探讨肝癌患者在实施肝动脉灌注化疗（HAIC）期间提前下床活动，对HAIC患者灌注期间安全性与舒适度的影响。

选取2023年12月至2024年3月在海军军医大学第三附属医院行HAIC的102例肝癌患者进行前瞻性研究。其中男92例，女10例；年龄38~66岁，中位年龄55岁。患者均签署知情同意书，符合医学伦理学规定。采用便利抽样法将患者分为对照组与试验组，各51例。对照组按照TACE护理常规，试验组通过检索文献查找最佳循证医学证据，结合我院患者实际情况，予灌注后12 h首次下床。观察比较两组患者不良事件、并发症情况、舒适度、满意度等指标。两组疲劳及舒适度评分比较采用t检验；满意度等比较采用χ²检验。

试验组与对照组不良事件发生率均无统计学意义（P>0.05），疼痛、失眠、腰背痛、尿潴留、便秘并发症分别为2、3、2、1、2例和11、14、21、7、9例，差异有统计学意义（χ²=7.141，8.541，20.265，4.883，4.993；P<0.05）。试验组患者疲劳及舒适度评分分别为（54.6±2.7）、（89.1±0.7）分，对照组相应为（78.1±3.2）、（71.5±1.2）分，差异有统计学意义（t=-9.255，6.176；P<0.05）；试验组患者满意度为98%（50/51），明显高于对照组的78%（40/51） （χ²=9.444，P<0.05）。

对肝癌患者行HAIC灌注期间，术后12 h提前下床活动对HAIC灌注期间安全无影响，卧床时限改变可提高患者的舒适度，提高患者满意度。

To evaluate the effect of early off-bed activity on the safety and level of comfort of patients with liver cancer during hepatic arterial infusion chemotherapy (HAIC).

In this prospective study, 102 patients with liver cancer who underwent HAIC in the Third Affiliated Hospital of Naval Military Medical University from December 2023 to March 2024 were enrolled. Among them, 92 patients were male and 10 female, aged from 38 to 66 years, with a median age of 55 years. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients were divided into the control (n=51) and study groups (n=51) based on convenient sampling method. Patients in the control group received TACE routine nursing. In the study group, the optimal evidence-based medical evidence was obtained through literature retrieval. Combined with the actual status of patients, they were advised for first off-bed activity at 12 h after HAIC. The incidence of adverse events, complications, level of comfort and degree of satisfaction were observed and compared between two groups. Fatigue and level of comfort scores were compared by t-test. The degree of satisfaction was compared by Chi-square test.

There was no statistically significant difference in the incidence of adverse events between the study groups and the control group. In the study and control groups, 2, 3, 2, 1, 2 and 11, 14, 21, 7 and 9 patients developed pain, insomnia, low back pain, urine retention and constipation, and the differences were statistically significant (χ²=7.141, 8.541, 20.265, 4.883, 4.993; all P<0.05). The scores of fatigue and level of comfort in the study group were 54.6±2.7 and 89.1±0.7, while 78.1±3.2 and 71.5±1.2 in the control group, and the differences were statistically significant (t=-9.255, 6.176; both P<0.05). The degree of satisfaction of patients in the study group was 98%(50/51), significantly higher than 78%(40/51) in the control group (χ²=9.444, P<0.05).

Off-bed activity at 12 h after HAIC exerts no effects on the safety of patients with liver cancer during HAIC. Changing bed rest duration can elevate the level of comfort, and improve the degree of satisfaction of patients.