原发性肝癌死亡病例临床分析(附130例报告)

CLINIC ANALYSIS OF 130 DEAD PATIENTS WITH PRIMARY LIVER CANCER

目的 总结原发性肝癌的临床经验。方法 分析 130例原发性肝癌死亡病例的临床资料 ,包括性别、年龄、病史、诊断方法、肿瘤的性质、治疗方法、生存期和死亡原因等。结果 本组男 :女为 5 .5∶ 1,平均年龄 5 3.5岁。有乙型肝炎病史或病毒携带者占70 .8% ,合并肝硬化占 46 .2 %。本组病例均属中晚期 ,平均生存期为 6 .8个月 ,各组平均生存期 :手术切除组 (4例 )为 16 .0个月 ,手术切除 +经皮穿刺肝动脉插管化疗栓塞 (TACE)组 (17例 )为 16 .5个月 ,两组无明显差别 (P>0 .0 5 ) ;单纯 TACE组 (37例 )为 5 .4个月 ,其它治疗组 (72例 )为 4.7个月 ,两组无明显差别 (P>0 .0 5 ) ,但与前两组相比差异明显 (P<0 .0 1)。病人的死亡原因依次为上消化道大出血 (40 .8% )、肝功能衰竭 (30 .0 % )、全身衰竭 (15 .4% )、肝癌破裂出血 (10 .0 % )及其它 (3.8% )等。结论 中晚期原发性肝癌手术切除率低 (16 .2 % ) ,预后差 ,目前最好的治疗方法仍为手术切除 ,能明显延长病人的生存期 ,但 TACE及其它治疗方法不能改善病人的预后。上消化道大出血、肝功能衰竭、全身衰竭和肝癌破裂出血等为肝癌的主要死亡原因。

Objective To summarize the clinical experience in primary liver cancer .Metods The clinical data of 130 dead patients with primary cancer liver were analysied.The data included sex,age,history,diagnose method,tumor character,therapy,survival period,and deadly causes.Results In this suit,the ratio of men and women was 5.5∶1,average age was 53.5 years old.The morbidity of the history of hepatitis or virus carrier was 70.8%,and the cirrhosis was 46.02%.All cases in this group belonged to metaphase and advanced liver cancer.Average survival period was 6.8 months.In patients who treated with resection operation their average survival period was 16.5 months (4 cases),and the operation plus TACE was 16.0 months (17cases,P>0.05),single TACE was 5.4 months (37 cases)and other therapy was 4.7 months (72 cases,P>0.05).Average survival period in two former teams and two posterior teams are obviously different (P>0.01).The causes of death were massive hemorrhage of superior alimentary tract (40.8%),liver failure(30.0%),systemic failure(15.4%), hemorrhage of fracture liver cancer(10.0%)and others(3.8%).Conclusion Metaphase and advanced primary liver cancer had a lower rate of resection(16.2%)and poor prognosis.At present,operation is still the most effective method to prolong the life of patient.TACE and other therapy method can’t improve the prognosis.The main causes of death in patients with primary cancer of the liver were the hemorrhage of superior alimentary tract,liver failure,systemic failure and the hemorrhage of fracture liver cancer.