肝癌TACE术后腹痛发生现状及影响因素研究  

Occurrence and influencing factors of abdominal pain after TACE for hepatocellular carcinoma

作　　者：连宗璞 李素新[1] 王蒙蒙[1] 马喧妍 LIAN Zong-pu;LI Su-xin;WANG Meng-meng;MA Xian-yan(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院肝胆外科,郑州450000

出　　处：《医药论坛杂志》2025年第3期260-263,268,共5页Journal of Medical Forum

摘　　要：目的探究肝癌经皮肝动脉化疗栓塞术(transcather arterial chemoembolization,TACE)术后腹痛发生现状,并分析其影响因素。方法选取2023年1月—2024年1月郑州大学第一附属医院收治的接受TACE术治疗的肝癌90例,统计其腹痛发生情况,并将发生腹痛的患者纳入腹痛组,未发生腹痛的患者纳入对照组,采用logistics回归模型分析肝癌TACE术后腹痛发生的影响因素。结果90例患者中,有56例患者于TACE术后出现腹痛,腹痛发生率为62.22%。单因素分析结果显示,两组的性别、文化程度、BMI、合并症、肝功能(Child-Pugh)评分、肿瘤大小、TACE史、手术时间、碘油用量、栓塞程度、使用明胶海绵、至胆囊距离比较,差异无统计学意义(P>0.05);腹痛组的年龄、肿瘤数量、焦虑自评量表(self-rating anxiety scale,SAS)评分高于对照组,美国东部肿瘤合作组(Eastern Cooperative Oncology Group,ECOG)评分、至肝包膜的距离小于对照组,差异有统计学意义(P<0.05);logistics回归分析结果显示,年龄(OR=3.058,95%CI:1.234~7.579)、肿瘤数量(OR=2.659,95%CI:1.349~5.239)、SAS评分(OR=2.756,95%CI:1.198~6.340)是肝癌患者TACE术后腹痛的独立危险因素(P<0.05),ECOG评分(OR:0.590,95%CI:0.377~0.923)、至肝包膜距离(OR=0.426,95%CI:0.217~0.836)是其保护性因素(P<0.05)。结论肝癌患者TACE术后腹痛发生率偏高,年龄、肿瘤数量、ECOG评分、至肝包膜距离、SAS评分是肝癌患者TACE术后腹痛的独立影响因素,临床中应重点筛查高危患者,及时干预以避免腹痛。Objective To investigate the occurrence of abdominal pain after percutaneous arterial chemoembolization(TACE)for liver cancer and analyze its influencing factors.Methods A total of 90 cases of liver cancer treated by TACE in our hospital from January 2023 to January 2024 were selected to analyze the occurrence of abdominal pain.Patients with abdominal pain were included in the abdominal pain group and those without abdominal pain were included in the control group.logistics regression model was adopted to analyze the influencing factors of the occurrence of abdominal pain after TACE for liver cancer.Results Among the 90 patients,56 had abdominal pain after TACE,the incidence of abdominal pain was 62.22%.Univariate analysis showed that there were no significant differences between the two groups in gender,education level,BMI,comorbidities,Child-Pugh grade,tumor size,TACE history,operation time,dosage of iodide,embolization degree,use of gelatin sponge and distance to gallbladder(P>0.05).The age,number of tumors and SAS score in the abdominal pain group were higher than those in the control group,and the ECOG score and distance to liver capsule were lower than those in the control group(P<0.05).logistics regression analysis results showed that age(OR=3.058,95%CI:1.234-7.579),number of tumors(OR=2.659,95%CI:1.349-5.239),SAS score(OR=2.756,95%CI:1.198-6.340)were independent risk factors for abdominal pain after TACE in patients with liver cancer(P<0.05),ECOG score(OR=0.590,95%CI:0.377-0.923),distance to liver capsule(OR:0.426,95%CI:0.217-0.836)was the protective factor(P<0.05).Conclusion The incidence of abdominal pain after TACE is high in patients with liver cancer.Age,number of tumors,ECOG score,distance to liver capsule and SAS score are independent factors affecting abdominal pain after TACE.In clinical practice,high-risk patients should be screened and timely intervention should be conducted to avoid abdominal pain.

关 键 词：肝癌 经皮肝动脉化疗栓塞术 腹痛 影响因素 

分 类 号：R735[医药卫生—肿瘤]