急诊TACE介入治疗肝癌破裂出血的效果及安全性分析

Efficacy and Safety of Emergency TACE Interventional Treatment for Liver Cancer Rupture and Bleeding

目的探讨急诊TACE介入治疗肝癌破裂出血的效果及安全性。方法回顾性分析35例肝癌破裂患者的临床特点、治疗方法及治疗效果。单因素和多因素分析影响生存的因素。结果中位生存时间为59天。24例患者行肝动脉化疗栓塞(TACE),11例患者行保守治疗。24例患者接受TACE达到止血效果,无并发症。TACE治疗患者30天的生存率83.3%。TACE破裂肝癌患者30天的存活率与Child-Pugh分级、血红蛋白水平、肌酸酐水平、TACE法有关。多因素分析显示,患者接受TACE[比值比(OR),0.076;P=0.020],或有较高的血红蛋白水平患者(OR,0.626;P=0.011),生存率越高。在TACE组,30天存活率与较高的血红蛋白水平独立相关(OR,0.609;P=0.036)。结论 TACE是一种微创的治疗方法,具有较高的止血成功率,且能延长肝癌破裂患者30天的生存期。

Objective To investigate the efficacy and safety of emergency TACE interventional treatment for liver cancer rupture and bleeding. Methods A retrospective analysis of clinical features,treatment and efficacy of 35 cases of liver cancer patients with rupture were conducted. Univariate and multivariate analysis were used to study the factors affecting survival. Results The median survival time was 59 days. 24 patients underwent TACE,and 11 patients were treated conservatively. 24 cases treated with TACE achieved hemostasis without complications. 30-day survival rate of liver cancer patients with rupture was 83. 3%,and it was related with Child-Pugh classification,hemoglobin levels,creatinine levels and TACE. Multivariate analysis showed that patients treated with TACE [odds ratio（ OR）,0. 076; P = 0. 020] or with higher hemoglobin levels（ OR,0. 626; P = 0. 011） had higher survival rate. In TACE group,30-day survival rate was independently associated with higher hemoglobin level（ OR,0. 609;P = 0. 036）. Conclusion TACE is a minimally invasive method of treatment,it has a high success rate of hemostasis and can increase 30-day survival of patients with liver cancer rupture.