TACE联合索拉非尼治疗23例中晚期肝细胞肝癌的护理

Nursing for patients with advanced hepatocellular carcinoma receiving transcatheter arterial chemoembolization combined with sorafenib: initial experience in 23 cases

目的探讨肝动脉化疗栓塞术（TACE）联合索拉非尼治疗中晚期肝细胞肝癌（HCC）的护理方法。方法选取符合纳入标准的23例中晚期HCC患者，TACE术后3-5d口服甲磺酸索拉非尼。期间观察、记录不良反应和并发症发生情况．出院患者由延续护理小组成员跟踪随访，予以健康教育和相应的护理干预措施。结果所有患者TACE术后均口服索拉非尼进行治疗，联合治疗的不良反应主要是：胃肠道反应（22例）和一过性肝功能损害（23例）。出院患者均得到定期随访和延续护理。结论TACE联合索拉非尼治疗晚期肝细胞肝癌不良反应发生率较高．采用院内观察结合院外延续护理的方式护理此类患者，可减轻治疗期间并发症反应，提高患者的生存质量。

Objective To discuss the nursing care for patients with advanced hepatocellular carcinoma （HCC） who are receiving transcatheter arterial chemoembolization （TACE） combined with sorafenib. Methods A total of 23 consecutive patients with advanced HCC who met the inclusion criteria were enrolled in this study. TACE was carried out in all patients. Three-five days after TACE the patients started to orally take sorafenib. During the treatment course, the patients were kept under close observation for adverse reactions and complications. After leaving the hospital the patients were followed up by the extended care team members, and health education as well as appropriate nursing intervention was carried out. Results All patients with advanced HCC took sorafenib orally after TACE. The major adverse events and complications were gastrointestinal adverse reactions （n = 22） and transient liver dysfunction （n = 23）. After leaving the hospital all the patients received regular follow- up examination and extended nursing care. Conclusion Usually, the incidence of adverse reactions is higher in patients with advanced HCC after TACE combined with sorafenib treatment. Careful in- hospital observation and extended out- hospital nursing can reduce the incidence of adverse reactions and thus improve the patient＇s quality of life. （J Intervent Radio1, 2014, 23： 449-451 ）