肝动脉插管化疗与栓塞治疗肝癌后消化道出血及防治

Treatment and Prevention of DigestiveTract Bleeding after Hepatic Artery Chemoembolization for Advanced Hepatoma

肝动脉插管灌注化疗与栓塞治疗中晚期肝癌３１０例（５６０次）中，并发消化道出血１３例，发生率占全组病例的４．１９％。出血原因有：ＩＣ６例；肝功能损害，凝血机制差３例；化疗药对胃粘膜毒性作用和部分栓子误入胃供血动脉２例；食管静脉曲张破裂１例；肝肿瘤破裂１例。本文对消化道出血原因与防治方法进行了探讨，并建议在行肝动脉灌注化疗和栓塞治疗前采取肝功能估计和预防出血的方法，以减少因出血、肝衰及感染造成的死亡。

Of 310 patients with advanced liver cancer treated by hepatic artery chemoembolization(560times),gastrointestinal hemorrhage occurred in 13 cases, accounting for 4.19% of this series of cases. The bleeding was attributable to DIC in 6 cases, insufficiency of liver function and defective coagulation in 3, entrance of chemotherapeutic drug into the gastric artery in 2, and the rupture of tumor and esophageal varices in 1 each. The cause of hemorrhage and the way of prevention were discussed in detail. It is suggested that the liver function should be fully assessed before the performance of hepatic artery chemoembolization to preclude hemorrhage, hepatic failure and infection from occurrence.