鸦胆子油乳经血管介入治疗老年人原发性肝癌的临床路径研究

Clinical Pathway of Javanica Oil Emulsion Through Blood Vessels Involved in Treatment of Elderly Primary Liver Cancer

目的评价鸦胆子油乳经血管介入治疗老年人肝癌方案的有效性、安全性和临床路径的患者满意度和费用-疗效比。方法将44例老年人肝癌患者随机分为临床路径治疗组(试验组)24例和常规治疗组(对照组)20例,比较两组疾病控制率(DCR)、体质量、生活质量、毒副反应、住院时间、住院费用、患者满意度等指标。结果试验组和对照组DCR分别为86.4%和80.0%,差异无统计学意义(P>0.05);体质量稳定率分别为86.4%和60.0%,KPS评分有效率分别为90.1%和70.0%,试验组生活质量QOL改善优于对照组,差异有统计学意义(P<0.05);治疗后试验组毒副反应发生率均少于对照组,差异有统计学意(P<0.05);试验组和对照组住院天数分别为(11.2±2.7)d和(15.3±5.1)d,住院费用分别为(18 020.1±4 181.8)元和(22 099.5±5 056.6)元,患者总满意度分别为81.8%和65.0%,差异有统计学意义(P<0.05)。结论鸦胆子油乳经血管介入治疗老年人原发性肝癌的临床路径为患者提供了优质服务,能稳定体质量,提高生活质量,减轻术后毒副反应,减少住院天数和住院总费用,提高患者满意度,值得临床推广应用。

Objective To preliminary evaluate the effectiveness and safety of Javanica Oil Emulsion through blood vessels involved in treatment of elderly primary liver cancer programs and patient satisfaction and cost-efficacy ratio of clinical pathways. Methods Forty-four elderly patients were randomly divided into clinical pathway treatment group （experimental group） with 24 cases and regulatory treatment group （control group） with 20 cases. The disease control rate （DCR）, weight, toxicity, quality of life, hospital stay and costs, patient satisfaction and other indicators of the two groups were compared. Results The DCR of experimental group and control group was 86.4% and 80.0%, respectively, the difference was not statistically significant （P〉0.05）. The body weight stable rate of experimental group and control group was 86.4% and 60.0%, respectively, the KPS score response rate was 90.1% and 70.0%, respectively, the QOL of experiment group was better than the control group, the difference was statistically significant （P〈0.05）. After treatment, the toxic and adverse effects of experiment group were less than the control group, the difference was statistically significant （P 〈0.05）. The average hospitalization time of experimental group and control group was respectively （11.2±2.7） days and （15.3±5.1） days, the average cost of hospitalization was （18 020.1 ±4 181.8） yuan and （22 099.5±5 056.6） yuan, respectively. The overall satisfaction was 81.8% and 65.0%, respectively, the difference was statistically significant （P〈0.05）. Conclusion The clinical path of Javanica Oil Emulsion through blood vessels involved in treatment of elderly primary liver cancer provide a quality service to the patients,it can improve quality of life, body weigh, and reduce the toxicity aspects, the number of days of hospitalization and the total cost of hospitalization after intervention, it is worthy of further promotion and application.