高强度聚焦超声治疗胰腺癌的护理_医学论文.docVIP

高强度聚焦超声治疗胰腺癌的护理_医学论文 高强度聚焦超声治疗胰腺癌的护理_医学论文 作者：张惠芳 徐叶青 贺蓓蓓 徐瑞英 李水英 【摘要】 目的 探讨高强度聚焦超声(high intensive focused ultrasound，HIFU)治疗胰腺癌的护理要点。方法 胰腺癌患者45例，HIFU治疗时均为俯卧位，每次治疗时间为55min。超声发射强度平均1.5kW，持续发射时间360ms，间歇时间180ms，发射次数50次。治疗前充分做好胃肠准备。治疗过程中加强对患者心理安慰，减少焦虑。每次治疗后观察治疗区有无皮肤灼伤。结果 38例(38/45，84.44%)完成整个疗程。6例(占15.79%)治疗后治疗区皮肤红肿，予冷敷而愈。3例治疗后疼痛加剧，经心理疏导及止痛药治疗后好转。38例均获随访，1年生存率为78.95%(30/38)；3年生存率为23.68%(9/38)。结论 HIFU为近年来胰腺癌治疗的新方法之一，治疗过程中良好的护理是取得良好疗效的重要因素。心理治疗和术前充分的肠道准备是HIFU治疗、护理中的重要环节。 【关键词】 高强度聚焦超声 胰腺癌 治疗 护理 【Abstract】 Objective To study the key points of nursing care in the treatment of pancreatic cancer (PCa) by high intensive focused ultrasound (HIFU).Methods 45 patients with PCa were treated by HIFU in prone position.Each treating time was 55 minutes.The intensity of ultrasound was 1.5kW and the lasting time was 360 milliseconds and with 180 milliseconds interval.The key points in treatment included comforting the patients，decreasing their anxiety，and observing the hurt of their local skin after treating was emphasized.Results 38 patients (38/45，84.44%) completed whole course.Red and swelling of skin was observed in the patients and was disappeared by cold compress the pain in the treating site was aggravated in 6 patients(15.79%) after treating and was improved by psychotherapy and analgesic.All 38 patients were followed up.The survival rate for a year was 78.94%(30/38).The survival rate for 3 years was 23.68%(9/38).Conclusion HIFU was a new method to treat the PCa.The satisfactory nursing care is one of the key factors to have well therapeutic effect.Psychological care and good preparation of gastrointestinal tract before treating are the key points in HIFU nursing care. 【Key words】 high intensive focused ultrasound pancreatic cancer treatment nursing care 高强度聚焦超声(high intensive focused ultrasound，HIFU)是近年来出现的治疗肿瘤新方法。有效的护理对提高其治疗效果，减少或避免相关并发症十分重要。2000年3月～2003年3月，我院采用HIFU共治疗45例胰腺癌患者，通过精心护理，效果显著。现总结报告如下。 1 资料与方法 1.1 一般资料 本组45例胰腺癌患者，男25例，女20例，年龄36～83岁，平均55.5岁。临床TNM分期(U