Zhao Xiaoyun, Sun Xingwei, Jing Jian, Zhou Huimin, Jin Yong
The Second Affiliated Hospital of Soochow University, 215000, Suzhou, China.
J Interv Med. 2021 Dec 23;4(4):203-207. doi: 10.1016/j.jimed.2021.10.003. eCollection 2021 Nov.
To investigate the safety of relieving bed restriction in hepatic arterial infusion chemotherapy (HAIC) and its effects on patient comfort.
A prospective study was conducted. Patients with malignant liver tumors, who met the enrollment criteria, were randomly divided into experimental and control groups. During HAIC treatment, the patients in the experimental group, who were not confined to bed and could get out of bed, used electronic injection pumps to infuse chemotherapy drugs. The patients in the control group, who were strictly confined to bed and prohibited from getting out of bed, used infusion pumps to infuse chemotherapy drugs. The complications of the two groups were observed. The Christenson standard improved method was used to evaluate the bleeding and hematoma of limbs on the operation side. The Kolcaba General Comfort Questionnaire (GCQ) and Barthel Index (BI) were used to evaluate the two groups.
Ninety patients with malignant liver tumors were enrolled, including 53 with primary liver cancer and 37 with colorectal liver metastasis. There were 70 males and 20 females, aged 41-81 years old, with an average age of 61.6 ± 9.248 years old. There were 60 patients in the experimental group and 30 patients in the control group. All patients underwent HAIC. The study showed that, during the treatment period, there were 3 cases of postoperative puncture point hematoma formation in the two groups, including 2 cases in the experimental group (2/60, 3.3%) and 1 case in the control group (1/30, 3.3%). The difference was not statistically significant (p > 0.05). There were 5 cases of postoperative puncture point bleeding, including 4 cases in the experimental group (4/60, 6.7%) and 1 case in the control group (1/30, 3.3%), and the difference was not statistically significant (p > 0.05). A total of 23 cases, with 6 cases in the experimental group (6/60, 10%) and 17 cases in the control group (17/30, 56.7%), complained of back pain after the operation, and the difference was statistically significant (p < 0.05). Twenty-one cases complained of poor defecation after the operation, including 10 cases in the experimental group (10/60, 16.7%) and 11 cases in the control group (11/30, 36.7%). The difference was statistically significant (p < 0.05). During the period of infusion chemotherapy, the two groups of patients had there was a significant difference between the two groups in terms of comfort status (GCQ) (88.78 ± 6.705, 78.47 ± 9.519, p < 0.001) and self-care ability (BI) (74.25 ± 9.152, 66.83 ± 6.628, p < 0.001).
During HAIC treatment, getting out of bed is safe and reliable and can increase the patients' comfort and self-care ability. Hence, it merits clinical application.
探讨肝动脉灌注化疗(HAIC)解除卧床限制的安全性及其对患者舒适度的影响。
进行一项前瞻性研究。将符合纳入标准的恶性肝肿瘤患者随机分为实验组和对照组。在HAIC治疗期间,实验组患者不限制卧床,可下床活动,使用电子注射泵输注化疗药物;对照组患者严格卧床,禁止下床活动,使用输液泵输注化疗药物。观察两组的并发症情况。采用克里斯滕森标准改良法评估手术侧肢体的出血和血肿情况。使用科尔卡巴一般舒适度问卷(GCQ)和巴氏指数(BI)对两组进行评估。
纳入90例恶性肝肿瘤患者,其中原发性肝癌53例,结直肠癌肝转移37例。男性70例,女性20例,年龄41 - 81岁,平均年龄61.6 ± 9.248岁。实验组60例,对照组30例。所有患者均接受HAIC治疗。研究表明,治疗期间,两组术后穿刺点血肿形成各3例,实验组2例(2/60,3.3%),对照组1例(1/30,3.3%),差异无统计学意义(p > 0.05)。术后穿刺点出血5例,实验组4例(4/60,6.7%),对照组1例(1/30,3.3%),差异无统计学意义(p > 0.05)。术后共有23例患者诉背痛,实验组6例(6/60,10%),对照组17例(17/30,56.7%),差异有统计学意义(p < 0.05)。21例患者诉术后排便不畅,实验组10例(10/60,16.7%),对照组11例(11/30,36.7%),差异有统计学意义(p < 0.05)。在输注化疗期间,两组患者在舒适度状态(GCQ)(88.78 ± 6.705,78.47 ± 9.519,p < 0.001)和自我护理能力(BI)(74.25 ± 9.152,66.83 ± 6.628,p < 0.001)方面存在显著差异。
在HAIC治疗期间,下床活动安全可靠,可提高患者的舒适度和自我护理能力,值得临床应用。