Application of supine position management scheme based on SMT theory in HAIC treatment of liver cancer patients
基于SMT理论的卧位管理方案在HAIC治疗肝癌患者中的应用

摘要

目的 依托症状管理理论（Symptom Management Theory, SMT）制定卧位干预方案，探究该方案应用于接受肝动脉灌注化疗（Hepatic Artery Infusion Chemotherapy，HAIC）肝癌患者的实际效果。方法 选取2024年1月-2024年12月期间在重庆市某家三甲医院肝胆外科接受HAIC治疗的肝癌患者80例，按随机数字表法分为两组，对照组采用常规卧位护理，观察组在对照组基础上应用基于SMT理论的卧位管理方案。对比两组疼痛程度、舒适度以及置管不良反应发生率。结果 观察组采用视觉模拟评分法（Visual Analogue Scale，VAS）评估所得疼痛评分低于对照组，在生理、心理及环境维度的评分均高于对照组；相较于对照组，观察组不良反应发生率更低（P＜0.05）。结论 基于SMT理论的卧位管理方案，通过HAIC治疗周期内的动态评估与个性化协同干预，可有效缓解患者长期卧床所致的腰背部酸痛及治疗相关疼痛，显著提升舒适度，降低恶心呕吐、导管堵塞等并发症风险，具备临床推广价值。

Abstract

Objective To develop a supine intervention plan based on symptom management theory (SMT ) and explore the actual effect of this plan applied to patients with liver cancer undergoing hepatic artery infusion chemotherapy (HAIC).
Methods From January 2024 to December 2024, 80 patients with liver cancer who received HAIC treatment in the hepatobiliary surgery department of a 3A hospital in Chongqing were randomly divided into two groups. The control group was given routine lying nursing, and the observation group was given a lying management scheme based on SMT theory. The degree of pain, comfort and incidence of adverse reactions of catheterization were compared between the two groups.
Results The results showed that the pain score of the observation group was lower than that of the control group using visual analog scale (VAS) evaluation, and the scores in physiological, psychological, and environmental dimensions were higher than those of the control group; Compared to the control group, the observation group had a lower incidence of adverse reactions (P<0.05).
Conclusion   The decubitus management scheme based on SMT theory, through the dynamic evaluation and personalized collaborative intervention in the HAIC treatment cycle, can effectively relieve the patients’ low back pain and treatment-related pain caused by long-term bed rest, significantly improve their comfort, and reduce the risk of complications such as nausea and vomiting, catheter blockage, which has clinical promotion value.