射频消融治疗肝癌术中并发症的观察与护理.doc

射频消融治疗肝癌术中并发症的观察与护理 首都医科大学附属北京佑安医院肝病介入治疗中心 100069 王春华 郑加生 孙健 刘莉 [摘要] 目的 针对射频消融技术（ radiofrequency ablation, RFA）对原发性肝细胞性肝癌治疗中出现的不同并发症，探讨护理规范和体会。方法 采用射频热消融技术对肝癌患者实施治疗，观察总结术中出现的各种并发症及术中护理配合要点。 结果：对348例原发性肝癌患者，行RFA治疗733例次，共出现14种不同术中并发症172例次，最常见的并发症为恶心呕吐，发生率8.4%（62/172），头晕头痛发生率为3.7％；右肩疼痛3.5％；肝被膜下出血2.9％；气胸1.2％；心绞痛1.0％；血压升高0.8％；心率失常、胆汁瘤、低血糖分别占0.4％；心包填塞、肠漏、皮肤灼伤、细电极折断分别占0.1％。由于护士对术中可能出现的并发症有充分认识，术中施以及时有效的护理配合，协助医师，及早发现、预防、治疗控制了术中并发症的进展。结论：尽管RFA术中会出现一些并发症，但运用医师熟练的操作技巧，护士耐心细致的护理，术中能够消除患者的消除紧张情绪、使其更好的配合治疗的顺利完成、提高RFA治疗效果。护士及时有效的护理配合及护士的预见性，能更好的协助医师工作，99％的术中并发症都能得到及时的控制，以及尽早的缓解，为减轻患者痛苦、延长患者生存期具有重要的意义。 [关键词] 射频消融术 并发症 肝癌Radiofrequency ablation Intraoperativecomplications complicating disease liver cancer Care [Abstract] Objective： To discuss the nursing of various intraoperativecomplications during treatment of primary hepatocellular carcinoma (HCC) via radiofrequency ablation (RFA). Methods ：348 patients with HCC were treated with RFA. Variant complications arising while performing RFA were observed and suitable measures were taken. Results ：Treatment with RFA in 348 cases with HCC was applied for 733 times, among which 14 types of complications developed for 172 times. The most common complication was nausea and vomit with an incidence of 8.4% (62/172). However, 99% of intraoperativecomplications were controlled due to the nurses fully knowing the possible complications before operation, taking effective care measures in operation and closely co-operating with the practitioner, which led to discovering, preventing, treating and controlling complications in time. Conclusion： Although there appear some complications while performing RFA, practical skill of the practitioner and patient care from nurses could favor to ease the nervous mood of patients, encourage them to overcome disease, and improve the treating effect of RFA. Taken together, effective care and full knowledge of nurses of various complications were able to better assist doctors to operate, and favor