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題名:一位糖尿病足併發周邊動脈阻塞性疾病病患之護理經驗
書刊名:長庚護理
作者:何婉綾曾瓊誼
作者(外文):He, Wan-lingTseng, Chun-yi
出版日期:2017
卷期:28:3=99
頁次:頁528-538
主題關鍵詞:糖尿病足周邊動脈阻塞性疾病護理經驗Diabetic footPeripheral arterial occlusive diseaseNursing experience
原始連結:連回原系統網址new window
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  • 共同引用共同引用:6
  • 點閱點閱:4
本文描述一位糖尿病足併發周邊動脈阻塞性疾病病患之護理經驗,病患因傷口反覆性感染及患肢出現酸麻感,故再度行清創手術,照護期間自2014 年10 月3 日至2014 年10 月29 日,經由觀察、直接照護、會談、傾聽、病歷查閱等方式收集資料,並運用Gordon 十一項功能性健康型態進行評估,收集主、客觀資料確立病患有急性疼痛、組織灌流改變:週邊、危險性感染、焦慮等健康問題。照護期間藉由家屬的關心與支持,建立良好護病關係,教導病患及家屬運用放鬆技巧及心理支持減輕疼痛不適,並以肢體保暖及按摩方式,促進血循順暢,以改善末梢冰冷及痠麻情形,透過認識傷口感染表徵,預防感染持續惡化,對於傷口照護要維持傷口清潔,並教導病患和家屬換藥技巧,換藥前可採腹式呼吸法,以緩解病患焦慮。藉由醫療團隊及中西醫共同照護,採遠紅外線照射療法及針灸治療,促進傷口癒合,以讓病患增強復原信心,並學習面對疾病,順利出院返家。希望藉此文獻探討及護理經驗的分享,作為臨床護理人員照顧類似病患之參考。
This paper illustrates the nursing experience of caring a patient with diabetic foot complicated with peripheral arterial occlusive disease. Due to repeated wounds infections and tingling sensation over affected extremity, once again debridement surgery was performed. During the period from October 3 to 29 in 2014, data was collected by observation, direct care, interview, listening, and review of medical records. After data analysis, the nurse assessed the patient with Gordon 11 Functional Health Status Assessment tool and collected subjective and objective data to establish patient who have acute pain, changes in tissue perfusion: peripheral, high risk of infection, and anxiety. During the nursing process, under family care and support, good treatment relationship was established. We educated patient and their family members about relax skills and psychological support to release patient's discomfort. Before changing dressing, we let the patient breathe by abdominal breathing for anxiety relief. By recognizing the wound infections sign, we prevented the condition of infection exacerbated. Besides, we kept the wound clean by wound care and educated the patient and family members about skills of changing dressing. Under combinational therapy of TCM far-infrared radiation therapy with acupuncture therapy for wound healing, the patient was confident in recovery and being discharged soon. We hope to share this nursing experience for future references.
期刊論文
1.沈惠民、林東亮、鍾進燈、許惠恒(20110800)。糖尿病足之臨床評估與治療。內科學誌,22(4),254-265。  延伸查詢new window
2.徐敏芬、楊秀月、許秀月(20100300)。糖尿病人足部傷口照護不同衛教模式之比較。榮總護理,27(1),65-72。new window  延伸查詢new window
3.Hottensen, Dory(2010)。Anticipatory grief in patients with cancer。Clinical Journal of Oncology Nursing,14(1),106-107。  new window
4.王小燕、劉孟芬(20130600)。一位糖尿病患者接受截肢術後之護理經驗。長庚護理,24(2)=82,208-217。new window  延伸查詢new window
5.莊伊雯、宋雅雯、黃敏瑢(20130200)。協助一位周邊動脈阻塞病人接受截肢之護理經驗。志為護理,12(1),108-117。  延伸查詢new window
6.喬宗涵、陳鈺如、李彩緣(20100900)。一位糖尿病足截肢病患之照護過程。中山醫學雜誌,21(3),295-307。  延伸查詢new window
7.于會功、胡國琦(2013)。糖尿病合併周邊動脈阻塞疾病病人之復健運動訓練--訓練計劃與最新實證。中華民國糖尿病衛教學會會訊,9(3),6-12。  延伸查詢new window
8.王紫藺、黃美園、王玉真(20150900)。照護一位妊娠婦女下肢骨折之護理經驗。長庚護理,26(3)=91,358-369。new window  延伸查詢new window
9.王舒儀、毛羿傑(2011)。認識糖尿病足。血管醫學防治季刊,8,15-17。  延伸查詢new window
10.林尚逸、林舜穀、陳朝宗(2012)。遠紅外線止痛原理探討。中醫骨傷科醫學雜誌,11,30-35。  延伸查詢new window
11.林姿妤、陳渼娟、蔡岱蓉、石惠美、蔡美菊、賀倫惠(20110300)。照顧一位人工膝關節置換術後併發周邊血管阻塞病患的護理經驗。長庚護理,22(1)=73,84-92。new window  延伸查詢new window
12.陳欣湄、顏啟華(20141100)。糖尿病足部潰瘍的治療方法。家庭醫學與基層醫療,29(11),296-302。  延伸查詢new window
13.陳旺全(20110600)。針灸臨床應用新知。北市中醫會刊,17(2)=64,3-19。  延伸查詢new window
14.劉伯瑜、施智源、許惠恒(20121200)。糖尿病足感染的最新診斷與治療建議。內科學誌,23(6),431-441。  延伸查詢new window
15.Alavi, A.、Sibbald, R. G.、Mayer, D.、Goodman, L.、Botros, M.、Armstrong, D. G.、Kirsner, R. S.(2014)。Diabetic foot ulcers: part II. Management。Journal of the American Academy of Dermatology,70(21),1-24。  new window
16.Castillo-Bueno, M. D.、Moreno-Pina, J. P.、Martmez-Puente, M. V.、Artiles-Suarez, M. M.、Company-Sancho, M. C.、Garcia-Andres, M. C.、Sanchez-Villar, I.、Hernandez-Perez, R.(2010)。Effectiveness of nursing intervention for adult patients experiencing chronic pain: a systematic review。JBI Library of Systematic Reviews,8(28),1112-1168。  new window
17.Flu, H. C.、Tamsma, J. T.、Lindeman, J. H.、Hamming, J. F.、Lardenoye, J. H.(2010)。A systematic review of implementation of established recommended secondary prevention measures in patients with PAOD。European Journal of Vascular and Endovascular Surgery,39(1),70-86。  new window
18.Hobizal, K. B.、Wukich, D. K.(2012)。Diabetic foot infections: current concept review。Diabetic Foot & Ankle,3,1-8。  new window
研究報告
1.行政院衛生署。2014年國人死因統計結果。  延伸查詢new window
 
 
 
 
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