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56例肝癌自发性破裂出血的外科治疗 被引量:2

Surgical Management of Spontaneous Rupture ofHepatocellular Carcinoma-A Report of 56 Cases
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摘要 目的:探讨外科手术治疗肝癌自发性破裂出血的效果。方法:56 例肝细胞性肝癌( 肝癌)自发性破裂出血患者,其中6 例行填塞术,13 例行单纯缝合术,8 例行肝固有动脉或选择性肝动脉结扎术,18 例行肝动脉化学栓塞术,11 例行肝切除术。结果:1) 手术止血率: 平均为93 .0% (52/56) ,其中填塞术为66.7 % (4/6) ,缝合术为84 .6% (11/13) ,肝动脉结扎术为100 % (8/8) ,肝动脉化学栓塞术为94 .6 % (17/18) ,肝切除术为100 % (11/11) ;2)1 年生存率:平均为26 .8% (15/56) ,填塞术为0(0/6) ,缝合术为15.4% (2/13) ,肝动脉结扎术为12.5 % (1/8) ,肝动脉化学栓塞术为22.2% (4/18) ,肝切除术为72 .7% (8/11) ;3) 平均住院死亡率为10 .7 % 。结论:手术仍是肝癌自发破裂的有效治疗手段,应根据患者的具体情况择不同的手术术式。 Objective: To evaluate the effects of surgical treatment of spontaneous rupture of hepatocellular carcinoma (HCC). Methods: Fifty-six cases of spontaneous rupture of HCC were treated by: packing 6, suture plication 13, ligation of either the common hepatic artery or selective ligation of the branch supplying the tumor-bearing lobe of liver 8, hepatic artery chemo-embolization 18 and hepatic resection 11. Results: 1) The overall surgical hemostasis was achieved successfully in 93.0% (52/56) of patients. The hemostatic rates of packing, suture, ligation of hepatic artery, hepatic artery chemo-embolization and hepatic resection were 66.7% (4/6), 84.6%(11/13), 100% (8/8), 94.6% (17/18) and 100% (11/11) respectively. 2)The total one year survival rate was 26.8% (15/56), while the 1-year survival rates of packing, suture, hepatic artery ligation,hepatic artery chemo-embolization and hepatic resection were 0% (0/6), 15.4% (2/13), 12.5% (1/8), 22.2%(4/18) and 72.7% (8/11) respectively. 3) The overall postoperative mortality rate was 10.7% (6/56). Conclusion: The results suggest that surgical management of spontaneous rupture of HCC is still the effective treatment and that the best operative procedure should be selected according to the general and local condition of the patient.
出处 《中国肿瘤临床》 CAS CSCD 北大核心 1999年第11期812-814,共3页 Chinese Journal of Clinical Oncology
关键词 肝细胞癌 自发破裂 肝切除术 治疗 HCC Spontaneous rupture Hepatic artery ligation Hepatectomy Chemo-embolization
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