延迟性肝切除治疗肝细胞癌自发破裂

SPONTANEOUS RUPTURED HEPATOCELLULAR CARCINOMA TREATED BY DELAYED HEPATIC RESECTION

目的 :探讨应用延迟性肝切除治疗自发破裂的肝细胞癌。方法 :总结 6例自发破裂肝细胞癌患者应用延迟性肝切除治疗的临床、病理及随访资料。结果 :患者中男 5例 ,女 1例 ,平均年龄 45 .5岁。术前 3例保守治疗止血 ,1例行TAE止血 ,2例出血自行停止。首次入院至肝切除术平均 36d。 5例为根治性切除 ,1例姑息性切除 ,无手术及住院死亡者。肿瘤最大直径 4～ 11cm ,合并肝硬化者 83.3%。 5例术后复发转移 ,1例无瘤存活 4年 ,1年 ,3年生存率分别为 6 6 .7% ,33.3%。结论 :延迟性肝切除可有效地治疗肝细胞癌自发破裂。

Objective:To evalvated the efficiency of hepatic resection in the patients with spontaneous ruptured hepatocellular carcinoma (HCC).Methods:The clinical,pathological and follow-up records of six patients who underwent delayed hepatic resection for spontaneous ruptured HCC were reviewed.Results:Five cases were men,one case was woman.The mean age was 45.5 years.For hemostasis,conservative management was performed in three patients and TAE was used in one patient,whereas in the other two patients bleeding stopped without special procedures.Mean interval from hospitalization for the first time to hepatic resection was 36 days.Five cases underwent radical operations and one underwent palliative operation.There were no operative or hospital deaths.The maximum diameter of tumor were 4～11cm.83.3% patients had pathologic cirrhosis.Five patients had a recurrence and one patient has alived without tumor morethen four years.The 1-and 3-year survival rates were 66.7%,33.3% respectively.Conclusions:Delayed hepatic resection is and effective method in treating spoutaneous ruptured HCC.