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目的研究影响肝细胞癌(HCC)患者肝动脉化疗栓塞术(TACE)术后发生恶心呕吐的非化疗因素。方法随机选取我院2014~2016年诊治的360例确诊为HCC患者,记录所有HCC患者的性别、年龄、体质指数(BMI)、肝区疼痛、肿瘤质地、大小、是否发生转移、手术次数、是否发热、发热持续时间、腹部有无肿胀、注射碘化油的量等,并采用Logistic回归分析逐一分析以上所有因素与HCC患者TACE术后发生恶心呕吐的关系。根据恶心程度语言描述分级和主诉疼痛程度分级法进行评价。结果在360例HCC患者中,发生2级恶心58例(16.11%),1级恶心83例(23.06%),0级恶心219例(60.83%);在大部分HCC患者中,其年龄越大,发生恶心呕吐的程度越轻(r=-0.303,P<0.05);疼痛和腹胀程度越严重,发生恶心呕吐的程度越重(r=0.299,r=0.497,P<0.05);疼痛时间越长,恶心呕吐程度越重(r=-0.203,P<0.05);Logistic回归分析结果显示,高龄是HCC患者TACE术后恶心呕吐的保护因素,而长时间的腹痛和腹胀是TACE术后恶心呕吐的危险因素;根据结构方程模型的分析结果显示,恶心呕吐与腹部疼痛和腹胀程度呈现出直接的正向效应(β=0.39,β=0.69,P<0.01),年龄与腹胀也呈现出正向效应(β=0.02,P<0.01),而年龄与腹疼程度呈现出负向效应(β=-0.02,P<0.01)。结论引起HCC患者TACE术后恶心呕吐的发生是与多种不同因素共同作用引起的,其中与年龄、腹痛和腹胀程度关系最为密切,其中高龄是HCC患者TACE术后恶心呕吐发生的保护因素,而长时间的腹痛和腹胀是TACE术后恶心呕吐发生的危险因素。
Objective To study the non-chemotherapeutic factors that affect the occurrence of nausea and vomiting after transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods A total of 360 HCC patients diagnosed as HCC from 2014 to 2016 were randomly selected and their gender, age, body mass index (BMI), liver pain, tumor size, size, metastasis, number of operations, Fever, duration of fever, abdomen with or without swelling, the amount of iodized oil injection and so on. Logistic regression analysis was used to analyze the relationship between all the above factors and nausea and vomiting after TACE in HCC patients. According to nausea level description of language classification and complained of grading pain rating. Results Among 360 HCC patients, 58 were grade 2 nausea (16.11%), 83 were grade 1 nausea (23.06%) and 219 were grade 0 nausea (60.83%). In most patients with HCC, the older (R = -0.303, P <0.05). The more severe the pain and bloating were, the more severe nausea and vomiting occurred (r = 0.299, r = 0.497, P <0.05) Long-term, nausea and vomiting were more severe (r = -0.203, P <0.05). Logistic regression analysis showed that advanced age was the protective factor of nausea and vomiting in patients with HCC after long-term TACE and long-term abdominal pain and bloating were nausea and vomiting after TACE (Β = 0.39, β = 0.69, P <0.01). The age and bloating also showed a positive trend. According to the analysis of structural equation model, nausea and vomiting showed a direct positive effect on the degree of abdominal pain and bloating (Β = 0.02, P <0.01), while the age and abdominal pain showed a negative effect (β = -0.02, P <0.01). Conclusions The occurrence of nausea and vomiting after TACE in HCC patients is caused by the combination of various factors, which are closely related to the age, abdominal pain and distention. Among them, advanced age is the protective factor of nausea and vomiting after TACE in HCC patients Long-term abdominal pain and bloating are risk factors for nausea and vomiting after TACE.