舒适护理在微波消融结合门静脉灌注治疗原发性肝癌围术期的应用效果观察

Clinical analysis of comfort care during the perioperative period of primary liver cancer treated by the microwave ablation combined with portal vein perfusion chemotherapy

目的:探讨舒适护理在超声引导经皮微波消融结合门静脉灌注化疗治疗原发性肝癌围术期的临床应用效果。方法:选取我院2014-03~2017-10收治的行超声引导下经皮微波消融并门静脉灌注化疗的原发性肝癌患者178例为研究对象,随机分为观察组及对照组,每组89例。对照组采用常规护理,观察组在对照组基础上行舒适护理。对比分析两组术前准备、术中配合、术后观察的综合护理效果,记录术后不良反应,调查护理满意度。结果:178例患者均顺利完成手术治疗,未见烫伤、肝包膜下出血、胆漏等严重并发症,按诊疗计划如期出院。两组的满意率、紧张焦虑、恐惧、血压升高、心率加快比例及不良反应发生率比较,观察组均优于对照组,差异有统计学意义(P<0.05)。结论:在超声引导经皮微波消融并门静脉灌注化疗治疗原发性肝癌围术期采用舒适护理,可改善患者心理健康状态,增强耐受力,缓解应激反应,有助于手术顺利进行,有效降低患者不良反应发生率,促进术后康复,提高舒适度及满意度,具有一定的临床应用价值。

Objective：To discuss clinical effects of the comfort care during the perioperative period of primary liver cancer treated by the microwave ablation combined with portal vein perfusion chemotherapy guided by ultrasound.Methods：A total of 178 cases with primary liver cancer treated by ultrasonic guided percutaneous microwave ablation combined with portal vein perfusion chemotherapy from March 2014 to October 2017 were divided into observation group and control group,89 cases in each group.The control group was given routine nursing,and the observation group was given comfort care on the basis of control group.The comprehensive nursing effect of preoperative preparation,intraoperative coordination and postoperative observation in two groups were compared and analyzed,and the postoperative adverse reactions were recorded,nursing satisfaction was investigated.Results：A total of 178 cases were successful treated with surgical treatment and discharged on schedule.There were no severe complications such as scald,subcapsular hemorrhage,biliary fistula,et al.The rate of satisfaction,tension,anxiety,fear,elevated blood pressure,heart rate acceleration and the incidence of adverse reactions in observation group was better than that in control group,the difference was statistically significant（P〈0.05）.Conclusion：The comfort care during the perioperative period of primary liver cancer treated by the microwave ablation combined with portal vein perfusion chemotherapy guided by ultrasound can improve mental health status,enhance tolerance,relieve stress reaction,help the operation proceed smoothly,effectively reduce the incidence of adverse reactions,promote postoperative rehabilitation,improve comfort and satisfaction,and has certain clinical application value.