超早期肝动脉栓塞抢救肝癌破裂出血的临床意义

Transcatheter arterial embolization for spontaneous rupture of hepatocellular carcinoma

目的 研究经导管肝动脉栓塞 (TAE)抢救肝细胞肝癌 (hepatocellularcarcinoma ,HCC)自发性破裂出血的方法及效果。方法 对 15例HCC自发性破裂出血患者行急诊肝动脉插管 ,联合运用明胶海绵 ,碘油 ,真丝线段 ,弹簧钢圈作出血动脉分支栓塞治疗。结果 15例行TAE后出血均得到完全控制。除 1例术后第 5天死于严重肝肾功能衰竭外 ,其余 14例均存活 3月以上 ,1例随访 30个月仍存活。结论 用多种栓塞剂行急诊TAE治疗可使HCC自发性破裂出血立即止血。其适应症宽 ,创伤小 ,是安全、可靠、简便的抢救手段 。

Objective To evaluate effects of transcatheter hepatic arterial emolization (TAE) on spontaneous rupture of hepatocllular carcinoma(HCC).Methods Emergent hepatic arterial catheterization was performed in 15 cases of spontaneous rupture of HCC,using sponge gelatin,iodized oil,silk thread and coil to embolize blooding arterial branch.Results Blooding was completely cortrolled by TAE in all 15 cases,of which one case died of severe hypohepatia and reanl insufficiency 5 days later,14 patients remained to be alive after 3 months one patient was still alive over 30 months.Conclusions arterial embolization can immediately stop hemorrhage due to spontaneous haptorrhexic in patients with HCC, which is strongly recommended for its safety ,mininum damage,convenience and reliability.