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中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2026, Vol. 15 ›› Issue (03) : 362 -371. doi: 10.3877/cma.j.issn.2095-3232.2026.03.010

临床研究

肝脏恶性肿瘤钇-90微球选择性内放射治疗全程管理模式构建
蒋泉1, 刘康寿1, 王梓霖1, 程勇2, 刘玉龙3, 叶艳彬4, 孙健1, 曹明溶1, 谌小龙1,†()   
  1. 1　510630　广州，暨南大学附属第一医院肝胆外科
    2　510630　广州，暨南大学附属第一医院核医学科
    3　510630　广州，暨南大学附属第一医院介入与血管科
    4　510630　广州，暨南大学附属第一医院临床营养科
  • 收稿日期:2025-09-15 出版日期:2026-06-10
  • 通信作者: 谌小龙
  • 基金资助:
    国家自然科学基金(82100691，82370663); 广东省自然科学基金(2022A1515012581，2021A1515010259); 暨南大学附属第一医院护理科研专项基金(2022224); 中国博士后科学基金(2021M69631)

Construction of whole-course management mode of selective internal radiotherapy with Yttrium-90 microspheres for malignant liver tumors

Quan Jiang1, Kangshou Liu1, Zilin Wang1, Yong Cheng2, Yulong Liu3, Yanbin Ye4, Jian Sun1, Mingrong Cao1, Xiaolong Chen1,†()   

  1. 1 Department of Hepatobiliary Surgery, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
    2 Department of Nuclear Medicine, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
    3 Department of Interventional and Vascular Medicine, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
    4 Department of Clinical Nutrition, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
  • Received:2025-09-15 Published:2026-06-10
  • Corresponding author: Xiaolong Chen
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蒋泉, 刘康寿, 王梓霖, 程勇, 刘玉龙, 叶艳彬, 孙健, 曹明溶, 谌小龙. 肝脏恶性肿瘤钇-90微球选择性内放射治疗全程管理模式构建[J/OL]. 中华肝脏外科手术学电子杂志, 2026, 15(03): 362-371.

Quan Jiang, Kangshou Liu, Zilin Wang, Yong Cheng, Yulong Liu, Yanbin Ye, Jian Sun, Mingrong Cao, Xiaolong Chen. Construction of whole-course management mode of selective internal radiotherapy with Yttrium-90 microspheres for malignant liver tumors[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2026, 15(03): 362-371.

目的

构建肝脏恶性肿瘤钇-90微球选择性内放射治疗（90Y-SIRT）的全程管理模式。

方法

自2022年10月暨南大学附属第一医院开展第一例90Y-SIRT治疗以来，目前已累计施行90Y-SIRT治疗 300例次。基于以往治疗经验，通过不断优化治疗流程、加强多学科协作和提升医疗质量，形成具有自身特色的90Y-SIRT治疗体系，并构建了肝脏恶性肿瘤患者行90Y-SIRT治疗的全程管理模式。全程管理模式主要涵盖三方面内容：（1）90Y-SIRT就诊引导；（2）90Y-SIRT规范化治疗；（3）90Y-SIRT治疗后随访。该模式通过多学科协作、信息化管理和个性化护理等手段，确保患者得到规范、全面、系统的治疗。

结果

成功构建了涵盖就诊引导、规范化治疗及治疗后随访的90Y-SIRT全程管理模式，提出了该模式的主观及客观评价指标。全程管理模式根据科学、规范的就诊引导、治疗流程和随访体系确保患者在治疗过程中的各个环节都得到充分的关注和管理。通过多学科协作和个体化治疗方案的制定与实施，提高治疗的针对性和有效性，降低并发症的发生率，提升患者的生活质量。全程管理模式整合多学科资源和优化治疗流程，优化医疗资源的配置并提高医疗服务的效率和质量。充分利用各学科的专业知识和技术优势，为患者提供更加全面和个性化的治疗方案。同时，通过优化治疗流程和减少不必要的检查和治疗环节，可以降低医疗成本并提高医疗服务的效率和质量。全程管理模式强调以患者为中心的服务理念，重视与患者的沟通和交流工作，通过及时解答患者的疑问和关注其需求和意愿可以提高患者的依从性和满意度。通过心理支持和疏导等措施可以帮助患者缓解焦虑、恐惧等负面情绪并提高生活质量。同时还可以通过个性化的康复指导和建议来促进患者的身体康复和社会功能的恢复。

结论

本中心成功构建了科学的90Y-SIRT全程管理模式，有助于提高疗效、患者满意度和生存质量，减少不良反应。同时还建立了全程管理模式的评价指标，为全面评估全程管理模式的实施效果提供了依据。

关键词: 肝脏恶性肿瘤, 钇-90微球, 选择性内放射治疗, 全程管理
Objective

To construct the whole-course management mode of selective internal radiotherapy using Yttrium-90 microspheres (90Y-SIRT) for malignant liver tumors.

Methods

Since the first case of 90Y-SIRT was carried out in the First Affiliated Hospital of Jinan University in October 2022, 90Y-SIRT has been performed in 300 cases. Based on clinical experience, a 90Y-SIRT treatment system with its own characteristics was formed by continuously optimizing the treatment process, strengthening multidisciplinary cooperation and improving medical quality. In addition, whole-course management mode of 90Y-SIRT for patients with malignant liver tumors was constructed. The whole-course management mode mainly covers three aspects: (1) medical guidance for 90Y-SIRT; (2) standardized treatment of 90Y-SIRT; (3) post-90Y-SIRT follow-up. This mode ensures that patients can receive standardized, comprehensive and systematic treatment through multidisciplinary cooperation, information management and personalized nursing care.

Results

A whole-course management mode of 90Y-SIRT covering medical guidance, standardized treatment and post-90Y-SIRT follow-up was successfully constructed. Subjective and objective evaluation indexes of this mode were proposed. The whole-course management mode guarantees that all aspects of patients are fully considered and managed according to scientific and standardized medical guidance, treatment process and follow-up system. Formulation and implementation of multidisciplinary cooperation and individualized treatment regimen enhanced treatment specificity and effectiveness, lowered the incidence of complications and improved the quality of life of patients.The whole-course management mode integrated multidisciplinary resources and optimized treatment process as well as the allocation of medical resources and improved the efficiency and quality of medical services. By making full use of professional knowledge and technological advantages of various disciplines, this mode provided patients with more comprehensive and personalized treatment regimens. Meantime, by optimizing treatment process and reducing unnecessary examination and treatment procedures, it lowered medical costs and enhanced the efficiency and quality of medical services. The whole-course management mode adhered to the patient-centered service concept and highlighted the communication and exchange with patients. By answering patients' questions in a timely manner and caring about their needs and willingness, this mode increased patients' compliance and the degree of satisfaction. Psychological support and counseling could help patients to alleviate anxiety, fear and negative emotions, and improve their quality of life. Besides, it delivered personalized rehabilitation guidance and suggestions to promote patients' physical rehabilitation and social function recovery.

Conclusions

In our center, a scientific management mode of 90Y-SIRT is successfully constructed, which is helpful to improve clinical efficacy, the degree of satisfaction and quality of life, and reduce adverse reactions. It also establishes the evaluation indexes of the whole-course management mode, providing evidence for comprehensively evaluating the implementation effect of the whole-course management mode.

Key words: Malignant hepatic tumor, Yttrium-90 microspheres, Selective internal radiation therapy, Whole-process management
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