肝切除术治疗肝癌自发性破裂出血

Hepatectomy in the treatment of bleeding of spontaneous rupture of hepatocellular carcinoma

目的探讨肝切除术治疗肝癌自发性破裂出血的临床效果。方法对24例肝细胞性肝癌自发性破裂出血患者的临床资料、肝切除方法及随访结果进行回顾性分析。结果手术止血成功率为100%,手术后病死率为4.1%(1/24),并发症发生率16.7%(4/24),术后肝功能2周内基本恢复正常。平均住院(14.75±6.25)d。21例获随访;其中8例术后10个月内复发死亡,10例生存1年以上,2例生存2年以上,1例生存3年,1年生存率为54.2%(13/24)。结论肝切除术在治疗肝癌自发性破裂出血时可有效止血并同时切除肿瘤,部分患者可达根治切除,如患者的病情允许应作为首选。

ObjectiveTo investigate the clinical results of hepatectomy for bleeding of spontaneous rupture of hepatocellular carcinoma (HCC). MethodsThe clinical data of 24 cases admitted to our hospital from Jan 1990 to Mar 2004 was analyzed retrospectively.ResultsSurgical hemostasis was achieved successfully in 100.0% (24/24) of patients. The postoperative mortality rate was 4.1% (1/24), and the (complication) rate 12.5%(4/24). Liver function recovered within two weeks after operation. The length of hospital stay was 14.756.25 days.Twenty-one patients were followed-up from 6 month to 36 months. 8 patients died from recurrence within 10 months postoperatively; 10 patients survived over 1 year, 1 patient over 2 years and 1 over 3 years. The overall 1-year survival rate was 58.3%(13/24).ConclusionsIn the management of bleeding of spontaneous rupture of HCC, hepatectomy can effectively stop the bleeding and excise the tumor at the same operation. In some patients, a radical excision can be achieved, and, if the (patient)s condition permits it, hepatectomy should be the treatment of choice.