奥沙利铂化疗致外周神经毒性的护理体会

Nursing Experience of Oxaliplatin-induced Peripheral Nerve Toxicity

奥沙利铂是一种新的铂类抗癌药,具有广谱的体外细胞毒性及体内抗肿瘤活性作用,对顺铂耐药的肿瘤模型仍然有效,常用于转移性结、直肠癌或辅助治疗原发性肿瘤完全切除后三期结肠癌,也适用于经5-氟尿嘧啶治疗失败的结、直肠癌转移患者。但其突出的不良反应是外周感觉神经毒性,主要表现为感觉迟钝和(或)感觉异常,遇冷加重,这种毒性作用与其剂量有关,可表现为急性神经毒性和迟发型感觉神经障碍,影响其疗效和患者的生活质量。研究表明,治疗前后给予肿瘤患者正确有效的护理措施对于提高化疗的疗效和改善患者的预后具有十分重要的临床意义。因此,本文对健康指导、预防、对症护理及心理护理四个方面的护理体会进行了归纳,以期为奥沙利铂毒副反应的有效护理提供更多的参考依据。

Oxaliplatin is a new kind of anticancer platinum drug, which has a broad spectrum of cytotoxicity in vitro and antiturnor activity in vivo and is also effective against cisplatin-resistant tumor model, so it is commonly used in the adjuvant treatment of metastatic colorectal cancer or primary tumor after complete resection, and is also applied in the failure of 5-fluorouracil（5-FU） treatment of colorectal cancer with metastasis. But their prominence is the toxicity of peripheral sensory neurotoxicity, mainly insensitive and （or） sensory abnormalities, encounter cold accentuation. The toxicity is related to dose of drug, shows acute neurotoxicity and delayed sensory nerve disorder, affecting the efficacy of chemotherapy and quality of life. It has been indicated that correct and effective nursing intervention before and after treatment have great important clinical significance for improving the efficacy of chemotherapy and prognosis of patients. Therefore, four areas of nursing experiences i.e. health guidance, prevention, symptomatic care and psychological nursing care were summarized in this article, so as to provide more references for the chnical apphcation of oxaliplatin.