乳腺癌 IV 期患者化疗所致周围神经病变的综合康复案例研究

Baneeha Zainab, Um I Lela, Kiran Shahzadi, Laiba Manzoor
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摘要

背景:化疗诱发的周围神经病变(CIPN)是癌症治疗的一个重要并发症,影响了相当一部分患者,严重影响了他们的生活质量。目前的管理策略往往无法解决这种病症的多面性,这就凸显出需要采取包括生理、心理和社会因素在内的综合方法:本研究旨在评估多模式康复计划在改善一名患有中度 CIPN 的 IV 期乳腺癌患者的身体功能和心理健康方面的效果:一名 40 岁的 IV 期乳腺癌女性患者接受了为期 5 周的多模式康复计划,包括物理治疗、社会心理支持和移动治疗。在干预前后,使用手部测力计、动态关节角度计和标准化心理量表对患者的握力、膝关节和肩关节屈伸、神经性疼痛(DN4)、焦虑和抑郁(HADS)以及整体生活质量进行了评估:治疗后的结果显示:患者的握力有了明显改善:右手握力从 10 千克增至 13 千克,左手握力从 9 千克增至 14 千克;膝关节屈曲度从 120°增至 129°(右手),125°增至 132°(左手);肩关节屈曲度从 149°增至 160°(右手),152°增至 159°(左手)。心理评估显示,焦虑(HADS)得分从 12 分降至 8 分,抑郁从 10 分降至 5 分。DN4 评分从 7 分降至 4 分,表明神经性疼痛有所减轻。生活质量评估也显示出明显的改善:综合康复计划有效地显著改善了一名重度 CIPN 患者的生理和心理指标。该病例证明了多学科方法在管理 CIPN 方面的潜在益处,表明类似的综合护理模式在肿瘤康复中具有更广泛的适用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case Study on the Integrated Rehabilitation of Chemotherapy-Induced Peripheral Neuropathy in a Patient with Stage IV Breast Cancer
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a significant complication of cancer treatments, affecting a substantial proportion of patients and severely impacting their quality of life. Current management strategies often fall short in addressing the multifaceted nature of this condition, highlighting the need for integrated approaches that encompass physical, psychological, and social elements. Objective: This study aimed to evaluate the efficacy of a multimodal rehabilitation program in improving physical function and psychological well-being in a patient with Stage IV breast cancer experiencing moderate CIPN. Methods: A 40-year-old female with Stage IV breast cancer underwent a 5-week multimodal rehabilitation program, including physical therapy, psychosocial support, and mobility therapy. Assessments of grip strength, knee and shoulder flexion, neuropathic pain (DN4), anxiety and depression (HADS), and overall quality of life were conducted pre- and post-intervention using a hand dynamometer, goniometer, and standardized psychological scales. Results: Post-treatment results demonstrated significant improvements: grip strength increased from 10 kg to 13 kg (right hand) and 9 kg to 14 kg (left hand); knee flexion improved from 120° to 129° (right) and 125° to 132° (left); shoulder flexion increased from 149° to 160° (right) and 152° to 159° (left). Psychological assessments showed a reduction in anxiety (HADS) scores from 12 to 8 and depression from 10 to 5. The DN4 score decreased from 7 to 4, indicating a reduction in neuropathic pain. Quality of life assessments also noted significant enhancements. Conclusion: The integrated rehabilitation program was effective in significantly improving both the physical and psychological parameters in a patient with severe CIPN. This case supports the potential benefits of multidisciplinary approaches in managing CIPN, suggesting wider applicability for similar comprehensive care models in oncological rehabilitation.
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