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肺癌射频消融后注意事项

时间:2020-02-27 22:53来源:未知作者:admin

Post-ablation Care Through Discharge Post-procedural nurse and physician assessment Observation: 4 to 6 hours (outpatient) Limited or overnight admission for observation depending on clinical course and assessment Acceptable side effects -

Post-ablation Care Through Discharge

Post-procedural nurse and physician assessment
Observation: 4 to 6 hours (outpatient)
Limited or overnight admission for observation depending on clinical course and assessment
Acceptable side effects

- Reasonable patient discomfort as managed by conscious sedation and iv and oral analgesics

Ibuprofen 布洛芬

Acetominophen（对乙酰氨基酚一种替代阿司匹林的解热镇痛药） + hydrocodone (Vicodin)

Dextromethorphan (右美沙芬）+ codeine（可待因片） + guaifenesin（愈创甘油醚）

± prophylactic antibiotics and/or corticosteroid pulse
- Reasonable outcomes related to CT-guided device placement

Courtesy of Kamran Ahrar, M.D., MD Anderson Cancer Center (data compiled from 2000-2006)

Complications*	Major	Minor	Total
Air Leak Related	111 (10.3%)	285 (26.4%)	396 (36.6%)
Effusion	8 (0.7%)	155 (14.3%)	163 (15.1%)
Hemorrhage Related	4 (0.4%)	66 (6.1%)	70 (6.5%)
Pain	0	86 (8%)	86 (8%)
Fever	0	34 (3.1%)	34 (3.1%)
Infections	24 (2.2%)	0	24 (2.2%)
Pulmonary function	4 (0.4%)	4 (0.4%)	8 (0.7%)
CNS Related	1 (0.1%)	7 (0.6%)	8 (0.7%)
Tumor Seeding	1 (0.1%)	0	1 (0.1%)
Excessive Necrosis	1 (0.1%)	0	1 (0.1%)
Pulmonary Embolus	1 (0.1%)	0	1 (0.1%)
Death	4 (0.37%)	0	4 (0.37%)
Total	159 (14.8%)	637 (58.9%)	797 (73.7%)

* Number of complications reported per session, total of 1081 sessions

Pneumothorax Avoidance Techniques

O2 administration
Autologous blood administration 5-10 cc’s, if lung punctured
Ablation site dependent（位置依赖） at least 2 hours, decubitus position（卧位）

- No change in overall PTX rate

- Significant decrease in PTX requiring intervention（需要干预的气胸显著减少）

Quiet respiration-avoid:

- Coughing

- Shouting

- Valsalva related to lifting or straining

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