肝癌破裂出血急诊动脉栓塞术在基层医院的应用体会

Emergency Transcatheter Arterial Embolization for Bleeding of Liver Cancer Spontaneous Rupture in the Basic-level Hospitals

目的:探讨在基层医院肝癌破裂出血急诊行动脉栓塞术的临床价值。方法:对2012-2014年收治15例肝癌破裂出血不宜行急诊根治术的患者行急诊动脉栓塞,栓塞材料为明胶海绵颗粒(或条),其中8例辅助以表柔比星碘油乳剂栓塞,回顾分析止血效果及后续肿瘤治疗情况。结果:15例均止血成功,获得后续治疗肿瘤的机会,4例行外科根治术,11例行经肝动脉化疗栓塞术。结论:对基层医院不宜行急诊根治术的肝癌破裂出血患者,动脉栓塞术(或辅助以化疗栓塞)是合理、安全、有效的止血措施。

Objective： To evaluate the efficacy of emergency transcatheter arterial embolization（TAE） for spontaneous rupture of in the basic-level hospitals.Method： We retrospectively reviewed 15 cases of spontaneous ruptured HCC which had been treated in our hospital between 2012 and 2014.Emergency TAE was performed with with gelfoam particles（strips） in the 15 patients, which was not suitable for emergency radical prostatectomy.TACE was performed with epirubicin hydrochloride and lipiodol emulsion in 8 eases.Result： Bleeding from the ruptured HCC was stopped at the end of the procedure. Following the achievement of hemostasis by TAE, 4 cases underwent radical nepbreetomy, and TACE was performed in 11 cases.Conclusion： Emergency TAE（or TACE） is reasonable and safe and effective for bleeding due to spontaneous rupture in HCC in the basic-level hospitals.