PSE联合TACE治疗肝癌合并脾功能亢进的疗效观察及护理干预

PSE Combined with TACE in Treatment of Hepatocellular Carcinoma with Hypersplenism: Curative Effect Observation and Nursing Intervention

目的探讨部分性脾动脉栓塞(partial splenic embolization,PSE)与选择性肝动脉化疗栓塞(transcatheterarterial chemo embolization,TACE)联合治疗肝癌合并脾功能亢进的疗效及护理干预的意义。方法将103例肝癌合并脾功能亢进患者分为A、B两组。A组53例行PSE联合TACE治疗;B组50例行单纯TACE治疗,通过肝脏肿瘤大小、脾脏大小及外周血象变化评价PSE联合TACE治疗肝癌合并脾功能亢进的疗效。53例行PSE联合TACE治疗的患者根据术后采用的护理方式不同再次分成两组(A1组和A2组)。A2组采取常规护理,A1组根据患者情况采取不同护理干预。出院时通过自我护理能力测定量表(ESCA)对接受PSE联合TACE治疗的患者评分。结果 A、B两组的肝脏肿瘤缩小差异无统计学意义,A组患者脾脏组织缩小30%～50%,外周血白细胞(WBC)和血小板(PLT)均有不同程度升高。A1组患者ESCA评分明显高于A2组。结论 PSE联合TACE治疗肝癌合并脾功能亢进有确切的疗效;护理干预有利于改善PSE联合TACE治疗肝癌合并脾功能亢进患者的预后。

Objective To study the clinical value of PSE combined with TACE and nursing intervention in the treatment of hepatocellular carcinoma（HCC） patients with hypersplenism.Methods 103 HCC patients with hypersplenism were divided into A and B group.In group A（n=53）,the patients received treatment of PSE combined with TACE,and in group B（n=50）,the patients received treatment of TACE.The curative effect was valued by tumor size,size of spleen,peripheral blood cell test.The group A was divided into A1 and A2 subgroups.In group A1,the patients adopted conventional nursing care,and in group A2,the patients adopted nursing intervention.ESCA score was used to evaluate the nursing intervention.Results There was no significant difference of tumor size between group A and B.In group A,the spleen decreased 30%-50% of volume.WBC and PLT had increased.ESCA score in group A1 was significantly higher than that in group A2.Conclusion Nursing intervention can improve the curative effect of PSE combined with TACE in HCC patients with hypersplenism.