肝癌介入术后并发消化道出血的病因分析及防治措施

Pathogeny and Prevention of Gastrointestinal Tract Bleeding after Interventional Therapy for Advanced Hepatocarcinoma

对２０４例中晚期肝癌患者采用Ｓｅｌｄｉｎｇｅｒ法肝动脉灌注化疗栓塞，术后并发消化道出血１６例（７．８４％）。结合下列七个相关临床因素进行分析出血原因并提出防治方案。结果示肝功能Ｂ、Ｃ级者（列为肝功能差者），化疗药物返流及肝硬化合并有食道静脉曲张三因素分别在出血组与未出血组间差异有显著性，而年龄、性别、门脉癌栓、介入次数四因素在两组间差异均无显著性。故术前积极改善肝功能。

Two hundred and four patients with advanced hepatocarcinoma were treated by transcatheter hepatic artery infusion and chemoembolization.Of them 16 patients (7.84%) were complicated by gastrointestinal tract bleeding.Seven clinical factors were analyzed to seek the cause of bleeding and the measures of preventive treatment.Results: Significant difference existed between the bleeding group and non bleeding group with respect to ,liver function grade B and C, drug reflux including hepatic cirrhosis associated with esophageal varices.While,none of the factors including:sex,age,tumorous portal thrombi and the times of interventional treatment had statistical significance.Therefore, it is necessary to improve liver function before operation,to superselect catheterization during operation and to use vasoconstrictor for prevention and treatment of haemorrhage.