原发性肝癌自发性破裂大出血介入治疗的临床疗效分析

Clinical analysis of interventional therapy in the treatment of bleeding of spontaneous rupture of primary liver cancer

目的探讨原发性肝癌自发性破裂大出血介入治疗的临床疗效及安全性。方法回顾性分析2005年4月至2010年4月收治的71例原发性肝癌自发性破裂大出血患者的临床资料,按照其治疗方式进行分组,介入组患者48例,手术组患者23例,比较两组患者的临床疗效及安全性。结果两组患者腹腔积血、止血成功率差异无统计学意义(P>0.05),介入组患者治疗过程中出血及接受输血量显著低于手术组患者(P<0.05)。介入组患者并发症发生率为8.3%(4/48),手术组患者并发症发生率为65.2%(15/23),介入组患者并发症发生率显著低于手术组。两组患者1年生存率差异无统计学意义(P>0.05),介入组患者2年、3年生存率均显著高于手术组,差异有统计学意义(P<0.05)。结论介入治疗可达到有效的控制出血、预防再出血作用,同时,该方法能够有效保证患者的生存率,安全性良好,在今后急诊治疗时应将介入治疗作为首选方案,以改善患者的预后。

Objective To analyze the clinical efficacy and safety of interventional treatment for hemorrhage of spontaneous rupture of primary liver cancer. Methods A retrospective analysis of 71 cases of our hospital in April 2005 to April 2010 in admitted to primary liver cancer in patients with clinical data of large spontaneous rupture and bleeding, were grouped according to their treatment, intervention group of 48 eases, 23 cases in operation group, two groups were compared the clinical efficacy and safety. Results The two groups of patients with hemoperitoneum, the success rate of hemostasis with no statistical difference （ P 〉 0. 05 ）, the intervention group during the treatment of hemorrhage and blood transfusion volume was significantly lower than the operation group （ P 〈 0. 05 ） ; interventional group there were 4 cases of complications, the incidence of 8. 3% , 15 cases of complications appeared in operation group, the incidence of 65.2% , the incidence of complications of intervention group was significantly lower than operation group ; 1 year survival rate in patients of two groups with no significant statistical difference （ P 〉 0. 05 ）, yet the 2 years, 3 years survival rates of intervention group were significantly higher than that of the operation group （P 〈 0. 05）. Conclusions Interventional therapy can achieve effective control of hemorrhage, prevention of rebleeding, at the same time, this method can effectively ensure the survival rate of patients, good security, in the future the emergency treatment should be the intervention as a preferred solution, in order to improve the prognosis of the patients.