肝切除联合腹腔热灌注化疗在肝癌自发破裂出血中的应用  

Application of hepatectomy combined with hyperthermic intraperitoneal chemotherapy in primary liver cancer with spontaneous rupture and bleeding

作　　者：何坤[1] 胡泽民[1] 阮嘉后[1] 黄东东[1] 龚雪屹 罗启杰 

机构地区：[1]中山市人民医院/中山大学附属中山医院肝胆外科,广东中山528400

出　　处：《肝胆胰外科杂志》2017年第6期464-467,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：中山市社会发展攻关计划项目(20132A123)

摘　　要：目的探讨肝切除联合腹腔热灌注化疗在肝癌自发破裂出血中的应用价值。方法回顾性分析2013年1月至2016年10月在中山市人民医院行肝切除联合腹腔热灌注化疗的20例肝癌自发破裂出血患者的临床资料。统计和分析患者的手术时间、术中出血量、术后并发症、术后住院时间及随访情况。结果患者均顺利完成手术,肿瘤切除后切缘均为阴性,患者无围手术期死亡。手术时间为(204±45)min;术中出血量为100~800 m L,平均270 m L;术后住院时间为(11±4)d。术后发生胸腔积液及腹腔积液各2例,经保守治疗治愈。1例于术后3个月肿瘤复发并死亡,其余恢复良好。结论肝切除联合腹腔热灌注化疗应用于肝癌自发破裂出血是安全、有效的,具有止血确切、防治肿瘤种植转移及复发的优势。Objective To investigate the application value of hepatectomy combined with hyperthermicintraperitoneal chemotherapy in primary liver cancer with spontaneous rupture and bleeding. Methods Clinicaldata of 20 patients with liver cancer and spontaneous rupture and bleeding undergoing precise hepatectomyas the core of comprehensive treatment in Zhongshan People’s Hospital between Jan. 2013 and Oct. 2016 wereanalyzed retrospectively. The operation time, intraoperative hemorrhage volume, postoperative complication,postoperative hospitalzation duration and follow-up data were recorded. Results Hepatectomy was performedsuccessfully in all patients. The incisional margins were detected as negative after tumor resection. No patientsdied during the perioperative period. The mean operation duration was （204±45） min, intraoperative hemorrhagevolume was 100 to 800 mL with an average of 270 mL, postoperative hospitalization duration was （11±4） d.Two cases of pleural effusion and abdominal cavity effusion postoperative were cured by conservative treatment.One patient suffered from recurrence at 3 months and death at 12 months post-operative, the rest cases recoveredwell. Conclusion The application of hepatectomy combined with hyperthermic intraperitoneal chemotherapy inprimary liver cancer with spontaneous rupture and bleeding is safe and effective, it has advantages of efficienthemostasis, prevention and treatment of tumor metastasis and recurrence.

关 键 词：肝肿瘤 自发性破裂出血 肝切除术 腹腔热灌注化疗 

分 类 号：R735.7[医药卫生—肿瘤]