肝细胞癌自发性破裂出血的诊治分析

Analysis of diagnosis and treatment of spontaneous rupture of hepatocellular carcinoma

目的:探讨肝细胞癌自发性破裂出血诊治措施的治疗效果。方法:回顾性分析我院2011-06-01~2016-06-01诊治的41例肝细胞癌自发性破裂出血患者的临床资料。其中行手术治疗(一期手术+介入后手术)26例,单纯接受介入治疗(肝动脉栓塞术与肝动脉化疗栓塞术)15例。对两组的临床疗效及生存时间进行评价。结果:两组在年龄、性别、是否合并肝硬化、肝功能分级、肿瘤数目、肿瘤大小、生活质量评分等方面比较,差异无统计学意义(P>0.05);中位生存时间手术组为18个月,单纯介入组为10个月,手术组患者生存率高于单纯介入组,差异有统计学意义(P<0.05)。结论:手术切除及介入治疗均是有效治疗肝细胞癌自发性破裂出血的方式,在仔细评估患者病情的基础上实施手术治疗可延长患者生存时间,应根据患者个体化情况合理选择诊疗方案。

Objective:To investigate the effect of diagnostic and therapeutic measures for spontaneous rupture of hepatocellular carcinoma(HCC).Methods:A retrospective analysis was performed on the clinical data of 41 patients with spontaneous ruptured HCC hospitalized at our hospital from June 1th 2011 to June 6th 2016.26 patients received operation(including one-stage operation and second-stage hepatectomy after interventional therapy).15 patients treated with transcatheter arterial embolization(TAE)or transcatheter arterial chemoembolization(TACE)alone.The clinical effect and outcomes of these groups were evaluated.Results:There was no significant difference between the two groups in age,gender,liver cirrhosis,Child-Pugh grade,tumor number,tumor size and PS score(P>0.05).The median survival in operation group and intervention group was 18 months and 10 months,respectively.The survival rates of operation group were higher than those with only intervention group(P<0.05).Conclusion:Surgical resection and interventional therapy are both effective ways to treat spontaneous rupture of HCC,based on careful assessment of patients′condition,surgical treatment can prolong their survival time.We should choose an appropriate strategy according to the individual situation of patients with spontaneous rupture of HCC.