Pre and Post Operative Cares

🟢 場景一：術前護理對話 / Pre-Operative Care Dialogue

Narrator: Now let's dive into a dialogue between a doctor and a patient in the pre-operative care setting. Let's listen in. 旁白： 現在，讓我們進入術前護理環境中醫生與患者之間的對話。讓我們一起來聽一聽。

Dr. Johnson: Good morning, Mrs. Smith. I'm Dr. Johnson, and I'll be overseeing your pre-operative care today. How are you feeling? 約翰遜醫生： 早上好，史密斯太太。我是約翰遜醫生，今天由我來負責您的術前護理。您感覺怎麼樣？

Mrs. Smith: Good morning, Doctor Johnson. I'm feeling a bit nervous, to be honest, but I know this surgery is necessary. 史密斯太太： 早上好，約翰遜醫生。老實說，我有點緊張，但我知道這個手術是必須做的。

Dr. Johnson: It's completely normal to feel nervous before surgery, Mrs. Smith. We're here to support you every step of the way. Before we proceed, I'd like to go over a few things with you. Have you eaten or drunk anything in the past eight hours? 約翰遜醫生： 手術前感到緊張完全是正常的，史密斯太太。我們在每一步都會全力支持您。在我們開始之前，我想和您核對幾件事。在過去的八小時內，您有吃過或喝過任何東西嗎？

Mrs. Smith: No, I followed the fasting instructions as advised. I haven't had anything since last night. 史密斯太太： 沒有，我是嚴格按照醫囑禁食的。從昨晚開始我就什麼都沒吃沒喝了。

Dr. Johnson: Excellent. That's very important to ensure your safety during the procedure. Now, I'd like to review your medical history and current medications. Are you currently taking any medications or supplements? 約翰遜醫生： 太好了。這對於確保您在手術過程中的安全非常重要。現在，我想複查一下您的病史和目前正在服用的藥物。您目前有服用任何藥物或保健品嗎？

Mrs. Smith: Yes, I'm taking blood pressure medication and a daily multivitamin. 史密斯太太： 有的，我正在服用降壓藥和一種每日複合維他命。

Dr. Johnson: Thank you for letting me know. We'll ensure that your medications are managed appropriately throughout your stay. I also see here that you've had surgery in the past. Have you experienced any complications with anesthesia or surgery previously? 約翰遜醫生： 謝謝您告訴我。我們會確保您在住院期間這些藥物得到妥善的管理。另外，我看到您以前做過手術。您以前在麻醉或手術過程中遇到過任何併發症嗎？

Mrs. Smith: No, everything went smoothly with my previous surgeries. 史密斯太太： 沒有，我以前的手術都進行得很順利。

Dr. Johnson: That's reassuring to hear. We'll take all necessary precautions to ensure a safe and successful procedure this time as well. 約翰遜醫生： 聽到這個消息令人放心。我們這次也會採取一切必要的預防措施，以確保手術安全、成功。

Dr. Johnson: Now, I want to go over everything with you about the lumpectomy procedure. We'll start with what the procedure entails and then discuss any risks involved. 約翰遜醫生： 現在，我想和您詳細說明一下關於乳房腫塊切除術（Lumpectomy）的流程。我們先從手術內容開始，然後討論涉及的風險。

Dr. Johnson: A lumpectomy is a surgical procedure where we remove your breast tumour along with a small margin of surrounding healthy tissue from your breast. During the surgery, you'll be under general anaesthesia, so you won't feel any pain. Once we remove the tumour, we'll close the incision with stitches, and you'll likely go home the same day or stay overnight depending on your recovery. 約翰遜醫生： 乳房腫塊切除術是一種手術，我們會切除您的乳房腫瘤以及周圍的一小部分健康乳房組織（切緣）。在手術過程中，您將接受全身麻醉，因此不會感到任何疼痛。一旦我們切除了腫瘤，就會用縫線關閉切口。根據您的恢復情況，您可能當天就可以回家，也可能需要留院觀察一晚。

Mrs. Smith: Okay, that sounds manageable. What about the risks? 史密斯太太： 好的，聽起來還可以接受。那風險方面呢？

Dr. Johnson: There are risks with any surgery, and a lumpectomy is no exception. The most common risks include bleeding, infection, and a small chance of damage to nearby tissues or nerves. Additionally, there's a risk of changes in breast shape or size, and in some cases, the need for additional surgery if we don't remove all the cancerous tissue. 約翰遜醫生： 任何手術都有風險，乳房腫塊切除術也不例外。最常見的風險包括出血、感染，以及少部分可能損傷周圍組織或神經的機率。此外，還有乳房形狀或大小發生改變的風險。在某些情況下，如果我們未能完全切除所有癌變組織，可能需要進行二次手術。

Mrs. Smith: Are there any long-term effects I should be aware of? 史密斯太太： 有什麼我需要注意的長期影響嗎？

Dr. Johnson: In the long term, some women may experience changes in sensation or scar tissue formation at the surgical site. It's also important to understand that while a lumpectomy removes the cancerous tissue, it doesn't guarantee that the cancer won't return. We'll discuss follow-up care and monitoring to catch any recurrence early if it were to happen. 約翰遜醫生： 從長期來看，有些女性可能會在手術部位出現感覺變化（麻木或敏感）或疤痕組織形成。同樣重要的是要理解，雖然乳房腫塊切除術切除了癌變組織，但它並不能百分之百保證癌症不會復發。我們之後會討論隨訪護理和監測，以便在萬一發生復發時能夠盡早發現。

Dr. Johnson: Lastly, do you have any questions or concerns about the surgery or your care? 約翰遜醫生： 最後，您對這次手術或您的護理還有什麼疑問或顧慮嗎？

Mrs. Smith: Actually, I do have a few questions about what to expect after the surgery and how long the recovery process might take. 史密斯太太： 事實上，我確實對術後需要注意什麼，以及康復過程需要多長時間有一些疑問。

Dr. Johnson: Of course, Mrs Smith. After the surgery, you'll likely spend some time in the recovery area where our team will closely monitor your vital signs and ensure you're comfortable. Since a lumpectomy is a relatively minor procedure, you may not need to stay in the hospital overnight, but it depends on your specific situation and how you're feeling post-surgery. 約翰遜醫生： 當然可以，史密斯太太。手術後，您會先在麻醉復甦室待一段時間，我們的團隊將在那裡密切監測您的生命體徵並確保您感到舒適。由於乳房腫塊切除術是一個相對較小的手術，您可能不需要在醫院過夜，這取決於您的具體情況和您術後的感覺。

Dr. Johnson: As for the recovery process, you can expect some soreness and tenderness in the area where the lump was removed. We'll provide you with pain medication to help manage any discomfort. It's essential to avoid strenuous activities and heavy lifting for a few days to allow your body to heal properly. You may also experience some swelling and bruising, which is normal and should improve over time. 約翰遜醫生： 至於康復過程，切除腫塊的部位可能會有一些酸痛 and 觸痛。我們會為您提供止痛藥來緩解不適。術後幾天內必須避免劇烈運動和提重物，以便讓您的身體妥善癒合。您可能還會經歷一些腫脹和瘀青，這都是正常現象，會隨著時間逐漸改善。

Dr. Johnson: Most patients are able to resume their normal activities within a week or two after a lumpectomy. However, it's essential to follow your surgeon's post-operative instructions carefully to ensure a smooth recovery. We'll schedule follow-up appointments to monitor your progress and discuss any concerns you may have. 約翰遜醫生： 大多數患者在術後一到兩週內就能恢復正常活動。然而，認真遵循您的手術醫生的術後醫囑對確保順利康復至關重要。我們會為您安排隨訪預約，以監測您的進度並解答您的任何顧慮。

Dr. Johnson: If you notice any signs of infection, such as increased pain, redness, or swelling at the surgical site, or if you have any other concerns during your recovery, please don't hesitate to contact us. We're here to support you every step of the way and ensure you have a successful outcome. 約翰遜醫生： 如果您發現任何感染跡象，例如手術部位疼痛加劇、發紅或腫脹，或者在康復期間有任何其他顧慮，請隨時與我們聯繫。我們隨時為您提供支持，確保您獲得最好的康復結果。

Mrs. Smith: Thank you, Doctor Johnson. I appreciate your time and reassurance. 史密斯太太： 謝謝您，約翰遜醫生。非常感謝您的耐心解答和安慰。

Dr. Johnson: It's my pleasure, Mrs Smith. We'll work together to ensure you have the best possible outcome. If you have any more questions or if anything comes up, don't hesitate to let me know. We're here to support you. 約翰遜醫生： 這是我的職責，史密斯太太。我們將共同努力，確保您獲得最好的結果。如果您還有更多問題或有任何突發情況，請隨時告訴我。我們隨時支持您。

Mrs. Smith: Thank you, Doctor Johnson. I feel better knowing that I'm in good hands. 史密斯太太： 謝謝您，約翰遜醫生。知道自己託付給了優秀的醫療團隊，我感覺好多了。

Dr. Johnson: You're very welcome, Mrs Smith. We'll take great care of you. Now, let's get you ready for surgery. 約翰遜醫生： 不客氣，史密斯太太。我們會好好照顧您的。現在，讓我們為您做術前準備吧。

Narrator: And that concludes our dialogue on preoperative care, including what to expect after surgery and the recovery process for a lumpectomy. 旁白： 以上便是我們關於術前護理的對話，其中包括了術後注意事項以及乳房腫塊切除術的康復過程。

🔵 場景二：術後護理對話 / Post-Operative Care Dialogue

Narrator: Let's continue our exploration of patient care with a dialogue between a post-operative patient and a nurse. Let's listen in. 旁白： 讓我們通過護士和術後患者之間的對話，繼續了解患者的護理情況。讓我們一起來聽一聽。

Nurse Taylor: Good afternoon, Mrs Smith. I'm Nurse Taylor, and I'll be looking after you during your post-operative care today. How are you feeling? 護士（泰勒護士）： 下午好，史密斯太太。我是泰勒護士，今天由我來負責您的術後護理。您現在感覺怎麼樣？

Mrs. Smith: Good afternoon, Nurse Taylor. I'm feeling a bit groggy, but I'm doing okay. The surgery went well, right? 患者（史密斯太太）： 下午好，泰勒護士。我覺得有點迷迷糊糊的，但其他還好。手術很順利，對吧？

Nurse Taylor: Yes, Mrs Smith, your surgery went smoothly, and you're now in the recovery room. We're monitoring your vital signs closely to ensure everything continues to progress as expected. How's your pain level right now? Are you experiencing any discomfort? 護士： 是的，史密斯太太，您的手術進行得非常順利，您現在在恢復室。我們正在密切監測您的生命體徵，以確保一切繼續按預期進展。您現在的疼痛程度如何？有什麼不舒服的地方嗎？

Mrs. Smith: It's a bit sore around where the surgery was, but the pain medication is helping. I'd say it's about a 4 out of 10. 患者： 手術部位周圍有點酸痛，但止痛藥挺管用的。如果滿分是10分的話，現在的痛感大概是4分。

Nurse Taylor: Alright, I'll make a note of that. We'll continue to manage your pain medication to keep you as comfortable as possible. Now, let's talk about your mobility. It's essential to start moving around as soon as you're able to prevent blood clots and promote healing. Can you try to wiggle your toes and move your legs a bit for me? 護士： 好的，我會把這個情況記錄下來。我們會繼續管理您的止痛藥物，讓您儘可能保持舒適。現在，我們來談談您的活動能力。一旦您能夠活動，儘早開始活動是非常重要的，這可以預防血栓形成並促進癒合。您可以試著幫我動動腳趾，稍微抬抬腿嗎？

Mrs. Smith: Sure, let me try. 患者： 好的，我試試。

Nurse Taylor: Great job, Mrs Smith. It looks like you're able to move your legs well. We'll continue to encourage you to do gentle exercises and get up and walk with assistance when you're ready. 護士： 做得很好，史密斯太太。看起來您的腿部活動得很好。我們會繼續鼓勵您做一些輕微的練習，並在您準備好時，在協助下下床走動。

Mrs. Smith: Okay, I'll do my best. Can you tell me when I can expect to go home? 患者： 好的，我會盡力的。您能告訴我大概什麼時候可以回家嗎？

Nurse Taylor: Typically, patients can go home on the same day or the day after a lumpectomy, depending on how they're feeling and their surgeon's recommendations. Since your surgery went well and you're recovering nicely, we'll aim for you to go home tomorrow morning. In the meantime, we'll continue to monitor your progress and provide any necessary care and support. 護士： 通常情況下，做完乳房腫塊切除術的患者可以在當天或第二天回家，這取決於他們的個人感受和手術醫生的建議。既然您的手術很順利，而且恢復得很好，我們的目標是讓您在明天早上出院。在此期間，我們將繼續監測您的進展，並提供必要的護理和支持。

Mrs. Smith: That sounds good. Is there anything else I should be aware of or do during my recovery at home? 患者： 聽起來不錯。在我回家休養期間，還有什麼需要注意或需要做的嗎？

Nurse Taylor: Before you go home, we'll provide you with instructions on wound care, medication management, and any activity restrictions you should follow. It's essential to follow these instructions closely to ensure a smooth recovery and prevent complications. We'll also schedule a follow-up appointment with your surgeon to check on your progress and remove any stitches or dressings. 護士： 在您回家之前，我們會為您提供有關傷口護理、藥物管理以及您應該遵守的任何活動限制的詳細醫囑。嚴格遵守這些指示對於確保順利康復和預防併發症至關重要。我們還會為您預約手術醫生的隨訪，以檢查您的恢復進度並拆除縫線或敷料。

Mrs. Smith: Thank you, Nurse Taylor. I appreciate all your help and support during my recovery. 患者： 謝謝你，泰勒護士。非常感謝你在我康復期間給予的所有幫助和支持。

Nurse Taylor: You're welcome, Mrs Smith. It's our pleasure to care for you. If you have any questions or concerns at any time, don't hesitate to ask. We're here to help you every step of the way. 護士： 不客氣，史密斯太太。照顧您是我們的榮幸。如果您隨時有任何問題或顧慮，請儘管提出來。我們每一步都會在這裡為您提供幫助。

1. 核心临床阶段与流程 (Core Clinical Phases & Processes)

Preoperative care 術前護理 (手術前的準備與管理階段)

Postoperative care 術後護理 (手術後的持續管理、監測與康復支持)

Informed consent 知情同意書 (患者在充分了解手術風險與益處後簽署的法律文件)

Fasting instructions 禁食醫囑 / 禁食要求 (手術前限制飲食，通常為術前8小時的指令)

Follow-up appointment 隨訪預約 / 回診 (術後定期回醫院複查的預約)

2. 手術與解剖學術語 (Surgical & Anatomical Terms)

Lumpectomy 乳房腫塊切除術 / 腫塊切除術 (局部切除乳房腫瘤及周圍少部分健康組織的手術)

Breast cancer 乳癌 (發生在乳房腺上皮組織的惡性腫瘤)

Tumour 腫瘤 / 腫塊 (術中切除的病變組織)

Margin 切緣 (腫瘤周圍切除的健康組織邊緣，需確保無癌細胞殘留)

Incision 切口 (手術時用手術刀切開的傷口)

Stitches / Sutures 縫線 (用於關閉手術切口的醫用縫線)

Dressings 敷料 / 紗布 (覆蓋在傷口上用於保護和吸收滲出物的材料)

3. 麻醉与临床监测 (Anesthesia & Clinical Monitoring)

General anesthesia 全身麻醉 (全麻) (讓患者在手術中失去知覺、無痛感的藥物麻醉)

PACU (Post-Anesthesia Care Unit) 麻醉復甦室 / 術後恢復室 (患者術後甦醒、密切監測生命體徵的專門區域)

Vital signs 生命體徵 (包括血壓、心率、呼吸頻率、體溫等核心生理指標)

ECG / EKG (Electrocardiogram) 心電圖 (術前評估心臟功能的常規檢查)

Groggy 迷迷糊糊 / 意識未完全清醒 (麻醉甦醒期常見的頭暈、嗜睡狀態)

4. 术后症状与并发症管理 (Symptoms & Complications Management)

Pain management 疼痛管理 / 止痛控制 (術後使用止痛藥物或方法緩解患者痛感的流程)

Pain medication / Analgesics 止痛藥 (醫生開具的用於緩解術後不適的藥物)

Wound care 傷口護理 (清潔、消毒及更換手術切口敷料的過程)

Mobility 活動能力 / 肢體活動 (術後儘早進行的肢體活動，用以促進血液循環)

Blood clots 血栓 (術後長期臥床可能在深靜脈形成的塊狀凝血)

Infection 感染 (術後常見併發症，症狀包括發紅、腫脹、發熱、疼痛加劇)

Hemorrhage / Excessive bleeding 大出血 / 出血過多 (手術部位異常且大量的血液流失)

Swelling and Bruising 腫脹與瘀青 (術後組織創傷引起的常見局部生理反應)

Scar tissue 疤痕組織 (傷口癒合過程中形成的纖維組織)

Recurrence 復發 (癌症在切除後重新生長或出現)