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目的探讨原发性中小肝癌行肝动脉化疗栓塞(TACE)联合CT引导射频消融(RFA)序贯治疗的观察与护理。方法对我院102例不愿手术或不能外科手术以及术后复发的中小肝癌患者,行肝动脉化疗栓塞(TACE)联合CT引导射频消融(RFA)序贯治疗,序贯治疗前做好心理护理和一般护理,治疗后重视疼痛管理,加强发热、出血、胃肠道反应、肝功能异常等并发症的观察与护理,并同时做好出院指导。采用随机数字表法将102例分成实验组53例和对照组49例,对照组术前不使用芬太尼,术后疼痛评分≥4分再遵医嘱给予止痛药;实验组术前6 h常规予芬太尼透皮贴4.2 mg贴前胸壁,术后常规医嘱给予氨酚羟考酮长期口服。结果两组术后平均疼痛VAS评分比较,实验组低于对照组(P<0.05);实验组患者满意度高于对照组(P<0.05);102例患者治疗后病灶控制良好,无严重并发症发生。结论对肝动脉化疗栓塞联合射频消融序贯治疗后患者应实施相应的护理措施,可提高疗效,以降低患者不舒适感,减少并发症发生,达到快速康复。
Objective To investigate the observation and nursing care of primary small and medium hepatocellular carcinoma treated by sequential hepatic arterial chemoembolization (TACE) combined with CT-guided radiofrequency ablation (RFA). Methods A total of 102 patients with small and medium-sized hepatocellular carcinoma who did not want surgery or surgery and postoperative recurrence were treated with TACE combined with CT-guided radiofrequency catheter ablation (RFA) sequential therapy before psychological treatment And general care, attention to pain management after treatment, to strengthen the fever, bleeding, gastrointestinal reactions, liver dysfunction and other complications of observation and care, and at the same time do the discharge guidance. The 102 cases were divided into experimental group (n = 53) and control group (n = 49) by random number table. The patients in control group were given fentanyl before operation, To fentanyl transdermal paste 4.2 mg chest wall, postoperative regular doctor given long-term oral oxycodone. Results Compared with the control group (P <0.05), the mean pain VAS scores of the two groups were significantly lower than those of the control group (P <0.05). The 102 patients had good control of the disease and no serious complications Disease occurs. Conclusions The patients should receive corresponding nursing measures after combined hepatic arterial chemoembolization and radiofrequency catheter ablation to improve the curative effect so as to reduce the uncomfortable feeling of patients and reduce the occurrence of complications and achieve rapid recovery.