肝癌局部治療及其照護

Local Ablative Treatments and Nursing Care of Hepatocellular Carcinoma

李梅琛(Mei-Chen Lee) ； 梁嘉德(Ja-Der Liang) ； 李釙汾(Pu-Fen Lee) ； 王芳婷(Fang-Ting Wang)

《腫瘤護理雜誌》 12卷1期 (2012/06) Pp. 19-29

https://doi.org/10.6880/TJON.201206_12(1).03

摘要

台灣為肝癌的高盛行區域，根據2010年行政院衛生署統計肝癌為男性癌症死亡原因的首位，女性則居第二位，肝癌初期症狀並不明顯，通常於確診後僅有15-20%適合外科治療或肝臟移植，晚期肝癌則採取支持性療法。小型肝癌患者大多數採取局部治療方式如：經皮酒精注射療法、經皮醋酸注射療法、無線頻率電燒療法、經皮微波凝固療法、冷凍療法等。病患接受局部治療期間，可能引起生理、心理層面的健康問題，如體溫過高、急性疼痛、焦慮、潛在危險性出血、潛在危險性感染等。因此，護理人員於治療期間必須密切監測生命徵象變化，指導降低體溫、減緩疼痛及焦慮的方法，及協助預防出血及感染等併發症的產生。目前相關文獻著重在外科手術及經動脈化學治療的介紹，較少提及局部治療的整體介紹。希望藉由本文簡介肝癌局部治療方式及其照護，提供臨床護理人員照護學理之依據，期能提升患者於治療期間之照護品質。

關鍵字

肝癌 ； 肝細胞癌 ； 局部治療

並列摘要

The incidence of hepatocellular carcinoma (HCC) is high in Taiwan. Based on the accounting and statistics from Executive Yuan, department of health in 2010, hepatocellular carcinoma is the first ranked cause of death in man and the second in women. The symptoms of the HCC patients at the initial stage are usually unnoticed, and only about 15-20 percents of patients after confirming the diagnosis could receive surgical treatment or liver transplantation. The HCC patients at the terminal stage usually received supportive therapy. The majority of the patients with the small type of HCCs received local ablative treatments, such as percutaneous ethanol injection therapy, percutaneous acetic injection, radiofrequency ablation, percutaneous microwave coagulation therapy, cryotherapy, and so on. The patient's physical and mental health problems were identified during the period of the local ablative treatment, including hyperthermia, pain, anxiety, bleeding risk for, infection risk for. Therefore, nurses must closely monitor the patients' vital sign during the treatment period, teach them how to lower body temperature, relieve pain and anxiety, and detect hemorrhage and infection complications. Most literature focused on the introduction of the surgical operation and transcatheter arterial chemoembolization, and little mentioned about the local treatment. Therefore, this article is to guide clinical nurses how to provide nursing care based on scientific knowledge, and promote the patient care quality during the treatment period.

並列關鍵字

hepatic cancer ； hepatocellular carcinoma ； local ablative treatments