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照顾身患癌症濒临死亡的儿童:姑息治疗团队在儿科肿瘤学中的作用。

Care of a child dying of cancer: the role of the palliative care team in pediatric oncology.

作者信息

Postovsky Sergey, Ben Arush Myriam Weyl

机构信息

Department of Pediatric Hemato-Oncology, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Pediatr Hematol Oncol. 2004 Jan-Feb;21(1):67-76.

Abstract

The last period of life of a child suffering from cancer is of crucial importance not only for the child himself but for his parents and relatives as well. The way the child dies will remain in the memory of his parents for ever. Multiple problems in management of dying child may arise during this last phase. Timely and sensitive discussion of such aspects of management as implementation of Do Not Resuscitate order, possible provision of fluids and parenteral nutrition, initiation of palliative sedation and management of depression is necessary and may help parents to better cope with this tragic situation. Palliative care team consisting of medical and psychosocial staff plays vital role conveying comprehensive and timely management of all these problems and providing all necessary assistance for parents and other involved during ones' last weeks, days, and hours of child's life. The palliative care team cannot avert approaching death but it is responsible for making it as peaceful and as free of suffering as possible. This is achieved by vigorous control of all physical symptoms in the dying child and by paying close attention to all existential, emotional, and social demands of both the child and his relatives.

摘要

身患癌症儿童生命的最后阶段不仅对孩子自身至关重要,对其父母和亲属也意义重大。孩子的离世方式将永远铭刻在父母的记忆中。在这最后阶段,可能会出现诸多临终儿童管理方面的问题。及时且贴心地讨论诸如下达“不要复苏”医嘱、可能提供的补液和肠外营养、启动姑息性镇静以及抑郁管理等管理方面的问题很有必要,这或许能帮助父母更好地应对这一悲惨局面。由医疗和心理社会工作人员组成的姑息治疗团队在全面、及时地处理所有这些问题,并在孩子生命的最后几周、几天和几小时内为父母及其他相关人员提供一切必要帮助方面发挥着至关重要的作用。姑息治疗团队无法避免死亡的临近,但有责任让死亡尽可能平静且免受痛苦。这通过积极控制临终儿童的所有身体症状以及密切关注孩子及其亲属在生存、情感和社会方面的所有需求来实现。

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