淺談化學治療引起周邊神經性病變之護理照護

Nursing Care of Chemotherapy-Induced Peripheral Neuropathy

化學治療引起周邊神經性病變（chemotherapyinducedperipheral neuropathy, CIPN）為接受神經毒性藥物如：紫杉醇類（taxanes）、鉑類（platinum）、長春花鹼類（vinca alkaloids）患者常見副作用，其會出現遠端肢體難以忍受的對稱性麻木、燒灼及刺痛感，嚴重影響病人生活功能及生活品質，嚴重時需降低藥量甚至中斷治療，故醫護人員應重視此議題。文獻查證發現，目前相關文獻對於CIPN照護文章較缺乏，故本文旨在協助護理人員瞭解化學治療引起之周邊神經性病變之臨床表徵、致病機轉、臨床評估及照護，適度強化患者肌力、平衡訓練及預防跌倒因子，以減緩症狀嚴重度並確保安全，進而提升此族群病人之生活品質。

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse event occurring in patients who receive neurotoxic chemotherapeutic agents such as taxanes, platinum, and vinca alkaloids. The manifestations of CIPN include intolerable symmetric numbness, burning and tingling in distal limbs, disruption of daily functions, reduced quality of life, and the reduction in dosage or discontinued use of these agents. There is a paucity of articles on nursing care related to CIPN in the literature. This article reviews the pathophysiology, clinical presentation, diagnostic criteria, medical management and nursing care of CIPN. Review findings are intended to help nurses identify high-risk groups in order to implement preventive measures that strengthen the muscles, train the balance, and initiate falling precautions of persons in this population. Timely preventive measures may effectively alleviate CIPN symptoms and assure the safety and overall quality of life of patients.