一位應力性尿失禁併膀胱脫垂個案之手術全期護理

Perioperative Nursing Experience of Caring for Stress Urinary Incontinence and Cystocele

10.29494/LN.202206_23(2).0007

姚毅敏(Yi-Min Yao)；楊曜蓮(Yao-Lian Yang)；葉惠玲(Hui-Ling Yeh)

應力性尿失禁 ； 膀胱脫垂 ； 手術全期護理 ； stress urinary incontinence ； cystocele ； perioperative nursing

領導護理

23卷2期（2022 / 06 / 01）

92 - 103

繁體中文

本文是一位83歲女性，因應力性尿失禁併膀胱脫垂行經陰道骨盆底重建之手術全期護理經驗。護理期間於2018年02月20日至02月23日，藉由訪談、觀察、手術期間直接照護、病歷查閱及訪視，並運用Gordon十一項功能性健康型態收集資料，確立個案健康問題為焦慮、情境性低自尊、潛在危險性損傷。手術前期提供經陰道骨盆底重建手術資訊及症狀治癒率，提升疾病認知；手術中期避免擺位傷害，溫毯機維持個案體溫在36－37.5°C，避免潛在危險性皮膚損傷；手術後教導傷口換藥以及衛教避免腹壓增加，如：咳嗽、提重物等行為降低尿失禁可能之復發，手術後個案漏尿程度改善。期盼藉由此照護經驗分享提供日後照護類似個案之參考。

This article explores the perioperative nursing experience of an 83-year-old woman undergoing transvaginal pelvic floor reconstruction due to stress urinary incontinence and cystocele. The nursing period starts from February 20th to 23rd in 2018; through interviews, observations, direct care during surgery, medical record review and visits and applies Gordon's Eleven Functional Health Types to collect data and establish the health issues of the case including anxiety, situational low self-esteem, and potentially dangerous injuries. In the preoperative stage, by providing information about transvaginal pelvic floor reconstruction surgery, as well as the cure rate of postoperative symptoms, to improve the patient's awareness of the disease. In between the process of the operation, use the warm blanket machine to maintain the body temperature in between 36 to 37.5°C to avoids hazardous harmful skin damage. After surgery, guide wound dressing and educate the patient to avoid elevating abdominal pressure, such as coughing, lifting heavy objects and other behaviors in order to reduce the possible recurrence of urinary incontinence. The situation of urine leakage had improved after the surgery in this case. Through sharing this care experience, we anticipate to provide this case as a reference for future care of similar cases.

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