一位青少年罹患骨軟骨瘤術後併腔室症候群之照護經驗

A Nursing Experience of a Teenager with Compartment Syndrome as a Complication After Osteochondroma Removal Surgery

10.6540/NTJN.202203_24(1).0013

鍾雅喻(Ya-Yu Chung)；鄭碧芬(Pi-Fen Cheng)；潘慧娟(Hui-Chuan Pan)

骨軟骨瘤 ； 腔室症候群 ； 青少年 ； osteochondroma ； compartment syndrome ； teenager

新臺北護理期刊

24卷1期（2022 / 03 / 01）

147 - 156

繁體中文

本文描述一位青少年因左小腿骨軟骨瘤，手術後併發腔室症候群之照護經驗，筆者照護期間為2019年01月24日至02月28日，運用Gordon十一項功能性健康型態進行整體性評估及資料整合分析，確立個案有組織完整性受損、身體活動功能障礙及社交隔離等健康問題，筆者以個別性及持續性護理措施，製作換藥百寶盒及拍攝換藥步驟的影片，讓個案返家後能妥善的照顧傷口；研擬專屬個案之復建計畫，無縫銜接返家復健不中斷；運用同理心、主動關懷及引導個案說出自我感受及想法，規劃祝福同樂會，在同儕、師長的鼓勵及陪伴下，增進個案參與社交活動的意願，以正向態度面對即將回歸的校園團體生活。期望藉此照護經驗的分享，讓臨床醫護人員在照護骨軟骨瘤術後病人時，能提早發現是否有腔室症候群的發生，以便盡早擬訂相關照護措施，並期許未來能依據不同年齡層的病人，多舉辦身、心、社會和靈性的評估照護課程，使護理同仁在臨床上遇到相關案例時，能盡早擬定介入計劃及措施，以提升護理照護品質，讓病人得以早日回歸社會。

This article describes the nursing experience of a teenager with osteochondroma of the left leg with postoperative compartment syndrome. During the care period from January 24 to February 28 in 2019, Gordon's 11 health assessments was applied to evaluate overall and data integration analysis, and established that the main nursing problems were impaired tissue integrity, impaired physical mobility and social isolation. The author used individual and continuous care measures to make a dressing box and film the dressing procedure, so that the individual could be properly cared for the wound after returning home. The author also developed a rehabilitation plan for the exclusive case, seamlessly connecting rehabilitation without interruption, using empathy and taking the initiative to care and guide the case to express self-feelings and thoughts, planning a blessing club and with the encouragement and accompaniment of peers and teachers to enhance the individual's intention to participate in social activities with a positive attitude to face the upcoming campus group life. It is hoped that through the sharing of nursing experience, clinical staff can find out whether the patients with compartment syndrome after osteochondroma surgery early, and draw up relevant care measures as soon as possible. It is hoped that in the future, we can schedule more physical, mental, social and spiritual assessment courses for patients of different ages, so that when the nursing colleagues encounter relevant clinical cases, they can draw up intervention plans and measures early to improve the quality of nursing care, and patients can return to society as soon as possible.

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