肝癌介入治疗后并发急性上消化道出血的原因分析及治疗措施  

Acute upper gastrointestinal massive hemorrhage induced by the interventional therapy of hepatic carcinoma:pathogeny and treatment

作　　者：马新明[1] 王敬忠[1] 

机构地区：[1]湖北省襄樊市中心医院介入室,襄樊市441021

出　　处：《实用医学影像杂志》2004年第1期47-48,51,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨肝癌介入治疗后并发急性上消化道大出血的原因及治疗措施。方法分析1124例肝癌介入治疗后出现14例此类并发症的发生原因和治疗过程。12例经肝动脉注入化疗药并碘油化疗药乳剂(10ml～30ml)栓塞治疗,2例行单纯灌注化疗。结果14例均在介入术后24h内出现上消化道大出血。经内科治疗后止血,无一例死亡。结论碘油逆流入门静脉引起门静脉高压或加重原有门静脉高压是出血的主要原因,药物降低门静脉压和止血是治疗该症的有效方法。Objective To explore the pathogenic cause and therapeutic measure of acute upper gastrointestinal massive hemorrhage (AUGIMH) complicated with the interventional therapy of hepatic carcinoma.Methods The pathogenic cause and therapeutic measure of 14 patients with AUGIMH which complicated with interventional therapy of hepatic carcinoma in 1124 cases were analyzed,of them,12 patients underwent transhepatic artery infusion chemotherapy and embolization by lipiodol chemotherapy emulsion(10～30 ml),other 2 patients underwent single infusion chemotherapy.Results AUGIMH in 14 cases all occurred within 24 hours after the interventional procedure.The hemostasis occurred after medical treatment and there was not any death.Conclusion The hypertension of portal vein induced by the countercurrent of lipiodol towards the portal vein or the increase of original portal vein hypertension are main pathogenic cause of AUGIMH.Using drugs to decrease the pressure of portal vein and hemostasis are an effective means for treating AUGIMH.

关 键 词：肝癌 上消化道 出血 治疗措施 

分 类 号：R735.7[医药卫生—肿瘤]