肝癌破裂出血的急诊TACE治疗

Emergency TACE Treatment for Rupture and Hemorrhage of Liver Cancer

目的总结急诊经动脉化疗栓塞(TACE)治疗原发性肝癌破裂出血的疗效及并发症。方法回顾2016年—2021年36例原发性肝癌破裂出血患者资料。对36例接受急诊TACE的患者分别进行了1~12个月的随访,以了解有关急诊TACE效果及并发症的发生情况。结果所有36例患者(100%)术中出血完全控制,1例(2.8%)栓塞后第二天因呼吸、循环衰竭死亡,2例(5.6%)1周内再次出血,接受二次栓塞治疗,2例(5.6%)介入术后肿瘤降期,于肝胆外科行根治术。接受栓塞治疗的患者中,36例(100%)出现栓塞后腹痛、发热、胃肠道反应,1例(2.8%)出现肝脓肿。结论急诊TACE治疗原发性肝癌破裂出血安全有效,能有效止血,挽救患者生命,为后期外科手术切除提供机会。常见并发症有栓塞后综合征、胃肠道反应,肝脓肿、肝功能衰竭等严重不良反应较少见。

Objective To summarize the curative effect and complications of emergency TACE in the treatment of rupture and hemorrhage of primary liver cancer.Methods The data of 36 patients with primary liver cancer rupture and bleeding from 2016 to 2021 were reviewed.Thirty-six patients who received emergency TACE were followed up for 1-12 months to understand the effect of emergency TACE and the occurrence of complications.Results All 36 patients(100%)had complete control of intraoperative bleeding,1 patient(2.8%)died of respiratory and circulatory failure on the second day after embolization,and 2 patients(5.6%)had bleeding again within one week and received secondary embolization therapy,2(5.6%)cases underwent tumor downstaging after intervention and underwent radical resection in hepatobiliary surgery.Among the patients who received embolization,36 patients(100%)developed abdominal pain,fever,and gastrointestinal reactions after embolization,and 1 patient(2.8%)developed liver abscess.Conclusion Emergency TACE is safe and effective in the treatment of primary liver cancer rupture and bleeding,which can effectively stop bleeding,save the patient's life,and provide an opportunity for later surgical resection.Common complications include post-embolization syndrome,gastrointestinal reactions,liver abscess,liver failure and other serious adverse reactions are rare.