肝细胞性肝癌自发破裂出血56例临床分析  

Clinical analysis of spontaneously ruptured hepatocellular carcinoma in 56 cases

作　　者：钟锋[1] 王金重[1] 郭永学[1] 程新生[2] 周杰[3] 

机构地区：[1]江门市人民医院普通外科,广东江门529000 [2]深圳市南山区人民医院肝胆外科,广东深圳518052 [3]南方医科大学南方医院肝胆外科,广州510515

出　　处：《中华实用诊断与治疗杂志》2014年第8期779-781,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：2011年广东省江门市科技局科研立项项目(江科2011(90)号)

摘　　要：目的分析肝细胞性肝癌(hepatocellular carcinoma,HCC)自发性破裂出血保守治疗、肝动脉栓塞术(transcatheter arterial embolization,TAE)和肝切除术的治疗效果及预后。方法回顾性分析56例HCC自发性破裂出血患者临床资料。结果入院后经液体复苏治疗,56例中6例行保守治疗,行肝切除手术43例(其中急诊肝切除术31例,TAE治疗后行肝切除手术12例),行单纯TAE治疗7例;保守治疗患者30d病死率(83.3%)高于行肝切除及TAE患者(8.0%);行肝切除手术者30d、1a生存率分别为95.3%(41/43)、62.8%(27/43)。结论治疗HCC自发性破裂出血应根据个体情况选择方案,肝脏切除术并保护肝功能治疗有助于延长患者生存时间。Objective To explore the therapeutic effect of conservative treatment,transcatheter arterial embolization（TAE）and hepatectomy on spontaneously ruptured hepatocellular carcinoma（HCC）and the prognosis.Methods The clinical data of 56 patients with spontaneously ruptured HCC were retrospectively analyzed.Results After primary fluid resuscitation,6of 56 patients underwent conservative treatment,43 underwent hepatectomy including emergency hepatectomy in 31 and TAE plus hepatectomy in 12,and 7received TAE.The 30-day fatality was higher in patients receiving conservative treatment（83.3%）than that in the patients receiving hepatectomy or TAE（8.0%）.The 30-day and 1-year survival rates were 95.3%（41/43）and 62.8%（27/43）in patients receiving hepatectomy.Conclusion The treatment of ruptured HCC should be selected on the basis of the patients condition.Hepatectomy and liver function protection can prolong patients life.

关 键 词：肝细胞性肝癌 破裂 肝切除术 肝动脉栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]