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| 阶梯式管理对院外晚期肝细胞癌患者服用仑伐替尼的影响 |
| Effect of step-wise management on lenvatinib taken by the patients with advanced hepatocellular carcinoma out of hospitals |
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| DOI：10.3969/j.issn.1007-8134.2019.05.016 |
| 中文关键词: 晚期肝细胞癌 院外护理 肝性脑病 |
| 英文关键词: advance hepatocellular carcinoma out-hospitals nursing care hepatic encephalopathy |
| 基金项目:国家重大专项基金资助项目（2008ZX10002-018）；首都临床特色重点基金资助项目（Z151100004015221） |
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| 中文摘要: |
| 目的 探讨院外晚期肝细胞癌（hepatocellular carcinoma, HCC）患者服用仑伐替尼治疗的新型护理管理模式，实现减少因仑伐替尼相关显性肝性脑病而中断或终止仑伐替尼治疗的病例。方法 采用单中心随机对照研究，评价以微信为媒介的闭合阶梯式护理管理院外晚期HCC患者服用仑伐替尼治疗的可接受性效果，以显性肝性脑病中断或终止仑伐替尼治疗为主要终点。结果 阶梯式护理管理组晚期HCC患者服用仑伐替尼12周内肝性脑病的诊断率为60.0%，明显高于家庭管理组的20.0%（P＜0.05）；经有效护理干预，阶梯式护理管理组持续服用仑伐替尼患者达93.3%，高于家庭管理组的80.0%；尤其因显性肝性脑病终止仑伐替尼治疗的病例患者仅为6.7%，低于家庭护理组的20.0%。结论 阶梯式护理管理院外晚期HCC患者服用仑伐替尼治疗可早期判定肝性脑病，是减少因仑伐替尼相关肝性脑病中断或终止治疗事件，延长晚期HCC患者生存期的必要手段。 |
| 英文摘要: |
| Objective To develop a novel taking lenvatinib nursing management pattern for the patients with advanced hepatocellular carcinoma out of hospitals and reduce the number of case suspended or terminated due to lenvatinib-related overt hepatic encephalopathy. Methods A single-center randomized controlled trial was conducted to assess the acceptability of closed step-wise nursing management in patients with advanced hepatocellular carcinoma taking lenvatinib out of hospitals, taking WeChat as the medium. The primary endpoint was the discontinuation or termination of lenvatinib treatment due to overt hepatic encephalopathy. Results In step-wise nursing management group, the diagnostic rate of hepatic encephalopathy in patients with advanced hepatocellular carcinoma within 12 weeks after lenvatinib treatment was 60.0%, which was obviously higher than that in family caregiver group 20.0% (P＜0.05); after effective nursing intervention, 93.3% of the patients in step-wise nursing management group continued taking lenvatinib, which was higher than that in family caregiver group (80.0%); especially. The discontinuation of lenvatinib treatment due to overt hepatic encephalopathy was only 6.7%, which was lower than that in family caregiver group (20.0%). Conclusions Step-wise nursing management can predicate hepatic encephalopathy at early phase in patients with advanced liver cancer taking lenvatinib out of hospitals. It is the necessary means to reduce the discontinuation or termination of lenvatinib treatment due to lenvatinib-related hepatic encephalopathy, and prolong the life of patients with advanced hepatocellular carcinoma. |
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