肝癌切除联同门静脉癌栓取出术治疗肝癌的临床护理及对患者肝功能指标的影响
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摘要
目的探讨肝癌切除联同门静脉癌栓取出术治疗肝癌的临床护理及对患者肝功能指标的影响。方法研究对象方便选择2016年1月—2018年3月在该院进行治疗的肝癌患者90例,将所选患者随机分为两组,其中对照组肝癌患者采取肝癌切除联同门静脉癌栓取出术进行治疗,研究组肝癌患者在进行肝癌切除联同门静脉癌栓取出术治疗后强化护理。比较两组肝癌患者手术完成之后的临床护理的满意程度,比较两组患者治疗前、后的肝功能指标,比较两组肝癌患者不良反应的发生率。结果对照组总护理满意度为68.9%,研究组总护理满意度为86.7%,研究组患者的临床护理满意度显著高于对照组(χ~2=16.027,P<0.05)。治疗前,两组患者的肝功能指标无显著差异,治疗后,对照组肝脏排泄功能为(57.9±6.8)U/L,凝血酶原时间为(17.2±2.3)s,肝脏合成凝血因子功能为(17.4±3.3)μmol/L,研究组肝脏排泄功能为(33.6±5.2)U/L,凝血酶原时间为(12.9±2.2)s,肝脏合成凝血因子功能为(15.8±2.7)μmol/L,研究组患者的肝功能指标显著优于对照组(t=14.207,16.379,12.315,P<0.05)。对照组总不良反应发生率为82.2%,研究组总不良反应发生率为51.1%,研究组患者的不良反应发生率明显低于对照组(χ~2=7.039,P<0.05)。结论在治疗过程当中,对肝癌患者采取肝癌切除联同门静脉癌栓取出术的同时加强护理可以有效的提高患者的临床护理效果,改善患者的肝功能指标,降低肝癌患者不良反应的发生率,提高患者的治疗效果,该方法可在临床上进行推广。
Objective To investigate the clinical nursing of liver cancer resection combined with portal vein tumor thrombectomy for liver cancer and its influence on liver function indexes. Methods 90 patients with liver cancer who were treated in our hospital from January 2016 to March 2018 were convenient selected and divided into two groups. The patients in the control group were treated with liver cancer resection and portal vein tumor thrombectomy. The liver cancer patients in the study group underwent intensive care after liver cancer resection combined with portal vein tumor thrombectomy. The satisfaction degree of clinical nursing after the operation of the two groups of liver cancer patients was compared. The liver function indexes of the two groups before and after treatment were compared, and the incidence of adverse reactions of the two groups of liver cancer patients was compared. Results The total nursing satisfaction of the control group was 68.9%, and the total nursing satisfaction of the study group was 86.7%. The clinical nursing satisfaction of the study group was significantly higher than that of the control group(χ~2=16.027, P<0.05). Before treatment, there was no significant difference in liver function between the two groups. After treatment, the liver excretion function of the control group was(57.9±6.8)U/L, the prothrombin time was(17.2±2.3)s, and the liver synthesis clotting factor function was(17.4±3.3)μmol/L, the liver excretion function of the study group was(33.6±5.2)U/L, the prothrombin time was(12.9±2.2)s, and the liver synthesis clotting factor function was(15.8±2.7)μmol/L. The liver function index of the study group was significantly better than the control group(t=14.207,16.379, 12.315, P<0.05). The incidence of total adverse reactions was 82.2% in the control group and 51.1% in the study group. The incidence of adverse reactions in the study group was significantly lower than that in the control group(χ~2=7.039, P<0.05). Conclusion In the course of treatment, the liver cancer resection combined with the portal vein tumor thrombectomy and enhanced nursing can effectively improve the clinical nursing effect of patients, improve the liver function index of patients, reduce the incidence of adverse reactions of liver cancer patients, and improve the patient's therapeutic effect, the method can be promoted clinically.
Objective To investigate the clinical nursing of liver cancer resection combined with portal vein tumor thrombectomy for liver cancer and its influence on liver function indexes. Methods 90 patients with liver cancer who were treated in our hospital from January 2016 to March 2018 were convenient selected and divided into two groups. The patients in the control group were treated with liver cancer resection and portal vein tumor thrombectomy. The liver cancer patients in the study group underwent intensive care after liver cancer resection combined with portal vein tumor thrombectomy. The satisfaction degree of clinical nursing after the operation of the two groups of liver cancer patients was compared. The liver function indexes of the two groups before and after treatment were compared, and the incidence of adverse reactions of the two groups of liver cancer patients was compared. Results The total nursing satisfaction of the control group was 68.9%, and the total nursing satisfaction of the study group was 86.7%. The clinical nursing satisfaction of the study group was significantly higher than that of the control group(χ~2=16.027, P<0.05). Before treatment, there was no significant difference in liver function between the two groups. After treatment, the liver excretion function of the control group was(57.9±6.8)U/L, the prothrombin time was(17.2±2.3)s, and the liver synthesis clotting factor function was(17.4±3.3)μmol/L, the liver excretion function of the study group was(33.6±5.2)U/L, the prothrombin time was(12.9±2.2)s, and the liver synthesis clotting factor function was(15.8±2.7)μmol/L. The liver function index of the study group was significantly better than the control group(t=14.207,16.379, 12.315, P<0.05). The incidence of total adverse reactions was 82.2% in the control group and 51.1% in the study group. The incidence of adverse reactions in the study group was significantly lower than that in the control group(χ~2=7.039, P<0.05). Conclusion In the course of treatment, the liver cancer resection combined with the portal vein tumor thrombectomy and enhanced nursing can effectively improve the clinical nursing effect of patients, improve the liver function index of patients, reduce the incidence of adverse reactions of liver cancer patients, and improve the patient's therapeutic effect, the method can be promoted clinically.
引文
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[10]刘诗泆,刘素兰,尹秋林.黄芪四君子汤联合不同营养方式对肝硬化肝癌大鼠肝部分切除术后营养状态与免疫功能的影响[J].中国老年学杂志,2016,36(23):5807-5809.
[11]胡婷业,许秀芳,陆玉和,等.CT引导下经皮穿刺氩氦刀微创治疗中晚期肝癌的集束化围手术期护理[J].介入放射学杂志,2018,27(1):80-82.
[12]李文敬,李洪艳.液体敷料用于肝癌介入术后压迫器胶带致皮肤撕裂伤应用效果与护理[J].中国急救医学,2016,36(z2):46-48.
[13]陈铁霞,韩哲娜,罗平平.舒适护理在肝癌患者射频消融术中的应用[J].中华肿瘤防治杂志,2016,9(s1):333-334.
[14]王叙德,刘华高,方有智,等.氨甲环酸对肝癌患者肝切除手术出血量及术后凝血功能的影响[J].中国临床药理学杂志,2017,23(67):2351-2353.
[15]刘晔,曹素玉,刘瑶,等.Orem自理理论在经导管动脉化疗栓塞术后肝癌患者护理中的应用[J].中国介入影像与治疗学,2016,13(10):605-608.
[2]张玉扬,赵林,董奇观.原发性肝癌切除术后行肝动脉化疗栓塞效果及对患者血清AFP、CA19-9水平的影响[J].山东医药,2018,58(2):52-54.
[3]陈惟,卢绮萍,刘升辉,等.谷氨酰胺免疫营养对有营养风险肝切除术患者肝功能、淋巴细胞计数及C反应蛋白的影响[J].中华实验外科杂志,2017,34(6):36-39.
[4]柴芳,吴承容,张小毅,等.恩替卡韦联合中药注射液对中晚期肝癌合并乙型肝炎病毒感染患者的疗效及预后的影响[J].中华医院感染学杂志,2017,27(13):2916-2919.
[5]Ye J Z,Wang Y Y,Bai T,et al.Surgical resection for hepatoce llular carcinoma with portal vein tumor thrombus in the Asia-Pacific region beyond the barcelona clinical liver cancer treatment algorithms:A review and update[J].Oncotarget,2017,8(54):93258-93278.
[6]陈仲武,林征宇,张志波,等.腔内导管射频消融联合TACE治疗原发性肝细胞癌门静脉癌栓的疗效观察[J].中国介入影像与治疗学,2017,14(9):525-529.
[7]张继宗,胡亮,韩建波,等.血清天冬氨酸-天冬酰胺β羟化酶表达与肝细胞癌术后患者预后的关系研究[J].中国全科医学,2016,19(35):4350-4353.
[8]Jung D,Hwang S,Song G,et al.Longterm prognosis of combined hepatocellular carcinoma‐cholangiocarcinoma following liver transplantation and resection[J].Liver transplantation:official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society,2017,23(3):330-334.
[9]费国雄,崔龙久,曹梅利,等.血小板及血小板源性5-羟色胺对早期肝癌切除术患者预后的影响:前瞻性队列研究[J].第二军医大学学报,2016,37(6):683-689.
[10]刘诗泆,刘素兰,尹秋林.黄芪四君子汤联合不同营养方式对肝硬化肝癌大鼠肝部分切除术后营养状态与免疫功能的影响[J].中国老年学杂志,2016,36(23):5807-5809.
[11]胡婷业,许秀芳,陆玉和,等.CT引导下经皮穿刺氩氦刀微创治疗中晚期肝癌的集束化围手术期护理[J].介入放射学杂志,2018,27(1):80-82.
[12]李文敬,李洪艳.液体敷料用于肝癌介入术后压迫器胶带致皮肤撕裂伤应用效果与护理[J].中国急救医学,2016,36(z2):46-48.
[13]陈铁霞,韩哲娜,罗平平.舒适护理在肝癌患者射频消融术中的应用[J].中华肿瘤防治杂志,2016,9(s1):333-334.
[14]王叙德,刘华高,方有智,等.氨甲环酸对肝癌患者肝切除手术出血量及术后凝血功能的影响[J].中国临床药理学杂志,2017,23(67):2351-2353.
[15]刘晔,曹素玉,刘瑶,等.Orem自理理论在经导管动脉化疗栓塞术后肝癌患者护理中的应用[J].中国介入影像与治疗学,2016,13(10):605-608.