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中醫藥研究論叢
 262.4 中醫居家急性後期照護顱腦損傷後吞嚥困難之病例報告
TJ TCM.26(2) : 41-50, 2023
DOI : 10.6516/TJTCM.202306_26(2).0004
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中醫居家急性後期照護顱腦損傷後吞嚥困難之病例報告
A Case Report of a Patient with Dysphagia after Craniocerebral Injury Receive Post-
Acute Home Healthcare of Traditional Chinese Medicine
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許霂蓉1 方羽偵1 林原禾1,2 林新杰1,2 陳冠佐1,2,*
1 義大醫院癌治療醫院中醫科，高雄，台灣
2 義守大學學士後中醫系，高雄，台灣
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【摘要】
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本病例為33 歲女性病患，在2021 年6 月遭遇車禍時受到嚴重頭部外傷，經過多次手術，病況穩定後攜帶鼻胃管於7 月21 日出院，返家後吞嚥障礙仍存，經口進食易嗆咳，情志抑鬱寡歡，遂於8 月19 日開始接受居家醫療照護整合計畫之中醫訪視。期間以中藥、針灸及電針治療持續三個月，患者吞嚥功能大幅改善，於11 月由西醫團隊評估成功移除鼻胃管。本病例記錄了中醫治療創傷後吞嚥困難並成功移除鼻胃管之病案，說明了中醫參與居家醫療照護整合計畫不僅使患者加速恢復吞嚥機能、促進患者生活品質，更彰顯中醫在居家急性後期照護的可行性。由於家屬期望增加治療頻率，在醫病共享決策後於12 月由居家照護轉銜為門診照護。
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【關鍵詞】中醫藥、吞嚥障礙、針灸、居家醫療整合照護、急性後期照護
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Hsu Mu-Jung1Fang Yu-Jeng1Lin Yuan-Ho1,2Lin Hsin-Chieh1,2
Chen Kuan-Tso1,2,*
1Department of Traditional Chinese Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan
2School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan
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【Summary】
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This is a 33-year-old female who suffered severe head trauma in a car accident in June 2021. After multiple surgeries, she was discharged from the hospital on July 21 with a nasogastric tube in stable condition. After returning home, the swallowing disorder still exists. She was prone to choking and coughing when eating in the mouth, and was emotionally depressed and unhappy, so she began to receive Post-Acute Home Healthcare of Traditional Chinese Medicine (TCM) on 8/19. During the period, Chinese medicine, acupuncture, and electropuncture lasted for three months, and the patient’s swallowing function improved significantly. In November, the nasogastric tube was successfully removed after evaluated by the Western medical team. This case records a patient suffered from post-traumatic dysphagia whose nasogastric tube was successfully removed after the care of TCM. It shows that TCM’s participation in the home medical care
integration plan can not only accelerate the recovery of swallowing function and improve the patient’s quality of life, but also demonstrates the feasibility of TCM in the Post-Acute Home Healthcare. Due to the family’s expectation to increase the frequency of treatment, after the decision of sharing the doctor and the patient, this case was transferred from home care to outpatient care in December.
【Keywords】Traditional Chinese Medicine, Dysphagia, Acupuncture, Home Medical
Integrated Care, Post-Acute Care
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