应用损伤控制性理论治疗原发性肝癌合并肝硬化的体会（附49例报道）

Application of damage control surgery for primary hepatocellular carcinoma with cirrhosis （report of 49 cases）

目的 探讨损伤控制性手术（DCS）在原发性肝癌合并肝硬化中的临床应用.方法 回顾性分析我院2005年3月至2008年10月采用DCS原则治疗49例原发性肝癌合并肝硬化患者的临床资料.结果 49例患者无一例手术死亡病例.术后并发症8例,其中切口感染4例、肺部感染1例、胸腔积液1例及中度腹水2例,经保守治疗后痊愈.结论 原发性肝癌合并肝硬化患者,应积极按照DCS原则,选择合适的手术处理方式以减少手术风险、手术并发症及死亡率.

Objective To explore the clinical application of damage control surgery （DCS） for primary hepatocellular carcinoma （HCC） with cirrhosis. Methods The clinical data of 49 patients with primary HCC with cirrhosis from March 2005 to October 2008 were retrospectively analyzed on prefer- ence of DCS. Results All of 49 cases survived. Incision infection occurred in 4 cases, lung infection in one case,pleural effusion in one case, and moderate ascites in 2 cases. All complications were cured by conservative treatments. Conclusion To reduce complications and increase survival rate,primary HCC with cirrhosis should be treated positively under DCS, and eligible operations are chosen.