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目的评价鸦胆子油乳经血管介入治疗老年人肝癌方案的有效性、安全性和临床路径的患者满意度和费用-疗效比。方法将44例老年人肝癌患者随机分为临床路径治疗组(试验组)24例和常规治疗组(对照组)20例,比较两组疾病控制率(DCR)、体质量、生活质量、毒副反应、住院时间、住院费用、患者满意度等指标。结果试验组和对照组DCR分别为86.4%和80.0%,差异无统计学意义(P>0.05);体质量稳定率分别为86.4%和60.0%,KPS评分有效率分别为90.1%和70.0%,试验组生活质量QOL改善优于对照组,差异有统计学意义(P<0.05);治疗后试验组毒副反应发生率均少于对照组,差异有统计学意(P<0.05);试验组和对照组住院天数分别为(11.2±2.7)d和(15.3±5.1)d,住院费用分别为(18 020.1±4 181.8)元和(22 099.5±5 056.6)元,患者总满意度分别为81.8%和65.0%,差异有统计学意义(P<0.05)。结论鸦胆子油乳经血管介入治疗老年人原发性肝癌的临床路径为患者提供了优质服务,能稳定体质量,提高生活质量,减轻术后毒副反应,减少住院天数和住院总费用,提高患者满意度,值得临床推广应用。
Objective To evaluate the efficacy, safety, and clinical pathology of patient-satisfaction and cost-effectiveness ratio of Brucea javanica oil transvascular interventional treatment for elderly patients with hepatocellular carcinoma. Methods Totally 44 elderly patients with hepatocellular carcinoma (HCC) were randomly divided into clinical pathological treatment group (experimental group) and routine treatment group (control group), 20 patients. The disease control rate (DCR), body mass, quality of life, Response, hospital stay, hospitalization costs, patient satisfaction and other indicators. Results The DCR of experimental group and control group were 86.4% and 80.0%, respectively, with no significant difference (P> 0.05). The stability rates of body mass were 86.4% and 60.0%, and the KPS scores were 90.1% and 70.0% The improvement of quality of life in the experimental group was better than that of the control group (P <0.05). The incidence of toxic reactions in the experimental group was less than that in the control group after treatment, the difference was statistically significant (P <0.05) (11.2 ± 2.7) d and (15.3 ± 5.1) d respectively, and hospitalization costs were (18 020.1 ± 4 181.8) yuan and (22 099.5 ± 5 056.6) yuan respectively. The patients’ total satisfaction were 81.8 % And 65.0%, the difference was statistically significant (P <0.05). Conclusion The clinical pathway of Brucea javanica oil-transfused percutaneous vascular intervention for the treatment of primary hepatocellular carcinoma in elderly patients provides excellent service to patients, which can stabilize the body mass, improve the quality of life, reduce the postoperative side effects, reduce the length of hospital stay and hospitalization costs, and improve Patient satisfaction, it is worth clinical application.