- 期刊
一位乳癌病人術後慢性複雜性疼痛以高壓氧治療之呼吸照護
Respiratory Care in Hyperbaric Oxygen Therapy for a Breast Cancer Patient with Chronic and Complicated Pain after Receiving Surgery
摘要
根據文獻調查，乳癌病人術後接受化學療法與放射療法後，發生持續性關節和肌肉疼痛與僵硬的盛行率為62%，其疼痛與僵硬會影響病人生活品質甚至中斷治療。本個案為乳癌病人，2007年4月接受左側乳房和淋巴部分切除，自2007年起陸續接受化學藥物治療與放射線治療後，除了發生慢性持續性關節和肌肉疼痛與僵硬之外，並於2007年被醫師診斷為肌纖維痛症（fibromyalgia）。病人依照醫囑服用止痛藥物（Celebrex），期間因發生嚴重副作用（視力無顏色、無法行走、自殺傾向），於2008年1月停用。之後，病人除了疼痛和精神倦怠等症狀，視力、聽力、呼吸系統、腸胃系統也受到影響。多年來，病人接受醫師各種不同的治療方式（藥物、復健、靜脈雷射、自體血小板血漿注射），症狀仍無法有效改善。病人自2011年起陸續接受高壓氧治療，治療後病人自覺性評估與臨床客觀的觀察結果發現，高壓氧除了能進一步改善疼痛與僵硬外，精神倦怠，視力、聽力、呼吸系統、腸胃系統的改善也令病人感到滿意。顯示高壓氧治療效果良好，也許可以做為頑固性肌纖維痛症病人的替代療法。目前慢性骨骼肌肉疼痛和肌纖維痛症非美國海底暨高壓氧醫學會（UHMS）認可的適應症，但高壓氧廣泛應用於各種症狀的治療（包括慢性骨骼肌肉疼痛和肌纖維痛症）。雖然對許多症狀的治療證據力仍然不足，但其發展潛力不容小覷。為此，本文藉由乳癌術後慢性複雜性疼痛以高壓氧治療有效改善持續性疼痛個案，延伸呼吸治療角色與功能於緩和疼痛領域的經驗分享。
關鍵字
無資料並列摘要
The prevalence of developing chronic and complicated pains and stiffness was 62% percent in breast cancer patients accept chemotherapy and radiotherapy after performing mastectomy. A variety of complications have affected quality of life, breast cancer patients may stop the treatment due to pains and stiffness.Causes of chronic pains and stiffness are age, osteoarthritis, chemotherapy drug (taxane), aromatase inhibitors and tamoxifen. Medications were effective methods to relieve chronic and complicated post-mastectomy pain in most patients, but were invalid in a few patients. And alternatives were physical therapy, ecotherapy, massage, low level intravenous laser, platelet rich plasma, and hyperbaric oxygen therapy.Our case was a breast cancer patient, she underwent left breast mastectomy and lymph node dissection in April 2007, and took chemotherapy and radiotherapy from 2007. She had has articular and muscular aches with stiffness. The fibromyalgia was also diagnosed in 2007, and she took an analgesia (Celebrex) to relieve pain. The side effects of vision without color, inability to walk, suicide attempting were developed, so Celebrex was cancelled by her doctor. She also felt fatigue, and affected by vision, hearing, respiratory system, and gastro-intestinal system.Her doctor was trying many strategies (drugs, intravenous laser, hyperbaric oxygen therapy, platelet-rich plasma) to treat her suffering, but don't satisfy the client. According to study, local muscle hypoxia was the major reason of fibromyalgia, and hyperbaric oxygen therapy can effectively improve patient's persistent pain and points of tenderness. So, she took several times of hyperbaric oxygen therapy from 2011. We asked the patient to perform self-evaluation and took clinically objective observation. Through the outcome evaluation, pains and stiffs were further improved, she was also satisfied for improving in activities, vision, hearing, respiratory system, and gastro-intestinal system. These amazing improvements in hyperbaric oxygen therapy may be an alternative to fibromyalgia.Fibromyalgia is not the indication for hyperbaric oxygen therapy has approved by The Undersea and Hyperbaric Medical Society. But, many doctors still convinced the benefits of hyperbaric oxygen therapy to fibromyalgia, although there are not enough evidences. From the vigorous tendency of studying in hyperbaric oxygen. The future space of development of respiratory therapist is significantly broadening and important in the field. Therefore, we want to expand the role and function of respiratory therapist in hyperbaric oxygen therapy by this case report of alleviating consistent fibromyalgia pain.