護(hù)患情境會(huì)話

胃部術(shù)后舒適護(hù)理

Comforting a Patient after Gastric Operation

交流

病人：這么多管子在身上，我都不敢翻身。我真想拔掉這些管子，尤其是這根從鼻子插進(jìn)去的胃管。

護(hù)士：這么大的一個(gè)手術(shù)你都挺過(guò)來(lái)了。這些管子現(xiàn)在對(duì)你很重要，它們會(huì)幫你盡快恢復(fù)的。不要怕，再堅(jiān)持兩天，我會(huì)盡力和你一起度過(guò)這個(gè)難關(guān)的。

病人：這些管子到底有什么作用，要多久才能拔掉呢？

護(hù)士：手術(shù)一般都會(huì)在腹腔內(nèi)留下積液、積血。插在腹壁上的兩根引流管主要是幫助引流腹腔中的積血或積液。2～3天后，引流液明顯減少，醫(yī)生就可以幫你拔掉兩根管子了。至于胃管，是引流胃液用的，起初也有一些手術(shù)后的血液引流出來(lái)。你的胃部被切掉一部分，并和下面的腸子做了吻合，為了吻合口能愈合的更快、更好，胃本身分泌的胃液必須及時(shí)引流出來(lái)，否則會(huì)影響吻合口的愈合。過(guò)早拔掉管子，胃里液體太多，張力大了會(huì)讓吻合的傷口裂開(kāi)的。

病人：可是，胃管刺激我喉部的感覺(jué)，真難以忍受。

護(hù)士：你嘗試著深吸氣，再呼氣，象我一樣，（示范深呼吸的動(dòng)作）會(huì)好一些。還有，因?yàn)槟愕淖⒁饬Χ荚谶@幾根管子上，不舒服的感覺(jué)就會(huì)更明顯了。

病人：明天，我可以讓我的愛(ài)人把收音機(jī)帶來(lái)聽(tīng)，可以嗎？

護(hù)士：當(dāng)然可以，我正想建議你這樣做呢。你還可以做一些其他的事情，只要不經(jīng)常想這些管道，就會(huì)感覺(jué)好多了。

病人：好的。這些管子既然那么重要，我會(huì)盡量克服的。謝謝你。

Interactions

Patient：I dare not to turn my body with so many tubes on me.I really feel like pulling them out，especially the gastric tube through my nose.

Nurse：You have made through the operation.These tubes are very important to you，because they can help you recover quickly.Don’t be afraid，insist for two more days，let’s overcome the barrier together.

Patient：What’s the function of these tubes and when will they be removed？

Nurse：Usually there will be some blood and fluid accumulated in the abdominal cavity after operation.The two drainage tubes placed in the abdominal wall are used to help drain these fluids.After two or three days，when the drain-age fluid decreases，the doctor will pull out the tubes for you.The gastric tube is used to drain the gastric juice and some accumulated blood from your stomach.Portion of your stomach has been removed and the remaining portion was connected to the intestines below.In order to heal the wound better and more quickly，the gastric juice must be drained out in time.If the tubes were taken out too early，the fluid would be accumulated in the stomach，and the wound could be split by the weight of the fluids.

Patient：The gastric tube irritates my throat.It is really unbearable.

Nurse：Try to take deep inhalation，then exhalation，like what I am doing（Giving a demonstration），it will make you feel better.You will feel more uncomfortable if you keep focusing and pay too much attention to these tubes.

Patient：Could I ask my wife to bring the radio for me tomorrow？

Nurse：Of course，I was just about to suggest you to do so.You can do other things as well.Just do not think of the tubes too often.

Patient：OK，I’ll try to overcome the difficulties since they are so important to me.Thank you very much.

結(jié)果

在護(hù)士的指導(dǎo)和鼓勵(lì)下，病人主動(dòng)嘗試轉(zhuǎn)移注意力的各種方法。他讓家人帶來(lái)了收錄機(jī)和他平時(shí)愛(ài)看的書籍，在疼痛不適可以忍受的情況下，聽(tīng)優(yōu)美抒緩的音樂(lè)，看書，病人臉部的痛苦表情明顯緩和。

Result

With the nurse’s guidance and encouragement，the patient tried many ways to divert his attention from the tubes and the discomfort.He asked his wife to bring him the radio and books he liked to read.By listening to nice music and reading books，the discomfort has become bearable.The painful expression in the patient’s face had obviously eased.

（毛莉芬）