原发性肝癌自发性破裂出血的相关危险因素分析

Analysis of risk factors of spontaneous rupture in primary hepatic carcinoma

目的探讨原发性肝癌自发性破裂出血的相关危险因素。方法将2006年1月至2012年12月重庆医科大学附属第一医院收治的原发性肝癌自发性破裂出血的56例患者纳入研究组,另选择同期住院肝癌未发生破裂的56例患者纳入对照组。比较两组患者一般情况、实验室检查结果、影像学检查结果等资料。结果对照组与研究组在有无门静脉癌栓、肿瘤突出肝脏表面是否大于1cm,以及甲胎蛋白、凝血酶原时间、纤维蛋白原(FIB)、乙肝病毒e抗原(HBeAg)水平等方面比较差异有统计学意义(P<0.05)。Logistic回归分析显示肿瘤突出肝脏表面大于1cm,以及FIB、HBeAg水平为原发性肝癌自发性破裂出血的独立危险因素。结论肿瘤突出肝脏表面大于1cm,以及FIB、HBeAg水平是原发性肝癌自发性破裂出血的独立危险因素。

Objective To study the risk factors relating to spontaneous rupture of hepatocellular carcinoma.Methods A total of 56 patients with spontaneous rupture of hepatocellular carcinoma were selected into study group,and 56 patients without rupture of hepatocellular carcinoma were selected into control group.The general status,the results of laboratory examination and imageological diagnosis were compared between the two groups from 2006 to 2012.Results There were significant differences on the portal tumor thrombus,alpha fetoprotein（AFP）,tumor protuberated more than 1cm above the liver surface,prothrombin time（PT）,fibrinogen（FIB）,HBeAg between the two groups（P〈0.05）.Multivariate analysis identified that tumor protuberated more than 1cm above the liver surface,FIB,HBeAg were significant independent risk factors for spontaneous rupture of hepatocellular carcinoma.Conclusion Tumor protuberated more than 1cm above the liver surface,FIB,HBeAg are significant independent risk factors for spontaneous rupture of hepatocellular carcinoma.