性疼痛、焦慮、腹瀉等健康問題。護理期間以關懷、同理技巧與病人、家屬建立護病關係，鼓勵家人陪伴聊天，以分散疼痛的注意力；衛教採少量多餐及低渣飲食；適時傾聽及鼓勵表達內心感受，執行任何醫療處置前充分說明，降低對治療的不確定性及焦慮感。建議未來照護此類病人時可運用實證，蒐集相關文獻，區辨不同疾病史、其適當及正確的進食時機，或相關吻合處滲漏的早期徵象以利團隊早期預防及治療。

This article describes the nursing experience of caring for a patient with colon cancer who received right hemicolectomy and had anastomosis leakage after the surgery. The patient had to stay in hospital for a long period and was upset. The period of nursing and care was between May 3 and May 23. The method of data collection and assessment was based on Gordon's 11-item Functional Health Pattern Guidelines and included observation, face-to-face interviews, and assessment of medical records. The main nursing problems were acute pain, diarrhea, and anxiety. With care and empathy, the author built a harmonious relationship with the patient and her family. The author encouraged the family members to accompany and chat with the patient to distract her from pain. Health education was given and addressed the need for small meals and low-residue diet. Moreover, the patient was notified before the nursing intervention was given. A team's prevention and management activities can be improved if nursing staff use evidence-based nursing, collect literature on the differences between diseases to determine the appropriate timing of recommencing eating, and notice the signs of anastomosis leakage.

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