肝癌移植等待供肝期间介入治疗的研究及护理

Research on interventional therapy for advanced hepatocellular carcinoma when waiting for donors for liver transplantation

目的：探讨肝癌肝移植供体等待期间介入治疗的疗效及护理。方法：对我院23例肝癌患者在供体等待期经股动脉插管肝动脉内灌注奥沙利铂、表阿霉素、氟尿嘧啶,2～3次后评价其疗效。并从毒副反应和并发症等方面进行详细观察和处理。结果：23例中完全有效（CR）1例（4.3%）,部分有效（PR）13例（56.5%）,稳定（SD）7例（30.4%）,进展（PD）2例（8.7%）,总有效率（CR＋PR）为60.9%（14/23）。甲胎蛋白下降幅度为64.7%（11/17）。介入治疗术后药物毒副作用轻,生活质量良好。结论：在肝癌肝移植供体等待期,TACE可抑制肿瘤进展,加强该治疗的护理是肝癌肝移植成功的关键。

Objective To evaluate the curative effect of interventional therapy for the hepatocellular carcinoma patients during waiting for donors for liver transplantation and the nursing care therefor. Methods 23 hepatocellular carcinoma patients for liver transplantation were treated with Oxaliplatin, epirubici （EPI） and 5--FU through intra--arterial hepatic administration of TACE when waiting for donated organ. The short--term activity and toxicity were studied after 2～3 times of therapy. Results Among them, 1 case was in complete response （CR） （4. 3%）, 13 cases were in partial response （PR） （56.5%）, 7 cases were stable （SD） （30.4%） and 2 cases were in progress （PD） （8.7%）. The total efficiency rate （CR＋PR） was 60.9% （14/23）. The rate of descent of AFP was 64.7% （11/17）. The toxicity was little after TACE, and the patients have a good quality of life. Conclusions TACE can in- hibit hepatocellular carcinoma progress during patients waiting for donated liver. Improving nursing is the important way for succeeding in transplanting liver.