ܜطࡔهᗁੰฯੰડщှঽ᜕ٗநर *ᅃࡻࡊԫ̂ጯ᜕நրӄநି צ͛͟ഇĈ96ѐ9͡7͟ ࣒Լ͟ഇĈ96ѐ10͡29͟ ତצΏྶĈ96ѐ11͡1͟ ఼ੈү۰гӬĈధᐖา ࡚ԫఙጯੰ᜕நր 80758 ฯξˬϔડ̋ڌූ5ޒ19ཱི ྖĈ(07)3162409; E-mail: joan1012.@yahoo.com.tw
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ᙯᔣෟĈքᒛćᓜঽଈć֗ă͕ăី᜕Ą ܕ˩ѐֽೋّཚሳا઼̰˩̂ѪЯௐ˘ ҜĂॲፂҖ߆ੰϠཌࢍྤफ़Ăϔ઼95 ѐೋّཚሳՏ˩༱ˠ˾Ѫ˸த྿28.1%Ă̚ քᒛا˩̂ѪЯ̝ௐ˟ҜĂշẵͧதࡗࠎ 3:1ĂҫБ઼ᓁѪ˸த19.1%(Җ߆ੰϠཌϠ ࢍྤੈშĂ2007)Ąքᒛϐഇଈ۰дϠந˯ົ னূ൭ăវࢦഴᅅăเ̈́ཛͪඈাېĂ֭ ͷΞਕЯࠎ֗វ͕ညԼត҃யϠШ۞ҋԧ࠻ ڱĂซ҃ӎؠҋԧхд۞ᆊࣃ(ՂĂ2004)ćѩ γĂдࢬ၆ϠӈඕՁॡĂੵ˞ಉεҋԧଠ טਕ˧γĂࡶπॡᄃछˠ࠹̙։Ă˵ົٺᓜ ݈ѣཋೋ̈́ປຏĂٕЯࠎڱҹڇѪ˸ ֽٙ۞ऻᛵ҃யϠ˘ాҚ۞͕ីયᗟ(ౘĂ 2006)Ą ඊ۰ٺᓜԖ᜕࿅̚Ă៍၅זѩքᒛ࣎ ९ੵ˞ࢬᓜ֗វΑਕੜ̙ዋ̝γĂᔘᅮࢋ ҹڇϏۢѪ˸ֽٙ۞ऻᛵᑅ˧Ă̈́၆छˠஎ ޘ۞ᓪͣຏĂ߇͔൴ඊ۰Ᏼፄ᜕ѩ࣎९̝જ ፟Ăഇޞ࿅ᗁ᜕ဥฤˠࣶ۞ཏវЪүĂ၁ኳ ೠ೪࣎९֗ă͕ăីېڶĂ֭೩ֻ࠹ᙯঽଐྤ ੈĂଳ࣎Ҿّ۞᜕நନ߉Ăග̟࣎९̈́छᛳፋ វّ͚Ăͽםӄдᓜ࿅̚ᒔ֗ă͕ă ីЧᆸࢬ۞አዋᄃ᜕ĂഇధਕͽϒШ᎕ໂ۞ ၗޘЯᑕᓜ࿅Ăࢬ၆Ѫ˸ֽᓜĂ֭ ౯рܓତϠ۞ᕇĄ˘ăᓜঽଈ۞Ϡநયᗟůၙّূ൭ Ķၙّূ൭ķߏனх۞ٕሕдّ۞ᖐຫ ᗼ ٙ ͔ ۞ ˘ ຏ ء ˯ ٕ ଐ ჰ ˯ ̙ ԣ ۞ གྷ រĂূ൭ޘଂᅅޘҌࢦޘăࡎٕቤၙă҃ ͷᜈٕͅᖬхд൴Ϡ࿅̱࣎͡(Ă2005)Ą ূ൭ߏᒛাϐഇଈ۰૱൴Ϡ۞াې̝˘Ăࡗ 85%ᒛϐঽଈົனᜈّূ൭ன෪ĂࣧЯΞ̶ ࠎཚሳۡତܬϚăᒛা࠹ᙯڼᒚăᄃཚሳᑅ࢝ ̈́ ᒛ া ڼ ᒚ ۡ ତ ࠹ ᙯ ۞ ূ ൭ ඈ ˬ ( เ Ă 2003ćᛂăౘăᏥăڒĂ2004)ćԛၗડ̶ࠎ ᖻវّّ̰̈́ăৠགྷঽតّূ൭ඈˬ̂ᙷĂ ࡗѣ1/3ᒛϐଈ۰ࠎტЪّূ൭Ăࢋᇈېࠎ൸ ѭă⪰͕ăယФĂᓚొܑଐ۳វᄬ֏ԼតĂ ТॡᇆᜩჂ্ăࢴᇒ̈́߿જඈ(เăౘăୖă അăᐼĂ2003)Ą ᗁᒚဥฤјࣶдநᒛাূ൭ॡĂᑕͽፋ វ൭̝҂ณࠎࣧĂ࿅Ϡநă͕நăჟৠۤ ົ̈́ីّඈ࠹ᙯЯ৵ֽෞҤূ൭ޘĂ֭ᖣ Ϥ࠹఼̢྿ј˘۞ᄮۢăၗޘ̈́ԫμĂͷ ֶW.H.O.ˬล߱͞ёග̟ᘽۏڼᒚĂࡗ90%̝ ᒛ൭ΞᖣϤᘽۏቤྋ(ችĂ2004)ćТॡགྷϤЪآ න ዋ ̝ ᕚ Ҝ Ă ׀ ϡ ۏ ந ّ ͞ ڱ Ă т ҽ ᇳ ă ሤ ᇳăྻજăགྷϩৠགྷו፬(TENS)ăᑅă ᇝו፬Ъٕ֖ˬ֧ඈϱҜৠགྷញჯĂΞѣड़ ᅃӄԼචূ൭ćѩγĂՀΞֶ࣎ˠಈрᏴፄ ᖤҗਨă߶ϟළඈჟڵᖤࢶĂ࿅পঅనࢍ۞ ࢰ ሄ ٕ Ъ ׀ ࡆ ᘤ ă ه Ң Ă ྻ ϡ ຐ ည ˧ ă எ ײ ӛă̶ڦຍ˧ĂͽഴቤଐჰЄĂѣड़྿ז ቤྋূ൭۞ड़ڍ(गඈĂ2004ćధĂ2004ćૺă ᆒăՂăౘăĂ2006)Ą ˟ăᓜঽଈ۞͕நયᗟ ᓜ ঽ ଈ Я ၅ ᛇ ז ঽ ڶ ត ̼ Ă ົ ன च ُă൏ᇋăមᑂă̙࠹ܫăϠঈăӎᄮְ၁ă ୕ăயϠཋೋຏඈଐჰćᐌҋԧ᜕ਕ˧ ۞ࢫҲă͟૱Ϡ߿Αਕಉεᄃ࣎ˠӈࢬᓜѪ ˸ĂщБຏצזރĂౄјˠϠ͞Шᄃϫᇾ ใĂົᆧΐঽଈ၆छलᜪ۞ֶᏥĂͷЯࠎ ຏזҋ̎јࠎछल̚۞ፉĂӄă୕ă ϡ̈́ᆊࣃ۞ڷಉຏڵ̿ĂጱҋҲ ར(ՂĂ2004)ĄଐဩّҲҋӈ࣎९дࢬ၆˘ன х۞ଐဩԛјࢬ۞ҋԧᆊࣃຏצĂົனӎ ؠҋԧă֍ăӄຏă˘ߏ̈́ڱ நְІඈͅᑕćΞਕࣧЯࠎ֗វ͕ည৴ใăΑ ਕᅪᘣăεརăεୀăٕͻᄮТ̈́а㒝ඈЯ ৵(Ă2005)Ą ၆ѩĂᗁ᜕ဥฤᑕАޙϲฟٸăܫЇ۞ڼ ᒚّᙯܼĂଳౖ͕ҡĂТந఼͕ഴᅅঽଈ ۞ڷಉ̈́൏ᇋຏćТॡͽ႙ซّ͞ёĂםӄঽ ଈᑕϡྤֽޙϲҋԧૻޘĂᆧΐ၆ڼᒚ۞ ણᄃ፟ົĂ֭ᗃયᗟĂͽቁᄮΞҖ۞ྋՙᏱ ڱĂࢎؠវϫᇾ͔ጱ;ኜҖજĂᖣϤҖજ۞ јಶຏ̈́၆ᒖဩ۞ೠଠĂΞᆧΐଈ۰۞ҋԧᆊ ࣃຏćТॡ࿅ҋԧଣ৶͕நڼᒚĂ͔ጱଈ ۰ᄃछᛳۡତ఼ăܑ྿̰͕ଐჰĂֹຏצ זజຑᄃజତৼĂซ҃ॆৼۺؠҋ̎(ՂĂ 2004ćܭăᛂăᖡĂ2004)Ą ˬăᓜঽଈ۞ីّયᗟ ីّؠཌྷࠎ࣎ˠ၆Ϡ̚ᆊࣃٙિ۞ܫ ه ٕ ܫ Ј Ă ົ ᇆ ᜩ ࣎ ˠ ۞ ְ ၗ ޘ ă Җ ࠎ ܑ னăϠ߿አዋԫμᄃˠᅫᙯܼĂࠤҌ͕֗ઉ (ՆĂ2004)ćᓜଈ۰૱Я়ঽЯ৵Ăົ݇ऴٕ ᗼ၆࿅Νăன၁ăϏۢ̈́Ϗֽ̙അѣ࿅۞ኳ ႷĂͷજອঽˠ۞ҋܫᄃ؟ିܫЈĂТॡயϠ ˠ ᅫ ᙯ ܼ ۞ ૪ ྋ Ă ̈́ ε Ν ࿅ Ν ѣ ड़ ۞ ᑕ ၆ ඉ ர Ă Я ѩ ົ ய Ϡ ᅮ ࢋ ౖ ҡ ă ؟ ି ă ϲ ҋ ă ᒔ ֖ ૉ ҋ ֗ ᜪ ۞ ྤ ੈ ă ણ ᄃ छ ߿ જ ă Ԇ ј Ϗ Ⴝ ̝ ְ Ϡ Ї ચ ă ྋ ՙ ໂ ბ ൭ ࡴĂᄃຏצזҋϒШ۞ၗޘඈីّᅮՐ(ౘĂ 2006)Ą
ᗁ ᜕ ဥ ฤ д ី ّ ᜕ ˯ υ ื Ӏ ϡ Ъ ү ͞ ё Ă ͽ ঽ ଈ ࠎ ̚ ͕ ҂ ณ Ă ࿅ ෞ Ҥ ̈́ ͚ ԫ μĂֶፂ࣎ˠ̙Т۞ᅮՐĂҥͽ͕நăۤົ̈́ ីّ͞ࢬ۞םӄĂֹଈ۰೩ѝϒෛăତצ֭ࠎ Ѫ˸ઇ౯ĂТॡώචهᙯᘃ۞ჟৠĂםӄ ଈ۰ܑ྿ຑˠăజຑăΒटᄃᆵ़۞ຏצĂֹ ਕૉۺؠϠԆј͕ᙸ(ౘĂ2004ćGalek, Flannely, Vane, ō Galek, 2005; Hunt, Cobb, Keeley, & Ahmedzai, 2003)ćѩγĂםӄଈ۰ቤ ྋ͕֗൭ࡴă̰࠷ϠᆊࣃĂቁᄮ၆ҋԧ ᄃˠăҋԧᄃ˯ޓٕٙܫЈ۞ৠ̝ม۞࠻ڱ ᙯܼĂТॡྋՙᄃˠ۞ᅣ̈́ཋೋຏĂ֭ ࿅؟ିܫЈᒔԓ୕̰д͚˧ณĂವՐ Ϡঽ൭ࡴᄃϠᆊࣃ۞ᙯܼĂ࠰ࠎࠎី᜕ّ ̝ࢦᕇ(Albinsson & Strang, 2002)ĄЯѩĂᗁ᜕ ဥฤΞᖣϤዋॡ೩ֻଈ۰ቤྋЧᆸࢬયᗟ̝න ዋᜪĂܳซछᛳม̢જĂ྿זщှච᜕ ̝ϫ۞Ą ͳАϠĂ41໐ĂᖚலĂܫЈҢିć̏ ֈѣ˟Щ̄̃Ă఼ᄬ֏઼ăέᄬĂଂְՠ֘ ᜕࣒̍үкѐĂѣ٩ඵ̈́ಅ੧௫ၚĂͭᏐᎮଈB ݭ ք ۆ Ă ϓ Ꮠ ѣ Ꭴ Ԍ ঽ ঽ Ϋ ć छ ̚ གྷ ᑻ ̈ ĂࢋགྷᑻֽࠎᎮঽ݈᎕ᄊ੨ઊдᗁੰ ፉЇ᜕ҥ̍үćҝੰഇมࢋ᜕۰ࠎ੨ઊ̈́ ̃Ăछᙉ֍ဦ˘Ą ˘ăঽΫ̈́Րᗁགྷ࿅ ࣎९ଈѣBݭքۆĂҭϏᜈܝ෧ᖸڼ ᒚĂઊѣຏ݂াېĂࢦ়̂ঽĄٺϔ઼2007 ѐ2͡Яཛණ̈́Π˯ཛొ್൭̙ዋҌߙᗁੰՐ ෧ Ă གྷ Ϥ ཝ ᕝ ᆸ ̈́ ଳ ะ ք ᖐ ࡪ ̷ ͯ ᑭ រĂቁؠᎮଈքᒛ֭ٺܝ෧ڼᒚĄ3͡8͟ன ૻধཛ൭̈́ᐝຶ̙ዋĂާ෧ཛొཝᕝᆸᑭߤ ൴னքཚሳෘҕćღާซҖքཚሳજਔং ڼᒚޢˢੰĄ3͡14͟ତצௐ˘Ѩٸडቢڼ ᒚĂன⪰͕ăယФ̙ዋাېĂ߇١ГѨڼ ᒚĂٺ3͡17͟াېԼචޢੰܝ෧ᖸĂТॡ ତצᏐ̓ޙᛉವՐ̚ᗁ̈́ΩᙷᒚڱଠטাېĄ3 ͡27͟ᚑࢦཛ൭Ъ׀ᗕ˭۳ূ൭ă˧ГѨˢ ੰĂཛొཝᕝᆸᑭߤཛͪć4͡1͟൴னк ᖼொᒛࡪĂགྷᗁरШछᛳ̈́࣎९ޙᛉщ ှᒚ᜕ĂТຍົ෧щှဥฤĂٺ4͡6͟ᖼˢщ ှঽٗᜈڼᒚĄ ˟ă᜕நෞҤ ᜕நഇมҋϔ઼2007ѐ4͡6͟Ҍ4͡24͟Ă ଳ᜕᜕ந͞ёĂӀϡ֗វෞҤăົኘ̈́៍၅ छल̢જඈ͞ёќะ࣎९ྤफ़Ă֭ྻϡᘲͩዋ ᑕநኢߛၹĂෞҤ࣎९۞ઉયᗟĄ Ğ˘ğϠநᆸࢬ 1.উЪ ˢੰീณϠᇈ෪Ă͕ྯĈ84Ѩ/minăײ ӛĈ12Ѩ/minăҕᑅĈ120/70mmhgĂα۳ϐ ϩቲືĂѣᇅّĂϥҕგГ·ॡมࡗ1-70໐ Bݭքۆ ဦ˘ छဦᙉ 66໐ ᎤԌঽ 45໐ 43໐ 41໐ քᒛ 40໐ 13໐ 9໐
2ࡋĄਔຨఢޠͷᘦؠĂଳёײӛĂݭၗఢ ޠĂ෧ᗕײӛࢰ႟ĂొCXRওማĄ4 ͡7࣎͟९෦ཛొ್൭Ă៍၅֗វன൸ѭă α۳ϐДҽăײӛൺܳᇈېĂѩॡീณϠ ᇈ෪Ă͕ྯĈ102Ѩ/minĂײӛĈ22Ѩ/minĂҕ ᑅĈ140/90mmhgĄ 2.ᒉዳ ࣎९γ៍ពሴĂᓚᐙΌౝĂ֗169cmĂវ ࢦ Ꭾ ঽ ݈ 69kg(BMI: 24.16%)Ă Ꭾ ঽ ޢ 51kg ( B M IĈ 1 7 . 8 6 % ) ഴ ᅅ ŵ 1 0 % Ă Ϩ క Ϩ Ĉ 2 . 4 mg/dLĂᛳᚑࢦᒉዳ̙։Ąˢੰ݈ࢴઐ҇ᙷͷ ߄ࢴĂՏᐠࡗซࢴ1༦Ϩฺćˢੰޢˬᐠϒ૱Ă Տᐠࡗซࢴ1༦ංฺĂઊЯཛొණ൭҃̒ᕘࢴ ᇒĂ෦Ķև̄˘൭ֽಶ՟ࡤ˾ĂЫ̙˭Ї ңڌҘķĂົᒉዳरĂෞҤٙᅮሤณ1800̂Ι/ ͇Ă҃࣎९၁ᅫᛷפሤณࡗ1500̂Ι/͇Ą 3.ଵڴ Ꭾঽ݈ଵڴΑਕϒ૱Ăࡗ1-2͇ྋ˘Ѩ̚ณ เҒహܮćྋԌึၰĂԌณࡗ1500ml/͇ĂӔเ ͷ႟ĄˢੰޢՏ2-3̈ॡྋԌ˘ѨĂྋԌึၰ ፵լຏĂԌณࡗ200ml/ѨĂӔਮነҒćͷЯֹ ϡપᙷͤ൭Ăጱனܮ৪ଐԛĂ෧བ ᛅજઐၙࡗ1-2Ѩ/̶ᛗĂΣ෧ཛొனခࢰĂࡗ Տ2-3͇ྋ˘Ѩ̚ณเർܮĂᆧΐహܮֹϡ ޢĂাېᒔԼචĄ 4.߿જᄃЃि ˢੰ݈͟૱Ϡ߿ا࠰ΞϲԆјĂᎮঽ ݈дՠ᜕࣒֘ᇄ̍үˣ̈ॡ/͟Ă˭ޢྻજ ௫ၚĄˢੰޢ҉҇ਕ˧ෞҤĂᗕ˯۳҉˧Ĉ5 ̶Ă˭۳҉˧Ĉ3̶Ăα۳҉҇ኳᗫహĂᙯ༼ តԛĂ˭ԖтೂՎၗ̙ᘦᅮԬĂ͟૱᜕ ϤछˠםӄĄҝੰഇมЯऴăཛණ̈́ᗕ˭۳ ূ൭ࡗ7-8̶Ă߿જຍᙸઐҲͷజજĂ෦ĶՏ Ѩ ᖙ ֗ ̈́ ߿ જ ॡ ౌ ൭ ז ̙ Җ Ă ԧ Ϊ ຐ ಶ рķĂ߇̂ొ̶࠰ۻԖЃिĄፂ෦дछ؆Ⴢࡗ 5-6̈ॡĂஎՕ̙צ̒ᕘĄˢੰޢ៍၅؆্ࡗჯ 5-6̈ॡĂ4͡9͟؆্Яূ൭̒ᕘĂ่ჯࡗ 2-3̈ॡĂϨ͇ᄃົኘॡពিࢽĂڦຍ˧̙ะ ̚Ăᗕீனโீͷᛒ̙щĄ 5.ຏᛇᄃۢᛇ ࣎९ෛăăקăăᛈăăᑅᛇਕ ᏰᙊĄ෦ٺ2007ѐ2͡൴ঽޢĂགྷ૱ຏזΠ ˯ཛొன್ו൭Ăূ൭ૻޘ̈́ᜈॡม࠰̙ ˘ؠĂՏѨ࿅Ⴢ্ٕԡ˘˭ӈΞቤྋĄˢੰ ޢෞҤΠ˯ཛొ૱̙ؠॡຏז್ו൭Ă˭۳Я ᒛࡪᖼொĂӔனкᅕ౫൭Ăͽᇴфূ൭ ณܑෞҤ࣎९ূ൭̶ᇴ4-5̶Ă៍၅ᖙ֗̈́߿જ ॡӤͷܑଐ൭ࡴĂજ͕҃̈ᓍᓍ۞ͽᗕ͘ Ԭཛొ̈́ᗕ˭۳ĂᗕϫღౕĂ࠺ᐝღሸĂ֗ វئѡјኇѼېĂ෦ূ൭ᇴΐᆐҌ7-8̶Ă ՏѨূ൭ॡมჯࡗ15-30̶ᛗĂ៍၅࣎९ٽצ ঽވዎᓏࢰ̒ᕘ҃ពතঈᇷᛒĄ 6.វ୵ྋኳ ࣎९ቲҒᜐเĂϩቲᇅّإΞҭពᒌĂ ˾ටᕆቯԆፋĂα۳ͪཚĂཛొனཛͪĂ ീ ณ ཛ ಛ 1 0 4 c m ć ٩ ҕ ᑭ រ Ă ҕ Ԍ ৵ ധ Ĉ 20mg/dLă҉ᅕĈ0.9 mg/dLĂϠᇈ෪ᘦؠĂ ໂޘ˾ഽă̙щăᛒજ̈́ယФĄ 7.ৠགྷ̶̰̈́ک ࣎९ຍᙊᏹĂ၆ٺˠăॡăг۞၆ኘӮ Ξ ϒ ቁ а ඍ Ă ৠ གྷ ۞ ຏ ᛇ ᅪ ᘣ Ă α ۳ ͪ ཚĂทĈ131 meq/dLă࿔Ĉ3.1 meq/dLăถĈ7.5 mg/dLćᓁᓙࡓ৵Ĉ26.2mg/dLĂϩቲனเ ćវჯд36˚C-36.8˚CĂ˭۳ϐٽᒅ ҽĂΞдΐૻజᄏޢаĄ 8.ᄮۢ ࣎९ؠШ˧ָĂڦຍ˧ะ̚Ăܜăൺഇ ጸ։рĂΞϒቁҿᕝ̈́аᑕĂҭূ൭ॡ၆ᗁ᜕ ˠ ࣶ ྙ ય ૱ ຏ ̙ Ă ព ྵ ୶ ႐ ̈́ ١ а ᑕĄ 9.ّůϠത ࣎९ϫ݈̏ĂֈѣЩ̄̃ĂᑭෛϠത ጡءγ៍Αਕϒ૱Ą Ğ˟ğ͕நᆸࢬ
1.ҋԧໄه ࣎ ९ ܑ ϯ ѐ ᅅ ॡ ຑ ە ͷ ၆ छ ल ྵ ̙ య ЇĂдγڈ̓кĂˠቡໂָĂπ͟ಈᝌײڈ͔ ҡჸົĄᎮঽޢЯཛͪăเඈγ៍ֹຏז ӄăᇙޤĂഅШ९؍ܑϯĶ̙ࢋӘ෦ڈ̓ԧ ҝ ੰ ۞ ঐ ि Ă ன д ᆃ ᔟ Ă ̙ ຐ జ ࣇ ࠻ ֍ĄķĂ֏ኘมܑଐརွĂࢰณត̈ć࿃ѣᏐ̓ ଣෛĂϲӈٛజପᄏࡎ̝ཛొͷౕீЃिć ҝੰഇมᔿ͌ঽٕٗᄃঽଈ̢જĂခᐽ γ߿જ૱ͽ֏ᄬٕ١аᑕĂ෦Ķև ̄ණ̂ͷБ֗൴เĂᛇҋ̎рည⾩ގĂ֕ ঽٗົᑂזҾˠĊķĄՀЯࠎ˭۳ऴ˧Ă˭ Ԗтೂăᎋ߾̈́ᖙ֗ඈ͟૱Ϡ߿࠰ᅮࢋҾˠם ӄĂᛇҋ̎ည࣎ᆿˠĂ࣎९ܑϯĶͽ݈̦ᆃ ְౌΞͽҋ̎ઇĂனдݒాЫฺౌࢋҾˠᔼĂ ᛇޝϴᓚă՟ѣϡĂ૱౫Ҿˠᛇޝ̙р ຍޥĄķĄࣧ؟ିܫЈĂҭЯछˠܫҢି҃ ྫྷ ᐌ Ă ࣎ ९ ӄ ۞ ܑ ϯ Ķ ߏ ̙ ߏ Я ࠎ ̙ ૉ ྕĂٙͽҢয়̖ົᘂჳԧĂឰԧϠঽĉķĶѪ˸ ୧ྮՏ࣎ˠౌࢋ֕ĂҭـϠޢ˘࣎ˠ̙ۢົ ࿃ז̦ᆃְĉҢয়ົ̙ົᑒԧĉķ 2.֎ҒΑਕ ࣎९ௐ˘֎Ғࠎ41໐շّćௐ˟֎Ғࠎˮ ͈ăͭᏐă̄ăՠ᜕࣒֘ᇄࣶ̍ćௐˬ֎Ғ ࠎᒛাଈ۰ĄֶEriksonˠᙷ൴णล߱நኢĂ࣎ ९ٺϠய˧ٕᏂ୧ຏ̝јˠഇĂѩล߱ࢦ ᕇдϠயăିዳᇬֈ̄̃Ą࣎९ѐᅅॡ૱ᄃ̓ ˠಅ੧ăኯ౾ćଠᇒૻͷઇְާᛒĂٽЯְ ଐ̙ึ͕҃ᄃ੨ઊۋӝĂ၆ޅ̄ྵنෛĂϫ݈ ᎮঽޢϠய˧ઃ႖Ăڱౖҡ᜕̈́ϒࣃܦߋ ഇ̄̃ВТјܜĂдᇇůநຐůჟৠԧ۞̰ ࠷˯ĂປͷҋయߏεᖚͭᏐ̈́ܧநຐˮ͈Ă അ ݖ ๋ ෦ Ķ ன д ҝ д ᗁ ੰ Ă ՟ Ᏹ ڱ ᜪ ޅ ̄Ă̙ۢࣇдछѣ՟ѣॡЫฺĉķĶϠঽ ̝ޢ՟̍үĂ͉͉ࢋయछ྆ྫྷᗁੰ۞ְĂည ᜐᒍᐝ፵Ăᛇޝ၆̙сĊķĄѩγĂ࣎९ ᎮঽޢᔵЯऴă˭۳˧ڱҋԧ᜕Ăҭ ෦၆ঽڶ·̶˞ྋĂΞϒෛҋ়֗ঽĂϏ ன ࿅ ޘ ഇ ޞ Ă ҃ ៍ ၅ ࣎ ९ ኘ ̈́ Ѫ ˸ ᛉ ᗟ ॡĂ֏ኘมពڦຍ˧̙ะ̚Ăܑଐ൏ᇋĂઊ னᇙޤଐჰĄ 3.࠹ֶ̢Ꮵ ҝੰഇมࢋ᜕۰ࠎ९؍Ăߏ࣎९Ϡ ̚ࢦࢋ̈́ѣຍཌྷ۞ᙯܼˠĂ࠹ᙯ۞ᗁᒚՙඉ ࠰ Ϲ Ϥ ९ ؍ ՙ ؠ ć ၆ ٺ ९ ؍ ͕ ͷ ͕ ۞ ࠻ ᜕Ă࣎९࠹༊ຏજᄃຏᔁĂ࠹၆ٺѐᅅॡҋ̎ ۞ᇷᛒතঈĂڱචޞ੨ઊĂஎஎ۞ຏזປ ᄃཋೋĂĶѐᅅ۞ॡ࣏තঈᇷᛒĂ૱ྫྷ͉͉ӝ ߛĂனдсᔘᙸຍᇹᜪԧĂᛇ၆сѣᓪ ͣຏĄķćᎮঽޢ࣎९ࢬ၆ҋ̎ӈـϠڱ ᜪछलຏזҋయĂ҃ͷचُፉ͕̄̃ڱந ྋѪ˸ຍཌྷĂϏજШ९̄̃ྋᛖঽڶត̼Ą ҝੰഇม៍၅९̄̃ଣෛѨᇴࡗ1-2Ѩ/ฉĂଣෛ ഇมкӱٺԖय़ٕԖԍĂᄃ࣎९̢જழᗓĂྵ ͌જᏐܕ̈́םӄ᜕Ă࿃ঽଈূ൭ॡܑଐព ຖใĄ९؍ܑϯĶᔵۢঽଐు႙ೋ̼Ăҭ ՟ᄲĂԧ˵̙ۢྍިᇹฟ˾યޢְࢋި ᆃᏱĉ̙ۢरͭΞ̙Ξͽᑒѓĉķ ඊ۰ֶፂᘲͩዋᑕநኢߛၹăྻϡ֗វෞ Ҥă៍၅ă఼̈́ົኘඈԫμტЪᕩৼ࣎९ ˬ࣎ࢋઉયᗟĂ̶Ҿࠎၙّূ൭ăଐဩّ Ҳҋ͕̈́ីӧᕘĂಶЧઉયᗟ۞᜕நࢍထ ̶Ҿೡٺܑ˘ƂܑˬĄ ᒛϐূ൭ߏ˘࣎ኑᗔͷкᆸࢬ۞યᗟĂົ צ࣎ˠ͕நăۤົ̈́ីّඈᆸࢬ۞ᇆᜩĂ࿅ ܧ็ͤ൭ᘽۏ۞͞ёĂтଳTENSăᖤҗਨჟ ڵᖤࢶăࢰሄ̈́؟ିर۞ᅃӄĂֹ࣎९۞ূ൭ ᇴځពഴᅅĂѩᄃगඈˠ(2004)ăధ(2004)ă
ૺඈˠ(2006)ٙ೩׀ϡۏநّ̈́Ωᙷᅃӄᒚ ڱĂΞѣड़྿זቤྋূ൭ड़ڍ࠹ӚЪć᜕ഇ ม˵ྻϡ࣎९إх۞ొЊҋԧᜪਕ˧Ăםӄ ͽѣࢨ۞ਕณ̈́ΑਕֽԆј͟૱Ϡ߿߿જĂ ᖣѩᆧซ࣎९۞ҋր̈́ҋԧᆊࣃຏצćГ གྷϤೈԔ႙ซ͞ёĂವԱϠঽ൭ࡴ̝ຍཌྷĂ ֹ࣎९дҝੰഇมຏצזజ؍̄̃ᆵ़ă ᛝ़ҋ̎ăజຑຑˠ۞གྷរĂ࣒֭ೇಉε ۞ छ ल ј ࣶ ม ̝ ̢ ຑ ᙯ ܼ Ă ֹ ࣎ ९ ѣ ঈ ࢬ ၆ăତצă֭౯ҋ̎۞Ѫ˸Ą ༊ᒛϐଈ۰ࢬᓜϠ۞ႽᐝĂߏᅮࢋᗁ ᜕ဥฤˠࣶ̈́छˠ۞͚ᄃᙯຑĂᖣϤ೩ֻѣ ܑ˘ ઉયᗟ˘Ĉၙّূ൭Ɲքཚሳᑅ࢝Ъ׀ᖼொ މ៍ྤफ़ ᜕நϫᇾ ᜕நନ߉ ᜕நෞࣃ ҖࠎෞҤ (ௐ˘ᆸѨෞҤ)Ĉ ៍ྤफ़Ĉ 1. 4/7ĶՏѨᖙ֗̈́߿જॡౌ൭ז̙ҖĂԧ ΪຐಶрķĄ 2. 4/7Ķև̄˘൭ֽಶ՟ࡤ˾ĂЫ̙˭Ї ңڌҘķĄ މ៍ྤफ़Ĉ 1. 4/7ূ൭ॡன൸ѭăα۳ϐДҽăײ ӛൺܳĂ͕ྯĈ102Ѩ/minĂײӛĈ22Ѩ /minĂҕᑅĈ140/90mm-HgĄ 2. 4/7࣎९߿જຍᙸઐҲĂ၆ᖙ֗̈́߿જଳ జજĂͷܑன᜕ّܲҖࠎůજͷ̈ ͕ᓍᓍͽᗕ͘Ԭᗕ˭۳̈́ཛొĄ 3. 4/8ۻԖЃिॡ൴ӤĂᓚొܑଐ൭ ࡴĂᗕϫღౕĂ࠺ᐝღሸĂ֭னᛋԦ ّҖࠎůᗕ͘ٱҝཛొĂ֗វئѡјኇ ѼېĄ 4. 4/8ূ൭ॡٽצᓏࢰ̒ᕘ҃ពᇷᛒٽޤĄ 5. 4/9Яূ൭̒ᕘĂ؆Ⴢ่2-3̈ॡĂϨ͇ ពিࢽĂڦຍ˧̙ะ̚Ăᗕீனโீ ͷᛒ̙щĄ 6. 4 / 6 - 4 / 1 8Π˯ཛొ૱̙ؠॡຏז್ו ൭Ăᗕ˭۳ЯᒛࡪᖼொĂӔனк ᅕ౫൭Ă4/7ͽূ൭̶ᇴᇴфณܑෞҤཛ ొূ൭ᇴ7-8̶Ăᜈূ൭ࡗ15-20̶ ᛗĂ၆᜕நˠࣶྙયຏז̙ă୶႐ ̈́١аᑕĄ ᇆᜩЯ৵ (ௐ˟ᆸѨෞҤ)Ĉ 1.ࢋו፬Ĉքཚሳᑅ࢝ă˭۳ᒛࡪ ᖼொĄ 2.࠹ᙯו፬Ĉᖙ֗̈́߿જॡౄјொજّূ ൭Ą 3.౺ዶו፬Ĉ࿅Νূ൭གྷរĄ 1. 4 / 9࣎ ९ ਕ ૉϒቁͽᇴ фূ൭ณܑ ෞҤ֭˾ᐝ ܑ྿ূ൭ొ Ҝăݭၗ̈́ ̶ᇴĄ 2. 4/12࣎९Ξ ͽд९؍ם ӄ˭Ăϒቁ ેҖҌ͌ ีܧᘽۏূ ൭ଠט͞ڱ ቤྋূ൭Ą 3. 4 / 6 - 4 / 2 0࣎ ९෦࿅ ᘽۏ̈́ܧᘽ ۏ̝ূ൭͞ ڱĂፋវূ ൭ᇴΞϤ 7 - 8̶ ࢫ Ҍ 1-2̶Ą 1. 4/6-4/23࿅ՏѨֹϡᘽۏޢ30̶ᛗĂ̈́ Տ̈ॡજ៍၅࣎९ᓚొܑଐă۳វ જүăϠᇈ෪ត̼Ăજ൴னূ൭ય ᗟĂ֭ͽᇴфূ൭ณܑෞҤ࣎९ূ൭ૻ ޘăᐛதăّኳăᜈॡมĂϒቁࡔᐂ ٺূ൭ෞҤܑĄ 2. 4/6ෞҤΐࢦূ൭ૻޘ̝ࣧЯĂ֭םӄ ቤྋтĈିጱ९؍Տ࣎̈ॡĂӀϡLݭ ᖙ֗ڋᅅߘᖙ֗ăᕚҜĂͷᖙ݈֗೩ѝ Әۢᖙ֗ՎូĂ֭ͽٱڋዋ༊͚ᨓཛొ ̈́˭۳ĂᔖҺ҉҇ԵĄ 3. 4/6-4/18Տ͟Ⴢ݈ͽ࣎९ٙᏴፄ̝ᖤҗਨ ჟڵĂᖤࢶ࣎९30̶ᛗ-1̈ॡĂֹٸ ᗫ͕ଐĄ 4. 4/8ᄃ࣎९ኢ̈́ෞҤޢĂିጱՏ͟Ѩ ซҖஎײӛٸᗫྻજĂࡗ10-15̶/ѨĂ ࿅ӛঈФৼ͞ёٸᗫ҉҇ćТॡЪ׀ ઐр̝̂ҋڒࢰሄĂනቤଐჰ֭ ᖼொ၆ূ൭̝ڦຍ˧Ą 6. 4/10࣎९ূ൭ॡϡTENSו፬ЪϱҜͽ ቤྋূ൭ĂТॡିጱछᛳВТᑅᇝ ֖ˬ֧ϱҜĂࡗ15-20̶/ѨĂঐੵ҉҇ღ ૺĂܳซҕ୵ೈᒖĄ 7. 4/7-4/10ᗁ᜕ဥฤֶፂ࣎९۞ূ൭ෞҤĂ ૱ఢᘽۏMorphrine 10mg q6h po qdአ ፋјMorphrine 10mg q4h po qdֹϡĂ֭ ྎШ࣎९̈́छᛳྋᛖᘽۏЩჍăณ ֹ̈́ϡ͞ёĂֹਕ੨ЪॡڇᘽĂ̈́ ഴᅅֹϡᘽۏ̝ႷᇋĄ 8.࣎९γણᄃঽٗ߿જ݈Ăֶᗁឤග̟ Morphrine 10mg po statĂͽ֨ূ൭൴ ϠĄ 9. 4/7-4/22જଣෛăᙯᘃ้࣎९ূ൭ ॡᛒ̈́चُѪ˸ຏצĂགྷТຍᓑඛ؟ ିरᄃົኘĄ 1. 4 / 9࣎९જͽ˾ ᐝܑ྿ཛొٺᖙ֗ ॡӔன5-6̶್ו ൭Ą 2-1. 4/10࣎९࿅ᇫ ٸ ̂ ҋ ڒ ࢰ ሄĂᄃ९؍ϒቁે ҖஎײӛྻજĂ ෦ূ൭̶ᇴϤ5-6 ̶ࢫז3̶ĂТॡ ܑϯĶࢰሄ˘Ă ឰፋ࣎ˠౌනڇͷ ͕ଐٸᅅᗫ˞Ąķ 2-2. 4/12࣎९д९؍ םӄ˭Ξϒቁ Ъ֖̈́ˬ֧ඈϱ ҜĂ֭ٺূ൭ॡϒ ቁેҖϱҜᇝĂ Тॡܑϯূ൭̶ᇴ Ϥ 4 - 5 ̶ ࢫ ז 1 - 2 ̶Ą 3. 4/20࣎९෦࿅ ֹϡͤ൭ᘽۏ֭ᅃ ӄTENSăᖤҗਨ ჟڵᖤࢶ̈́ࢰሄڼ ᒚĂБ֗ূ൭̶ᇴ Ϥ 7 - 8 ̶ ࢫ ࠎ 1 - 2 ̶Ą
ड़۞࣎Ҿ᜕ّநନ߉Ăֹώ͛࣎९дᓜ࿅ ̚ᒔ֗ă͕ăីЧᆸࢬ۞አዋᄃ᜕Ă֭д ிˠ۞ຑᄃᙯᘃ˭ᒔචĄаᜪѩѨ᜕࿅ ĂЯ࣎९̄̃ྵ͌ҌੰଣෛĂඊ۰ڱѣ ·ྈ۞ॡมĂஎˢଣ̄̃၆ͭᏐѪ˸۞࠻ ڱć҃ᗁ᜕ဥฤјࣶ˵ЯᓜԖ̍үᓄѓĂ૱д ࣎९ـϠޢӈඕՁ᜕ĂྵटٽنரـϠ۰छ ᛳ ͕ ந ۞ ຏ צ ̈́ ᅮ Ր ć ඊ ۰ ٺ ࣎ ९ ـ Ϡ ޢ ˘ ฉĂ࿅ྖᄃ९؍ᓑᘭົኘĂᙯᘃଐჰͅ ᑕĂፂܑϯछᛳมᔵ̏ତצ࣎९ـϠְ၁Ă ҭ̪ڱ֕ݖ๋ଐჰć߇ඊ۰ޙᛉĂд࣎९ ـϠޢΞ࿅ۤ̍ˠࣶӀϡྖᖸĂᖣϤົ ኘ ͔ ᅳ छ ᛳ ቤ ྋ ݖ ๋ ͅ ᑕ Ă ֭ ග ̟ ͕ ந ͚ ćТॡĂՀΞͽᖼ̬࠹ᙯّ͚ဥវᅃጱĂ ٕགྷϤاछщှ᜕͞ёซҖᙯᘃĂᖣͽ ྿ ז Б ˠ ă Б छ ă Б ă Б ฤ ۞ ᜕ ݡ ኳĄ Җ߆ੰϠཌϠࢍྤੈშ(2007Ă7͡22 ͟)Ćϔ઼95ѐѪЯࢍඕڍၡࢋĆშྮၡ ҋhttp://www.doh.gov.tw/cht2006/index_po-pulace. aspx ܑ˟ ઉયᗟ˟ĈଐဩّҲҋƝ֗វ͕ည৴ใăεརѣᙯ މ៍ྤफ़ ᜕நϫᇾ ᜕நନ߉ ᜕நෞࣃ ҖࠎෞҤ (ௐ˘ᆸѨෞҤ)Ĉ ៍ྤफ़Ĉ 1. 4/9 Ķα۳˧Ă̦ᆃְౌࢋҾˠᑒѓĂᛇҋ̎рည ᆿˠķĄ 2. 4/9 Ķͽ݈̦ᆃְౌΞͽҋ̎ઇĂனдݒాЫฺౌࢋҾ ˠᔼĂᛇޝϴᓚă՟ѣϡĂ҃ͷ૱౫Ҿˠᛇޝ̙ рຍޥķĄ 3. 4/12Ķ̙ࢋӘ෦ڈ̓ԧҝੰ۞ঐिனдᆃᔟĂ̙ຐజ ࣇ࠻֍ķĄ 4. 4/12Ķև̄ණ̂ăБ֗൴เĂᛇрည⾩ގĂ֕ঽٗ ົᑂזҾˠķĄ މ៍ྤफ़Ĉ 1. 4/6 ᓚᐙΌౝĂቲҒᜐเĂཛొӔனཛͪĂീณཛಛ 104cm ᗕ˯۳҉˧Ĉ5̶Ă˭۳҉˧Ĉ3̶Ăڱϲ Ԇј͟૱᜕Ą 2. 4/10 Ꮠ̓ଣෛॡĂϲӈٛజପᄏࡎ̝ཛొͷౕϫЃ िĄ 3. 4/12 ࣎९၆னхγܑ̙႕ຍĂኘ̈́γᄻԼតྖᗟॡĂܑ ଐརွăࢰณត̈Ăពӄ̈́ᇙޤĄ 4. 4/12 ࣎९ഴ͌γ߿જ፟ົĂခᐽγ߿જĂ૱֏ᄬ ٕ١аᑕĄ ᇆᜩЯ৵ (ௐ˟ᆸѨෞҤ)Ĉ 1.ࢋו፬Ĉ়ঽౄј֗វγ៍ԼតĂጱ֗វ͕෪৴ ใĄ 2.࠹ᙯו፬Ĉ۳វ˧ͷ͟૱Ϡ߿᜕ΑਕಉεĂயϠε ར̈́ӄຏĄ 3.౺ዶו፬ĈҋᛇᆊࣃĄ 1. 4/12࣎९ٺ ९؍םӄ˭ ਕેҖᎋ߾ ̈́ซࢴඈ˟ ีҋԧᜪ ԫਕĄ 2. 4/15࣎९ਕ જྻϡ౺ ዶΑਕĂם ӄঽٗҶཉ ᒖဩĄ 3. 4/15-4/20࣎ ९ਕͽ˾ᐝ ܑϯ၆ҋ̎ ̝ ϒ Ш ೡ Ă֭ਕҋ ԧତצĄ 1. 4/7-4/10ົኘॡĂͽฟٸّયྖ ͔ጱ࣎९ܑ྿၆ڱҋԧ᜕ٙ யϠ̝ڷಉຏăγ៍ត̼۞ҋԧ နೋ࠻ڱĂͽ̙Բҿ۞ၗޘĂщ ᐖ้֭ТநЯҋԧ᜕Αਕಉ ε͔̝ٙεརăӄ͕ଐĄ 2. 4 / 11ᄃ࣎९ኢĂෞҤវ˧ధ ΞĂӀϡԖय़ॸ̈́ԖᅃӄซҖ ᎋ߾̈́ซࢴĂᆧૻ ۳វ۞ଠ טຏćТॡᄃԠ̍ˠࣶдҋҖ ᎋ߾ॡග̟Ⴭ៙ć֭੫၆ซࢴԫ μĂ೩ֻ ഼ટֹϡͽഴ͌क़Զ ຏĄ 3. 4/12ᖣϤঽٗሄ߿જĂϤԠ̍ ˠࣶ͔ጱ࣎९ĂВТጯ௫οە ઊᄦү֭םӄҶཉϹኖះᒖဩĄ 4. 4/13ᄃԠ̍ВТࠎ࣎९ፋநᆇ टĂ֭ዋ༊ͽҗۏପᄏཛొĂֹ ϡഎםӄ࣎९γણΐঽٗΙ ٛOKႇભ߿જĄ 5. 4/16ۤ̍ˠࣶᄃ࣎९ВТ̶ֳঽ ̰ٗ࠹Т়ঽ९ּĂ࿅ᄃঽ̓ ̈́छᛳ̢̝જĂซҖ়ঽགྷរ ̶ֳĂֹ࣎९ڦຍଈ۰۞х дĂഴᅅ؝ຏĄ 1. 4/12д९؍ם ӄ˭ٺԖ˯ҋ Җ ᎋ ߾ ̈́ ซ ࢴĂ͕ଐԣ ͷ˾ᐝܑϯ႕ ຍҋܑ̎னĄ 2. 4/15࣎९ٺϹ ኖះᄃԠ̍В ТԆјˬ࣎ οەઊĂ֭ͽ ҶཉᒖဩĂ ࣎९ܑϯĶᔵ ཙ˧Ăҭ ͘ ᔘ ៌ ី ߿ ۞Ăઇֽ۞ ەઊޝ႓ܪĂ ၆̙Ꮾγࢬ ۞Ąķ 3. 4/17࣎९ܑϯ Ķ ࣧ ֽ Ϡ ঽ ۞ ˠ ᆃ кĂ҃ͷԧ̙ ߏᔟă՟ ϡ۞ĂҌ͌ԧ ᔘΞͽભႇĂ ҋ̎Ыฺה ͰķĄ
ܑˬ ઉયᗟˬĈ͕ីӧᕘƝ၆छᛳᓪͣăѪ˸൏ᇋ̈́၆؟ି۞ழᗓ މ៍ྤफ़ ᜕நϫᇾ ᜕நନ߉ ᜕நෞࣃ ҖࠎෞҤ (ௐ˘ᆸѨෞҤ)Ĉ ៍ྤफ़Ĉ 1. 4/12ĶனдҝдᗁੰĂ՟Ᏹڱᜪޅ ̄Ă̙ۢࣇдछѣ՟ѣॡЫ ฺĉķ 2. 4/12ĶϠঽ̝ޢ՟̍үĂ͉͉ࢋయ छ྆ྫྷᗁੰ۞ְĂညᜐᒍᐝ፵Ăᛇ ޝ၆̙сķĄ 3. 4/12ĶѐᅅॡතঈᇷᛒĂ૱ྫྷ͉͉ӝ ߛĂனдсᔘᇹᜪԧĂᛇ၆с ѣᓪͣຏĄķ 4. 4/13Ķͽ݈૱ຑྫྷڈ̓ΝەĂ၆छ ྆՟ѣయЇຏĄķ 5. 4/16Ķߏ̙ߏЯࠎ̙ૉྕĂٙͽҢ য়̖ົృჳԧĂឰԧϠঽĉķ 6. 4/16ĶѪ˸୧ྮՏ࣎ˠౌࢋ֕Ăҭ ـϠޢâ࣎ˠ̙ۢົ࿃ז̦ᆃְĉ Ңয়ົ̙ົᑒԧĉķ މ៍ྤफ़Ĉ 1. 4/10 ៍၅࣎९ᄃ̢̃જழᗓĂ࿃ ࣎९֗វ̙ዋॡẴܑଐຖใ̙ۢ ٙନĄ 2. 4/12 ࣎९ٺົኘॡĂ੫၆ᎮঽޢϠ ய˧ઃ႖Ăڱᜪछलౖ̈́ҡ̄̃ ВТјܜពҋయ̈́ປĂܑଐݖ๋Ą 3. 4/16 ࣎९Я၆؟ି̙ૉྕயϠཋ ೋຏĂचُצז؟ିୢĂֹـϠ࿅ ؝ಏĂ֏ኘมពӄĄ 4. 4/16 ኢѪ˸ᛉᗟॡĂ࣎९ڦຍ˧ ̙ะ̚Ăܑଐ൏ᇋઊனᇙޤଐჰĄ 5. 4/17 ፉ͕̄̃ڱநྋѪ˸ຍཌྷĂ إϏજШ९̄̃ྋᛖঽڶត̼Ă࣎ ९၆ٺӈ࿅͵՟ѣ·̶͕ந౯Ą 6. 4/19 ९؍ܑϯ࣎९၆ޢְϏ౯Ă ഇޞ؟ିםӄĄ ᇆᜩЯ৵ (ௐ˟ᆸѨෞҤ)Ĉ 1.ࢋו፬ĈЯܜഇڱචޞछᛳĂ҃ யϠ၆छˠ۞ᓪͣຏĄ 2.࠹ᙯו፬ĈࢬᓜѪ˸۞൏ᇋ̈́ޢְ ౯ă၆؟ିழᗓĂፉ͕צזৠҢ۞ ୢĄ 3.౺ዶו፬Ĉҋᛇ؝ຏĄ 1. 4/15࣎९Ξ જܑ྿၆ छˠ۞ᓪͣ ຏ࣒֭ೇك ѩ ᙯܼĄ 2. 4/17࣎९Ξ જܑϯ֭ Ϥछˠםӄ ྿јϏԆј ͕ᙸĄ 3. 4/20࣎९ਕ જ҃ ۞ኘኢϠѪ ᛉᗟĂ֭ତ צӈѪ˸ ۞ְ၁Ą 4. 4/23࣎९ਕ જᄃछˠ ኢ̈́щଵ ޢְ౯Ą 1. 4/10-4/18Տ͇30̶ᛗů1̈ॡજౖҡ࣎ ९ĂޙϲܫЇᙯܼĂᖣϤᅅ೪ᗕ͘Ă̈́ீ၆ ீତᛈĂගౖ̟ҡܑ้̈́྿ፉ͕ޅ̄Ϗֽ Ϡ߿ͻˠᜪ̈́ώ֗ಏࢬ၆Ѫ˸चُ۞ຐ ڱĄ 2. 4/13ခᐽ࣎९Ăજͽ˾ᐝШ९؍ܑ྿кѐ ֽҋ̎၆छलழٺᜪ۞ႆຍ̈́ຏᔁ९؍၆ छल۞;ĂᖣϤ͔ጱጾٱೇЪᏐᙯܼĂ ۺؠكѩ۞֎ҒĄ 3. 4/13͔ጱ࣎९ᄃ९؍ВТаᜪϠĂ༊ኘ̈́ ܐඕॡВТጬЫࡴ۞࿅҃ᙱ࿅ஊॡĂ ̟ᅅ೪ᗕܑ͘྿ᙯᘃăڦౖ้̈́ҡĂ͔ ጱ९؍ܑ྿ຏᔁ̈́ۺؠ࣎९ࠎछल۞;Ą 4. 4/14̃ଣෛ࣎९ഇมĂםӄͽΙͯ३ᆷ͕ ଐᕇႍĂܑ྿၆࣎९۞ຑຍ̙̈́Ą 5. 4/14ᄃԠ̍ٺϹኖះᒉౄᛟϡᐠᒖဩĂם ӄ࣎९БछВТϡᐠĂٮᛷБछͯĄ 6. 4/15؟ିरᄃ࣎९̈́̃ВТ៍ካБछ ͯĂТॡаᜪ̃јܜ۞ԣְІĄ 7. 4/17࣎९ܑ྿ຐᄃछᛳВТྼ͕ᙸĂᗁ᜕ ဥฤෞҤវ˧ధΞĂགྷϤВТኢăᏴፄ гᕇĂ࿅ྎఢထྮቢĂିछᛳღާ நନ߉ĂםӄԆјБछҌҘ̄៉ྼ۞͕ ᙸĄ 8. 4/18щଵ९؍ᄃ࣎९дщᐖ̈́ˠ̒ᕘଐဩ ˭ࢬ၆ࢬ఼ăኢ̃ϏֽϠ߿᜕Ą 9. 4/19੫၆়ঽซणĂᗁ᜕ဥฤΡฟछलົ ᛉĂᄃ࣎९̈́छᛳྋᛖ়ঽត̼͔֭ጱםᛉ ޢְ౯̈́ޢᜈ᜕͞ШĄ 10.4/8-4/19ົТ؟ିरળҢགྷăΐஎܫЈໄ هĂͽα؞ϠၗࠎּĂឰ࣎९˞ྋ༱ۏ࠰ѣ хдᆊࣃĂ҃ϠҁঽѪߏҋೈᒖ۞˘ొ ̶ćᖣϤିጱᄪهҢགྷăೡᘱҢညĂͽπᐖ ͕ីĂΝੵѪ˸ऻᛵĄ 11.4/20ᄃۤ̍ВТග̟࣎९̈́छᛳᓜݖ๋͕ ந͚̈́አዋćͷᄃ࣎९ВТౖҡ९̄Ăᖣ Ϥᘱဦܑ྿၆Ѫ˸ऻᛵ࠻ڱĂ֭ዋॡග̟ ͕நᅃጱĄ 12.4/21щଵ࣎९ᄃछᛳҌםኘވĂᒉౄщᐖă ᔳռᄃϲ۩มᒖဩֹ࣎९ϹឤĂТॡ ВТኢăᏴፄ౯ـϠॡஐ֗۞җۏ ͯĂ֭Ϲ֗ޢְĂᒉౄҾଐဩĄ 13.4/23؟ିर೩ֻ࣎९ᄃछᛳޢְ౯࠹ᙯྤ ੈăཨᆇۤᓑᘭ̈́ࠀኘӄهְآĄ 1. 4/15࣎९Ш९؍ܑ ϯĶͽ݈ຑኯ౾ͷ ̙యЇޝ၆̙ ҰࣇĂҭԧߏຑҰ ࣇ ۞ ķĂ ࿅ જ ጾٱăϡᐠ̈́ٮᛷ ͯ͞ёĂ࣒ೇछ ˠكѩมᙯܼĂ࠹ ࿅ᏉࠀĄ 2. 4/17ᄃछˠҌҘ̄ ៉ྼĂܔੰޢ ෦͕ᙸԆјĄ 3. 4/20࣎९ᙸຍึڇ Ңয়Ѫ˸щଵĂͷ ၆ӈـϠਕ ତצćܑଐே ෦ĶՏ࣎ˠϠ˭ ֽౌߏѣЇચ۞Ă னдԧдˠ͵ม۞ Їચ̏གྷԆјĂְ ଐ˵ౌϹр˞Ă ࡶҢয়ֽତĂΞͽ щ͕ᗓฟĄķ 4-1.4/22࣎९Ӏϡᐂ ࢰ͞ёϹឤĂ Тॡᄃ९؍ᓑᘭཨ ᆇۤĂВТኢޢ ְͽҢିᆇёซ ҖĂ֭ࠀኘ࠹ᙯְ ี༼நĄ 4-2.4/24˯̾࣎९ຍ ᙊӔனڃਜ਼Ă؟ି रࢦ࣎९ᏹॡ ຍ ᙸ Ă ֹ ϡ ቷ ܅ ळă៍ࢰည̈́ᇫٸ Ң ି ࢰ ሄ ᄪ གྷ ӄ ળć˭̾࣎९ـϠ ॡᗁᒚဥฤјࣶБ ౖҡĂֹ࣎९̈́ छᛳצזࢦĂ֭ дே҃ఄᚑᒖ ဩ̚Ą
Ղพර(2004)Ćᒛϐঽଈ۞ۤົ͕நېၗᄃ ᜕Ćٺᜪ˜πඈᓁ७ዦĂщှቤ᜕நጯ (pp. 474-491)Ćέ̚Ĉරॾ֤Ą Նځጙ(2004)ĆኘីّᜪĆ᜕நᗔᄫĂ51(5)Ă 78-83Ą ܭࡻăᛂͽܦăᖡළ(2004)Ćྻϡҋԧۺؠ ቚЪ׀ᄮۢڼᒚٺԼචܝ෧˘ҜҲҋ ࣎९᜕̝நགྷរĆ᜕நᗔᄫĂ51(2) Ă97-103Ą ࡔ(2005)Ć᜕ந෧ᕝ͘Ί2005-2006ĆέΔĈ රՃĄ गလࠠăૺ̮ăԇϠăเ࡚༉ăͳսࢶă ో৵ܦ(2004)Ć۾ࢶᒚڱٺᒛাঽଈ̝ྻ ϡĆщှᒚ᜕ᗔᄫĂ9(3)Ă253-263Ą ధզ(2004)ĆᅃӄᄃΩᙷᗁጯᖎ̬Ćщှᒚ᜕ ᗔᄫĂ9(3)Ă264-275Ą ౘᇉዶ(2004)Ćᒛϐঽˠώ˿̼ីّᜪሀёĆ έ៉ᗁጯĂ8(5)Ă664-671Ą ౘِт(2006)Ćϐഇঽˠ۞ីّᅮՐᄃីّ ᜪĆຎᑻᗁጯĂ18(4)Ă61-66Ą ૺ Ⴖ ă ᆒ ፍ ۘ ă Ղ ֶ ৷ ă ౘ ལ ۾ ă ૈ ལ (2006)ĆϱҜᇝᓜԖ᜕நྻϡ̝͛ᚥа ᜪĆܜഇ᜕ᗔᄫĂ10(1)Ă91-101Ą เശබ(2003)Ćᒛাঽଈ۞ূ൭ᄃԓ୕ޘ̝࠹ ᙯّࡁտĆܜطࡊԫጯΏĂ2Ă113-128Ą เ щ ѐ ă ౘ к ᇍ ă ୖ Ѻ щ ă അ ᇉ ິ ă ᐼ ှ ⚻ (2003)ĆᘓѪঽଈ̝ূ൭ڼᒚĆщှᒚ᜕ᗔ ᄫĂ8(3)Ă283-298Ą ችᚊำ(2004)Ćূ൭યᗟᄃ᜕Ćٺᜪ˜πඈᓁ ७ዦĂщှቤ᜕நጯ(pp. 153-212)Ćέ ̚Ĉරॾ֤Ą ᛂ̈බăౘݡࠠăᏥ̯ܪăڒָᐖ(2004)Ćщှ ᒚ᜕ূ൭ཉણ҂͔ٺᒛϐঽଈֹϡј ड़̝አߤĆၷᓁ᜕நĂ21(4)Ă363-374Ą Albinsson, L., & Strang, P. (2002). A Palliative
approach to existential issues and death in endstage dementia care. Journal of Palliative Care, 18(3), 168-174.
Galek, K., Flannely, K. J., Vane, A., & Galek, R. M. (2005). Assessing a Patient’s spiritual needs. Holistic Nursing Practice, 19(2), 62-69. Hunt, J., Cobb, M., Keeley, V. L., & Ahmedzai, S.
H. (2003). The quality of spiritual care-developing a standard. International Journal of Palliative Nursing, 9(5), 208-215.
ABSTRACT
This report described the nursing experience of a terminal liver cancer patient who has obtained physical, psychological, and spiritual care experiences after hospice care. The author assessed physical, psychological, and spiritual aspects of the case by the ways of physical assessment, conversation, listening, observing family dynamics, hospice team care, and Roy Adaptation Model. Chronic pain, situational low self-esteem, and spiritual distress health problems were identified for the case. Nursing interventions for the case is to release his pain indicators through non-traditional pain-killer medicines and assist him to complete daily life activities by limited energy and function. Through the intervention process, the case’s self-esteem has been promoted so that he could search for the meaning of illness and pain by the way of conversation, education, counseling, and life-reviewing gradually. Additionally, the case has experienced being forgiven by his wife and children, being able to forgive himself, appreciated the process of being loved and loved, and had the courage to face, accept, and prepare his own death. Through exploring the physical, psychological, and spiritual care experiences of the terminal liver cancer patient, the author suggested social workers can follow up the case’s family and release their grief responses after the case’s death by telephone calling, hospice home care of family members, and transferred into the supporting groups that could achieve the highest quality of care in the whole person, whole family, whole process, and whole team.
Key words: liver cancer, terminal patient, physical, psychological, spiritual care.
Physical, Psychological, and Spiritual Care
Experiences of a Terminal Patient
with Liver Cancer
Ching-Wen Hsu
ąYa-Lie Ku*
RN, Nurse of Hospice Care, Chang Gung Memorial Hospital, Kaohsiung, *RN, MSN, Assistant Professor, College of Nursing, Fooyin University.
Received: September 7, 2007 Revised: October 29, 2007 Accepted: November 1, 2007
Address correspondence to: Ching-Wen Hsu, School of Nursing, Meiho Institute of Technology. No. 19, Lane 5, Shandong St., Sanmin District, Kaohsiung City 80758, Taiwan, R.O.C. Tel.: 886-7-3162409; E-mail: joan1012.@yahoo.com.tw
