不同治疗方式对原发性肝癌破裂出血的疗效及预后分析  

Curative effect of different treatment methods on rupture and hemorrhage of primary liver cancer and analysis of prognosis

作　　者：王建权 袁红彦 吴万庆[2] Wang Jianquan;Yuan Hongyan;Wu Wanqing(Department of general surgery,general hospital of Jinshui district,Zhengzhou,Henan,450008,China;Department of general surgery,the fifth affiliated hospital of Zhengzhou University,Zhengzhou,Henan,450008,China)

机构地区：[1]郑州市金水区总医院普外科,河南郑州450008 [2]郑州大学第五附属医院普外科,河南郑州450008

出　　处：《齐齐哈尔医学院学报》2023年第9期834-837,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨分析不同治疗方式对原发性肝癌破裂出血的疗效及预后。方法本研究采取回顾性分析方式,选择2015年3月—2019年6月郑州市金水区总医院收治的肝癌破裂出血患者85例作为研究对象,根据患者治疗方式的不同,将采取手术切除治疗的41例患者作为手术组,将采取TACE治疗的患者44例作为TACE组。比较两组患者术前、术后临床相关指标变化、术后并发症发生情况以及患者术后总体生存情况。结果术后两组患者总胆红素、白蛋白、血红蛋白、收缩压、舒张压水平显著升高(P<0.05),且术后TACE组患者总胆红素、收缩压、舒张压低于手术组(P<0.05),而白蛋白、血红蛋白水平高于手术组(P<0.05)。手术组患者术后发生腹水2例、继发出血5例、腹腔感染2例,并发症总发生率为21.95%(9/41),TACE组患者术后发生腹水2例、腹腔感染1例,并发症总发生率为6.82%(3/44),TACE组患者术后并发症发生率显著低于手术组(P<0.05)。手术组患者术后中位生存时间为20.85个月,TACE组患者术后中位生存时间为19.73个月,两组患者生存情况比较差异无统计学意义(P>0.05)。结论手术切除与TACE均是治疗肝癌破裂出血的有效手段,TACE治疗对患者创伤小、术后影响小,且能够显著降低术后并发症发生率,且两种治疗方式均可获得相似的远期生存率,在临床中可根据患者自身情况进行选择。Objective To explore and analyze the effect and prognosis of different treatment methods on rupture and hemorrhage of primary liver cancer.Methods Retrospective analysis was adopted in this study.85 patients with rupture and bleeding of liver cancer those were admitted to general hospital of Jinshui district in Zhengzhou from March 2015 to June 2019 were selected as the study subjects.According to the different treatment methods of patients,41 patients who were treated by surgical resection were selected as the operation group,and 44 patients who were treated by TACE were selected as the TACE group.The changes of clinical related indexes before and after operation,postoperative complications and overall survival of patients in the two groups were compared.Results The levels of total bilirubin,albumin,hemoglobin,systolic blood pressure and diastolic blood pressure in the two groups increased significantly after operation(P<0.05);the levels of total bilirubin,systolic blood pressure and diastolic blood pressure in the TACE group were lower than those in the operation group after operation(P<0.05),while the levels of albumin and hemoglobin were higher than those in the operation group(P<0.05).In the operation group,there were 2 cases of ascites,5 cases of secondary bleeding and 2 cases of abdominal infection,the total incidence of complications was 21.95%(9/41).In the TACE group,there were 2 cases of ascites and 1 case of abdominal infection,the total incidence of complications was 6.82%(3/44).The incidence of postoperative complications in the TACE group was significantly lower than that in the operation group(P<0.05).The median survival time of the patients in the operation group was 20.85 months,and the median survival time of the patients in the TACE group was 19.73 months,there was no statistical difference between the two groups(P>0.05).Conclusions Both surgical resection and TACE are effective methods for the treatment of rupture and bleeding of liver cancer.TACE treatment create little trauma to patients,lit

关 键 词：原发性肝癌 破裂出血 疗效 预后 

分 类 号：R735.7[医药卫生—肿瘤]