门静脉高压症合并原发性肝癌破裂出血的治疗(附120例报告)  

Treatment of ruptured primary liver cancer with portal hypertension(a report of 120 cases)

作　　者：王宏博[1] 廖晓锋[1] 孙华朋[1] 李晓云[1] 吴永娟[1] 

机构地区：[1]襄阳市中心医院普外科,湖北襄阳441021

出　　处：《腹部外科》2016年第5期375-379,共5页Journal of Abdominal Surgery

摘　　要：目的探讨门静脉高压症合并原发性肝癌破裂出血病人合理有效的治疗手段及可能影响远期预后的因素。方法根据治疗方法不同分为3组:急诊手术组、联合组、介入组。比较3组病人止血率、住院病死率、住院时间,术后并发症情况及1、2、3年生存率。行介入治疗的2组治疗前后血常规、肝功能、甲胎蛋白检查结果。结果急诊手术组的病人术后住院并发症发生率、病死率显著高于其他2组,远期生存率较其他2组病人明显偏低;行介入治疗的2组术后门静脉高压及脾功能亢进症状明显缓解。结论急诊行介入治疗是门静脉高压症合并肝癌破裂出血病人的首选治疗,再配合外科手术既可达到快速止血,改善门静脉高压症状,又可能根治病灶,延长病人生存期的目的。Objective To explore the reasonable and effective treatment means and the factors that may influence the long-term prognosis of patients with portal hypertension with ruptured primary liver cancer. Methods According to the treatment method the patients were divided into emergency operation group, TACE ＋ PSE ＋ selective operation group, and TACE ＋ PSE group. By comparing the indexes of different treatments, the reasonable and effective treatment means were explored. Results In the emergency operation group, the incidence of complication was higher, the mortality rate was higher, and the long-term survival rate was lower than in the other two groups. In the TACE ＋ PSE ＋ selective operation group, and TACE ＋ PSE group, the symptoms of portal hypertension and hyper- splenism were significantly alleviated postoperatively. Conclusion TACE ＋ PSE is the preferred treat- ment for the patients. Conclusions use of TACE ＋ PSE with surgical resection can achieve the fast bleeding, improve the portal hypertension symptoms, radically resect lesions and prolong the survival.

关 键 词：原发性肝癌破裂出血 门静脉高压症 肝动脉化疗栓塞脾动脉部分栓塞 

分 类 号：R657.34[医药卫生—外科学] R735.7[医药卫生—临床医学]