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| Management and Nursing Care for Acute Encephalopathy Induced by TPF Neoadjuvant Chemotherapy in Nasopharyngeal Carcinoma |
| SUN YAT-SEM University Cancer Center， Guangzhou 510060， China |
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Abstract Objective： To investigate the nursing intervention for acute encephalopathy induced by TPF neoadjuvant chemotherapy in nasopharyngeal carcinoma， and to sum up the nursing experience for it. Method： We retrospectively analyzed the clinical data of three patients treated with TPF（ Docetaxel + Cisplatin + 5-fluorouracil）neoadjuvant chemotherapy， which was part of the combined treatment modality with chemoradiotherapy， from September 2012 to July 2013. Result： Encephalopathy occurred at the ending day of chemotherapy in one patient and at the day after chemotherapy in the other two patients. The three patients suffered from confusion， dysphoria， irrelevant speech， delirium and gatism， etc. Symptoms were relieved after 250 mL 20% mannitol plus 5 mg dexamethasone intravenous infusion，bedside electrocardiographic monitoring， low flow rate oxygen inhalation， antihypertension， intravenous nutrition and supportive care were given， as directed by the doctor. Nursing care of disease observation， safety nursing， psychological counseling， gastrointestinal tract as well as bone marrow suppression was given closely and cautiously meanwhile. After symptomatic treatment and nursing intervention， all the three patients recovered from acute encephalopathy and were discharged safely. Conclusion： Timely symptomatic treatment and corresponding nursing intervention are key points to ensure successful treatment for rare acute encephalopathy induced by TPF neoadjuvant chemotherapy in nasopharyngeal carcinoma.
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