頁籤選單縮合
題 名 | 一位膀胱癌病患接受再造新膀胱的護理=A Case of Radical Cystoprostatectomy and Completely Detubularized Sigmoid Colon Neobladder Reconstruction |
---|---|
作 者 | 黃淑玲; | 書刊名 | 榮總護理 |
卷 期 | 13:1 1996.03[民85.03] |
頁 次 | 頁78-85 |
分類號 | 419.77 |
關鍵詞 | 根除性膀胱前列線切除術; 完全去管狀乙狀結腸再造新膀胱手術; Radical cystoprostatectomy; Completely detubularized sigmoid colon neobladder reconstruction; |
語 文 | 中文(Chinese) |
中文摘要 | 本個案為67歲男性病患,診斷為:膀胱癌、兩側腎孟腎細胞癌、前列腺癌,所幸 尿道正常,醫師採行完全去管狀乙狀結腸再造新膀胱手術。此種手術乃為臺北榮總陳光國教 授首創,術後能同正常人由尿道解尿,故引發筆者研究的動機。 住院期中個案常抽菸、責罵家屬、表情愁苦、獨坐不語等,經過常探視問候,真誠的同 感心關懷,兩天後建立信任的治療性人際關係,探討出心中的不安、無助及疑慮,例如:擔 心不能再繼續教職或參加社交等。所以,耐心傾聽並提供專業知識;陪同相似疾患病友分享、 交換經驗;藉由醫護討論會與個案、家屬面對面溝通、討論、共同參與護理照顧,最後,個 案勇敢的接受手術。術後於筆者計劃的示範腹壓排尿及回示教下,成功的完成新膀胱排尿訓 練,於出院時個案能自解小便60ml。手術後近一年,白天約2~3小時自解小便一次,夜眠時 輔以尿布墊防滲尿,同時能繼續教職,生活圓滿。筆者首次照顧接受此種手術之病患,為瞭 解病患有那些主要問題?如何以護理措施來協助病患?故選此為研究個案之動機,並採以護 理診斷的方式加以探討。 個案之動機,並採以護理診斷的方式加以探討。 |
英文摘要 | This is the case of a 67 year old male patient diagnosed with urinary bladder cancer, transitional cell carcinoma of bilateral renal pelvis, and adeno-carcinoma of the prostate. Since the patient's urethra was functional, right nephro-ureterectomy and enucleation of the left renal pelvic tumor, radical prostatectomy, and complete detubularized sigmoid colon neobladder reconstruction were done. The innovative operation has been performed only 12 times by Prof. Chen Kwan-kuo of the VGH-Taipei. These rare cases lead to the main motif of this research. During the patient's stay at the hospital, he often smoked, sat alone displaying sadness and worry, refused to socialize with others, and scolded his family. Showing sympathy, care, and dedication, we built a mutual understanding. He expressed his uneasiness, helplessness, and doubt about whether he would be able to continue his teaching job and lead a normal life. Providing professional advice and establishing a support group with family members and doctors encouraged the patient undertake the operation. After surgery, the patient was able to successfully urinate 60ml by himself using the abdominal-pressurized voiding method. One year after the operation, he is able to urinate by himself once every two or three hours in the daytime and use adult diapers at night. He continues his teaching job and leads a normal life. Using the methods of nursing diagnosis, this research was done to explore the major problems of similar patients and to establish the proper nursing plan to assist them. |
本系統中英文摘要資訊取自各篇刊載內容。