肝细胞癌自发性破裂的相关问题探讨  

Spontaneous rupture in hepatocellular carcinoma:a discussion on key issues

作　　者：夏丰 张必翔[1] 朱鹏 Xia Feng;Zhang Bixiang;Zhu Peng(Department of Hepatic Surgery,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Hubei Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院肝脏外科,湖北武汉430030

出　　处：《腹部外科》2025年第1期1-6,共6页Journal of Abdominal Surgery

基　　金：四大慢病重大专项(NSFC82473040);国家科技重大专项(2023ZD0502001)。

摘　　要：肝细胞癌(hepatocellular carcinoma,HCC)自发性破裂是HCC病人中一种危及生命的急性并发症,临床表现为自发性肿瘤破裂及腹腔内出血。尽管TNM分期系统将其归类为T4期,但针对性的治疗策略可显著改善病人的生存预后。此文综合分析了HCC自发性破裂的流行病学特征、危险因素、病理生理机制以及多种治疗方式的效果差异。重点探讨了破裂相关因素、围手术期管理策略及术后预后预测模型的应用,旨在为临床治疗提供循证依据。此外,还结合近年来的研究进展,讨论重新定义该疾病分期的重要性,以期优化诊疗策略,提升病人生存率和生活质量,并综合华中科技大学同济医学院附属同济医院肝脏中心既往经验得出同济经验。Spontaneous rupture of hepatocellular carcinoma(HCC)is a life-threatening acute complication in HCC patients,clinically manifested as spontaneous tumor rupture and intra-abdominal hemorrhage.Although classified in T4 by the TNM staging system,targeted treatment strategies can significantly improve the survival prognosis of spontaneous rupture of HCC.This review comprehensively analyzed the epidemiological characteristics,risk factors,pathophysiological mechanisms,and the efficacy differences of various treatment modalities for spontaneous rupture of HCC.It focused on the timing of surgery,perioperative management strategies,and the application of postoperative prognostic prediction models,aiming to provide evidence-based guidance for clinical treatment.Additionally,by integrating recent research advancements,we discussed the importance of redefining the staging of spontaneous rupture of HCC to optimize diagnostic and therapeutic strategies,thereby improving the survival and quality of life.The review also incorporated the previous experience of our center to present the clinical experience in managing spontaneous rupture of HCC at Liver Center,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology.

关 键 词：肝细胞癌 破裂 风险因素 预后 临床管理 

分 类 号：R657.3[医药卫生—外科学] R735.7[医药卫生—临床医学]