肝动脉栓塞治疗原发性肝癌自发性破裂出血的临床价值

Clinical value of super selective transcatheter arterial embolization for spontaneous rupture of hepatocellular carcinoma

目的研究经导管肝动脉栓塞（TACE）抢救原发性肝癌自发性破裂出血（SRHC）的方法及效果。方法对38例原发性肝癌自发性破裂出血患者行急诊肝动脉插管，联合应用碘油、明胶海绵或聚乙烯醇（PVA）行出血动脉栓塞治疗。结果35例行TACE后出血均得到完全控制，1例术后第3天死于多器官功能衰竭，2例死于误诊，其余35例均存活3个月以上，半年生存率86．8％（33／38），1年生存率73．7％（28／38）。结论急诊TACE治疗可使SRHC患者立即止血。该法适应证宽，创伤小，是安全、可靠、简便的抢救手段，对于不可切除的肝癌优于外科止血方法。

Objective To evaluate effects of transcatheter hepatic arterial embolization（TACE） on spontaneous rupture of hepatocellular carcinoma （SRHC）. Methods Emergent hepatic arterial catheterization was performed in 38 cases of SRHC, using sponge gelatin, iodized oil and PVA to embolize blooding arterial branch. Results Blooding was completely cortrolled by TACE in 35 cases, of which one patient died of severe hypohepatia and renal insufficiency 3 days later, and two patients died of misdiagnosis, 35 patients remained to be alive after 3 months. 33 patients remained to be alive after 6 months. 28 patients remained to be alive after 12 months. Conclusion Arterial embolization is a good method for treating SRHC,especially to the patients which could not completely removal the cancer,its effect is superior to other surgical operation for hemostasia.