liver cancer is one of the most common malignant tumors in the world, and its incidence rate ranks 6th in malignant tumors [1]. The incidence of liver cancer in my country is also increasing year by year, and many patients have reached the middle and late stages once discovered [2].
. For patients with intermediate and advanced stage liver cancer, surgical resection can be used in time. There is still a high recurrence rate after the operation [2].
For these patients, non-surgical palliative treatment methods are mostly adopted, such as hepatic arterial embolization chemotherapy, anhydrous ethanol injection, radiofrequency ablation, microwave ablation, targeted and immunotherapy [2].
Among them, chemoembolization of hepatic artery has now become one of the most commonly used methods for the treatment of middle- and advanced liver cancer. Let us learn about this treatment method today.
What is hepatic artery chemoembolization? [3,4]
Hepatic arterial chemoembolization (TACE) is an interventional treatment.
Simply put, after local anesthesia of the thigh, it is given an injection into the femoral artery, inserted into the catheter, and then injected contrast agent for hepatic angiography to clarify the size, number, location of the tumor and the condition of the blood supply artery.
Then the catheter is inserted into the tumor blood vessel through the hepatic artery, and an appropriate amount of chemotherapy drugs and embolization agents are injected to make the drug slowly release locally and play a chemotherapy role.
At the same time, the injected embolizer can also block the blood vessels for the tumor, causing the tumor to be ischemia and necrosis, thereby achieving the purpose of treatment.
Hepatic arterial chemoembolization is a minimally invasive treatment. It can be treated only through puncture, and the toxicity is less than chemotherapy.
Heloar artery chemoembolization suitable for? [2]
1. Patients with early stage liver cancer who cannot benefit from the recommended plan;
2. Patients with early stage liver cancer who are not suitable for surgical or percutaneous ablation;
3. Patients with intermediate and advanced stage liver cancer who cannot undergo surgery;
4. Patients with liver transplantation who cannot undergo tumor degradation to transplantable standards.
What preparations are needed before treatment? [5-9]
1. Quit smoking and alcohol to reduce the occurrence of complications in the lungs and cardiovascular areas after treatment.
2. One day before treatment, you need to take good personal hygiene, such as washing your hair, taking a bath, etc. Before treatment, the nurse will shave the hair from the treatment area to facilitate the doctor's handling and prevent wound infection.
3. Before treatment, blood tests (such as routine blood, liver and kidney function, coagulation function, electrolyte), iodine allergy tests, electrocardiograms, etc. must be completed to help the doctor determine whether you can complete this treatment.
4. Since you need to rest in bed for 12 to 24 hours after treatment, you need to practice urinating and defecating in bed in advance to prevent complications caused by not getting used to defecation in bed after surgery.
5. Before treatment, you must fast for 6 to 8 hours, and remove dentures, watches, mobile phones, rings, earrings and other items and hand them over to the family for proper care.
6. If you have jaundice (yellow skin or whites of your eyes) or ascites, you should also pay attention to the following:
jaundice
1. Cut your hands and toenails shortly and don't scratch your skin.
2. Do not use soap or hot water to scrub the skin, and do not use hot water to soak your feet to avoid irritating the skin, causing ulcers and inducing infection.
3. Use a shower ball to gently rub the skin, or clean the skin with warm water and apply olive oil to lubricate the skin.
4. Choose soft and cotton clothes. If necessary, you can apply topical medication to the affected area of the skin as required, or take anti-allergic drugs orally to allergic drugs to alleviate the symptoms of itch.
Ascia
1. When lying in bed, a soft pillow can be placed on the back to facilitate breathability and dryness of the sacral and coccyx skin.
Both lower limbs are slightly staggered, and a thin pillow is placed between the knees to prevent the skin on the raised bones on the medial knee from being pressed against each other.
2. Turn over once every 2 hours with the assistance of the family to prevent pressure ulcers.
3. Try not to press your hands or elbows for a long time to prevent local pressure from being exposed to excessively long periods of time and causing poor blood circulation in the abdomen.
What can be done after treatment? [7,8,10]
prevent bleeding
1. After the treatment is over, the doctor will use a bandage to bandage the puncture area with a bandage.
Please keep the lower limbs straight and motionless on the puncture side within the first 6 hours to facilitate the contraction and closure of the vascular puncture point and the blood flow smoothly, and do not use force or bend.
2. Within 12 to 24 hours after treatment, you cannot leave the bed to move. Eat, drink, pull and sprinkle must be performed on the bed to avoid bleeding at the puncture point.
3. Avoid severe coughing, sneezing and hard defecation to avoid sudden increase in abdominal pressure and causing bleeding to the puncture point.
4. Keep the puncture point dressing clean and dry.
If the skin on the lower limbs on the puncture side is pale, wet, cold, paralyzed, dull, or hematoma appearing at the puncture point, you need to contact medical staff in time.
Reasonable diet
1. After treatment, you generally need to fast for 6 to 8 hours.
If there is no symptoms such as nausea, vomiting, abdominal pain, etc., you can drink a small amount of warm water, and then gradually eat light liquid food, such as rice soup, juice, etc.
Please drink more water to facilitate the excretion of contrast agents and chemotherapy drugs and reduce damage to renal function.
2. According to the condition, slowly return to normal diet.
Please eat less and eat more meals, choose a low-salt, low-fat, appropriate amount of high-quality protein, high calorie, high vitamins, light and easy to digest, such as fish, lean meat, fresh vegetables and fruits.
3. Avoid soy milk and milk for the first time to avoid abdominal distension.
4. Avoid dry, hard, rough and spicy irritating foods to avoid gastrointestinal bleeding caused by patients with intravenous hypertension.
or above are all precautions for hepatic arterial chemoembolization. I hope friends will gain something after reading it.
Finally, the editor wishes everyone to recover as soon as possible and get back to health!
all pictures are from: Photo Network
References:
1. Ma Jingzhi, Yan Zhiping. Further thinking on interventional treatment of liver cancer [J]. Journal of Interventional Radiology, 2019, 028(006):507-510.
2. Zhao Chang, Ma Yilong. Research progress in advanced liver cancer in vascular interventional treatment [J]. Journal of Guangxi Medical University, 2021.
3. Chen Qian, Li Qiang. Research progress in interventional treatment of primary liver cancer [J]. Chinese tumor clinical, 2006.
4. National Health and Family Planning Commission. Diagnosis and Treatment Standards for Primary Liver Cancer (2017 Edition). 2017-06
5. Clinical Pathway for Percutaneous Hepatic Arterial Chemoembolization (TACE) for Primary Liver Cancer (2016 Edition). 2016-12-09.
html l36.Uptodate—[Patient Education: Liver Cancer (Basics)]
7. Li Li, Zhang Dashuang. Health Education Manual for Common Clinical Diseases-Surgery Volume (1st Edition) [M]. Beijing: People's Health Press, 2018.
8. Liu Fang, Shi Donglei, Liu Weinan, et al. Nursing for Hepatic Arterial Embolization Chemotherapy [J]. Chinese Modern Nursing Journal, 2006, 12(5):456-457
9. Yang Wanju, Liu Xuemei, Jiang Zhilan. Nursing in the perioperative treatment of primary liver cancer by chemoembolism in hepatic artery [J]. Chinese Medical Guide, 2012, 10(18):309-310.
10. Li Lezhi, Lu Qian. Surgical Nursing [M]. Beijing: People's Health Press, 2017, 11
