经皮肝穿刺氩氦刀冷冻消融治疗巨块型肝癌患者的围手术期护理

发布时间：2018-01-04 00:29

本文关键词：经皮肝穿刺氩氦刀冷冻消融治疗巨块型肝癌患者的围手术期护理　出处：《护理实践与研究》2017年01期 　论文类型：期刊论文

【摘要】：目的:探讨经皮肝穿刺氩氦刀冷冻消融治疗巨块型肝癌的疗效,总结围手术期护理经验。方法:回顾性分析本医院2014年8月~2016年7月介入治疗科收治的经皮肝穿刺氩氦刀冷冻消融治疗巨块型肝癌36例患者的临床资料,总结术前、术中及术后护理经验。结果:36例患者均顺利完成经皮肝穿刺氩氦刀冷冻治疗,术后住院时间为4~18 d,平均(12.6±3.9)d,术中未出现肝破裂、出血、胆漏、皮肤冻伤或穿刺部位感染症状。术后1例患者出现气胸,36例患者均伴有不同程度发热,21例患者伴有上腹部疼痛,其中6例患者疼痛剧烈,恶性呕吐13例,寒战8例,均经对症支持治疗后症状消失,恢复正常。术后1个月随访,CT检查肿瘤出现坏死,肿瘤病灶边缘范围缩小。术后3个月CT复查肿瘤明显缩小。结论:经皮肝穿刺氩氦刀冷冻消融治疗巨块型肝癌疗效确切、术后恢复快,可有效控制病灶范围,围手术期的精心护理是手术顺利实施及疗效的保障。
[Abstract]:Objective: to evaluate the efficacy of cryoablation with argon and helium in the treatment of massive hepatocellular carcinoma (HCC). Summary of perioperative nursing experience. Methods:. The clinical data of 36 patients with giant hepatocellular carcinoma treated by percutaneous argon-helium ablation from August 2014 to July 2016 in our hospital were retrospectively analyzed. Results 36 patients were successfully treated with cryotherapy with argon and helium percutaneous transhepatic puncture. The postoperative hospitalization time was 4 ~ 18 days, with an average of 12.6 卤3.9 days. There were no symptoms of liver rupture, bleeding, bile leakage, skin frostbite or puncture site infection during the operation. Among them, 6 cases had severe pain, 13 cases had malignant vomiting, and 8 cases had shivering. The symptoms disappeared and returned to normal after symptomatic support treatment. The margin of tumor focus was reduced and CT reexamination 3 months after operation. Conclusion: percutaneous liver ablation with argon-helium knife is effective in the treatment of giant hepatocellular carcinoma, and can effectively control the focus area. The careful nursing during the perioperative period is the guarantee of the successful implementation and curative effect of the operation.
【作者单位】：南方医科大学附属新会医院;
【基金】：2016年度江门市卫生计生局科研立项(16A046)
【分类号】：R473.73
【正文快照】： 肝细胞癌是我国一种常见的消化道恶性肿瘤,其特点是病程短,80%以上的患者出现症状时已经是中晚期,同时合并肝硬化[1],多数已无法用手术的方法根治,且放、化疗对肝癌不敏感[2]。巨块型肝癌是原发性肝癌的常见类型,肿瘤直径多≥5 cm,形状呈现单块、融合快及多块状,明确诊断后常

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