デジタルサブトラクション血管造影画像による肝癌のインターベンション化学塞栓術後の感染症と神経障害合併症の相関因子分析

Correlation Factor Analysis of Infections and Neurological Complications after Interventional Chemoembolization of Liver Cancer by Digital Subtraction Angiography Images.

• Mengyan Xing
• Zhonghua Ma
• Hanfang Fu
• Fang Jin
• Jing Wang
• Yujie Hua
• Li Han

抄録

原発性肝癌（PLC）に対する経カテーテル動脈化学塞栓療法（TACE）治療後の感染症および神経障害合併症の影響因子を探るために，TACEを受けたPLC患者80例を対象に，術後感染症，発熱，消化器症状，肝機能障害，骨髄抑制，ヨウ化油の異所性塞栓による神経障害などのTACE後合併症の発生率を観察した。α-フェトプロテイン（AFP）値の違い、肝機能グレードの違い、腫瘍形態の違い、腫瘍血流の違い、動静脈瘻の違い、手術中のヨウ素化油投与量の違いによる6つの合併症の群間の違いを分析した。Pが<0.05の時に統計的な差があった。その結果、TACE後の合併症のうち、感染症による神経障害、発熱、消化器症状、肝機能障害、骨髄抑制、ヨウ素化油の異所性塞栓症の発生率は、58.75％、90％、86.25％、77.5％、22.5％、1.25％であった。AFPは術後の6つの合併症の発生に有意な影響はなく、肝機能分類は術後の消化器症状、肝機能障害、骨髄抑制の発生に有意な影響があり、腫瘍形態と腫瘍血液の供給は術後の感染症、発熱、消化器症状、肝機能障害に有意な影響があった。結論として、TACE後の神経損傷の合併症と影響因子との関係から、TACE手術の成功率を向上させ、患者の生存期間を延長するために、臨床的に対応する看護介入を行うことができると考えられた。

In order to explore the influencing factors of infections and nerve injury complications after transcatheter arterial chemoembolization (TACE) treatment of primary liver cancer (PLC), 80 PLC patients who underwent TACE were included to observe the incidence rates of post-TACE complications, such as postoperative infections, fever, gastrointestinal symptoms, liver function damage, bone marrow suppression, and nerve damage caused by ectopic embolization of iodized oil. The differences between the 6 complications in different groups of different alpha-fetoprotein (AFP) levels, liver function grades, tumor morphology, tumor blood supply, arteriovenous fistula, and different iodized oil dosage during surgery were analyzed. There was a statistical difference when P was <0.05. The results showed that among the complications after TACE, the incidence of neurological damage caused by infection, fever, gastrointestinal symptoms, liver function impairment, bone marrow suppression, and ectopic embolization of iodized oil were 58.75%, 90%, 86.25%, 77.5%, 22.5%, and 1.25%. AFP had no significant effects on the occurrence of 6 postoperative complications; liver function classification had a significant effect on the occurrence of postoperative gastrointestinal symptoms, liver function damages, and bone marrow suppression; tumor morphology and tumor blood supply had a significant effect on postoperative infection, fever, gastrointestinal symptoms, and liver function damages. In conclusion, according to the relations between the post-TACE nerve injury complications and the influencing factors, corresponding nursing interventions could be performed clinically to improve the success rate of TACE surgery and prolong the survival time of patients.

Copyright © 2020. Published by Elsevier B.V.