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目的探讨围手术期呼吸训练在CT引导下经皮穿刺放射性~(125)I粒子植入治疗中晚期老年胰腺癌患者的应用价值。方法收集郑州大学第一附属医院2009年9月—2015年4月行CT引导下放射性~(125)I粒子植入治疗的老年胰腺癌患者103例;其中观察组54例进行围手术期呼吸训练及围手术期常规护理,告知患者术中要求匀速呼吸,避免不规则呼吸及深长呼吸,并训练患者听到屏气口令后于呼气末暂停呼吸5 s,术前3 d进行呼吸训练,每天进行30 min;对照组49例进行常规围手术期的护理;所有患者术后均密切监测生命体征及并发症,常规给予抑制胰液分泌、抑制胃酸分泌、抗感染等药物;采用SPSS 17.0统计学软件进行数据分析,观察比较2组患者术中呼吸平均调整次数及并发症发生情况。结果观察组54例术中穿刺至病灶平均调整次数为2.2次,术中出现腹腔出血为6例;对照组49例,术中穿刺至病灶平均调整次数为5.8次,术中出现腹腔出血为15例,观察组术中调整次数、出血例数均明显少于对照组,2组数据差异具有统计学意义(P<0.05)。2组患者均未出现腹腔感染、胰瘘、急性胰腺炎等并发症。结论围手术期呼吸训练在放射性~(125)I粒子植入治疗老年胰腺癌过程中可以减少穿刺次数,降低出血风险。
Objective To investigate the value of perioperative respiratory training in the treatment of advanced pancreatic cancer in elderly patients undergoing CT guided percutaneous radioactive 125I seed implantation. Methods 103 cases of elderly patients with pancreatic cancer undergoing CT-guided radioactive 125 I seed implantation were collected from September 2009 to April 2015 in the First Affiliated Hospital of Zhengzhou University. Among them, 54 cases in the observation group underwent respiratory training during the perioperative period And perioperative routine care, to inform patients requiring uniform breathing during surgery, to avoid irregular breathing and deep breathing, and training patients to hear breath-hold password to stop breathing at the end of expiratory 5 s, 3 d preoperative breathing training, daily 30 min. The control group received routine perioperative nursing care. All patients were closely monitored for vital signs and complications postoperatively, routinely administered drugs that inhibit pancreatic juice secretion, inhibit gastric acid secretion and anti-infection. SPSS 17.0 statistical software Data analysis, observation and comparison of two groups of patients during the average number of respiratory adjustments and complications. Results In the observation group, the average number of punctures to lesions in operation was 2.2 and the number of intraperitoneal hemorrhage was 6 in the observation group. In the control group, the average number of punctures to lesions was 5.8, and intraperitoneal hemorrhage was 15 For example, the number of intraoperative adjustments and the number of hemorrhage in the observation group were significantly less than those in the control group. The difference between the two groups was statistically significant (P <0.05). 2 patients did not appear abdominal infection, pancreatic fistula, acute pancreatitis and other complications. Conclusion Perioperative respiratory training can reduce the number of punctures and reduce the risk of bleeding in the treatment of pancreatic cancer with radioactive 125 I seed implantation.