不同方法治疗原发性肝癌自发破裂出血的疗效比较  

The curative effect of hemorrhage due to spontaneous rupture in hepatocellular carcinoma by different methods

作　　者：罗小平[1] 廖锦歧[1] 黄华容[1] 李胜新[1] 王革[1] 

机构地区：[1]惠州市中心医院肝胆外科,广东省惠州516001

出　　处：《中国基层医药》2006年第10期1603-1604,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨经肝动脉插管栓塞(TAE)治疗原发性肝癌自发破裂出血的临床价值。方法50例原发性肝癌自发破裂出血患者,根据治疗方法的不同分为四组TAE后择期部分肝切除(A组)12例;单纯TAE治疗(B组)12例;急诊手术治疗(C组)13例;保守治疗组(D组)13例。结果A、B两组患者治疗前腹腔动脉造影,有6例可见造影剂外渗(25%),其余为富血供肿瘤染色。A、B、C三组的止血成功率(100%)明显高于D组(40%,P<0.05),三组的住院死亡率分别为0、4%和17%(P=0.286),明显低于D组的60%(P<0.01)。A组1年存活率为76%,明显高于B组(48%)和C组(44%)。D组未有生存期超过1年者,与前述三组差异有统计学意义(P<0.01)。结论TAE是原发性肝癌破裂急诊止血的有效、安全方法。对可切除的肝癌患者,TAE后择期手术切除应作为首选治疗方案。Objective To evaluate the efficacy of transarterial embolizadon（TAE） for intraperitoneal hemorrhage due to spontaneous rupture in hepato-cellular carcinoma（HCC）. Methods 50 cases with ruptured HCC were divided into 4 groups according to the type of their previous treatment：group A,TAE followed by elective hepatectomy 12;Group B. TAE alone 12 ;Group C, emergency Operation 13;Group D, medical conservative management. Resulks Celiac：arterio-graphy done before the present treatment showed extravasation of contrast material in 6（25 % ） of the 24 patients in group A and B, and hypefvascular tumor was observed in the rest. The hemostasis success rate of group A, B and C were 100% , which were much higher than that of group D（ 40% ）（ P 〈 0.05）. The in-hospital mortality rates of group A,B and C were 0,4 % and 17 % （ P = 0. 286） ,which were much lower than that of group D （600/0） （P 〈 0.01 ）. The i-year survival rate of group A（76% ） was higher than those in group B（48% ） and C （44%）. There was no 1-year survivor in group D. Conclusion Transarterial embolization is safe and effective for hemorrhage due to spontaneous rupture in hepatocellular carcinoma. For resectable lesions, TAE is a preferential treatment to be given first, then followed by elective hepatectomy.

关 键 词：癌 肝细胞 栓塞 治疗性 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]