肝癌患者接受肝动脉灌注化疗栓塞术后护理康复效果分析

摘要

Objective We explored the effect of nursing care and its impact on rehabilitation in patients with primary liver cancer (PLC) after transhepatic arterial chemoembolization (TACE) in order to provide guidance for improving the life quality of patients. Methods 50 patients with moderate and advanced PLC underwent TACE with hepatic artery perfusion of raltitrexed,and we carried out holistic nursing,including psychological,febrile,dietary,abdominal and local nursing post-operatively for them. We also measured blood liver function indexes and alpha-fetoprotein (AFP) before and after the treatment. Results Four weeks after TACE, serum alanine transaminase,aspartic transaminae,total bilirubin and albumin levels decreased from (43.58±10.15)U/L,(41.25±11.34)U/L,(22.46±6.49)μmol/L and (35.32±4.12) g/L at admission to (38.23±7.86) U/L,(38.56±8.49) U/L,(16.84±10.16)μmol/L and(31.49±5.48) g/L,post-operatively,all no significant difference(P>0.05);serum AFP decreased from(1215.46±125.14) ng/mL to(811.27±165.28) ng/mL(P<0.01);The white blood cell counts decreased in two (4%),fever in two (4%),psychological stress in three(6%),local pain in six(14%),and nausea/vomiting in eight (16%),suggesting the improvement by nursing care in this setting. Conclusions TACE with raltitrexed in treatment of patients with PLC is effective,and the postoperative nursing care might reduce the occurrence of complications,which greatly improve the postoperative rehabilitation of patients.%目的：探讨肝癌介入术后护理康复的效果，对提高患者生活质量的影响，以为肝癌患者术后康复提供指导。方法对50例中晚期肝癌患者进行肝动脉灌注雷替曲塞化疗，术后给予优质全面护理，包括心理护理、发热的护理、胃部护理、穿刺处局部护理、腹痛的护理及饮食护理等。常规对治疗前及治疗后4周的肝功能指标和血清AFP进行测定，对护理前后不良事件发生情况行x2检验分析。结果50例PLC患者经过TACE治疗及优质护理4周后，血清 ALT、AST、TBIL和 ALB 水平由治疗前的（43.58±10.15） U/L、（41.25±11.34） U/L、（22.46±6.49）μmol/L和（35.32±4.12） g/L降至（38.23±7.86） U/L、（38.56±8.49） U/L、（16.84±10.16）μmol/L和（31.49±5.48） g/L，恢复良好，但前后变化无统计学差异（P>0.05）；血清AFP水平由治疗前的（1215.46±125.14） ng/mL降至（811.27±165.28） ng/mL，显著降低（P＜0.01）；同时，不良反应情况得到巨大改善，发生白细胞降低和发热者均为2例（4%），心理紧张3例（6%），出现疼痛6例（14%），恶心或呕吐8例（16%）。结论肝动脉灌注雷替曲塞化疗术可有效治疗肝癌，术后护理可以预防并发症的发生，大大提高术后康复效果。