一位創傷性主動脈剝離患者之護理經驗

A Nursing Experience of an Aortic Dissection Patient with Potential Posttraumatic Stress Disorder

10.6540/NTJN.202309_25(2).0009

陳逸霖(Yi-Lin Chen)；洪玉敏(Yu-Min Hung)

主動脈剝離 ； 潛在危險性創傷後症候群 ； 焦慮 ； aortic dissection ； potential PTSD ； anxiety

新臺北護理期刊

25卷2期（2023 / 09 / 01）

100 - 109

繁體中文;英文

個案因車禍併發B型主動脈剝離，在臨床上為罕見案例，故引發筆者探討的動機。本文描述一位創傷性主動脈剝離患者之護理經驗，照護期間為2020年11月12日至2020年11月21日，運用Gordon十一項功能性健康型態進行評估及分析，藉由觀察、照護個案以及病歷查閱等方式收集資料，確立健康問題為『急性疼痛』、『焦慮』、『潛在危險性創傷後症候群』及『活動無耐力』。個案因B型主動脈剝離於胸主動脈行支架放置術，對於術後傷口疼痛之問題，教導個案減輕疼痛之技巧，以減緩疼痛情況；因疾病導致無法勝任工作使個案焦慮，給予個案傾聽及陪伴，並教導可使用放鬆技巧以降低焦慮感；個案遭遇一場嚴重車禍，於照護過程發現個案有潛在危險性創傷後症候群，鼓勵個案說出對車禍的感受，與個案一起探討減少創傷性反應的策略，教導家人適時陪伴，給予個案安全感。住院期間提供個案照護指導，同時給予個案希望，滿足心理需求，鼓勵正向思考模式，降低個案發生創傷後反應，協助個案返家後的自我調適能找到平衡點。希望藉此個案照護經驗，作為日後照護此類病人之參考。

The motivation of this article was because the patient had type B dissection caused by the car accident, which was rare in clinical practice. This article described a nursing experience of an aortic dissection patient with potential posttraumatic stress disorder, from Nov. 12th to 21st in 2020. Gordon's 11 functional health patterns were used to point out the health problems with acute pain, anxiety, potential PTSD, and activity intolerance. In order to relieve her chest pain, we taught her some skills to relieve the pain. As to her anxiety, we listened to her attentively and taught her many ways to reduce her worries. The patient suffered from a severe car accident, and after we found that she had a potential PTSD, we encouraged her to talk about the feeling with us and taught her family to keep her company. In addition, we discussed the strategy of how to reduce the trauma reaction together. We provided nursing instructions and gave her hope to encourage her to think positively. Furthermore, we helped her find the balance of her life. Finally, a nursing experience of an aortic dissection patient with potential PTSD could give reference in the future.

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