肝细胞癌自发性破裂出血相关危险因素及治疗进展

Risk factors and treatment progress of spontaneous rupture and hemorrhage in hepatocellular carcinoma

肝细胞癌是临床上最常见的恶性肿瘤之一,从世界范围看,我国的发病率最高。肝细胞癌自发性破裂出血是肝癌的严重并发症,其发生机制和危险因素复杂,包括肿瘤大小、位置、高血压、肝硬化、HBsAg阳性、肥胖及接受索拉非尼靶向治疗等,均可能是其影响因素。近年来,肝细胞癌破裂出血的治疗方式在不断的完善与发展,包括保守治疗、经导管动脉化疗栓塞术、急诊肝切除术、阶段性肝切除术等,经导管动脉化疗栓塞术后行选择性手术是目前最有效的治疗方法。本文就肝细胞癌破裂出血的危险因素及治疗进展进行综述,以便为肝细胞癌破裂出血研究的方向提供参考,以早发现、早预防、早治疗,改善预后,延长患者生存期。

Hepatocellular carcinoma is one of the most common malignant tumors in clinical practice,and China has the highest incidence in the world.Spontaneous rupture of hepatocellular carcinoma is a serious complication of hepatocellular carcinoma.Its mechanism and risk factors are complex,including tumor size,location,hypertension,cirrhosis,HBsAg positivity,obesity and receiving targeted therapy with sorafenib,which may be its influencing factors.In recent years,the treatment methods of rupture and hemorrhage of hepatocellular carcinoma have been continuously improved and developed,including conservative treatment,transcatheter arterial chemoembolization,emergency hepatectomy,staged hepatectomy,etc.Transcatheter arterial chemoembolization followed by selective surgery is the most effective treatment at present.This article reviews the risk factors and treatment progress of rupture and hemorrhage of hepatocellular carcinoma,in order to provide reference for the direction of research on rupture and hemorrhage of hepatocellular carcinoma,so as to improve the prognosis and prolong the survival time of patients with early detection,early prevention and early treatment.