原发性肝癌自发性破裂外科治疗81例分析

Surgical treatment of spontaneous rupture of primary liver carcinoma:report of 81 cases

目的探讨原发性肝癌自发性破裂的外科治疗方法及疗效。方法对81例原发性肝癌自发性破裂出血行外科治疗,其中肝叶切除47例,出血癌灶切除10例,肝动脉结扎22例,纱布填塞止血2例的临床资料分析。结果81例中1个月内死亡7例,占8.64%,余74例1、2、3年生存率分别为41.1%、25.5%、7.3%,最长存活达5年3个月。术后发生腹腔转移38例,肺转移25例,脊柱转移8例。结论原发性肝癌自发性破裂出血并非癌肿晚期,手术治疗是控制出血、处理癌灶、延长生存期的有效方法。

Objective To assess the surgical treatment of 81 patients with spontaneous rupture of primary liver carcinoma and their outcome after liver resection.Methods In this series,47 patients underwent liver resection,10 underwent resection of hemorrhagic carcinoma,22 received hepatic artery ligation,and 2 were given gauze packing to stop bleeding respectively.Results The 1-month death rate was 8.64%（7/81）,and the 1-,2-,3-year survival rates were 41.1%,25.5%,and 7.3% respectively.The longest survival was 5 years and 3 months.Conclusions Spontaneous rupture of primary liver carcinoma is not the end-stage of the tumor.Surgical treatment for spontaneous rupture of primary liver carcinoma is to control bleeding and to improve the survival.