全国肝动脉灌注化疗护理现状分析

肝癌电子杂志 ›› 2025, Vol. 12 ›› Issue (4): 43-49.

全国肝动脉灌注化疗护理现状分析

柳书悦¹, 黄中英², 李静³, 占正寅⁴, 雷娟娟⁵, 张湉⁶, 温子芦⁷, 张耀军¹, 李福霞^7,*

1.中山大学肿瘤防治中心肝脏外科,广东广州 510060;
2.中山大学肿瘤防治中心护理部,广东广州 510060;
3.徐州医科大学附属医院肝胆胰外科,江苏徐州 221000;
4.国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院肝胆外科,广东深圳 518116;
5.广州医科大学附属肿瘤医院肝胆外科,广东广州 510060;
6.中国医科大学附属盛京医院第二消化内镜治疗病房,辽宁沈阳110000;
7.山东第一医科大学附属省立医院肿瘤中心四病区,山东济南 250021

收稿日期:2025-04-16 出版日期:2025-12-30 发布日期:2026-01-16
通讯作者: ^* 李福霞,E-mial:lifuxia123@126.com

Nationwide analysis of current nursing practices for hepatic arterial infusion chemotherapy

Liu Shuyue¹, Huang Zhongying², Li Jing³, Zhan Zhengyin⁴, Lei Juanjuan⁵, Zhang Tian⁶, Wen Zilu⁷, Zhang Yaojun¹, Li Fuxia^7,*

1. Department of Liver Surgery, Cancer Prevention and Treatment Center, Sun Yat-sen University, Guangzhou 510060, Guangdong, China;
2. Department of Nursing Services, Cancer Prevention and Treatment Center, Sun Yat-sen University, Guangzhou 510060,Guangdong,China;
3. Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China;
4. Department of Hepatobiliary Surgery, Shenzhen Hospital of Peking Union Medical College Cancer Hospital, National Cancer Center, National Clinical Research Center for Tumor, Chinese Academy of Medical Sciences, Shenzhen 518116, Guangdong, China;
5. Department of Hepatobiliary Surgery, Cancer Hospital, Guangzhou Medical University, Guangzhou 510060, Guangdong, China;
6. Second Digestive Endoscopy Treatment Ward, Shengjing Hospital, China Medical University, Shenyang 110000, Liaoning, China;
7. Oncology Ward 4, Shandong Provincial Hospital, First Medical University of Shandong, Jinan 250021, Shandong, China

Received:2025-04-16 Online:2025-12-30 Published:2026-01-16
Contact: ^* Li Fuxia, E-Mail:lifuxia123@126.com

摘要/Abstract

摘要： 目的：调查我国肝动脉灌注化疗（hepatic arterial infusion chemotherapy,HAIC）护理实践现状及关键问题。
方法：采用横断面调查设计,基于中国抗癌协会肝胆肿瘤整合护理专业委员会编制的《全国HAIC护理现状调查问卷》,于2024年10—12月通过便利抽样法对全国24省（自治区、直辖市）的83家医院开展调查。问卷内容包括 HAIC 实施机构与护理管理概况、HAIC 治疗方案、下肢入路、上肢入路、动脉药盒及延续护理现状。
结果： ①96%（80/83）医院在介入中心开展HAIC,76%（63/83）医院的患者收治于肝胆专科病区;FOLFOX（奥沙利铂+亚叶酸钙+氟尿嘧啶）方案应用率达84%（70/83）,52%（43/83）医院联合经导管动脉化疗栓塞术（transcatheter arterial chemoembolization,TACE）治疗。②94%（78/83）医院以股动脉为入路,88%（73/83）要求术后严格卧床,仅12%（10/83）允许术后6 h离床;22%（18/83）开展上肢入路HAIC,其优势集中于减少卧床需求（94%）及并发症风险（44%）;8%（7/83）医院实施动脉药盒植入术,但5/7存在肝素浓度使用不规范问题。③仅40%（33/83）医院开展延续护理,64%（21/33）依赖电话随访,27%（9/33）使用微信,智能管理模式尚未普及。
结论：我国HAIC护理存在技术路径标准化不足、术后活动限制过严、延续护理信息化滞后等问题。亟需构建循证护理规范,优化入路选择与术后管理策略,并推动智能化延续护理体系建设,以提升治疗安全性与患者生活质量。

关键词: 肝动脉灌注化疗, 经上肢动脉入路, 经下肢动脉入路, 经桡动脉入路, 动脉药盒, 延续护理

Abstract: Objective: To investigate the current status and key challenges of nursing practices for hepatic arterial infusion chemotherapy (HAIC) in China.
Methods: A cross-sectional survey was conducted using the National HAIC Nursing Practice Questionnaire developed by the Integrated Nursing of Hepatobiliary Tumor Committee of the Chinese Anti-Cancer Association. From October to December 2024, 83 hospitals across 24 provinces (autonomous regions/municipalities) in China were selected via convenience sampling. The questionnaire content includes the implementation institutions and nursing management status of HAIC, HAIC treatment plans, lower limb approaches, upper limb approaches, arterial port systems, and the current status of follow-up care.
Results: HAIC procedures were primarily performed in Interventional Therapy Department (96%, 80/83), with 76% (63/83) of patients managed in Hepatobiliary Department. The FOLFOX (Oxaliplatin+Calcium folinate+Fluorouracil) regimen was the dominant treatment protocol (84%, 70/83), and 52% (43/83) of hospitals combined HAIC with transcatheter arterial chemoembolization (TACE). Femoral artery access remained dominant (94%, 78/83), with 88% (73/83) requiring strictly limit bed confinement. Only 12% (10/83) permitted ambulation within 6 hours post-procedure. Upper-limb access (22%, 18/83) was valued for reducing bed rest requirements (94%) and complication risks (44%). Arterial port systems were implemented in 8% (7/83) of hospitals, but 5/7 exhibited nonstandard heparin concentrations during port maintenance.Only 40% (33/83) of hospitals provided post-discharge follow-up, predominantly via telephone (63%, 21/33) or WeChat (29%, 9/33), with intelligent management systems remaining underutilized.
Conclusion: HAIC nursing in China faces challenges including nonstandard technical protocols, excessive postoperative activity restrictions, and underdeveloped continuity of care systems. Establishing evidence-based guidelines, optimizing access strategies, and advancing intelligent follow-up frameworks are urgently needed to enhance treatment efficacy and patient outcomes.

Key words: Hepatic artery perfusion chemotherapy, Upper limb artery approach, Lower limb artery approach, Radial artery approach, Arterial drug kit, Extended nursing care

柳书悦, 黄中英, 李静, 占正寅, 雷娟娟, 张湉, 温子芦, 张耀军, 李福霞. 全国肝动脉灌注化疗护理现状分析[J]. 肝癌电子杂志, 2025, 12(4): 43-49.

Liu Shuyue, Huang Zhongying, Li Jing, Zhan Zhengyin, Lei Juanjuan, Zhang Tian, Wen Zilu, Zhang Yaojun, Li Fuxia. Nationwide analysis of current nursing practices for hepatic arterial infusion chemotherapy[J]. Electronic Journal of Liver Tumor, 2025, 12(4): 43-49.

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