不同手术时机治疗肝癌自发性破裂出血35例临床分析  

Clinical analysis of 35 cases of spontaneous rupture of liver cancer treated by operation at different times

作　　者：马李[1] 赵传庆[1] 胡继东[1] 彭沛[1] 吴波[1] 胡芳[1] 

机构地区：[1]江苏省泗洪县人民医院普外科,江苏宿迁223900

出　　处：《青岛医药卫生》2017年第6期407-409,共3页Qingdao Medical Journal

摘　　要：目的探讨急诊和延期肝切除术治疗肝癌自发性破裂出血的适应症、方法并评估疗效。方法回顾性分析肝癌自发性破裂出血35例患者的急诊或延期肝切除术临床资料,对比分析术前资料、手术方式、术后并发症及预后。结果本研究共纳入患者35例,男性29例,女性6例,年龄38~72岁,平均(52.3±11.6)岁,急诊手术组24例,经保守治疗出血停止后,延期手术11例。急诊手术组与延期手术组相比,在再出血、胆瘘、肝功能衰竭、消化道出血、肝性脑病、死亡率及生存期方面比较差异均无统计学意义(P>0.05)。结论对于原发性肝癌自发性破裂出血患者,经个体化选择治疗,严格把握手术适应证及更好地规划手术,仍可取得不错的手术疗效,为基层医务工作者提供参考的治疗方法,亦可为患者取得良好的社会经济效益。Objective To explore the indication coupled with its methods of emergency and delayed hepatectomy for spontaneous rupture of hepatocellular carcinoma（SRHCC）and to evaluate the therapeutic effect.Method The clinical data of 35 cases with spontaneous rupture of liver cancer undergoing emergency or delayed hepatectomy were retrospectively analyzed.The preoperative data,operative methods,postoperative complications and prognosis were compared and analyzed.Result We identified a total of 35 patients in the research.There were 29 males and 6 females,aged 38~72 years old,average（52.3±11.6）years old.24 cases undergone emergency operation,while 11 cases undergone delayed operation when the bleeding stopped after conservative treatment.We found no statistical difference of the rates of bleeding,biliary fistula,hepatic failure,gastrointestinal bleeding,hepatic encephalopathy,mortality and survival period between the emergency surgery group and the delayed operation group（P〉0.05）.Conclusion For SRHCC patients,they can achieve great surgical benefit through the individualized treatment options and strict grasp of the surgical indications and better surgical planning.Therefore it cannot only provide reference treatment for grassroots medical workers but also can create good economical benefits for patients.

关 键 词：肝肿瘤 破裂 自发性 出血 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]