癌性胸水局部化疗结合热疗观察及护理.docVIP

癌性胸水局部化疗结合热疗观察及护理[摘要]目的 观察胸腔置管局部灌注化疗后结合体外高频热疗治疗癌性胸水的疗效。方法 86例病人均经胸腔置入16G静脉导管,待胸腔引流干净或少量后,再通过导管注入顺铂(DDP)80mg/?,每10天1次,共注药3~4次;注药当天给予高频热疗1次,每周2次,每次40分钟,治疗结束4周后评价疗效。结果 86例病人经治疗后胸水完全消退50例(CR58.1%),部分缓解20例(PR23.3%),微小反应13例(MR15.1%)无效3例(NC3.5%),有效率(CR+PR)81.4%,毒副反应主要是骨髓抑制,主要并发症有疼痛,局部和全身感染,肝肾功能损害。 [关键词] 局部化疗;热疗;观察;护理 [中图分类号] R473.73 [文章标识码]A[文章编号] Observation and Nursing about treatment of Cancerous hydrothorax with partly Chemotherapy and Thermotherapy ( Sichuan province forestry central hospital,Chengdu,610081,China) [Abstract] Objective After observing the chest cavity sets at the tube partial irrigation chemotherapy, unifies in vitro high frequency thermotherapy treatment cancerous hydrothorax the curative effect and complication foresighted nursing.Methods86 example patients pass through the chest cavity to post the 16G ductus venosus, after treating the chest cavity drainage clean or few, pours into again through the drive pipe along the platinum (DDP) 80mg/m2, every other 10 days one time, altogether pour the medicine 3-4 times; Pours the medicine to give the high frequency thermotherapy at the same day one time, every week two times, each time 40 minutes, the treatment finished 4 weeks later appraises the curative effect. Results86 example patients after treatment the hydrothorax abates completely 50 examples (CR58.1%), the part alleviates 20 examples, responds 13 examples small, the invalid 3 example, is always effective, the poisonous side reaction is mainly the marrow suppresses, the main complication has the ache, partial and the general infection, the hepatorenal function harm [key words]Partly Chemotherapy;Thermotherapy;Observation;Nursing 恶性胸腔积液是恶性肿瘤晚期的表现之一,由于胸水压迫肺组织,影响呼吸功能,导致患者生活质量很差,而此时病人一般情况很差,大多无法耐受全身化疗,可通过局部治疗阻止胸水重聚。我院2006年5月至2009年6月对86例癌性胸水患者采用胸腔置管引流,腔内灌注化疗药物结合体外高频热疗,并通过对主要并发症预见性护理,阻止或减少胸水生成,减少了并发症的发生,极大地提高了晚期癌症病人的生活质量,现报告如下: 1 资料与方法 1.1 临床资料86例病人均为晚期癌症病人,胸水中均查见癌细胞。其中,男性68例,女性18例,平均年龄62.5岁;非小细胞肺癌30例,小细胞肺癌18例,胃癌9例,食管癌1例,大肠癌13例