60例亚临床肝癌的临床研究  

Clinical Strategy of 60 Cases Subclinical Hepatocellular Carcinoma

作　　者：黄怀坚 黄志耿 

机构地区：[1]广东省普宁市华侨医院普外科,广东普宁515300

出　　处：《河北医学》2008年第6期677-679,共3页Hebei Medicine

摘　　要：目的：总结亚临床肝癌治疗的经验，为肝癌的三早处理提供临床策略。方法：回顾性分析20年60例亚临床肝癌患者的临床资料，其中45例合并肝硬化，47例HBsAg阳性；AFP〈20μg／L 12例，20-400μg／L 31例，〉400μg／L 17例；肝功能Child Pugh A级41例，B级19例。42例予不规则肝切除（7例病人同时行脾切除加贲门周围血管离断术），3例予不规则肝切除加无水酒精注射，15例予肝左外叶切除。结果：术后1、3、5年生存率依次85．1％、67．8％、39．7％。结论：早期发现、早期诊断、早期治疗的“三早原则”是提高肝癌生存率的关键；预防亚临床肝癌术后转移复发是提高肝癌疗效的保障。Objective： To summarize experience in surgery for subclinical hepatocellular carcinoma （SHC）. Method： The clinical data of 60 cases of subclinical hepatocellular carcinoma in our hospital in recent 8 years were retrospectively analyzed. Among them,47 cases were HBsAg positive ,fetoprotein level was less than 20μg/L in 12 cases , 20-400μg/L in 31 cases and more than 400μg/L in 17 cases ; liver function grade Child Pugh A was found in 36 cases , B in 24 cases. 51 cases underwent irregular hepatectomy （ including 7 cases received hepatectomy and operation for portal hypertension simultaneously） , 4 cases underwent irregular resection and injection with absolute alcohol, 5 cases underwent left lateral lobectomy and 3 cases underwent removal of the tumor emboli in left portal vein. Result： The 1,3,5 year survival rate was 85.1% ,67.8% ,39.7% ,respectively. Conclusion： Early discovery, early diagnosis, and early treatment are the key points to prolong the survival time of patients. It is the ensurance to prevent the metastasis and recurrence of SHC postoperatively.

关 键 词：亚临床肝癌 治疗 转移 复发 

分 类 号：R735.7[医药卫生—肿瘤]