照顧一位行唾液腺內視鏡手術病人之即日手術全期護理經驗

Nursing Experience of Caring for a Patient Undergoing Sialendoscopy-Assisted Ambulatory Surgery

10.6142/VGHN.202212_39(4).0006

鄭佩茹(Pei-Ru Jeng)；蘇芝庭(Chih-Ting Su)；袁秋榮(Chiou-Rung Yuan)

即日手術 ； Orem理論 ； 唾液腺內視鏡手術 ； ambulatory surgery ； Orem's self-care theory ； sialendoscopy

榮總護理

39卷4期（2022 / 12 / 01）

377 - 382

繁體中文

本文描寫一位左側唾液腺結石病人接受內視鏡手術之即日手術全期護理經驗。護理日期2019年12月30日並於出院一週與一個月進行電話訪談追蹤，透過觀察、訪談、傾聽及身體評估收集資料，並運用Orem理論確立焦慮、潛在危險性損害及知識缺失等健康問題。術前以支持與教育性的護理措施，主動提供病人手術全期相關訊息和護理指導，並滿足其個別性需要以減緩焦慮；術中病人採局部麻醉，過程中需維持平躺姿勢而失去部份自我照顧能力，此時提供部份代償性護理措施，以預防因使用器械、內視鏡系統及手術電刀而造成的潛在危險性損傷；術後立即照護包含觀察術後傷口與評估返家後的需求，並提供居家自我照護指導等支持與教育性護理措施，以促進自我照顧能力。筆者運用手術全期護理專業知識協助病人處理健康問題，度過手術過程並提昇返家自我照顧能力，希望藉此護理經驗提供未來照護之參考。

This article describes the experience in providing perioperative nursing care to a patient with left sialolithiasis who underwent sialendoscopy-assisted ambulatory surgery on December 30, 2019. One week and one month after surgery, telephonic interviews were conducted. Data were collected through observation, interviews, listening to the patient, and physical assessment. Orem's self-care theory was used to identify various health-related problems, including anxiety, potentially dangerous damage, and knowledge deficiency. At our institute, we provide personalized preoperative care to support and educate patients regarding nursing measures; moreover, we provide relevant information and nursing guidance throughout the surgery process and tailor to patients' individual needs to relieve anxiety. Patients receive local anesthesia and remain in the supine position during surgery. In this study, partial compensatory nursing measures were taken to prevent potentially dangerous injuries related to the instruments, endoscopic systems, and electrosurgical scalpels. The immediate postoperative care involved supportive and educational measures to promote self-care; these measures included at-home self-care guidelines for observing postoperative wounds and needs upon discharge. Using our professional knowledge, we assisted the patient in managing their health problems throughout the perioperative course. This study may serve as a reference for future nursing care.

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