原发性肝癌破裂出血的诊治体会

The experience of diagnosis and prognosis of the primary liver cancer fracture and hemorrhage

目的探讨原发性肝癌破裂出血的诊疗。方法回顾性分析1990～2005年我院26例原发肝癌破裂出血患者的诊断和治疗。结果26例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,26例中非手术治疗11例占42.3%;5例死亡,占非手术治疗的45.5%。手术治疗15例,占67.7%;3例死亡,占手术治疗的20%。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到重要作用,治疗根据病人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。

Objective To evaluate the diagnosis and prognosis of the primary liver cancer fracture and hemorrhage. Methods Review and analyze the diagnosis and prognosis of the 26 cases of the patients with primary liver cancer fracture and hemorrhage in my hospital from 1990 to 2005. Results All 26 patients have acute abdomen ache and acute peritonitis, and all positive with iconography inspect and abdomen puncture. 11 cases of patients without operate prognosis（42.3% in all） ;5 cases of patients death（45.5% in patients without operate prognosis）. 15 cases of patients with operate prognosis（57.7% in all） ;3 cases of patients death（20% in patients with operate prognosis）. Condusions The case history, iconography inspect and abdomen puncture are important in the diagnosis of the primary liver cancer fracture and hemorrhage. The prognosis have different methods in according with idiographic case. Such as conservative prognosis,ligate hemostasia,liver exscind,liver artery ligation.