腹腔热灌注联合靶向药物化疗治疗恶性腹水的临床护理路径及体会

Clinical nursing path and experience of hyperthermic intraperitoneal perfusion combined with targeted drugs chemotherapy in treatment of patients with malignant ascites

目的探讨腹腔热灌注联合贝伐珠单抗（安维汀）化疗的护理体会。方法66例确诊为恶性肿瘤伴腹水患者，灌注前先放尽腹水，以43～45℃的0．9％生理盐水注入腹腔，顺铂30nag持续有效循环40min以上，灌液后排尽腹腔液，第2天腹腔内注入贝伐珠单抗100-300mg和氟尿嘧啶1g或吉西他滨1g。结果全部患者均顺利完成灌注，其中出现不适的患者经对症处理后缓解，并总结出一套腹腔热灌注联合靶向药物化疗的临床护理路径。结论加强腹腔热灌注化疗患者的护理对于提高治疗效果、减少不良反应有着积极作用。

Objective To explore the nursing experience of hyperthermic intraperitoneal perfusion combined with bevacizumab in the treatment of patients with malignant ascites. Methods 66 malignant tumor patients with ascites were treated with exhaustion of ascites before perfu- sion, and then the abdominal cavity was infused with 0.9% saline （43 ℃ to 45 ℃ ） and 30 mg cis- platin for 40 minutes. The abdominal cavity was infused with 100 to 300 mg beacizumab and 1 g fluorouracil or 1 g gemcitabine on the second day. Results All the patients completed perfusion successfully, and the patients with discomfortableness were cured after sympomatic treatment. Conclusion Reinforcement of nursing for patients with combination therapy of hyperthermic in- traperitoneal perfusion and chemotherapy can improve the therapeutic efficacy and reduce the inci- dence of adverse reactions.