肝细胞肝癌经肝动脉灌注化疗栓塞术后快速康复外科理念康复的研究

Rehabilitation of FTS concept in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization

目的研究肝细胞肝癌经肝动脉灌注化疗栓塞术后快速康复外科理念(FTS)的临床价值。方法选取临沂市肿瘤医院2019年1月~2021年1月收治的148例经肝动脉灌注化疗栓塞术治疗的肝细胞肝癌患者,随机数表法分为对照组(n=74)和观察组(n=74)。对照组行常规围术期干预,观察组在此基础上行FTS干预。比较两组围术期指标,对比两组干预前后生活质量(SF-36)评分及日常生活能力(ADL)评分,分析两组干预前后健康行为能力(SRAHP)评分,观察两组术后并发症发生率。结果观察组术后首次下床时间、住院时间均低于对照组,差异有统计学意义(P<0.05),肿瘤体积较对照组比较差异无统计学意义(P>0.05)。两组干预后SF-36、ADL评分较干预前增加,且观察组均高于对照组,差异有统计学意义(P<0.05)。两组干预后营养管理、健康责任、运动管理、心理安适评分及SRAHP总分较干预前升高,差异有统计学意义(P<0.05);观察组干预后健康责任、运动管理及SRAHP总分高于对照组,差异有统计学意义(P<0.05),营养管理、心理安适评分较对照组比较差异无统计学意义(P>0.05)。观察组术后并发症发生率为4.05%,较对照组(12.16%)比较差异无统计学意义(P>0.05),结论肝细胞肝癌患者经肝动脉灌注化疗栓塞术后采用FTS干预可提高生活质量及日常生活能力,有助于形成健康行为,降低术后并发症发生风险,促进术后康复。

Objective To study the clinical value of fast recovery surgery concept(FTS)after transarterial chemoembolization for hepatocellular carcinoma.Methods A total of 148 patients with hepatocellular carcinoma treated in our hospital from January 2019 to January 2021 were selected and randomly divided into the control group(n=74)and the observation group(n=74).The control group received routine perioperative intervention,and the observation group received FTS intervention on this basis.The perioperative indicators of the two groups were compared,and the scores of psychological state[self-rating anxiety scale(SAS),self-rating depression scale(SDS)],quality of life(SF-36)and activities of daily living(ADL)were compared between the two groups before and after the intervention.)score,the health behavior ability(SRAHP)score before and after intervention in the two groups was analyzed,and the incidence of postoperative complications in the two groups was observed.Results The time of first getting out of bed and hospital stay in the observation group were lower than those in the control group(P<0.05),and there was no significant difference in tumor volume compared with the control group(P>0.05).The SDS and SAS scores of the two groups after the intervention were lower than those before the intervention(P<0.05);the SDS and SAS scores of the observation group after the intervention were lower than those of the control group(P<0.05).The scores of SF-36 and ADL in the two groups after the intervention were higher than those before the intervention(P<0.05);the scores of SF-36 and ADL in the observation group after the intervention were higher than those in the control group(P<0.05).Nutrition management,health responsibility,exercise management,psychological well-being scores and total SRAHP scores in the two groups after intervention were higher than those before intervention(P<0.05);after intervention,the observation group had higher scores on health responsibility,psychological well-being and SRAHP than those in the control group(P<0.05).There was no significant difference in the scores of nutrition management and exercise management compared with the control group(P>0.05).The incidence of postoperative complications in the observation group was 4.05%,which was not significantly different from 12.16%in the control group(P>0.05).Conclusion FTS intervention in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization can improve the quality of life and daily living ability,help to form healthy behaviors,improve negative emotions,reduce the risk of postoperative complications,and promote postoperative recovery,which is worthwhile.promotion.