응급실 내원 암환자의 항암화학요법 부작용에 대한 후향적 조사연구
Study on Cancer Patients Who Visited an Emergency Department with the Side Effects of Chemotherapy
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초록
본 연구는 항암화학요법 부작용으로 응급실에 내원한 암환자의 특성을 파악하기 위한 연구이다. 방법 : 2009년 3차 대학병원 응급실에 항암화학요법 부작용으로 내원한 암환자 294명의 의무기록을 후향적으로 조사하였다. 대상자의 특성과 항암화학요법 부작용에 대해 자료를 수집하였으며 SPSS프로그램을 통해 분석하였다. 결과 : 내원 당시 응급 환자 분류체계는 3군이 81.6%이었다. 대상자의 72.8%가 입원하였으며, 입원 후 사망이 6.5%이었다. 대상자의 항암화학요법 부작용의 빈도는 혈소판 감소(80.6%), 빈혈(74.5%), 통증(52.0%), 호중구 감소(50.7%), 백혈구 감소(46.3%) 등의 순이었다. 응급실 치료 후 입원한 경우가 퇴원한 경우보다 응급실 감소 정도가 높았다(p=.020). 호흡곤란 정도는 입원 후 사망한 경우에서 퇴원한 경우와 입원한 경우보다 높았다(p<.05). 결론 : 이 논문의 결과는 항암화학요법 후 부작용을 관리하기 위한 특별한 체계가 필요함을 보여준다. 또한 항암화학요법 부작용으로 암환자가 응급실에 내원할 때, 신속한 초기 평가를 통한 치료와 적절한 치료가 제공되어야 함을 알 수 있다. 그리고 다양한 부작용 증상에 대해 가정에서 대처할 수 있도록 더욱 효과적인 퇴원 교육 프로그램이 개발되어야 할 필요가 있다.
Abstract
This study was done to identify conditions of cancer patients who visited an emergency department(ED) with the side effects of chemotherapy. Methods: Data were collected retrospectively from medical recordsof 294 cancer patients who visited a tertiary hospital in 2009 for treatment of side effects of chemotherapy. Records were reviewed for characteristics of participants and side effects of chemotherapy. Data were analyzedusing SPSS software. Results: ED Triage grade 3 was 81.6%. The hospitalization ratio was 72.8%, and 6.5% diedduring the admission. Most frequent side effects were thrombocytopenia (80.6%), anemia (74.5%), pain(52.0%), neutropenia (50.7%), and leucopenia (46.3%). The hospitalization group showed more severeleucopenia than the discharge group (p=.020). Patients in the group who died had higher scores for dyspneacompared to patients discharged or hospitalized (p<.05). Conclusion: Results of the study suggest that thereis a special need to develop a system to manage side effects of chemotherapy. Also it is necessary to provideappropriate care and treatment with prompt initial evaluation when cancer patients with side effects ofchemotherapy present in the ED. More effective educational discharge programs should also be developedto help these patients cope with various side effects of chemotherapy.
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