一位噬血症候群患者行脾臟切除術之護理經驗

Caring for a Patient with Hemophagocytic Syndrome: a Nurse's Experience

賴盈彣(Ying-Wen Lai)；楊淑慧(Shu-Hui Yang)；韓玉蘭(Yu-Lan Han)

噬血症候群 ； 脾切除 ； 脾切除護理 ； Hemophagocytic syndrome ； nursing care ； splenectomy

安泰醫護雜誌

21卷2期（2015 / 12 / 01）

31 - 46

繁體中文

本文為照護一位因噬血症候群引發脾腫大導致白血球與血小板低下，面臨病危並切除脾臟之案例，於2011年8月10日至9月1日護理期間，以Gordon 11項功能性健康型態評估，透過直接照護、觀察、會談及身體評估檢查等技巧，確認護理問題有潛在危險性損傷、潛在危險性感染、急性疼痛及照顧者角色緊張。照護期間筆者為維護個案健康防禦能力，提供獨立性且合宜的護理措施，減輕手術後疼痛不適，並引領參與護理活動，了解疾病進展，主動發現問題，預防進一步損傷。期間更運用同理心、傾聽、主動關懷和個案及家屬建立治療性人際關係，鼓勵表達情緒，提供疾病與居家照護技巧以達整體性持續性照護，使個案於住院期間無續發性損傷，並減少家屬緊張及了解疾病照護，順利返家生活。期望藉此護理經驗，提供日後照護此類病患之臨床實務參考。

This article describes a nurse's experience of caring for a patient with hemophagocytic syndrome. The patient had splenomegaly, which induced neutropenia and thrombocytopenia, and received splenectomy. The author collected data from August 10 to September 1, 2011. She identified the high risk of bleeding, risk of infection, acute pain, and caregiver role strain as nursing concerns through direct care, observation, interview and physical assessment guided by the Gordon functional health assessment patterns. The author provided individual and expedient nursing care, which reduced the patient's post-operative discomfort. In addition, the author encouraged the patient to participate in physical activity, monitored the disease course, identified potential problems, and helped prevent further patient injury. Furthermore, the author also established a good therapeutic relationship with the patient's family and provided them with information about home care, thereby reducing their concerns about the patient's welfare. The author hopes this article will be helpful to nurses who provide individual and expedient nursing care.