復發性肝癌病人初次接受射頻腫瘤燒灼術合併Sorafenib的護理經驗

The Nursing Experience for a Recurrent Hepatocellular Carcinoma Receiving Initial Radiofrequency Ablation Plus, Sorafenib Therapy

黃后萱(Hou-Hsuan Huang) ； 司淑英(Shu-Ying Szu) ； 宋聖芬(Sheng-Fen Sung)

《高雄護理雜誌》 35卷1期 (2018/04) Pp. 81-91

https://doi.org/10.6692/KJN.201804_35(1).0007

摘要

癌症復發為癌症病人在完成癌症治療後最擔憂的議題。本文為一位63歲復發性肝細胞癌病人初次接受射頻腫瘤燒灼術合併口服標靶藥物Sorafenib的護理經驗。筆者自2015年5月1日～10日護理期間，藉由身體評估、會談、溝通、傾聽、引導等方式進行資料收集，運用Gordon十一項健康評估工具進行個案生理、心理、靈性、社會之整體性護理評估，歸納出個案有焦慮、急性疼痛、潛在危險性皮膚完整性受損等健康問題。藉由提供射頻腫瘤燒灼術的治療過程相關訊息，減輕個案治療前的焦慮，治療後運用疼痛評估給予疼痛處置；並發現個案於服用Sorafenib前，已有皮膚乾燥的問題，服用後恐會加重皮膚毒性反應，加強教導個案自我照顧的方式，預防副作用發生。希望藉此經驗分享，能提供護理同仁臨床實務之參考。

關鍵字

復發性肝細胞癌 ； 射頻腫瘤燒灼術 ； Sorafenib ； 皮膚照護

並列摘要

Fear of recurrence is the worry and fear that cancer will come back again after treatment. It is the primary concern of cancer survivors. This case report demonstrated the nursing experience for a 63 year-old patient with recurrent hepatocellular carcinoma, who received first time radiofrequency ablation (RFA) plus the oral target therapy, Sorafenib. During 2015/05/01 ~ 2015/05/10, the clinical data were collected from physical examination, interview, communication, listening and guiding. Besides, ＂Gordon 11 Function Health Patterns＂ was also used for evaluating this case's physics, mentality, spirituality social abilities, etc. Finally, it was conclusively found that this subject had such problems as anxiety, acute pain, and potential skin injury. In this article, the related information during RFA treatment course was provided, including how to reduce the pre-treatment anxiety and how to manage pain due to treatment and give appropriate nursing by means of pain assessment scales. In addition, skin dryness was noted as well, which might have synergistic effect on skin toxicity caused by Sorafenib. Therefore, educating the patient about correct self-care is necessary for prevention of adverse effects. This case study would aid for registered nurses in clinical practice.

並列關鍵字

recurrent hepatocellular carcinoma ； radiofrequency ablation ； Sorafenib ； skin care

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