1例希罗达致Ⅲ度手足综合征的循证护理

目的针对1例由卡培他滨（希罗达）所致的Ⅲ度手足综合征的乳腺癌患者，检索当前的最佳证据，寻求缓解病人症状和体征的护理方法。方法计算机检索Cochrane图书馆（2008年第1期）、ACP Journal Club（1991—2008）、MEDLINE（1966～2008）、CBMdisc（1995～2008），收集有关卡培他滨（希罗达）所致的Ⅲ度手足综合衙的护理方法的文献，并对所获证据进行评价。结果对由卡培他滨所致的Ⅲ度手足综合征的患者，有两种有效措施：①停药或调整药物剂量，并同时进行对症支持治疗和护理。②不停药或调整药物剂量，改用中草药治疗。我们遵循证据并结合患者意愿，对患者进行停药和对症支持治疗和护理，两周后患者恢复良好。结论对于由卡培他滨引起的Ⅲ度手足综合征患者，可以采用停药和对症支持的治疗和护理措施来缓解患者症状与体征。

Evidence-Based Nursing of a Patient with Grade Ill Hand-foot Syndrome Induced by Capecitabine

Objective To formulate an evidence-based nursing methods for a patient with grade Ⅲ hand-foot syndrome induced by capecitabine. Methods Based on the clinical questions, we searched The Cochrane Library （Issue 1, 2008）, ACP Journal Club （1991 to January 2008）, MEDLINE （1996 to 2008） and CBMdisc （1995 to 2008）. The retrieved studies were further critically appraised. Results There were two effective measures in patients with grade Ⅲ hand-foot syndrome induced by capecitabine： （1） Treatment interruption or dose reduction with supportive measures to reduce pain and discomfort and prevent secondary infection. （2） Using Traditional Ghinese Medicine and no need of treatment interruption or dose reduction. With patients preference, Treatment interruption and supportive measures were administered to the patient. After two weeks, the patient had a complete response. Conclusions To patients with grade Ⅲ hand-foot syndrome induced by capecitabine, treatment interruption and supportive measures are effective nursing methods.