原发性肝细胞肝癌破裂出血手术治疗的临床特点及影响其预后的因素分析  

Clinical Characteristics and Prognostic Factors of Surgical Treatment for Ruptured Hepatocellular Carcinoma

作　　者：李媛[1] 王影珍 张娣 LI Yuan;WANG Yingzhen;ZHANG Di(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2021年第11期1871-1873,共3页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划(编号:201721539)。

摘　　要：目的分析原发性肝细胞肝癌破裂出血手术治疗的临床特点及影响其预后的因素。方法选取原发性肝细胞肝癌破裂出血手术患者116例,采用我院自制《原发性肝细胞肝癌破裂出血手术患者临床资料》问卷,收集不同肝硬化程度、肿瘤大小、手术分期、手术时间等患者生存期信息,分析临床特点和影响患者预后的相关因素。结果肝硬化程度、肿瘤大小、手术分期、手术时间、输血量、术后栓塞化疗次数是影响手术治疗预后的单因素(P<0.05);logistic回归分析显示,重度肝硬化(95%CI 1.746~8.469,OR=3.845)、肿瘤>50 mm(95%CI 2.071~7.425,OR=3.921)、手术分期二期(95%CI 1.946~7.416,OR=3.799)、手术时间>3 h(95%CI 2.471~5.912,OR=3.822)、输血量>4U(95%CI 1.075~4.981,OR=2.314)、术后未行栓塞化疗(95%CI 1.643~5.719,OR=3.065)是影响手术治疗预后的危险因素(P<0.05)。结论原发性肝细胞肝癌破裂出血手术患者预后因素较多,与重度肝硬化、肿瘤病灶大、手术分期、手术时间长、输血量多、术后未行栓塞化疗密切相关,临床应结合预后危险因素,积极实施防控措施,以延长患者生存期。Objective To analyze the clinical characteristics and prognostic factors of surgical treatment for ruptured primary hepatocellular carcinoma.Methods 116 patients with rupture and hemorrhage of primary hepatocellular carcinoma were selected.The self-made"clinical data of patients with rupture and hemorrhage of primary hepatocellular carcinoma"questionnaire was used to collect the survival information of patients with different degree of cirrhosis,tumor size,surgical stage and operation time,and analyze the clinical characteristics of treatment methods and related factors affecting the prognosis of patients.Results The degree of liver cirrhosis,tumor size,operation stage,operation time,blood transfusion volume,and the number of postoperative chemoembolization were the single factors influencing the prognosis of surgical treatment(P<0.05);logistic regression analysis showed that severe liver cirrhosis(95%CI 1.746~8.469,or=3.845),tumor>50 mm(95%CI 2.071~7.425,or=3.921),operation stage II(95%CI 1.746~8.469,or=3.845),tumor>50 mm(95%CI 2.071~7.425,or=3.921)946~7.416,or=3.799),operation time>3 h(95%CI 2.471~5.912,or=3.822),blood transfusion>4 u(95%CI 1.075~4.981,or=2.314),no postoperative chemoembolization(95%CI 1.643~5.719,or=3.065)were the risk factors affecting the prognosis of surgery(P<0.05).Conclusion There are many prognostic factors in patients with rupture and hemorrhage of primary hepatocellular carcinoma,which are closely related to severe liver cirrhosis,large tumor focus,operation stage,long operation time,large amount of blood transfusion,and no postoperative chemoembolization.Clinical prevention and control measures should be actively implemented in combination with prognostic risk factors,so as to prolong the survival of patients.

关 键 词：原发性肝细胞肝癌 破裂出血 临床特点 预后因素 

分 类 号：R735.7[医药卫生—肿瘤]