Inoue Y, Tatewaki M, Mori S, Takahashi M
Dept. of Nursing Services, Tsuruoka Kyouritsu Hospital.
Gan To Kagaku Ryoho. 1997 Dec;24 Suppl 4:517-21.
The patient was an 86-year-old man with mild dementia, and a urinary bladder catheter already inserted for benign prostata hypertrophy. At this time he had jaundice due to duodenal papillary cancer and was inserted with a percutaneous transhepatic bile drainage tube (PTBD). Additionally, due to an obstruction of his duodenum, he received a percutaneous endoscopic gastrostomy tube (PEG) for suction of gastric juice and intravenous hyperalimentation catheter (IVH) for nutrition. He always wished to return home. The medical staff and his family discussed this many times to realize his hope. We his daughter-in-law how to handle the 4 tubes. When she learned how, he went home and was on the visiting care system. But only one week after, despite his stability, his son, who was living apart got drunk and sent him back to the hospital. We tried to persuade them, including all family members living apart. At last he could return home again, and one week after died quietly at home. We learn from this case that it is important and very difficult for a family to accept a terminal cancer patient at home. It is necessary to advice them from two stand-points, the medical techniques and the mental aspects.
患者为一名86岁男性，患有轻度痴呆症，因良性前列腺增生已插入膀胱导管。此时，他因十二指肠乳头癌出现黄疸，并插入了经皮肝穿刺胆道引流管（PTBD）。此外，由于十二指肠梗阻，他接受了经皮内镜下胃造瘘管（PEG）用于抽吸胃液和静脉高营养导管（IVH）用于营养支持。他一直希望回家。医护人员和他的家人多次讨论以实现他的愿望。我们教他的儿媳如何处理这4根管子。当她学会后，他回家并进入了上门护理系统。但仅仅一周后，尽管他情况稳定，与他分居的儿子喝醉后又把他送回了医院。我们试图劝说他们，包括所有分居的家庭成员。最后他再次得以回家，并在一周后在家中平静离世。我们从这个案例中了解到，让家庭在家中接受晚期癌症患者既重要又非常困难。有必要从医疗技术和心理两个角度为他们提供建议。
