基于雷达图的风险管理在肝癌TACE后肺部感染和癌因性疲乏防控中的应用  

Application of risk management based on radar chart in the prevention and control of pulmonary infection and cancer-related fatigue after transcatheter arterial chemoembolization for liver cancer

作　　者：史晓玉 尚亚利[1] 刘伟伟[1] 申晶晶 SHI Xiao-yu;SHANG Ya-li;LIU Wei-wei;SHEN Jing-jing(Department of Infectious Diseases,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院感染性疾病科,河南郑州450000

出　　处：《海南医学》2025年第3期441-446,共6页Hainan Medical Journal

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20200289)。

摘　　要：目的探究基于雷达图的风险管理在肝癌经导管动脉栓塞化疗(TACE)后肺部感染、癌因性疲乏防控中的应用效果。方法选取2023年1月至2024年2月就诊于郑州大学第一附属医院且接受TACE治疗的188例肝癌患者作为研究对象,按随机数表法分为观察组和对照组各94例。对照组患者给予常规护理,观察组患者于常规护理基础上给予基于雷达图的风险管理,干预至患者出院。比较两组患者术后即刻和术后12 h、24 h、48 h疼痛视觉模拟量表(VAS)评分、干预前后心理痛苦温度计(DT)评分、T淋巴细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、Piper疲乏自评量表(PFS)评分及TACE术后肺部感染发生率。结果术后12 h、24 h、48 h,观察组患者的VAS评分分别为(4.04±1.01)分、(2.38±0.52)分、(1.49±0.42)分,明显低于对照组的(5.59±1.16)分、(3.61±0.67)分、(2.94±0.68)分,差异均有统计学意义(P<0.05);干预后,观察组患者的DT评分为(3.13±0.68)分,明显低于对照组的(4.65±0.87)分,痛苦程度无、轻度、中度、重度占比分别为10.64%、68.09%、12.77%、8.51%,明显优于对照组的6.38%、44.68%、25.53%、23.40%,差异均有统计学意义(P<0.05);干预后,观察组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别为(59.57±5.94)%、(35.49±4.64)%、1.46±0.56,明显高于对照组的(46.03±4.32)%、(22.86±4.11)%、0.87±0.40,差异均有统计学意义(P<0.05);干预后,观察组患者的躯体疲乏、认知疲乏、情感疲乏、综合疲乏评分分别为(1.74±0.50)分、(1.93±0.61)分、(2.10±0.64)分、(2.65±0.81)分,明显低于对照组的(3.21±0.72)分、(2.55±0.74)分、(3.53±0.81)分、(3.74±0.83)分,差异均有统计学意义(P<0.05);观察组患者的肺部感染发生率为0,明显低于对照组的6.38%,差异有统计学意义(P<0.05)。结论基于雷达图的风险管理有助于改善肝癌患者心理状态,减轻疼痛程度及癌因性疲乏,增强机体免疫,从而达到降低TACE术后肺部感�Objective To explore the application effect of risk management based on radar charts in the prevention and control of pulmonary infection and cancer-related fatigue after transcatheter arterial chemoembolization(TACE)for liver cancer.Methods A total of 188 patients with liver cancer who were treated with TACE at the First Affiliated Hospital of Zhengzhou University from January 2023 to February 2024 were selected as the research objects.They were randomly divided into an observation group and a control group according to random number table method,with 94 patients in each group.Patients in the control group received routine care,while those in the observation group received risk management based on radar charts in addition to routine care.Intervention lasted until the patients were discharged.The score of Visual Analog Scale(VAS)for pain immediately after surgery,12 h,24 h,and 48 h after surgery were compared between the two groups,as well as the scores of psychological distress thermometer(DT),the scores of T lymphocyte subsets CD3^(+),CD4^(+),CD4^(+)/CD8^(+),Piper Fatigue Self-Assessment Scale(PFS)before and after intervention,and the incidence of pulmonary infection after TACE.Results At 12 h,24 h and 48 h after surgery,the VAS scores of patients in the observation group were(4.04±1.01)points,(2.38±0.52)points,and(1.49±0.42)points,respectively,which were significantly lower than(5.59±1.16)points,(3.61±0.67)points,and(2.94±0.68)points in the control group(P<0.05).After intervention,the DT score of patients in the observation group was(3.13±0.68)points,which was significantly lower than(4.65±0.87)points in the control group,and the proportions of patients with no pain,mild pain,moderate pain,and severe pain were 10.64%,68.09%,12.77%,and 8.51%,respectively,significantly better than 6.38%,44.68%,25.53%,and 23.40%in the control group(P<0.05).After intervention,the CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)of patients in the observation group were(59.57±5.94)%,(35.49±4.64)%,and 1.46±0.56,respectively,which were

关 键 词：肝癌 肝动脉化疗栓塞 雷达图 风险管理 肺部感染 

分 类 号：R735.7[医药卫生—肿瘤]