肝动脉栓塞化疗微创治疗中晚期肝癌护理体会.docVIP

肝动脉栓塞化疗微创治疗中晚期肝癌护理体会【摘要】目的探讨肝动脉栓塞化疗微创治疗中晚期肝癌的的整体护理方案,促进患者顺利渡过术,达到预期治疗目的。方法对42例患者实施改良Seldinger法经皮肝动脉栓塞化疗术。实施中晚期原发性肝癌动脉栓塞化疗术前、术中和术后的整体护理和配合工作,确保经皮肝动脉灌注栓塞术的顺利进行。选择肝动脉灌注化疗药物和栓塞剂。并严防并发症的出现及有效处理。结果由于措施得当,处理及时,本组未发生不能恢复的并发症,患者满意,效果好。结论TACE围手术期护理可消除患者心理紧张,使治疗顺利进行,术后恢复快,是综合治疗不可缺的重要环节。? 【关键词】 肝癌;经肝动脉栓塞化疗术;护理 ?? The Nursing Comprehend of Treating Middle-advanced Stage Liver Cancer using Transcatheter Hepatic Arterial Chemoembolization SHEN Yu-ying.Suzhou Municipal Hospital East Fumor Surgery.Suzhou 215001,China ? 【Abstract】ObjectiveTo applywhole nursing schema of treating middle-advanced stage liver cancer using transcatheter hepatic arterial chemoembolization.MethodsTo treat 42 cases middle-advanced stage liver cancer patients using improvementalSeldinger transcatheter hepatic arterial chemoembolization.Give Preoperative,mid-perative,postoperative nursing to ensurethe operation proceeding smoothly.To choose hepatic artery perfuse chemotherapeutics and embolism,and to prevent and handle promptly the complications.ResultsNo non-refectiouscomplications appeared because of good nursing schema and handling promptly.ConclusionThe whole nursing schema of treating middle-advanced stage liver cancer using TACE can eliminate the patients? psychologic tension,ensurethe operation proceeding smoothly and reach better postoperative recovery.It’s a important component ofTACE.? 【Key words】 Iiver cancer;TACE; Nursing ? 2007年7月至2009年7月,对42例肝癌患者进行了经皮股动脉插管肝动脉碘油抗癌药乳剂栓塞进行护理,取得了满意疗效,现将护理体会报告如下。? 1资料与方法? 1.1一般资料原发性肝癌42例,男32例,女10例,年龄(45.32±8.23)岁,全部病例均经症状、体征、临床检查、AFP测定、B超、CT、血管造影或肝脏经皮穿刺活组织检查证实为原发性肝癌。所有病例确诊时均已失去外科手术指征,肿瘤最大直径12 cm,最小直径5 cm,单一病灶30例,2个病灶及以上者为12例,均无远处转移,AFP≥200 g/L者占74.62%。? 1.2方法患者取仰卧位,常规消毒铺巾后,右腹股沟区局部麻醉下采用Seldinger技术,经皮沿右侧股动脉穿刺,将导管送人肝总动脉,先行DSA下血管造影,了解肿瘤的大小、部位、诊断和血供等情况,然后将导管缓慢地插至肿瘤所在肝叶的动脉。肿瘤位于两叶者,导管固定于肝固有动脉。用生理盐水稀释化疗药物,经导管行肝动脉灌注化疗,然后用液化碘油与适量化疗药物混悬成乳剂与明胶海绵微粒适量行肝癌供血动脉栓塞。 肝动脉化疗栓塞术常采用的抗癌药物为氟尿嘧啶、卡铂、丝裂霉素、阿霉素、栓塞用碘化油、乳化剂、明胶海绵微粒。治疗次数1~8次??[1]?。? 2结果?