兒童血液腫瘤科

Ⅰ. Objective 目的：
An intrathecal (IT) injection delivers drugs through the circulation of the cerebrospinal fluid (CSF) into the central nervous system to protect the system. It is capable of synergizing with other anticancer therapies to facilitate the development of a comprehensive cancer treatment approach. 髓鞘內化學藥物注射，(背針)是藉由脊髓液的循環將化學藥物運送到中樞神經系統，以保護病童的中樞神經系統，同時配合其他的抗癌治療，達到完整癌症治療的目的。
Ⅱ. IT Injection Procedure 檢查程序：
ⅰ. Before an IT injection, the physician explains the child patient’s condition and provides an Informed Consent Form for Pediatric Lumbar Intrathecal Injection of Chemotherapy Drugs and Informed Consent Form for Sedative and Analgesic Medication Administration to the child’s parent. After reading and understanding the content of both consent forms, the child’s parent is required to complete the forms and submit the duplicates to the nurse. 髓鞘注射前醫師解釋病情後，會給予「兒科腰椎及髓鞘內注射化療藥物告
知同意書」及「鎮靜止痛告知同意書」各兩份，了解及填寫完畢後，請將其中一份交由護理人員。
ⅱ. The child must not eat or drink anything for 2 hours before the injection. The nurse administers an antiemetic to the child 30 minutes before the injection.
髓鞘注射前兩小時請禁食，前 30 分鐘護理人員會先幫病童注射止吐劑。
ⅲ. The child should urinate directly before receiving the injection. 請病童先排空膀胱再至治療室做髓鞘注射。
ⅳ. The child is sedated under a general anesthesia before the injection. The nurse then instructs the child to lie on his or her side with knees drawn up to his or her chest to expose the puncture site.開始前會先給予病童全身麻醉，讓病童全身
 放鬆，護理人員會協助病童採側臥屈膝姿勢，露出穿刺部位。
ⅴ. During the injection, the child’s blood pressure and blood oxygen content are measured every 5 minutes. The child may receive oxygen supplementation if deemed necessary.執行過程中，護理人員每五分鐘會監測一次血壓及血氧變化，並視需要給予氧氣使用。
ⅵ. Once the injection is completed, the puncture wound is wrapped in a gauze bandage fastened with tape.髓鞘注射結束後，傷口以紗布覆蓋及膠布固定。
Ⅲ. Post-Injection Instructions 檢查注意事項：
ⅰ. After the injection, the child should lie in a prone position with his or her head facing downward and buttocks propped higher up by pillows under the abdomen for at least 1 hour (to enhance drug absorption and prevent headaches resulting from a CSF extraction). The child’s parent should press the puncture site with both palms for at least 30 minutes.做完後，需趴睡頭低臀高姿勢，會以枕頭將
腹部臀部墊高，至少一小時(幫助藥物吸收及避免因脊髓液抽取引起頭痛問題)，並請家屬在注射部位以雙手手掌加壓至少 30 分鐘。
ⅱ. The child must be kept under observation in the treatment room for 30 minutes,during which his or her blood pressure and blood oxygen content are measured every 15 minutes.
病童須於治療室觀察 30 分鐘，期間護理人員會每 15 分鐘監測一次血壓及血氧變化。
ⅲ. Side effects of the injection may include headache, back pain, dizziness, and/or nausea. Notify the nurse immediately if the child feels any discomfort or if pain and constant bleeding occur around the puncture site.
可能出現的副作用為：頭痛、背痛、眩暈、嘔吐現象，若出現不適或穿刺部位有疼痛及持續出血情形，請立即告知護理人員。
ⅳ. After awakening from the anesthesia, the child is allowed to eat if she or he does not feel nauseous or vomits when drinking water.
清醒後，若喝水無噁心及嘔吐情形，即可進食。
ⅴ. The nurse redresses the wound on the puncture site and covers the dressing with a plastic bandage 24 hours after the injection or when deemed necessary.When the wound dries out, the parent can remove the plastic bandage; the child is then allowed to shower.
24 小時後或視需要護理人員會在穿刺部位換藥，並以 OK 繃覆蓋，傷口乾燥後，可移除 OK 繃並可洗澡。
Ⅳ. Please feel free to ask our nurses any questions you may have.
如您有任何問題請隨時提出，護理人員非常樂意爲您服務。
May God Bless You!