47例原发性肝癌自发破裂出血的诊治分析

An Analysis of Diagnosis and Treatment of Primary Hepatic Carcinoma with Spontaneous Rupture and Hemorrhage in 47 Cases

目的探讨原发性肝癌(PHC)自发破裂出血的诊治特点及预后.方法回顾性分析1998年1月至2004年12月我院收治的47例PHC破裂出血患者的临床资料,并随访2 a.结果47例患者中,41例(87.23%)合并有肝硬化.行手术治疗44例(93.6%).其中行肝切除术者17例,有5例生存时间超过2 a;术后病人的死亡原因主要为肝功能衰竭(22例)、消化道出血(10例)和肾功能衰竭(5例).结论正确及时的诊断和治疗能够提高PHC自发破裂出血病人的生存率,手术切除肿瘤仍然是降低PHC破裂出血病人死亡率的主要手段.

Objective To analyze the influence of diagnosis and surgical treatment of spontaneous rupture and hemorrhage in patients with primary hepatic carcinoma （PHC） on prognosis. Methods 47 consecutive patients with spontaneous rupture and hemorrhage of HCC who had been admitted to our hospital from January 1998 to December 2004 were reviewed retrospectively and followed for 2 years. Results Among the 47 patients, 41 （87.23%） had liver cirrhosis and 44 （93.6%） had been treated by operation. In those cases hepatectomy had been performed in 17 patients and 5 survived for 2 years. The death reasons in ruptured PHC are mainly hepatic function failure, renal function failure and gastrointestinal bleeding. Conclusion The prolonged survival could be achieved through accurately and timely diagnosis and treatment and the resection of the tumor is still a main measure for reducing the mortality in patients with ruptured PHC.