中西醫結合照護一位缺血性腦中風個案復健期之門診護理經驗

Nursing Experience of Integrated Traditional Chinese and Western Medicine in an Outpatient Case of Ischemic Stroke Rehabilitation

張瑋芬(Wei-Fen Chang)；葉惠玲(Hui-Ling Yeh)；邱子瑄(Tzu-Hsuan Chiu)

缺血性腦中風 ； 復健期 ； 中西醫結合照護 ； integrated traditional Chinese and Western medicine ； ischemic stroke ； recovery period

志為護理-慈濟護理雜誌

22卷3期（2023 / 06 / 01）

94 - 106

繁體中文;英文

本文探討一位36歲男性，因暈厥、胸悶，突發A型主動脈剝離接受手術後併發缺血性腦中風，造成雙下肢無力需長期復健及接受中西醫門診治療，筆者為中西醫門診護理師，故引發書寫此中西醫照護經驗之動機。於2020年3月5日至5月21日每週三次於中西醫門診護理期間，運用身體評估及中醫望聞問切四診評估，歸納出身體活動功能障礙、便秘及焦慮之健康問題。依實證文獻結果，與復健師及中西醫師共同擬定復健計畫，解決個案生心理問題。持續西醫治療及復健並結合中醫指導穴位按壓及泡腳，改善其身體活動功能；透過飲食衛教及穴位按壓，改善便秘問題；頭部穴位按壓使用圓形梳輔助，促使內生性嗎啡的分泌，經貝氏焦慮量表評分由中度焦慮，改善為輕度焦慮。期望藉由此中西醫結合照護應用於臨床病人的經驗，提供護理人員照顧缺血性腦中風個案之參考。

This study investigated the combined use of traditional Chinese medicine and Western medicine in the recovery process of a 36-year-old man who suffered from ischemic stroke. During the recovery period syncope, chest tightness, and sudden onset type A aortic dissection were noted after surgery. The author was a nurse of outpatient department of Chinese and Western medicine. From March 5 to May 21, 2020, three times a week, during the outpatient department, health problem such as physical dysfunction, constipation, and anxiety were assessed by physical assessment and four examinations of Chinese medicine. Based on the empirical literature on the combination of traditional Chinese medicine and Western medicine, a rehabilitation plan was developed that included the physical therapist and nurse. The traditional Chinese medicine acupoint pressing and foot bath were combined for the therapy. Head acupoint assisted with combs was used with the aim of promoting the secretion of endorphin. Constipation was improved by diet and health education. The patient' s anxiety decreased from moderate to mild based on Baker Anxiety Scale scores. It is hoped that the combination of traditional Chinese and Western medicine can be helpful in clinical practice to improve the self-care ability of patients and to improve lower limbs muscle power.

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