227例经皮肝穿刺氩氦刀靶向治疗肝癌循环系统并发症的护理干预

超低温冷冻损毁肿瘤组织是近年开展的治疗新技术，氩氦刀靶向冷冻损毁技术（targeted cryoablationt herapy）是一种全监控、精确定位、快速冷冻、迅速复温的摧毁肿瘤组织治疗方法，不会导致过量肝组织破坏，可以使无法耐受肝切除术的肝癌病人接受该治疗。2003年4月-2006年12月我科在B超引导下经皮肝穿氩氦刀冷冻治疗肝癌227例，现将护理观察体会报告如下。     

经皮肝穿刺氩氦刀治疗肝癌的护理73例

氩氦刀靶向冷冻损毁术 (targetedcryoablationtherapy)是近年来开展的一项肿瘤冷冻治疗新技术[1] ,它采用局部超低温冷冻及快速复温的方法损毁肿瘤组织 ,不会导致过量肝组织的破坏 ,可以使一些无法耐受肝切除术的肝癌患者接受该治疗[2 ] 。2 0 0 1年 7月～ 2 0 0 2年 10月我院在B超引导下经皮肝穿刺氩氦刀冷冻治疗肝癌 73例 ,现将临床护理体会报告如下。1　临床资料1.1　一般资料2 0 0 1年 7月～ 2 0 0 2年 10月在B超引导下经皮肝穿刺氩氦刀冷冻治疗肝癌 73例 ,其中男 5 9例 ,女14例 ,男女比例 1.0∶4 .1,年龄 2 4～ 80岁 ,平均年龄5 4.4岁…     

经皮肝穿刺氩氦刀治疗肝癌的护理73例

氩氦刀靶向冷冻损毁术(targeted cryoablationtherapy)是近年来开展的一项肿瘤冷冻治疗新技术,它采用局部超低温冷冻及快速复温的方法损毁肿瘤组织,不会导致过量肝组织的破坏,可以使一些无法耐受肝切除术的肝癌患者接受该治疗。2001年7月～2002年10月我院在 B 超引导下经皮肝穿刺氩氦刀冷冻治疗肝癌73例,现将临床护理体     

经皮肝穿刺氩氦刀靶向治疗肝癌术后并发症的评估及护理

氩氦刀冷冻消融术是近年来新开展的治疗原发性肝癌的微创治疗技术,我科于2003年4月至2008年12月完成了500例次的治疗,其中对227例回顾性研究了氩氦刀冷冻消融治疗原发性肝癌并发症出现的原因,制定了护理观察表,建立了围手术期的临床护理规范和健康教育手册;并对273例前瞻性探索了围手术期的临床护理规范的有效性,现报道如下.     

氩氦刀冷冻治疗肝癌患者的护理

目的 观察氩氦刀冷冻消融治疗肝癌的临床疗效.方法 2006年12月-2007年9月对11例诊断为晚期肝癌却无法手术切除的患者行氩氦刀介入治疗肝肿瘤的术前准备、术中配合及术后护理.结果 11例患者手术顺利完成,疗效较佳,无严重并发症出现,原发性肝癌AFP下降率达95%以上.结论 B超引导下经皮肝穿刺氩氦刀治疗肝肿瘤能保证患者安全度过围手术期,通过术前宣教、术中配合及术后护理确保了整个过程顺利完成,是延长患者生命,提高患者生存期和生存质量的微创治疗肝癌新方法.     

肺癌氩氦刀术后皮肤冻伤的原因分析及护理干预

肺癌目前已成为发病率及死亡率最高的恶性肿瘤[1]。氩氦刀靶向治疗肺癌是技术成熟的微创肿瘤冷冻手段,对中晚期肺癌病人疗效确切,在我国已得到了普遍推广。氩氦刀可快速制冷包裹肿瘤组织最低可达-165℃,超低温可导致刀道局部冻伤。本研究探讨肺癌氩氦刀术后皮肤冻伤的相关因素,以进行相应的护理干预,降低冻伤发生率,现报道如下。1资料与方法1.1一般资料选择2009年5月—2013年2月我院氩氦刀治疗中心在CT引导下行氩氦刀靶向治疗肺癌病人480例,其中男288例,女192例;年龄38岁~80岁,平均57.4岁;周围型肺     

经皮氩氦刀靶向消融治疗肝癌30例护理体会

2004年12月~2005年12月,我院经皮氩氦刀靶向消融治疗肝癌30例,经积极手术配合,效果满意。现报告如下。1临床资料本组30例,男26例,女4例,21~78岁。小肝癌7例,大肝癌23例。AFP阳性21例,肝肿瘤直径1.5~13cm。单次冻融28例,两次冻融2例。2结果患者术中因多刀组合冷冻范围大致全身体     

超声引导下氩氦刀冷冻消融术治疗浅表恶性肿瘤的应用价值

氩氦刀对肿瘤的冷冻消融术多用于肺、肝等组织的肿瘤治疗,并取得了丰富的临床经验[1,2].为了扩展氩氦刀的临床应用范围,我院开展了在超声引导下对浅表软组织和器官肿瘤的氩氦刀冷冻消融治疗,现总结如下.     

超声引导下氩氦刀冷冻消融术治疗浅表恶性肿瘤的应用价值

氩氦刀对肿瘤的冷冻消融术多用于肺、肝等组织的肿瘤治疗,并取得了丰富的临床经验[1,2].为了扩展氩氦刀的临床应用范围,我院开展了在超声引导下对浅表软组织和器官肿瘤的氩氦刀冷冻消融治疗,现总结如下.     

氩氦刀冷冻消融治疗肝癌患者围术期护理

目的:探讨氩氦刀冷冻消融治疗肝癌患者的临床疗效及围术期护理方法。方法:选取2016年2~11月收治的42例采用氩氦刀冷冻消融治疗的肝癌患者为观察组,选取2015年2~11月收治的40例采用经导管肝动脉化疗栓塞治疗的肝癌患者为对照组。比较两组治疗效果,总结氩氦刀冷冻消融治疗的围术期护理方法。结果:观察组甲胎蛋白转阴率、肿瘤完全坏死率、12个月生存率均高于对照组(P0.05),术后不良反应发生率低于对照组(P0.05),满意度高于对照组(P0.05)。结论:氩氦刀冷冻消融治疗肝癌的临床疗效满意,完善的围术期护理是治疗有效的关键。     

肝移植后肝功能的异常★

背景：肝移植后导致肝功能异常原因复杂，早期弄清引起肝功能异常的原因对治疗至关重要。目的：较全面的了解肝移植后可以导致肝功能异常的原因，以便应用于临床诊治。方法：应用计算机检索CNKI和FMJS数据库，采用医学主题词检索，检索词为“肝移植；肝功能异常；转氨酶异常；胆红素升高；原因”或“liver transplantation；abnormal liver function；transaminase abnormalities；bilirubin increased, and causes”，时间范围为1991年1月至2012年7月，共检索到98篇文章，选择文章主要内容与肝移植后肝功能异常直接相关的、发表在权威杂志上的文章共35篇进行综述。结果与结论：肝移植后导致肝功能异常的原因众多，临床表现复杂。最常见的原因依次是急性排斥反应、胆道并发症及病毒感染。肝移植后早期，尤其是1个月内出现肝功能异常，需警惕小体积综合征和原发性移植物无功的发生。各种原因引起的肝功能异常，转氨酶及胆红素升高的程度不尽相同。急性排斥反应、自身免疫性肝炎、病毒感染、门静脉及肝静脉狭窄、缺血-再灌注损伤等转氨酶升高较胆红素升高显著；慢性排斥反应、胆道并发症、肝动脉狭窄、原发性胆汁性肝硬化、原发性硬化性胆管炎等早期以梗阻酶碱性磷酸酶、谷氨酰转移酶、总胆红素、直接胆红素升高为主；肿瘤导致的肝功能异常视肿瘤大小、压迫部位不同，可表现出以转氨酶升高为主或以胆红素升高为主。此外，各种原因多有其特殊病史，仔细询问病史有助于早期诊断。临床工作中，应重视尽量详尽的采集病史，根据转氨酶和胆红素升高的具体情况，首先考虑引起肝功能异常的常见原因，经临床证实排除后再考虑其他相对不常见原因，并结合实验室检查、影像学检查及肝脏穿刺病理活检，尽早明确病因及治疗。     

Acute liver failure: liver support therapies

PURPOSE OF REVIEW: We summarize the therapeutic approach to patients with acute liver failure with the main focus on bioartificial and artificial liver support. We also describe specific and general therapeutic approaches based upon recent advances in the understanding of the pathophysiology of acute liver failure. RECENT FINDINGS: Bioartificial liver support systems use hepatocytes in an extracorporeal device connected to the patient's circulation. Artificial liver support is intended to remove protein-bound toxins and water-soluble toxins without providing synthetic function. Both systems improve clinical and biochemical parameters and can be applied safely to patients. Although bioartificial liver-assist devices have not been shown to improve the survival of patients with acute liver failure, further development is underway. Artificial liver support systems have been shown to alter several pathophysiological mechanisms involved in the development of acute liver failure but survival data are still limited. SUMMARY: Mortality in patients with acute liver failure is still unacceptably high. The most effective treatment, liver transplantation, is a limited resource and so other therapeutic options to bridge patients to recovery or stabilization have to be considered. Better understanding of the pathophysiology of acute liver failure and device development is necessary to achieve the elusive goal of effective extracorporeal liver assist.     

Lipid peroxidation of the liver in liver disease

Material of puncture biopsy of the human liver left after morphological study was used to explore enzymatic and non-enzymatic lipid peroxidation, NADH-ferricyanide reductase activity, the content of triglycerides, cholesterol and protein. It was shown that the degree of lipid peroxidation varies considerably in different liver diseases. The highest degree of lipid peroxidation was discovered in patients with fibrosis accompanied by the symptoms of fatty dystrophy. It was established that the rate of peroxidation does not directly correlate with the level of liver lipid infiltration. It is concluded that NADH-ferricyanide reductase activity mirrors adequately the nature of a liver disease and can be used as a highly sensitive and very specific enzymatic test.     

Management of chronic liver failure until liver transplantation

Chronic liver failure is an important cause of morbidity and mortality and is the long-term consequence of many chronic liver diseases. In addition to determining the specific cause of the chronic liver disease, which may be amenable to targeted therapy, it is important to treat the sequelae of chronic liver failure effectively to improve quality of life, to prolong survival, and to provide a bridge to liver transplantation. Once a patient who has chronic liver failure develops hepatic decompensation, liver transplantation is the definitive treatment for those who qualify. Management of chronic liver failure is the focus of this article.     

晚期肝癌合并肝包膜下出血或肝破裂出血的护理

目的总结晚期肝癌并肝包膜下出血或肝破裂出血的护理要点。方法2001年1月~2004年12月对本院收治的56例晚期肝癌并肝包膜下出血或肝破裂出血病人进行抢救治疗,并配合护理。结果治疗总有效率为80.4%,死亡率为12.5%。结论晚期肝癌并肝包膜下出血或肝破裂出血,病情变化快,死亡率高,护理的重点在于止痛、止血、并发症的急救、病情观察,心理及支持性的护理,并开展健康教育,尽量消除各种诱发因素,有效地控制出血和防止再出血,从而提高病人的生活质量。     

Antipyrine kinetics in liver disease and liver transplantation

Antipyrine kinetics were studied in seven normal subjects, 10 patients with liver disease, and 13 clinically stable patients who received a liver transplant. Five patients were studied both before and after liver transplantation. Antipyrine concentrations in saliva after oral dosing were measured by HPLC. The antipyrine t1/2 was significantly longer (P less than 0.05) in patients with liver disease than in patients undergoing liver transplantation and normal subjects. Antipyrine clearance was not significantly different between patients undergoing liver transplantation and normal subjects, but it was significantly reduced (P less than 0.05) in patients with liver disease. In five patients who were studied before and after liver transplantation, there was a significant (P less than 0.05) increase in the antipyrine clearance and a marked reduction in its t1/2 after liver transplantation. These results indicate that liver transplantation improves the drug metabolizing ability of patients with liver disease and that the oxidative metabolizing capacity of the liver in clinically stable patients after liver transplantation is similar to that of normal subjects.