肝动脉化疗栓塞术治疗乙型肝炎病毒相关肝癌患者服药依从性调查研究

Investigation on compliance of medication in hepatic arterial chemoembolization for treatment of patients with HBV associated hepatocellular carcinoma

目的了解肝动脉化疗栓塞术(TACE)治疗乙型肝炎病毒(HBV)相关肝癌患者抗病毒治疗的依从性,分析影响因素,为制定针对性的干预措施提供依据。方法选取2014年3月-2015年2月收治的58例TACE治疗HBV相关性肝癌患者,采用自行设计的问卷进行抗病毒治疗服药依从性调查,采用多元线性回归方法分析影响患者服药依从性的因素。结果 TACE治疗的HBV相关性肝癌患者抗病毒治疗依从性差3例占5.2%,依从性较差25例占43.1%,依从性较好30例占51.7%;患者服药依从性实际得分(21.74±3.138)分、标准得分(80.52±11.621)分;多元线性回归分析结果显示,患者服药依从性的影响因素有医源性因素、经济状况、HBV三系、肝功能分级、职业等,差异均有统计学意义(P<0.01)。结论根据患者依从性不佳的主要因素,医护人员应为患者制定个体化干预方案,提高患者抗病毒治疗的依从性。

OBJECTIVE To understand the antiviral compliance of hepatic arterial chemoembolization（TACE）for treatment of HBV associated hepatocellular carcinoma and analyze the influencing factors,so as to provide reference for making targeted intervention measures.METHODS Totally 58 patients with HBV associated hepatocellular carcinoma who received TACE treatment during Mar.2014 to Feb.2015 were selected and surveyed for their compliance to antiviral medication by a self-designed questionnaire.The influencing factors of compliance were analyzed by multiple linear regression method.RESULTS Three patients had poor compliance,accounting for 5.2%;twenty five patients had relatively poor compliance,accounting for 43.1%;thirty patients had better compliance,accounting for 51.7%.The actual score of the medication compliance of patients was（21.74±3.138）points and the standard score was（80.52±11.621）points.The multiple linear regression analysis showed that the influencing factors included iatrogenic factors,economic conditions,three-line HBV,liver function grade,occupation and so on,with statistical significance（P〈0.01）.CONCLUSIONThe medical staff should constitute individualized intervention program for improving patient compliance of antiviral therapy corresponding to the main causes of poor compliance.