肝癌Chapter 9 Hepatic carcinoma
学习目标
1.了解肝癌的不同治疗方法
2.熟悉TACE手术路径及术后注意事项
3.掌握以下词汇
hepatic cell carcinoma 肝细胞癌（HCC）
transcatheter arterial chemoembolization （TACE） 经导管动脉化疗栓塞
radiofrequency ablation 射频消融
Zhang Jun is a patient who has been diagnosed with hepatic carcinoma (HCC).He comes to the hospital for transcatheter arterial chemoembolization (TACE) and radiofrequency ablation.After the operation, he returns to the ward.Xiao Ran is his primary nurse.She is talking with Zhang Jun and giving him a health instruction.
Xiao Ran: Hello, Zhang Jun, how are you feeling?
Zhang Jun: Hello, Xiao Ran.I am a little worried.Could you tell me what TACE and radiofrequency ablation are?
Xiao Ran: All right, take it easy.There are currently two kinds of TACE combined with thermal ablation.① Sequential ablation.One to four weeks after TACE treatment, additional radiofrequency ablation will be performed.② Synchronized ablation.During TACE treatment, radiofrequency or microwave ablation can significantly improve the clinical efficacy and reduce liver function damage.TACE takes advantage of the fact that HCC is mainly supplied by the hepatic artery.By injecting chemotherapeutic drugs and embolization materials into the blood supplying artery of the tumor, the purpose of tumor ischemic necrosis and local drug chemotherapy can be achieved.It has the advantages of good therapeutic effect, minimal trauma, repeatable treatment, etc., and is the preferred choice for treating mid to latestage liver cancer.
Zhang Jun: Can you tell me what I should pay attention to after operation?
Xiao Ran: OK, Zhang Jun.After the operation, you should monitor your temperature.Take good care of oral cavity.Fever after TACE is common, but infectious complications are rare.It is usually a result of tumor necrosis and collateral damage to normal liver tissue.When the body temperature exceeds 39.0°C or the fever lasts for more than one week, anti-infective treatment will be required.
Zhang Jun: Thank you very much, Xiao Ran.I will keep your advice in mind.
译文
张军是肝癌患者，他来到医院行经导管动脉化疗栓塞及射频消融术，术后安全返回病房，小冉是他的责任护士，她正在和张军对话并进行健康宣教。
小冉：你好，张军，感觉怎样？
张军：你好，小冉！我有些紧张。你能再解释一下经导管动脉化疗栓塞术（TACE）和射频消融术是什么吗？
小冉：好的，你不要太紧张，目前有两种TACE联合热消融治疗方式。① 序贯消融：先行TACE治疗，术后1～4周内加用射频或微波消融。② 同步消融：在TACE治疗时，同时给予射频或微波消融，可以明显提高临床疗效，并减轻肝功能损伤。TACE利用肝癌主要由肝动脉供血的特点，通过向肿瘤供血动脉注入化疗药物和栓塞材料，达到肿瘤缺血坏死和局部药物化疗的目的，具有疗效好、创伤小、可重复治疗等优点，是目前中晚期肝癌首选的治疗方法。
张军：你能告诉我，术后我要注意些什么？
小冉：好的，张军，术后你要监测体温，做好口腔护理，术后会出现肿瘤组织、坏死重吸收而致的吸收热。当体温超过39.0℃，或发热持续1周以上时，需要进行抗感染治疗。
张军：非常感谢你，小冉！我会牢记你的建议。