肝癌介入治疗后并发急性上消化道出血的原因及处理  

Cause and management of acute hemorrhage of upper digestive tract after chemo-embolization for hepatocellular carcinoma

作　　者：谢敏明[1] 刘冬生[1] 林漳国[1] 郑敏相[1] 

机构地区：[1]广东东莞市太平人民医院肿瘤科,523900

出　　处：《中国基层医药》2004年第8期970-971,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　探讨肝细胞癌介入治疗后并发急性上消化道大出血的原因及其处理方法。方法　肝癌139例经股动脉插管至肝固有动脉 ,注入化疗药及碘油 (10～ 2 0ml)混悬剂。结果　 15例介入治疗后出现上消化道出血 ,经降门静脉压等治疗 ,13例出血停止 ,2例死亡。结论　碘油逆流入门静脉引起门静脉压升高和加重原有门静脉高压是出血的主要原因 ,降低门静脉压是治疗该症的有效方法。Objective To evaluate the cause of acute hemorrhage of upper digestive tract after chemo-embolization for HCC.Methods 15 cases were encountered from 139 caess of HCC treated by chemo-embolization,including 12 males and 3 females.They were performed a catheterization through femoral artery to proper hepatic artery 10～20ml of a mixture of chemical agent and lipiodol was injected.Results Acute hemorrhage of supper digestive tract occurred within 12 hours after interrentional therapy.Bleeding was controlled in 13 cases after reducting of portal hypretension and mechanical tamponade but 2 patients died.Conclusion Portal hypertension caused by reflux of lipidoe to portal vein is considered the main cause of acute hemorrhage of upper digestive tract after chem-cmbolization for HCC.Reduction of the poreal hypertension is an effective method of controlling the acute hemorrhage.

关 键 词：肝癌 介入治疗 并发症 急性上消化道出血 病因 门静脉压升高 

分 类 号：R735.7[医药卫生—肿瘤] R573.2[医药卫生—临床医学]