原发性肝癌破裂出血的临床分析(附76例报告)

Clinical analysis of bleeding caused by rupture of primary liver cancer (A report of 76 cases)

目的探讨原发性肝癌破裂出血的诊疗。方法回顾性分析1990～2004年我院76例资料完整的原发性肝癌破裂出血患者的诊断和治疗。结果76例患者均有急性上腹部疼痛和急性腹膜炎表现,影像学检查和腹腔穿刺均阳性。76例中非手术治疗34例,占44.7%,12例死亡(占非手术治疗的35.3%);手术治疗42例,占54.3%,6例死亡(占手术治疗的14.3%)。结论病史、影像学检查和腹腔穿刺在原发性肝癌破裂出血的诊断中起重要作用。治疗根据患者的具体情况而采取保守治疗或缝扎止血、手术肝切除、肝动脉结扎等手术治疗方法。

Objective To investigate the diagnosis and treatment of bleeding caused by rupture of primary liver cancer. Methods From 1990 to 2004, 76 cases with bleeding caused by rupture of liver cancer were analyzed retrospectively. Results 76 patients had acute epigastric pain, manifestation of acute peritonitis, and the imaging examination and abdominocentesis were positive in all cases. Among them, 34 cases underwent conservative treatment （account for 44.7%）. 12 cases died. The mortality was 35.3%. 42 cases underwent operative treatment （account for 54.3%）. 6 cases died.The mortality was 14.3%. Conclusion Medical history,imaging examination and abdominocentesis are very important to diagnose the bleeding caused by rupture of liver cancer. According to the patient＇s specific condition, the conservative treatment or operative treatment can be selected.