原发性肝癌肝动脉化疗栓塞术后腹痛的发生规律及影响因素
发布时间:2018-04-19 09:08
本文选题:肝动脉化疗栓塞术(TACE) + 肝细胞肝癌 ; 参考:《介入放射学杂志》2017年07期
【摘要】:目的调查原发性肝癌(PHC)患者行肝动脉化疗栓塞(TACE)术后腹痛的发生规律及影响因素。方法入组121例患者,均为浙江省肿瘤医院介入放射科2012年12月至2013年6月收住的PHC患者。观察患者在TACE术后48 h内腹痛的发生和持续时间、程度及吗啡用量等。结果 121例患者中有96例(96/121,78.5%)在介入术后感到不同程度的腹痛,其中72例(72/121,59.5%)为视觉模拟评分(VAS)4分以上的中重度疼痛。平均吗啡用量为19.7 mg/例次。统计分析发现TACE术后腹痛与年龄(≥60对60;odd ratio(OR)0.307,P=0.008),术前ECOG评分(2对0~1;OR 0.195,P=0.006),肿瘤至肝包膜距离(1 cm对≤1 cm;OR 0.296,P=0.007),动脉栓塞时所用化疗药物表柔比星(THP)对其他药物(非THP对THP;OR 0.232,P0.003 4)。具有上述危险因素1个以上的患者更易发生疼痛。结论腹痛是TACE术后的高频事件,更年轻者、更好的ECOG评分、距肝包膜更近的肿瘤位置以及使用THP混合碘油栓塞者是腹痛发生的独立影响因素。因此对于腹痛的中高危患者,在术前至术后12 h内常规使用止痛药物预防疼痛发生是有必要的。
[Abstract]:Objective to investigate the occurrence and influencing factors of abdominal pain in patients with primary hepatic carcinoma (PHC) after TACEE.Methods 121 patients received PHC from December 2012 to June 2013 in Department of Interventional Radiology, Zhejiang Cancer Hospital.The occurrence and duration of abdominal pain, the degree of abdominal pain and the dosage of morphine were observed within 48 hours after TACE.Results 96 of 121 patients (96 / 121 / 78.5) had different degrees of abdominal pain after interventional surgery, 72 of them (72 / 122 / 121 / 59.5) had moderate and severe pain with visual analogue score (VAS4).The average dose of morphine was 19. 7 mg/.Statistical analysis showed that after TACE, abdominal pain and age (鈮,
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