TACE及手术切除治疗肝癌破裂出血疗效观察

Therapeutic effect of TACE combined with operation on liver cancer rupture

目的:探讨经导管肝动脉化疗栓塞术(TACE)及手术切除治疗肝癌破裂出血的临床价值。方法:对我院30例肝癌破裂出血患者的临床资料进行回顾性分析,其中经TACE治疗21例、手术切除9例以及TACE后再手术切除10例。结果:经TACE治疗21例,其中1例患者因肝功能欠佳,治疗后两个月死于肝功能衰竭。10例患者1月后进行II期手术。单纯TACE治疗患者术后1年存活率为27.3%(3/11),10例经TACE治疗后II期手术患者1年存活率为70.0%(7/10),9例行Ⅰ期手术切除的患者中,死亡1例,发生腹腔种植转移者5例,术后1年存活率为44.4%(4/9)。TACE治疗后行II期手术患者治疗明显高于单纯TACE治疗患者(P<0.01)及I期手术切除患者(P<0.05)。结论:TACE治疗肝癌破裂出血安全、迅速,TACE治疗后行手术切除可显著降低肿瘤腹腔种植转移率,提高患者生存率。

Objective：To explore the clinical value of transcatheterhepatic arterial chemoembolization（TACE） combined with operation on liver cancer rupture.Methods：The clinical data of 30 patients with liver cancer rupture in our hospital were retrospectively analyzed.Among the 21 cases with TACE treatment,9 cases with the surgical removal,and 10 cases with the surgical removal after TACE.Result：In 21 cases with TACE treatment,1 case died from liver failure after 2 month and 10 cases took phase Ⅱ tumor resection after 1 month.During the first year after surgery,the survival rate of the cases with only the TACE treatment was 27.3%（3 /11）,of 10 cases with the TACE treatment and phase Ⅱ tumor resection was 70%（7 /10）,and of 9 cases with only the phaseⅠ tumor resection including 1 death and 5 peritoneal metastasis was 44.4%（4 /9）.Patients with the TACE treatment and phase Ⅱ tumor resection were much better than those with only the TACE treatment（P 0.01） and those with only the phaseⅠtumor resection（P 0.05）.Conclusion：TACE combined with operation was a safe and effective treatment with liver cancer rupture which can significantly decrease the peritoneal metastasis rate and increases the patients survival rate.