Wernicke encephalopathy in a caregiver: A serious physical issue resulting from stress in a family member caring for an advanced cancer patient
Wernicke encephalopathy in a caregiver: A serious physical issue resulting from stress in a family member caring for an advanced cancer patient
复制标题
护理人员的韦尼克脑病：护理晚期癌症患者的家庭成员因压力而导致的严重身体问题
DOI：
10.1017/s1478951521001784
复制
发表时间：
2021
影响因子：
2.2
通讯作者：
Onishi Hideki
中科院分区：
文献类型：
--
作者：
Ishida Mayumi;Uchida Nozomu;Yoshioka Akira;Sato Izumi;Hamaguchi Tetsuya;Horita Yosuke;Mihara Yoshiaki;Onishi Hideki
众所周知，癌症患者的家庭负担涉及许多方面，但没有报告的家庭成员发展谵妄由于照顾癌症患者的负担。MethodsWe报道了一名照顾者谁开发韦尼克脑病（WE），而照顾一名晚期癌症的家庭成员。诊断为胃癌和肝转移，5个月。在一位肿瘤科医生的推荐下，她去了“护理人员诊所”，这位肿瘤科医生担心她几周前出现的精神状况恶化。该女性有糖尿病史。观察到一些头晕，基于她无法回答问题，检查了她的意识水平，观察到一些定向障碍。她被诊断为精神错乱。采集血液样本以调查谵妄的原因，但测试数据显示无低血糖。自从她丈夫被诊断出患有癌症后，她的食欲就下降了。由于体内储存的硫胺素在约18天内耗尽，她的食欲不振持续了5个月，因此怀疑硫胺素缺乏症。静脉注射100 mg硫胺素后，她的意识水平在1小时内恢复正常。WE的诊断是由病人的血清硫胺素水平异常低支持。结果的意义癌症患者的家庭成员可能会发展食欲不振，由于照顾的负担，导致WE。在照顾家庭成员的痛苦迹象时，不仅要注意心理方面，而且要注意他们的意识水平和身体方面，特别是营养状况下降导致严重疾病的可能性。
ObjectiveIt is well known that the burden on the families of cancer patient extends across many aspects, but there have been no reports of family members developing delirium due to the burden of caring for a cancer patient.MethodsWe reported a caregiver who developed Wernicke encephalopathy (WE) while caring for a family member with advanced cancer.ResultsThe subject was a 71-year-old woman who had been caring for her husband, diagnosed with gastric cancer and liver metastases, for 5 months. She visited the “caregivers’ clinic” after referral by an oncologist who was worried about a deterioration in her mental condition that had appeared several weeks previously. The woman had a history of diabetes mellitus. Some giddiness was observed and, based on her inability to answer questions, her level of consciousness was checked and some disorientation was observed. She was diagnosed with delirium. A blood sample was collected to investigate the cause of the delirium, but the test data showed no hypoglycemia. Her appetite had declined since her husband was diagnosed with cancer. Thiamine deficiency was suspected as thiamine stores in the body are depleted within about 18 days and her loss of appetite had continued for 5 months. On intravenous injection of 100 mg of thiamine, her consciousness level was returned to normal in 1 h. A diagnosis of WE was supported by the patient's abnormally low serum thiamine level.Significance of the resultsThe family members of cancer patients may develop a loss of appetite due to the burden of caring, resulting in WE. When providing care for signs of distress in family members, it is necessary to pay attention not only to the psychological aspects but also to their level of consciousness and physical aspects, particularly the possibility of serious illness resulting from reduced nutritional status.