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肝移植治疗结直肠癌肝转移术后患者的体验。

Patient experiences following liver transplantation due to liver metastases from colorectal cancer.

机构信息

Division of Cancer Medicine, Surgery and Transplant at Oslo University Hospital Rikshospitalet HF, Norway.

出版信息

Eur J Oncol Nurs. 2013 Jun;17(3):269-74. doi: 10.1016/j.ejon.2012.07.004. Epub 2012 Aug 14.

DOI:10.1016/j.ejon.2012.07.004
PMID:22901549
Abstract

PURPOSE

Colorectal cancer is the second leading cause of cancer-related death in the western world. Little is known about patients undergoing liver transplantation (Ltx) due to liver metastases from colorectal cancer. This study aimed to explore individual patients' experiences having undergone this procedure as a treatment for liver metastases secondary to colorectal cancer.

METHOD

Exploratory research methodology was used, whereby in-depth interviews with 9 patients were carried out 6 months after they had undergone liver transplantation. Median patient age was 56 years at the time of the surgery. The interviews were transcribed verbatim and qualitative content analysis was applied to the data.

RESULTS

Three main themes emerged during the analysis phase. The first theme explored the informants' positive feelings about receiving experimental treatment that might prolong their life. The second theme related to the challenge presented by their feelings oscillating frequently between hope and despair. The final theme considered the strong wishes expressed by patients to live their lives as normally as possible thereafter. This last theme related in part to the patients' physical condition, side effects from medication and any relationships with loved ones.

CONCLUSION

These findings offer new insight into the situation of patients undergoing liver transplantation due to liver metastases from colorectal cancer. In spite of the risks and side effects of major surgery and the transplant medication all participants expressed an overall view that having undergone liver transplantation was a very positive experience.

摘要

目的

结直肠癌是西方世界癌症相关死亡的第二大主要原因。对于因结直肠癌肝转移而接受肝移植(Ltx)的患者,人们知之甚少。本研究旨在探讨个别患者接受这一手术作为治疗结直肠癌肝转移的经验。

方法

采用探索性研究方法,对 9 名患者进行深入访谈,这些患者在接受肝移植 6 个月后接受了访谈。手术时患者的中位年龄为 56 岁。访谈内容逐字记录下来,并对数据进行了定性内容分析。

结果

在分析阶段出现了三个主要主题。第一个主题探讨了受访者对接受可能延长其生命的实验性治疗的积极感受。第二个主题涉及到他们的情绪在希望和绝望之间频繁波动所带来的挑战。最后一个主题考虑了患者强烈希望此后尽可能正常地生活。这最后一个主题部分与患者的身体状况、药物的副作用以及与亲人的关系有关。

结论

这些发现为因结直肠癌肝转移而接受肝移植的患者的情况提供了新的见解。尽管面临重大手术的风险和副作用以及移植药物的副作用,所有参与者都表示,接受肝移植总体上是一次非常积极的经历。

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