運用鏡像治療照顧一位罕見血管性肉瘤個案膝上截肢之護理經驗

Applying Mirror Therapy on a Rare Case of Angiosarcoma with Above-Knee Amputation

10.6740/NTUHJN.202401_20(1).0003

陳俐妏(Li-Wen Chen)

膝上截肢 ； 疼痛 ； 身體心像改變 ； 身體活動功能障礙 ； Above-knee amputation ； disturbance of body image ； dysfunction of physical activity ； pain

臺大護理雜誌

20卷1期（2024 / 01 / 01）

16 - 27

繁體中文;英文

本文探討一位中年女性右下肢皮膚損傷導致肢體末梢血管壞死，經多次就醫，確診為血管性肉瘤而進行截肢之護理經驗。個案術後面臨傷口疼痛與幻肢痛、身體完整性及功能喪失，造成生活、社交及心理上很大的影響心理。於2019年3月11日至3月28日照護期間，運用生理、心理、靈性及社會層面整體評估，確立個案有急性疼痛、身體心像紊亂及身體活動功能障礙主要健康問題。照護期間運用鏡像治療緩解及幫助接受截肢及幻肢痛的事實，教導深呼吸、按摩、吹風機、紅外線或選擇個案喜愛的音樂、電視以轉移對疼痛感受的注意力，鼓勵參與護理及復健活動，以解決截肢所造成的活動設限問題，建議能建置截肢患者之病友團體，藉由團體分享支持協助身體心像重建，讓個案能正視及接受自己外觀的改變，積極參與日常生活照顧活動，適應截肢後生活。

This article describes the nursing experience of a middle-aged woman who sustained peripheral vascular necrosis of the right lower limb. She visited the doctor several times, and was subsequently diagnosed with angiosarcoma after undergoing amputation. She experienced wound pain, phantom limb pain, and loss of bodily integrity after surgery, which had a significant impact on her daily living, social activity, and psychology. From March 11 to 28, 2019, a comprehensive assessment of physical, psychological, spiritual, and social dimensions was conducted to identify the main health problems related to acute pain, disturbance of body image, and dysfunction of physical activity. During the nursing period, mirror therapy was administered to relieve the patient's phantom limb pain. In addition, the author diverted the patient's attention from pain through deep breathing exercises, puff massage, hair drying, infrared lamp, and listening to favorite music or TV shows. The patient's limited mobility was improved by participating in nursing and rehabilitation activities. Finally, the author suggested the establishment of a support group for amputees to help the patients reconstruct their body image. Thus, the patients could accept the changes in their appearance, participate in daily activities, and positively adjust to post-amputation life.