化學治療導致週邊神經病變之探討

Chemotherapy-Induced Peripheral Neuropathy

吳至容(Chih-Jung Wu) ； 王雅容(Ya-Jung Wang)

《腫瘤護理雜誌》 16卷1期 (2016/06) Pp. 25-33

https://doi.org/10.3966/168395442016061601004

摘要

化學治療導致週邊神經病變是癌症病人常見的副作用，受到化學治療藥物的使用劑量及累積劑量而影響各級神經系統的表現。因為症狀容易被忽視，一旦發生時，即已影響病人原有的生活品質，甚至中斷了持續進行的治療計畫。在臨床實務方面，護理人員仍缺乏化學治療導致週邊神經病變的標準評估方法和治療方式，經常遇到此症狀的病人時，對症狀的成因及處置不清楚的情境下，難以提供適切的照護措施。近幾年，國際間也漸漸重視此問題，並做為腫瘤照護發展重點之一。故本文針對化學治療導致週邊神經病變之症狀、影響因素、診斷評估方法、治療方向及護理措施，做一系統性的整理及探討。

關鍵字

化學治療 ； 化學治療導致週邊神經病變

並列摘要

Chemotherapy induced peripheral neuropathy (PICN) is one of the common side effects in patients with cancer. The manifestation of CIPN signs and symptoms of the nerves are different based on administered dosage or cumulative dosage of antineoplastic drug. CIPN is easily missed. Therefore, when it's noted, it usually is already in the stage where the patient's quality of life is impacted and even with the scheduled chemotherapy interrupted. There is still a lack of standardized clinical assessment and managing guideline leaving the nursing staff often feeling inadequate when facing patients with the CIPN, because they are not clear on the causes or related care. This CIPN guideline issue has become an international concern in cancer care. The focus of this review is to identify the signs and symptoms, impact factors, assessment and diagnostic methods, and treatment of the CIPN.

並列關鍵字

chemotherapy ； chemotherapy-induced peripheral neuropathy(CIPN)

參考文獻

Argyriou, A. A., Bruna, J., Marmiroli, P., & Cavaletti, G. (2012). Chemotherapy-induced peripheral neurotoxicity (CIPN): An update. Critical Reviews in Oncology/ Hematology, 82(1), 51-77. doi:10.1016/j.critrevonc.2011.04.012

Armstrong, T., Almadrones, L., & Gilbert, M. R. (2005). Chemotherapy-induced peripheral neuropathy. Oncology Nursing Forum, 32(2), 305-311. doi:10.1188/05.ONF.305-311

Binkley, J. M., Harris, S. R., Levangie, P. K., Pearl, M., Guglielmino, J., Kraus, V., & Rowden, D. (2012). Patient perspectives on breast cancer treatment side effects and the prospective surveillance model for physical rehabilitation for women with breast cancer. Cancer, 118(8, Suppl), 2207-2216. doi:10.1002/cncr.27469

Binner, M., Ross, D., & Browner, I. (2011). Chemotherapy-induced peripheral neuropathy: Assessment of oncology nurses’ knowledge and practice. Oncology Nursing Forum, 38(4), 448-454. doi:10.1188/11.ONF.448-454

Carey, M., Jefford, M., Schofield, P., Kelly, S., Krishnasamy, M., & Aranda, S. (2006). Development and evaluation of an audiovisual information resource to promote self-management of chemotherapy side-effects. Support Care Cancer, 14(4), 361-368. doi:10.1007/s00520-005-0909-1