全方位冷冻治疗中晚期肝癌术后并发症的观察与护理

论文编号:HL170  论文字数:12206.页数:28

论文题目：全方位冷冻与手术治疗中晚期肝癌患者疗效的比较研究
摘  要
研究目的
 目前我国发病人数约占全球的半数以上，占全球肝癌病人的55%，已经成为严重威胁我国人民健康和生命的一大杀手，其危险性不容小视。冷冻治疗中晚期肝癌成为进一步提高其疗效和存活率的一种有效途径。通过对比相同病理类型的肝癌患者采用全方位冷冻及手术治疗的并发症发生率、患者术后满意度、患者1年及3年生存率，选取对患者更有利的治疗手段。
研究方法
 将因患中晚期肝癌入住肝胆外科需治疗患者按其所选治疗方案分成全方位冷冻治疗组（冷冻组）和传统手术组（手术组），记录比较两组病例术后并发症的发生，随访调查患者1年及3年生存率，评价更为有效的治疗手段。
研究结果 
⑴两组患者的临床资料包括性别、发病起源、乙型肝炎表面抗体、病理分期相比，表明两组临床资料无显著差异（p>0.05），具有可比性。
⑵相同病理类型，病情严重程度相当的中晚期患者接受手术及冷冻治疗后，两组患者的并发症发生率有差异，总体上讲冷冻治疗的并发症发生率低于手术治疗组，P<0.05 , 差异有统计学意义。
⑶接受冷冻治疗的患者对手术的满意度较传统手术组高；尽管两组患者1年生存期相当，但是冷冻治疗组患者的3年生存率高于单纯手术组，P<0.05 , 差异有统计学意义。
⑷冷冻治疗与传统的单纯手术行相比，并发症发生率低，P<0.05 , 差异有统计学意义。患者远期生存率及生活质量高，冷冻治疗值得在中晚期肝癌患者临床治疗中推广。
研究结论
 中晚期肝癌患者行全方位冷冻治疗并采取及时、安全、有效的护理可以有效的防止和减少并发症的发生，提高病人近远期生存率及生存质量，是一种安全有效的治疗手段。
关键词
     全方位冷冻治疗；手术治疗；中晚期肝癌；并发症
论文类型：回顾性调查分析研究

Abstract
Objective
 The complication rate using the full range of frozen and surgical treatment, by contrast to the same pathological type of liver cancer patients, patients satisfaction, patients 1 year and 3-year survival rate, select the more favorable treatment to patients.
Methods
 Suffering from advanced liver cancer stay in hepatobiliary surgery needed to treat patients according to the selected treatment program into a full range of cryotherapy (freezing group) and conventional surgery group (surgery group), records were compared between the two groups of cases of postoperative complications occurred,follow-up investigation in patients 1 year and 5-year survival rate, evaluation of more effective treatment.
Results
(1) Compared the clinical data, including gender, incidence of origin of hepatitis B surface antibody, pathological stage of patients in the two groups, the difference was not significant (p> 0.05), showing that the two sets of clinical data was no significant difference,and was comparable.
(2)The same pathological type, severity of disease is considerable in patients with advanced surgery and cryotherapy, two groups of patients with complication rate differences, cryotherapy Overall complication rate is lower than the surgical group. P < 0.05, the difference was statistically significant
(3)Accept the freezing treatment, patient satisfaction with surgery than the conventional surgery group; P < 0.05, the difference was statistically significant. one year survival in two groups of patients is quite frozen in patients treated with 3-year survival rate is higher than the surgery alone group..
(4) Compared to conventional surgery, cryotherapy has the low incidence of complications, P <0.05, which difference has statistically significant. With long-term survival and quality of life, the cryotherapy is worthy promoting on patients with advanced hepatocellular carcinoma in the clinical treatment.
Conclusions
 With advanced hepatocellular carcinoma in patients with a full range of cryotherapy and to take timely, safe and effective care can effectively prevent and reduce complications and improve patient and long term survival and quality of life, is a safe and effective treatment.
Keywords
 Full range of cryotherapy; Surgery; With advanced hepatocellular carcinoma; Complications
Paper type: clinical study
目 录 
摘要…………………………………………………………………………………
1 前言………………………………………………………………………………14                                               
1.1研究背景及意义 ………………………………………………………………14                     
1.2研究目的及目标 ………………………………………………………………15                        
1.2.1研究目的…………………………………………………………………… 15                                             
1.2.2研究目标…………………………………………………………………… 16                                         
1.3关键词及定义………………………………………………………………… 16
1.3.1全方位冷冻治疗…………………………………………………………… 16
1.3.2手术治疗…………………………………………………………………… 16  
1.3.3中晚期肝癌………………………………………………………………   16 
1.3.4并发症……………………………………………………………………… 16
1.4文献回顾……………………………………………………………………… 17                                      
1.4.1中晚期肝癌的判断标准…………………………………………………… 17
1.4.2 中晚期肝癌研究现状……………………………………………………… 17
1.4.3中晚期肝癌治疗方法……………………………………………………… 17
1.4.4 肝癌的手术治疗效果……………………………………………………  18
2研究设计与方法…………………………………………………………………20
2.1研究设计………………………………………………………………………20
2.2研究对象………………………………………………………………………21
2.3研究步骤………………………………………………………………………21
2.4研究工具及方法………………………………………………………………21
2.5资料分析………………………………………………………………………22
3结果与分析………………………………………………………………………22
3.1试验组与对照组的临床资料的分析…………………………………………22
3.2两组术后并发症相关分析………………………… 23
3.3两组患者术后随访结果对比………………………23
4讨论 …………………………………………………………………………… 25
4.1 冷冻治疗肝癌…………………………………………………… 25
4.1.1 全方位冷冻治疗中晚期肝癌……………………………………………… 25
4.1.2 冷冻治疗的适应症及禁忌症……………………………………………… 25
4.1.3 冷冻治疗术后并发症及应对措施………………………………………… 25
4.2 手术治疗肝癌…………………………………  25
5 结论………………………………………………………………………………27
6 致谢………………………………………………………………………………28
参考文献………………………………………………………………………… 29
附表……………………………………………………………………………… 31