本文旨在探討一位罹患慢性阻塞性肺疾病併肺腺癌的84歲男性，因呼吸衰竭行氣切術後長期使用呼吸器，協助其脫離呼吸器之護理經驗。於2012年9月20日至11月15日護理期間，運用Gordon十一項功能性健康型態評估收集資料，分析後確立存在健康問題：呼吸道清除功能失效／痰液增加及呼吸肌耐力衰竭、無法有效咳嗽，活動無耐力／使用呼吸器致長時間臥床致肌力下降，睡眠型態紊亂／痰液增加夜咳頻繁，焦慮／陌生環境及擔心呼吸器不運作影響其呼吸。護理過程中，與醫師、呼吸治療師、營養師、復健師等團隊合作，提供飲食指導、教導有效咳嗽、鼓勵漸進下床等措施，以利清除痰液。執行復健計畫加強肌耐力，改善活動無耐力情形。藉由藥物使用及夜間集中護理措施，緩解夜咳以改善睡眠品質。個案嘗試脫離呼吸器的過程中，多次失敗導致喘不過氣的失敗經驗，除承受生理疲勞，也產生焦慮等心理問題，個案的疲憊也使得家屬面臨照護方面的壓力。照護期間，藉由紙筆交談方式，引導個案說出內心感受、抒發不安情緒，給予正向鼓勵，並教導家屬返家後的照護技能，成功協助個案脫離呼吸器。藉此個案護理經驗分享，提供日後照護此類病患之護理人員參考。

This article presents the nursing experience of assisting an 84-year-old male patient with chronic obstructive pulmonary disease and lung adenocarcinoma weaning from a mechanical ventilator on which he had depended for a long time since his surgery of tracheostomy caused by respiratory failure. During the nursing period from 20th September, 2012 to 15th January, 2012, using Gordon eleven-functional health patterns as the assessment tool, four major nursing problems were identified. They included airway clearance-ineffective, exercise intolerance, sleep disturbance, and anxiety. During the process of nursing care, we teamed up with the doctors, respiratory therapists, dietitians, and physical therapists to provide instructions of nutrition, deep breathing exercises and effective coughing, and encourage the patient to get out of the bed for exercising in order to cough up sputum more easily. To improve symptoms of exercise intolerance, a rehabilitation plan was established. Through administrating medications and providing concentrated care at night, we were able to relieve night coughs and improve the patient’s. sleep quality. Most of the failed experiences of out of breathing made the patient suffer not only physical fatigue but also helpless feeling and anxiety during the training process of weaning from the mechanical ventilator. The patient’s family also faced the challenge. During the nursing, we communicated with the patient through writing, guided him to talk about his feelings, provided him positive feedback, and taught his family homecare skills. Finally, we helped the patient wean from the mechanical ventilator successfully. Hence, we share this nursing experience as an example for nurses on how to take care of this type of patients.