癌症食慾不振和惡病質症候群之處置

Management of Cancer-Related Anorexia and Cachexia Syndrome

廖幼婕(Yu-Chien Liao) ； 李芸湘(Yun-Hsiang Lee) ； 賴裕和(Yeur-Hur Lai)

《腫瘤護理雜誌》 11卷2期 (2011/12) Pp. 11-21

https://doi.org/10.6880/TJON.201112_11(2).02

摘要

食慾不振—惡病質症候群是癌症病人最常見的症狀，往往能導致病人體力衰退、病人—照顧者關係緊張、情緒困擾、社會活動受限，甚至造成死亡。然而，卻也是最易被臨床人員及研究者忽略的問題之一。護理人員在癌症照護團隊中扮演樞紐角色，應熟悉此高發生率問題之症狀及現有實證研究結果，以提供病人及家屬及時的評估、處置及轉介。本文旨在論述食慾不振－惡病質症候群之定義、機轉、相關症狀、及其對病人之衝擊，統整近十年處置此症候群之實證研究結果，並提出臨床護理應用之建議。為能提供以病人為中心之個別化症狀處置方式，護理措施應包括常規性的食慾不振－惡病質評估及營養評估、增加食物攝取、促進能量代謝的平衡，及處置造成食慾不振－惡病質的原因，以預防及改善此症候群進而提升癌症病人的生活品質。

關鍵字

癌症食慾不振—惡病質症候群 ； 症狀處置 ； 體重減輕 ； 實證護理

並列摘要

Cancer-related anorexia and cachexia syndrome (CACS) is the most prevalent problem in cancer patients. It leads to adverse outcomes including physical deterioration, patient-caregiver strain, psychological distress, social activity isolation as well as mortality. However, this problem has not been well managed and fully studied. Nurses play a key role in timely symptom management and referral for cancer patients in a multidisciplinary cancer care team. Thus a greater understanding of the CACS's etiology, mechanism, and evidence-based management strategies is imperative. This report reviews the literature on the definition, mechanism, symptoms, impacts on patients and families, and management strategies of the CACS. Based on the latest empirical evidence of the CACS, several clinical implications are proposed. To provide individualized cancer care and improve patients’ quality of life, it is essential to develop a nurse-led symptom management program emphasizing on routinely assessment of CACS symptoms and nutrition status, increasing intake of food, eliminating factors causing the CACS and keeping energy balance.

並列關鍵字

cancer-related anorexia and cachexia syndrome ； symptom management ； weight loss ； evidence-based practice