CAJ | 학술논문

目的：分析影响肝癌患者肝动脉化疗栓塞术（TACE）后发生恶心呕吐的非化疗因素。方法采用整群抽样法，选取2012年10月—2013年10月在中国医科大学附属第一医院介入病房住院的符合纳入与排除标准的肝癌患者272例。记录患者年龄、性别、肿瘤是否转移、肿瘤大小、碘化油注射液剂量、疼痛程度、疼痛时间、介入手术次数、发热程度、发热天数、有无腹胀等，分析上述指标与 TACE 后恶心呕吐的关系。结果272例患者中恶心程度语言描述分级（NVSD）为0级169例（占62.1％），1级59例（占21.7％），2级44例（占16.2％）。年龄与恶心呕吐呈负相关性（r ＝-0.217，P ﹤0.05），疼痛程度、疼痛时间、腹胀与恶心呕吐呈正相关（r ＝0.333、0.538、0.188，P﹤0.05）。多因素 Logistic 回归分析显示，年龄高为患者 TACE 后恶心呕吐的保护因素〔OR ＝0.916，95％ CI（0.841，0.998），P ＝0.044〕，疼痛时间长、有腹胀为患者 TACE 后恶心呕吐的独立危险因素〔OR ＝373.019，95％ CI（8.197，16974.798），P ＝0.002；OR ＝3.677，95％ CI（1.064，12.702），P ＝0.040〕。疼痛因素对恶心呕吐有直接正向效应（β＝0.42，P ﹤0.01），恶心呕吐对腹胀有直接正向效应（β＝0.77，P ﹤0.01）；年龄对疼痛有负向效应（β＝-0.01， P ＝0.072），对腹胀有正向效应（β＝0.01，P ＝0.069）；年龄及腹胀对恶心呕吐的效应均不显著（P ﹥0.05）。结论年龄、疼痛时间、腹胀均对TACE 后肝癌患者发生恶心呕吐有影响，患者恶心呕吐的发生是多因素共同作用的结果。
목적：분석영향간암환자간동맥화료전새술（TACE）후발생악심구토적비화료인소。방법채용정군추양법，선취2012년10월—2013년10월재중국의과대학부속제일의원개입병방주원적부합납입여배제표준적간암환자272례。기록환자년령、성별、종류시부전이、종류대소、전화유주사액제량、동통정도、동통시간、개입수술차수、발열정도、발열천수、유무복창등，분석상술지표여 TACE 후악심구토적관계。결과272례환자중악심정도어언묘술분급（NVSD）위0급169례（점62.1％），1급59례（점21.7％），2급44례（점16.2％）。년령여악심구토정부상관성（r ＝-0.217，P ﹤0.05），동통정도、동통시간、복창여악심구토정정상관（r ＝0.333、0.538、0.188，P﹤0.05）。다인소 Logistic 회귀분석현시，년령고위환자 TACE 후악심구토적보호인소〔OR ＝0.916，95％ CI（0.841，0.998），P ＝0.044〕，동통시간장、유복창위환자 TACE 후악심구토적독립위험인소〔OR ＝373.019，95％ CI（8.197，16974.798），P ＝0.002；OR ＝3.677，95％ CI（1.064，12.702），P ＝0.040〕。동통인소대악심구토유직접정향효응（β＝0.42，P ﹤0.01），악심구토대복창유직접정향효응（β＝0.77，P ﹤0.01）；년령대동통유부향효응（β＝-0.01， P ＝0.072），대복창유정향효응（β＝0.01，P ＝0.069）；년령급복창대악심구토적효응균불현저（P ﹥0.05）。결론년령、동통시간、복창균대TACE 후간암환자발생악심구토유영향，환자악심구토적발생시다인소공동작용적결과。
Objective To analyse non - chemotherapy influence factors for nausea and vomiting among hepatic carcinoma patients after transarterial chemoembolization( TACE). Methods According to Inclusion and exclusion criteria, 272 hepatic carcinoma patients who were admitted to Intervention Ward of First Hospital Affiliated to China Medical University from October 2012 to October 2013,were selected as study subjects. Age,gender,neoplasm metastasis,tumor size,dose of iodinated oil injection,pain degree,duration of pain,the number of interventional operation,fever degree,duration of fever, and abdominal distension of patients were recorded,the relationship between the above indicators and nausea and vomiting after TACE was analysed. Results 272 cases were graded using NVSD classification system,169 cases(62. 1% )were grade 0,59 (21. 7% )were grade 1,44(16. 2% )were grade 2. Age was negatively correlated with nausea and vomiting(r = - 0. 217,P﹤ 0. 05 ); pain degree, duration of pain, abdominal distension were negatively correlated with nausea and vomiting, respectively(r = 0. 333,0. 538,0. 188,P ﹤ 0. 05). According to multivariate Logistic regression analysis results,advanced age was protective factors for nausea and vomiting after TACE〔 OR = 0. 916,95% CI(0. 841,0. 998),P = 0. 044〕;both long duration of pain and abdominal distension were independent protective factors for nausea and vomiting after TACE〔OR =373. 019,95% CI(8. 197,16 974. 798),P = 0. 002;OR = 3. 677,95% CI(1. 064,12. 702),P = 0. 040〕. Factors about pain had positive direct influence on nausea and vomiting(β = 0. 42,P ﹤ 0. 01),nausea and vomiting had direct positive direct influence on abdominal distension(β = 0. 77,P ﹤ 0. 01);age had negative influence on pain(β = - 0. 01,P = 0. 072), while age had positive influence on abdominal distension(β = 0. 01,P = 0. 069);the effects of age and abdominal distension on nausea and vomiting were not significant( P ﹥ 0. 05). Conclusion Age,duration of pain and abdominal distension have influence on occurence of nausea and vomiting among hepatic carcinoma patients,the occurrence of nausea and vomiting among hepatic carcinoma patients after TACE is the result of multiple factors.