急诊TACE介入治疗肝癌破裂出血的临床疗效及安全性分析  

Clinical Efficacy and Safety Analysis of Emergency TACE Intervention in Liver Cancer Rupture and Bleeding

作　　者：李丹[1] 范静雯 程素霞[1] LI Dan;FAN Jingwen;CHENG Suxia(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]河南省郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2022年第2期270-272,共3页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划(编号:2019050109)。

摘　　要：目的探讨急诊肝动脉化疗栓塞术(TACE)介入治疗肝癌破裂出血的临床疗效及安全性。方法选择肝癌破裂出血患者38例,均行TACE介入治疗。分析急诊TACE介入治疗效果,随访180 d,观察患者TACE术后生存率,并对影响患者生存的相关因素进行分析。结果随访180 d,中位生存时间为(59.83±3.61)d;经30 d治疗后共9例死亡,存活29例。死亡患者中包括肺炎2例,低血容量性休克4例,肝肾综合征1例,肝功能衰竭2例;依据患者预后情况分为存活组(29例),死亡组(9例);存活组Child-Pugh分级C级发生率低于死亡组,血红蛋白水平高于死亡组,肌酐水平低于死亡组,差异有统计学意义(P<0.05);Child-Pugh分级C级、血红蛋白水平是影响急诊TACE介入治疗肝癌破裂出血患者生存的独立危险因素(OR值≥1,且P<0.05)。结论急诊TACE介入治疗肝癌破裂出血,能够延长患者生存时间,Child-Pugh分级及血红蛋白水平是影响急诊TACE介入治疗肝破裂患者生存率的主要因素,在临床干预中需予以积极重视,以降低不良事件发生率。Objective To investigate the clinical efficacy and safety of emergency hepatic arterial chemotherapy embolization(TACE) in the interventional treatment of rupture and hemorrhage of liver cancer.Methods 38 patients with liver cancer rupture and bleeding were treated with TACE interventional therapy.The effects of emergency TACE intervention were analyzed, followed at 180 d, observed survival, and analyzed related factors affecting survival.Results Follow up for 180 d, median survival was(59.83±3.61) d;9 cases died after 30 d and 29 survived.Death patients included 2 pneumonia, 4 hypovolemic shock, 1 hepatorenal syndrome, 2 liver failure.Patients were divided into survival group(29) and death group(9),Survival group had lower Child-Pugh grade C,higher hemoglobin levels and lower creatinine than death group(P<0.05);Child-Pugh grade C and hemoglobin levels were independent risk factors affecting survival in patients(OR ≥ 1,and P<0.05).Conclusion Emergency TACE intervention can prolong the survival time of liver cancer rupture and bleeding.Child-Pugh classification and hemoglobin level are the main factors affecting the survival of patients with emergency TACE intervention, in clinical intervention should be conducted to reduce the incidence of adverse events.

关 键 词：肝癌破裂出血 急诊肝动脉化疗栓塞术 生存率 

分 类 号：R735.7[医药卫生—肿瘤]