臨床護理人員在嵌合抗原受體T細胞治療中的角色

The Role of Nurses in Chimeric Antigen Receptor T-Cell Therapy

CAR-T（chimeric antigen receptor T-cell）細胞治療是近年癌症醫學的重要突破，透過改造病人自體T細胞以精準攻擊腫瘤，為難治型血液腫瘤病人帶來新的治療契機。然而，此療法過程複雜，並伴隨細胞激素釋放症候群、免疫效應細胞相關神經毒性及感染等高風險副作用，對臨床護理提出嚴峻挑戰。護理人員在CAR-T治療中扮演關鍵角色，涵蓋治療前的衛教與健康評估、治療期間的嚴密監測與併發症處置，以及出院後的追蹤與自我照護指導。護理師需具備臨床敏銳度，能及早辨識副作用的危險徵兆，並與跨專業團隊緊密合作以確保及時處理。此外，護理人員也是病人與家屬的重要溝通橋梁，不僅協調跨專業團隊以確保治療計畫正確執行，並提供心理支持以減輕焦慮與不確定感。出院後，護理人員透過衛教與持續性追蹤，能有效提升病人與家屬的自我管理能力，增進治療安全與生活品質。總結而言，CAR-T細胞治療的成功不僅仰賴醫療技術的進展，更倚重護理人員全方位的專業照護與人文關懷。

Chimeric antigen receptor T-cell (CAR-T) therapy represents a significant breakthrough in contemporary oncology. By engineering patients’autologous T cells to precisely target tumor cells, CAR-T offers new treatment opportunities for individuals with refractory hematologic malignancies. However, the therapeutic process is complex and accompanied by high-risk adverse effects, including cytokine release syndrome, immune effector cell–associated neurotoxicity, and infections, all of which pose major challenges to clinical nursing. Nurses play a pivotal role across the CAR-T care continuum in terms of providing pre-treatment education and health assessments, vigilant monitoring and complication management during therapy, and post-discharge follow-up and self-care guidance. Clinical nurses must demonstrate acute clinical sensitivity to identify the early warning signs of adverse events and collaborate closely with multidisciplinary teams to ensure timely intervention. Moreover, nurses serve as essential communicators between patients and families, coordinating interdisciplinary care to ensure treatment plans are implemented accurately as well as providing psychological support to reduce anxiety and uncertainty. In the post-discharge phase, ongoing education and follow-up further empower patients and caregivers to strengthen self-management skills, thereby enhancing treatment safety and quality of life. In conclusion, the success of CAR-T therapy depends not only on advances in medical technology but also on the comprehensive professional care and humanistic support delivered by nurses.