潘科斯特腫瘤之介紹及其臨床照顧

Pancoast Tumor: Introduction and Clinical Nursing Care

近幾年來肺癌一直是國人十大死因之首，而潘科斯特腫瘤是屬於肺癌中少見的肺部腫瘤型態，這類型的腫瘤多侵犯肺部周邊位置，以致於咳嗽、呼吸困難及咳血等肺部症狀是較不常見的表現，也因此常被忽略為肺部疾病。病人常因肩膀疼痛而就醫，但卻往往被誤診為頸部骨關節炎、肩膀滑囊炎或旋轉袖損傷，而被延遲診斷。本文藉由相關文獻回顧提供病史詢問及理學檢查重點，以區辨出病人主要的問題，經由耐心傾聽及主動表達關心，與病人建立良好的治療性人際關係及信任感，培養具有希望的信念系統，增加對疾病及生活的控制力。有鑒於目前針對區辨初期潘科斯特腫瘤症狀的文獻甚少，期望透過本篇文獻回顧，提供臨床專科護理師未來在照顧此類個案的參考，提升個案的照護品質。

Recently lung cancer has become the top leading cause of cancer related deaths in Taiwan. A Pancoast tumor is an uncommon type of lung cancer. It tends to invade the apex and adjoining areas so the symptoms of cough, dyspnea and hemoptysis are uncommon. Patients usually have shoulder pain which was often misdiagnosed as cervical osteoarthritis, shoulder bursitis, or rotator cuff injury. This article reviewed related literature about appropriate history taking, diagnostic tests for differential diagnosis, and evidence-based treatment. It is hoped that it can provide nurse practitioners with a reference for this rare condition and using it as the base for improving the quality of care for patients with Pancoast cancer patients.