照顧一位藥物引起毒性表皮裂解症之護理經驗

The Nursing Experience of a Patient with the Drug-induced Toxic Epidermal Necrolysis Syndrome

王馥容(Fue-Jung Wang) ； 高淑雰(Shu-Fen Kao)

《安泰醫護雜誌》 19卷1期 (2013/03) Pp. 1-11

摘要

口腔癌近十年來躍升為位居台灣男性十大癌症死因第四位，佔男性癌症死亡的8.3%，與嚼食檳榔、抽煙及喝酒相關（行政院衛生署，2008）而毒性表皮裂解症發生率較低，每年每百萬人約有0.4－1.5個病例（Roland G.，Mathias N.，Thomas E.，2011）。口腔癌患者接受腫瘤切除手術後需利用顯微皮辦重建缺損部位；毒性表皮裂解症發生率雖低但死亡率高，因皮膚廣泛性脫落直到傷口癒合需要長時間治療。此個案於住院期間分別罹患上述兩種重症疾病，皆須學習返家後自我照護技能，如何提供各個案對疾病心理、生理變化及教導所需知識，筆者希望在此次照顧經驗能改善其病症，同時強化個案之居家照護技能。

關鍵字

毒性表皮裂解症 ； 口腔癌 ； 藥物引起

並列摘要

In the last decade, oral cancer has topped the forth place among the ten leading causes of cancer deaths in Taiwanese males, accounting for 8.3% of the male cancer deaths, and it is related to betel nut chewing, smoking and drinking (Department of Health, Executive Yuan, 2008). On the other hand, toxic epidermal necrolysis has a lower incident rate with approximately 0.4 to 1.5 cases in every million people each year (Roland G., Mathias N., Thomas E., 2011). Oral cancer patients having undergone tumor resection need to reconstruct the defected area by using microsurgical flaps, whereas the relatively lower incidence rate of toxic epidermal necrolysis can often lead to a high death rate for that there is a need of long-term treatment for extensive skin shedding until the wound is completely healed. The patients who have suffered the abovementioned two severe diseases respectively during their hospitalization need to learn self-caring skills before they return home. The writer intends to propose the necessary knowledge for the cases in terms of disease psychology, physiological changes and instructions so that the patients' symptoms can be improved through this caring experience while strengthening their home care skills at the same time.

並列關鍵字

Toxic Epidermal Necrolysis Syndrome ； Baccul Cancer ； Drug-induced