肝癌自发性破裂的机理及治疗进展

Pathogenesis and therapy of spontaneous rupture of hepatocellular carcinom

肝癌自发性破裂可能与门脉高压、瘤组织坏死、凝血功能障碍、血液流变学异常、血管病变及抗原抗体复合物的血管壁沉积有关。急诊治疗可采用肝动脉插管栓塞,待患者一般情况好转后采用二期手术治疗可取得良好的效果。破裂大出血者,如果符合手术指征,应尽可能的及时手术治疗,肝切除或肝动脉插管栓塞可作为首选。

The pathogenesis of spontaneous rupture was not clear . Possible factors included portal hypertension, tumor necrosis, the cruor blood function obstacle, the abnormality of blood rheology, vascular injury and the deposition of antigen - antibody complex in vascular wall. The first choice of emergency therapy for hemostasis was transcatheter arterial embolization （TAE）. The rational therapy of patients with ruptured HCC was followed by hepatectomy if the lesion was respectable. If the patients of HCC have no contraindications, emergent exploratory laparotomy is recommanded. Hepatectomy or TAE are the first choice.