摘要
目的调研原发性肝癌中肝细胞癌(HCC)经肝动脉化疗栓塞术(TACE)后股动脉压迫相关穿刺点周围皮肤并发症(FACR-SCAPS)的现况及影响因素。方法采用便利抽样法,选取2023年4月至2024年10月期间于北京市、天津市、山东省、河北省、青海省、内蒙古自治区等10家医院的介入中心、介入诊疗科、肿瘤科等进行TACE介入术治疗的HCC患者作为研究对象进行调查。采用描述性分析、单因素和logistic回归分析探究FACR-SCAPS的发生现况及影响因素。结果共调查了1573例行TACE介入治疗的HCC患者。28.99%(456/1573)的HCC患者于TACE术后发生FACR-SCAPS,共记录并发症476例次(30.26例次/100例患者)。其中单一并发症占96.93%(442/456),复合并发症占3.07%(14/456)。皮肤压红、皮肤淤青构成主要并发症类型,两者合计占比达96.49%(440/456)。血肿、水泡与破溃等三类并发症总构成比仅4.61%(21/456)。Logistic回归分析显示,压迫期间术后最高血压舒张压(OR=1.024,95%CI:1.013~1.035,P<0.001)、旋压式压迫止血器(OR=3.220,95%CI:2.120~4.891,P<0.001)、PT-INR(OR=19.630,95%CI:6.039~63.810,P<0.001)和近3月内是否服用抗凝药(OR=1.909,95%CI:1.064~3.427,P=0.030)是TACE术后发生FACR-SCAPS的影响因素。结论HCC患者TACE术后FACR-SCAPS发生率较高,压迫期间术后最高血压舒张压、旋压式压迫止血器、PT-INR和近3月内服用抗凝药是TACE术后发生FACR-SCAPS的影响因素。
Objective To investigate the epidemiological characteristics and influencing factors of Femoral Artery Compression-Related Skin Complications Around the Puncture Site(FACR-SCAPS)in patients with primary hepatocellular carcinoma(HCC)undergoing transarterial chemoembolization(TACE).Methods A multicenter cross-sectional study was conducted using convenience sampling.A total of 1573 HCC patients who underwent TACE between April 2023 and October 2024 were recruited from interventional radiology departments,oncology units,and specialized centers across 10 hospitals in Beijing,Tianjin,Shandong,Hebei,Qinghai,and Inner Mongolia.Descriptive statistics,univariate analysis,and multivariate logistic regression were used to explore the epidemiological characteristics and influencing factors of FACR-SCAPS in this population.Results Among the 1573 primary HCC patients undergoing TACE interventional therapy,FACR-SCAPS occurred in 28.99%(456/1573),with a total of 476 complication instances recorded(30.26 per 100 patients).Patients with a single complication accounted for 96.93%,whereas those with multiple complications constituted 3.07%.The most prevalent types of complications were skin erythema,skin ecchymosis,and hard lumps formation,collectively accounting for 96.49% of all complications.Hematoma,blisters,and rupture complications collectively accounted for only 4.61%.Logistic regression analysis revealed that peak diastolic blood pressure during compression(OR=1.024,95%CI:1.013-1.035,P<0.001),use of rotary compression hemostasis devices(OR=3.220,95%CI:2.120-4.891,P<0.001),elevated PT-INR(OR=19.630,95%CI:6.039-63.810,P<0.001),and anticoagulant use within the last three months(OR=1.909,95%CI:1.064-3.427,P=0.030)were significant influencing factors associated with FACR-SCAPS post-TACE.Conclusion FACR-SCAPS is commonly seen among primary HCC patients after TACE,its risk factors include peak diastolic blood pressure during compression,use of rotary compression devices,elevated PT-INR,and recent anticoagulant use.
作者
井学敏
马瑞英
张莉莉
葛慧娟
王咏梅
邢秀亚
荆霞
周丽
汪彩莲
桂万苗
任静婕
JING Xuemin;MA Ruiying;ZHANG Lili;GE Huijuan;WANG Yongmei;XING Xiuya;JING Xia;ZHOU Li;WANG Cailian;GUI Wanmiao;REN Jingjie(Center for Liver Diseases and Minimally Invasive Interventional Oncology,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China;School of Nursing,Capital Medical University,Beijing 100069,China;Department of Nursing,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China;Tianjin Medical University Central Hospital,Tianjin 300052,China;Inner Mongolia Autonomous Region People's Hospital,Hohhot 010017,China;School of Medicine,Sias University,Xinzheng,Henan Province 451150,China)
出处
《介入放射学杂志》
2025年第8期894-899,共6页
Journal of Interventional Radiology
基金
首都医科大学护理学院数智护理基础临床协同研究专项重点课题(SZHL23Z04)
首都医科大学附属北京佑安医院2023年度院内中青年人才孵育项目(BJYAYY-YN2023-25)。
作者简介
通信作者:马瑞英,E-mailmaruiying@ccmu.edu.cn。
