化學治療是非常重要的癌症治療方式,而化學治療引起的周邊神經病變(Chemotherapy-Induced Peripheral Neuropathy,CIPN)發生率大約10-100%,除了會影響癌症病人日常生活、社交活動或造成情緒困擾外,當CIPN症狀變嚴重時,病人則須減少藥物劑量的施打或暫停治療;但即使停藥,CIPN症狀仍可能會持續一段時間後才逐漸減輕,而有些藥物所產生的症狀,則為不可逆或不會緩解。目前醫護人員及病人普遍對CIPN的認知不足,常常忽略此症狀的存在,因此,希望透過此文章提供CIPN機轉、臨床表徵、危險因子、預防處置及護理照護的資訊,讓醫護人員對於CIPN有完整的認識,且能事先教導病人辨認CIPN可能產生的症狀及瞭解CIPN對其日常生活的影響。護理人員不僅可透過執行身體評估、有效症狀處置及病人教育,並參與跨團隊合作,以提供病人完善的居家照護,進而提升癌症病人的照護及生活品質。
Chemotherapy has been one of the main treatments used to fight cancer. The incidence of chemotherapy-induced peripheral neuropathy (CIPN), however, is approximately 10-100%. This condition can interfere with daily life, social activities and can cause emotional distress. In addition, it is common in practice to reduce the dosage or delay the administration of the next cycle of chemotherapy in response to worsened CIPN symptom. CIPN may lessen over time, but it’s a gradual process that requires several months to resolve. Unfortunately, in some cases, the damage is irreversible or may not diminish in intensity. Health professionals have little understanding about CIPN, and its existence is often overlooked. We hope this article will provide useful information of CIPN mechanism, signs/symptoms, risk factors, preventions and nursing managements to health professionals. Patients can identify their symptoms and understand the impact of CIPN on their life through education by nurses. Excellent home care services for cancer patients could be developed through nursing assessment, effective symptom management and patient education, and through the cooperation of the multi-disciplinary team to improve the care and quality of life.
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