肝癌化疗栓塞围手术期并发症及其防治

Complications and prevention for the peri-operative period of 565 hepatic cancer arterial chemotherapy embolism

目的探讨肝癌经导管肝动脉化疗栓塞（TACE）围手术期并发症及其防治措施。方法对565例行TACE的肝癌患者病历资料进行回顾性分析。结果按TACE引起的并发症发生的时间先后，将其分为三类：穿刺及插管时所致的并发症：局部血肿23例，动脉内膜损伤14例；TACE术中并发症：腹痛112例，恶心、呕吐242例。咳嗽3例；TACE术后并发症：发热528例，腹痛264例，肝功能损害241例，肝脓肿3例，肝肾综合征（HRs）2例。大多数并发症经治疗后症状好转或治愈，另有5例患者术后2周内死亡。结论TACE围手术期可发生多种并发症，加强术前、术中、术后护理为确保肝动脉化疗栓塞术治疗的顺利康复和降低反应率起到了重要的作用。

Objective To explore the complications and prevention for the peri-operative period of hepatic cancer arterial chemotherapy embolism （TACE）. Methods 565 hepatic cancer sufferers＇ medical record through TACE therapy were analyzed retrospectively. Results The complications could be divided into three types according to complications genesie date：during the puncture and intubation,23 local hematomas, 14 arterial intima damnifiea- tion ; during the TACE operation period, 112 bellyache, 242 spew, 3 chough ; after the TACE operation, 528 fever, 264 bellyache ,3 liver abscess ,2 hepatorenal complication. The research results indicated that the most complications could be cured or lightened. Only 5 sufferers died within two weeks. Conclusion There were many kinds of complications during TACE operations, and the sufferers could get well and the complications could be effectively reduced if the nurse got along abortively during the whole operation.