射频热凝治疗肝癌术后并发症的观察与护理

Observation and Nursing of Complications after Percutaneous Radiofrequency Ablation for Hepatic Malignancies

目的 通过对经皮肝穿刺射频热凝肿瘤所引发并发症的分析 ,探讨护理对策。方法 1999年 10月～ 2 0 0 0年9月对 10 0例肝脏恶性肿瘤患者进行了B超引导下经皮肝穿刺射频肿瘤热凝术 (PRFA)。术后所有患者给予定期随访。结果 小肝癌 (未手术 ,≤ 5cm)AFP阳性者术后AFP转阴 75 0 % (2 1/ 18) ,明显下降 2 1 4% (6 / 8) ,总有效率96 4%。术后出现发热 98%、肝功能损害 78%、腹腔内出血 1%、胃漏 1%、气胸 1%、肝脓肿 1%。结论 虽然PRFA是一种微创手术 ,但术后仍应密切观察生命体征和腹部体征的变化 ,及时防治PRFA引发的近期并发症。同时应认真做好患者的出院指导 ,及时防治远期并发症。

Objective\ To explore the countermeasures of nursing by analyzing the complications after percutaneous radiofrequency ablation(PRFA) for hepatic malignancies.Methods\ 100 patients with hepatic malignancies were performed PRFA guided by ultrasonography between October 1999 and September 2000.All patients were followed up after the treatment.Results\ The AFP positive with small hepatocelluar carcinoma had AFP value down to negative in 75.0%(21/18) and decreased markedly in 21.4%(6/8).After PRFA,these patients had fever in 98%,damage of hepatic function in 78%,intra-abdominal bleeding in 1%,gastric damage in 1%,hepatic abscess in 1% and 1%.Conclusion\ Although PRFA is a minimal invasive treatment,it is necessary to closely observe changing of life signs and abdominal signs in order to prevent and treat the complication in time.