目的：观察综合护理对肝动脉化疗栓塞术（ TACE）后并发症的影响。方法选取行TACE的肝癌患者118例，随机分为干预组和对照组各59例。对照组采用常规护理方法，干预组在对照组基础上进行综合护理，包括术前进行认知宣教，心理干预，家庭支持和术后预适应；术中建立舒适环境，保证情绪稳定并告知手术进程；术后针对可能出现的发热，腹痛，恶心呕吐，穿刺点出血、血肿，尿潴留等并发症进行观察和护理。于患者出院时比较2组患者并发症发生率、治疗时间及护理满意度。结果干预组TACE术后发热，腹痛，恶心呕吐，穿刺点出血、血肿，尿潴留的发生率均低于对照组（P均＜0．05）。干预组手术时间、卧床时间、住院时间均少于对照组（P均＜0．05）。干预组护理满意度显著高于对照组（P＜0．01）。结论综合护理干预能够有效降低肝癌患者TACE术后并发症的发生率。

Objective To evaluate emergency digital subtraction angiography(DSA) and transcatheter arterial embolization(TAE) in treating acute life-threatening massive bleeding in gastrointestinal tract.Methods During the period from January 2006 to December 2010 a total of 48 patients(35 males and 13 females) with acute gastrointestinal massive bleeding were admitted to authors’ hospital.Emergency TAE was carried out in all patients.Superselective catheterization was employed,and the catheter was placed in the bleeding site,which was followed by TAE using polyvinyl alcohol particles(PVA),Gelfoam or steel coils as embolic agents.The clinical results were analyzed.Results DSA correctly localized the bleeding site in all 48 patients.The bleeding arteries were successfully obstructed in 47 patients,in the remaining one patient TAE was not adopted.After embolization procedures the massive hemorrhage still remained in 4 cases,and the surgery had to be carries out in them.All the patients were followed up for 6 ～ 12 months.The total effective rate was 90%(43/48).Neither mis-embolization nor severe complications such as intestinal necrosis occurred.Conclusion Transcatheter arterial embolization is a safe and effective procedure for massive arterial hemorrhage in gastrointestinal tract.Proper selection of the target artery and suitable use of the embolization agents are the key points.

Objective To observe the clinical value of emergent interventional therapy for massive gastrointestinal arterial hemorrhage.Methods Twenty-five patients with massive arterial gastrointestinal hemorrhage received selective arterial angiography of celiac trunk,superior mesenteric artery and inferior mesenteric artery.Super-selective arterial angiography was performed when necessary.Gelatin sponge particles,coils and polyvinyl alcohol(PVA) particles were used to embolize the bleeding arteries after they were confirmed.The vital signs of all the patients were observed closely after the treatment.And follow-up observation and examination were conducted regularly.Results Among 25 patients,hemorrhage parts were confirmed and successfully embolized in 22,while the hemorrhage parts were not detected in 3 patients.The total success rate was 88.00%(22/25).The patients were followed up for 3 to 20 months(mean 6.5 months),no severe complication nor recurrent bleedings occurred.Conclusion Emergent interventional therapy is safe and effective for acute massive arterial hemorrhage of gastrointestinal tract.

目的 探讨消化道大出血急诊介入栓塞治疗的诊断与治疗价值.方法 回顾性分析2009年1月～ 2010年12月本院介入治疗急性消化道大出血24例临床资料.采用Seldinger技术使导管头端超选择至出血部位,用PVA、明胶海绵或弹簧圈栓塞治疗.结果 21例均能确定出血部位且栓塞成功,3例未找到出血部位,治愈率达88%.结论 介入栓塞治疗消化道大出血简单有效,正确选择栓塞的靶血管和合适的栓塞剂和用量是成功的关键.