肺小細胞癌合併上腔靜脈症候群及急性呼吸道阻塞病患之呼吸照護經驗

Respiratory Care Experience of a Patient with Small Cell Lung Cancer and Complicated with Superior Vena Cava Syndrome and Acute Airway Obstruction

潘建南(Jian-Nan Pan) ； 劉雅芳(Ya-Fan Liu) ； 簡瑞容(Ruei-Rong Jian) ； 葉咏欣(Yong-Sin Ye) ； 江盛君(Sheng-Chun Chiang) ； 李俊年(Chun-Nin Lee)

《呼吸治療》 8卷2期 (2009/07) Pp. 69-77

https://doi.org/10.6269/JRT.2009.8.2.06

摘要

上腔靜脈症候群是由於上腔靜脈阻塞或狹窄所引起，其原因有惡性腫瘤或良性病灶。常見的惡性腫瘤主要是肺癌和縱隔腔腫瘤。治療模式必須根據其潛在病因。在傳統治療上，有外科繞道手術、體外放射線治療、化學治療及內科療法。本個案是一位小細胞肺癌合併上腔靜脈症候群並併發急性上呼吸道阻塞的患者。病患接受緊急氣管切開術及內科療法（類固醇及利尿劑）以維持呼吸道通暢後再接受放射線治療。根據文獻查證顯示，氣管切開術並不常被建議在治療急性的上腔靜脈症候群。然而由此病患的治療經驗，我們發現緊急氣管切開術在緩解急性上呼吸道阻塞有其需要性

關鍵字

肺小細胞癌 ； 上腔靜脈症侯群 ； 急性呼吸道阻塞

並列摘要

Superior vena cava syndrome is caused by obstruction of the superior vena cava due to a variety of malignant and benign entities. The most common malignant entities are lung cancer and mediastinal tumor. Conventional treatments include bypass surgery, external beam radiation therapy, chemotherapy, and medical treatment. This patient is a victim of small cell lung cancer with superior vena cava syndrome and complicated with acute upper airway obstruction. Patient received urgent tracheostomy and medical treatment（corticosteroid and diuretics）to maintain the airway and then received radiotherapy. Based on literature review, tracheostomy usually was not recommended for the treatment of superior vena cava syndrome. However, base on the treatment experience of this patient, we found that tracheostomy may be necessary for relief acute upper airway obstruction.

並列關鍵字

Small cell lung cancer ； Superior vena cava syndrome ； acute airway obstruction