265例肝癌患者肝动脉化疗栓塞后近期死亡原因分析

Analysis of short-term death after transcatheter hepatic arterial chemoembolization in 265 patients with liver cancer

目的探讨减少肝动脉化疗栓塞 ( TACE)术后严重并发症及降低近期病死率的有效途径。方法对 2 6 5例肝癌患者行 TACE术 ,分析其中 19例近期 (术后 2 0天 )死亡原因。结果死于肝功能衰竭 9例 ,死于肝癌破裂 4例 ,死于上消化道出血 2例 ,死于胃十二指肠穿孔、肺栓塞、心肌梗死、高钾血症各 1例。其中原发性肝癌及转移性肝癌病死率分别为 9.2、1.4 ( P<0 .0 5 )。结论对晚期不能切除肝癌尤其原发性肝癌患者行 TACE术时 ,应严格掌握适应症 ,选择合理的个体化治疗方案。

Objective To explore the effective way to decrease serious complications and to minimize the mortality following transcatheter hepatic arterial chemoembolization (TACE).Methods In 265 liver cancer patients experiencing TACE,the causes of death in 19 (20 days after TACE) were analyzed.Results 9 cases died of liver failure,4 died of the rupture of liver tumors, and 2 died of upper digestive tract bleeding.Gastroduodenal perforation,pulmonary embolism,myocardial infarction,and hyperkalemia resulted in death in one case,respectively.The mortality rates of primary liver cancer and liver metastasis were 9.2% and 1.4%,respectively (P<0.05).Conclusion The indications must be seriously taken into account and individual treatments should be seleced properly when TACE is performed in patients who can not receive resection of liver cancer,especially in those with primary liver cancer.