Research progress on nursing management of adverse reactions related to immunotherapy for liver cancer
肝癌免疫治疗相关不良反应的护理管理研究进展

摘要

近年来，以免疫检查点抑制剂为代表的免疫治疗在晚期肝细胞癌治疗中取得突破，显著延长患者生存期。但ICIs激活免疫系统攻击肿瘤时，也可能攻击正常器官组织，产生独特免疫相关不良反应（irAEs）。irAEs可累及全身器官系统，发生时间、严重程度和临床表现异质性高，给临床护理带来挑战。本文综述肝癌免疫治疗中irAEs临床特点、评估工具、分级标准及护理管理策略的最新进展，重点阐述皮肤、胃肠道等常见irAEs的系统性护理干预措施，探讨多学科协作、患者教育与延续性护理在优化管理结局中的关键作用，为临床护士提供实践指导，改善肝癌患者生存质量和治疗安全性。

Abstract

In recent years, immunotherapy represented by immune checkpoint inhibitors has made breakthroughs in the treatment of advanced hepatocellular carcinoma, significantly prolonging the survival period of patients. However, when ICIs activate the immune system to attack tumors, they may also attack normal organs and tissues, causing unique immune-related adverse reactions (irAEs). irAEs can involve organ systems throughout the body, with high heterogeneity in the occurrence time, severity and clinical manifestations, posing challenges to clinical nursing. This article reviews the latest progress in the clinical characteristics, assessment tools, classification criteria, and nursing management strategies of irAEs in immunotherapy for liver cancer. It focuses on elaborating systematic nursing intervention measures for common irAEs such as those in the skin and gastrointestinal tract, and explores the key roles of multidisciplinary collaboration, patient education, and continuous nursing in optimizing management outcomes, providing practical guidance for clinical nurses to improve the quality of life and treatment safety of patients with liver cancer.