癌症末期病人成功脫離非侵襲性正壓呼吸器之照護經驗

Successful Weaning of Bi-PAP in Terminal Cancer Patients

黃惠美(Hui-Mei Huang) ； 陳孟君(Men-Jim Chen) ； 翁益強(Yih-Chyang Weng)

《安寧療護雜誌》 11卷1期 (2006/02) Pp. 52-58

https://doi.org/10.6537/TJHPC.2006.11(1).5

摘要

呼吸困難會發生在70%癌症末期病人身上，除了造成身體上不適外，也會讓病人感到焦慮、無助，甚至聯想到死亡的威脅。當病人出現呼吸困難，且不適合用人工呼吸器時，醫師可能會選擇使用非侵襲性正壓呼吸器(bi-positive airway pressure, Bi-PAP)輔助呼吸。但是病人若長期使用非侵襲性正壓呼吸器，不僅會影響病人舒適度，妨礙與他人溝通，還會增加病人不安與焦慮。本文分享臺中榮民總醫院安寧病房臨床實際脫離成功案例之經驗，並透過討論有效的安寧療護措施與整理相關文獻，希望提供其他醫療團隊面對使用非侵襲性正壓呼吸器的癌症末期病人，也盡可能利用安寧療護照護方法來協助病人脫離，減輕病人的不舒適，進而增加與家屬的互動，以提升病人的生命品質。

關鍵字

呼吸困難 ； 非侵襲性正壓呼吸器 ； 緩和療護

並列摘要

Seventy percentage of terminal cancer patients experience dyspnea, which induces physical distress, anxiety, hopelessness, and the thread of death. Physicians may choose bi-positive airway pressure (Bi-PAP) for dyspnea patient when the ventilator is not suitable or patient refuses it. But long term usage of Bi-PAP would make patient very discomfort, hinder from verbal function, and even exacerbates more anxiety. There are some experiences of successful weaning of Bi-PAP in terminal cancer patients at palliative care ward of Taichung Veteran General Hospital. Through discussing some effective nursing of palliative care, reviewing the literatures, and reporting the successful cases, we may provide the possibility of weaning Bi-PAP for terminal cancer patients with dyspnea, and it may really reduce patient discomfort, encourage interaction between patient and family, and promote patient's life quality.

並列關鍵字

dyspnea ； bi-positive airway pressure Bi-PAP ； palliative care