热疗联合放疗和化疗治疗恶性肿瘤不良反应的观察与预防

摘要

Objective: To investigate the causes and precaution of skin scalds of local hyperthermia in the treatment of patients with malignant tumor, and observation of the clinical effects of hyperthermia combined with radio-chemotherapy.Methods: The common complications of 345 patients underwent radiofrequency hyperthermia and 439 cases received microwave hyperthermia from November 1999 to May 2012 were analyzed retrospectively. The prevention measures of pre-treatment,inter-treatment,and post-treatment were provided.Results: All the patients completed the treatment safely and the clinical effect was remarkable. The adverse reaction during and post treatment was observed, there were 9 cases fatty scleroma occurred and no patients had skin burns in radiofrequency hyperthermia;4 Cases superficial II degree skin scalds and 5 cases I degree skin burn occurred in microwave hyperthermia. All the complications disappeared through the treatment and nursing without sequelae. Conclusions: Local tumor hyperthermia combined with radiotherapy、intraperitoneal perfusion chemotherapy and gene therapy is a safe and effective method for various malignant tumors. It improves the therapeutic effects and quality of life obviously for patients, and tolerable adverse reaction. We should comprehensive understand the patient's condition in the process of hyperthermia. Monitoring temperature and putting various nursing measures into practice can effectively prevent skin burn to ensure the patients successfully complete treatment.%目的:探讨在局部热疗中导致肿瘤患者皮肤烫伤的原因和预防对策,观察热疗联合放化疗的临床效果.方法:回顾性分析1999年1 1月至2012年5月我科收治的345例射频热疗患者和439例微波热疗患者的常见并发症,制定热疗前、中、后防范措施.结果:所有患者均安全完成治疗,临床疗效显著.观察治疗中和治疗后不良反应发生的情况,射频热疗中发生脂肪硬结9例,没有患者出现皮肤烫伤;微波热疗中发生浅Ⅱ0烫伤4例,Ⅰ0烫伤5例.所有并发症经对症处理后消失,无后遗症发生.结论:局部热疗联合放疗、腹腔灌注化疗及基因治疗是一种安全有效的治疗方法,能显著提高患者的治疗效果,改善生活质量,副作用可以耐受.在热疗过程中,应全面了解患者的情况,实施温度监测,落实各项防范措施,可有效防止皮肤烫伤,保证患者顺利地完成治疗.