肝癌破裂出血急诊TAE序贯手术切除联合腹腔热灌注化疗等综合治疗的研究分析  

The treatment of ruptured hepatocellular carcinoma by emergent TAE in combination with sequential resection or intraperitoneal hyperthermic perfusion chemotherapy

作　　者：段昌虎 刘晓晨 段建峰 丁建龙 赵李飞 邰升[2] DUAN Chang-hu;LIU Xiao-chen;DUAN Jian-feng;DING Jian-long;ZHAO Li-fei;TAI Sheng(Department of Hepatobiliary Surgery,3201 Hospital of Xi’an Jiaotong University Health Science Center,Hanzhong 723000,China;Department of Hepatobiliary Surgery,the 2nd Affiliated Hospital of Harbin Medical University,Heilongjiang 150086,China)

机构地区：[1]西安交通大学医学部附属三二〇一医院肝胆胰脾外科,陕西汉中723000 [2]哈尔滨医科大学附属第二医院肝胆外科

出　　处：《肝脏》2022年第4期455-459,共5页Chinese Hepatology

基　　金：黑龙江省自然科学基金(H2018025)。

摘　　要：目的探讨肝癌破裂出血行急诊肝动脉栓塞(transcatheter arterial embolization,TAE)序贯手术切除联合腹腔热灌注化疗等综合治疗的临床价值。方法回顾性分析我院自2015年1月至2021年6月治疗的30例肝癌破裂出血患者的诊治过程,将患者分为TAE后外科手术治疗组(10例)及TAE后保守治疗组(20例),比较两组患者1年、2年、3年及5年生存率。结果外科手术组的1年生存率为70%,明显高于保守治疗组的35%,外科手术组的2年、3年、5年生存率为40%、20%、10%,保守治疗组为0,外科手术组的远期生存率明显高于保守治疗组。结论针对肝癌破裂出血且有外科适应证的患者,通过急诊TAE序贯外科手术,术后行综合治疗是可以取得满意效果的。Objective To investigate the clinical value of emergent transcatheter arterial embolization(TAE)in combination with sequential resection or conserved intraperitoneal hyperthermic perfusion chemotherapy for the treatment of ruptured hepatocellular carcinoma.Methods Thirty cases of ruptured hepatocellular carcinoma that were diagnosed and treated from January 2015 to June 2021 were retrospectively analyzed.The patients were divided into a surgical treatment group(10 cases)and a conservative treatment group(20 cases).The 1-,2-,3-and 5-year survival rates of the two groups were compared.Results The 1-year survival rate of the surgical treatment group was 70%,which was significantly higher than that of the conservative treatment group(35%).The 2-year,3-year and 5-year survival rates of the surgical treatment group were 40%,20%and 10%,which were 0%in the conservative treatment group.The long-term survival rate of the surgical group was significantly higher than that of the conservative treatment group.Conclusion For patients with ruptured hepatocellular carcinoma that have surgical indication,emergent TAE combined with sequential surgical resection followed by postoperative intraperitoneal hyperthermic perfusion chemotherapy and other combined treatments can achieve satisfactory prognosis.

关 键 词：肝癌 破裂出血 外科手术 肝动脉栓塞术 综合治疗 

分 类 号：R73[医药卫生—肿瘤]