急诊肝切除术治疗肝癌自发性破裂附58例报告

Emergency liver resection for spontaneous rupture of primary hepatocellular carcinoma:Report of 58 cases

目的探讨急诊肝切除术治疗肝癌自发性破裂的适应证、方法和疗效。方法回顾性分析58例肝癌自发性破裂患者行急诊肝切除术的临床资料。结果本组患者58例,男49例,女9例,年龄45～74岁。术前均行CT检查。手术死亡率3.4%(2/58),术后并发症发生率24.1%(14/58)。术后均行肝动脉栓塞(TAE)等综合治疗,1、3、5年生存率分别为84%、52%和46%。结论术前的影像学评估是判断能否行急诊肝切除术的重要依据,完善的围手术期处理可以降低手术死亡率和并发症发生率,急诊肝切除术治疗肝癌自发性破裂可能获得良好预后。

Objective To investigate the indications, method and prognosis of emergency liver resection for spontaneous rupture of primary hepatocellular carcinoma. Methods A retrospective clinical analysis was made of 58 patients who underwent emergency liver resection due to spontaneous rupture of pri- mary hepatocellular carcinoma. Results Spontaneous rupture of primary hepatocellular carcinoma was found in 49 men and 9 women, with a mean age of 56.5 years. Preoperative CT scan was performed in all patients. Postoperative mortality and morbidity were 3.4% and 24. 1% respectively. Follow-up results showed the 1-,3-,and 5-year survivals were 84%, 52% and 46% respectively. Conclusions CT scan is essential to estimate the respectability of spontaneous rupture of primary hepatocellular carcinoma. Good prognosis may be achieved by emergency liver resection.