原发性肝癌自发破裂出血急诊肝切除及综合治疗  

Clinical analysis of emergency hepatectomy and combined therapy with spontaneous rupture of primary hepatic carcinoma patients

作　　者：穆振国[1] 王海水[1] 穆童[1] 

机构地区：[1]日照市中医医院普外科,山东日照276800

出　　处：《中国肿瘤外科杂志》2010年第4期213-216,共4页Chinese Journal of Surgical Oncology

摘　　要：目的探原发性肝癌自发破裂出血患者急诊肝切除及其综合治疗临床效果。方法回顾性总结1999年1月至2009年12月行急诊肝切除+术中温热化疗+术后肝动脉化疗栓塞(TACE)等综合治疗原发性肝癌自发性破裂出血21例的经验,并与同期行择期肝切除术的原发性肝癌66例作对比研究。结果原发性肝癌自发性破裂出血行急诊肝切除+术中温热化疗+术后TACE等综合治疗的21例与同期行择期肝切除术的66例相比在术后并发症、2年肿瘤复发率、2年生存率等方面无显著差异。结论原发性肝癌破裂出血只要肿瘤局部条件符合《原发性肝癌外科治疗方法选择(指南)》要求,应首选急诊肝切除。手术止血前实施限制性液体复苏可以提高抢救成功率。术中温热化疗,术后TACE能减少肿瘤的复发与种植性转移。Objective To study clinical effect of emergency hepatectomy and combined therapy with spontaneous rupture of primary hepatic carcinoma patients. Methods Retrospectively summarized the experience of emergency hepatectomy and hyperthermic chemotherapy during surgery plus postoperative TACE with 21 cases of spontaneous rupture of primary hepatic carcinoma patients from January 1999 to December 2009, comparative study with primary hepatic carcinoma patients who were performed hepatectomy synchronization. Results Compared spontaneous rupture of primary hepatic carcinoma patients who were treated with combined therapy of emergency hepatectomy and hyperthermic chemotherapy during surgery plus postoperative TACE with primary hepatic carcinoma patients who were treated with hepatectomy synchronization, in the postoperative complications, 2-year tumor recurrence rates, such as 2-year survival rate, all aspects were no significant difference. Conclusions Rupture of primary hepatic carcinoma patient, as long as tumor local conditions meet the require of ＂the choice of primary hepatic carcinoma surgical treatment （guide）＂ , should prefer to emergency hepateetomy. Surgery to stop bleeding before the limited fluid resuscitation can improve the success rate. Hyperthermic chemotherapy during surgery and postoperative TACE, which can minimize tumor recurrence and implantation metastases.

关 键 词：原发性肝癌 肝癌自发破裂出血 急诊肝切除术 术中温热化疗 肝动脉化疗栓塞 限制性液体复苏 

分 类 号：R735.7[医药卫生—肿瘤]