原發(fā)性肝癌肝動脈化療栓塞術(shù)后腹痛的發(fā)生規(guī)律及影響因素
發(fā)布時間:2018-04-19 09:08
本文選題:肝動脈化療栓塞術(shù)(TACE) + 肝細(xì)胞肝癌。 參考:《介入放射學(xué)雜志》2017年07期
【摘要】:目的調(diào)查原發(fā)性肝癌(PHC)患者行肝動脈化療栓塞(TACE)術(shù)后腹痛的發(fā)生規(guī)律及影響因素。方法入組121例患者,均為浙江省腫瘤醫(yī)院介入放射科2012年12月至2013年6月收住的PHC患者。觀察患者在TACE術(shù)后48 h內(nèi)腹痛的發(fā)生和持續(xù)時間、程度及嗎啡用量等。結(jié)果 121例患者中有96例(96/121,78.5%)在介入術(shù)后感到不同程度的腹痛,其中72例(72/121,59.5%)為視覺模擬評分(VAS)4分以上的中重度疼痛。平均嗎啡用量為19.7 mg/例次。統(tǒng)計分析發(fā)現(xiàn)TACE術(shù)后腹痛與年齡(≥60對60;odd ratio(OR)0.307,P=0.008),術(shù)前ECOG評分(2對0~1;OR 0.195,P=0.006),腫瘤至肝包膜距離(1 cm對≤1 cm;OR 0.296,P=0.007),動脈栓塞時所用化療藥物表柔比星(THP)對其他藥物(非THP對THP;OR 0.232,P0.003 4)。具有上述危險因素1個以上的患者更易發(fā)生疼痛。結(jié)論腹痛是TACE術(shù)后的高頻事件,更年輕者、更好的ECOG評分、距肝包膜更近的腫瘤位置以及使用THP混合碘油栓塞者是腹痛發(fā)生的獨(dú)立影響因素。因此對于腹痛的中高;颊,在術(shù)前至術(shù)后12 h內(nèi)常規(guī)使用止痛藥物預(yù)防疼痛發(fā)生是有必要的。
[Abstract]:Objective to investigate the occurrence and influencing factors of abdominal pain in patients with primary hepatic carcinoma (PHC) after TACEE.Methods 121 patients received PHC from December 2012 to June 2013 in Department of Interventional Radiology, Zhejiang Cancer Hospital.The occurrence and duration of abdominal pain, the degree of abdominal pain and the dosage of morphine were observed within 48 hours after TACE.Results 96 of 121 patients (96 / 121 / 78.5) had different degrees of abdominal pain after interventional surgery, 72 of them (72 / 122 / 121 / 59.5) had moderate and severe pain with visual analogue score (VAS4).The average dose of morphine was 19. 7 mg/.Statistical analysis showed that after TACE, abdominal pain and age (鈮,
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