原发性肝癌合并阻塞性黄疸的诊断和治疗

Diagnosis and treatment of primary liver cancer with obstructive jaundice

目的 探讨原发性肝癌合并阻塞性黄疸的诊断与治疗。方法 自1996年10月至2002年12月间我院收治原发性肝癌合并阻塞性黄疸70例,分成积极治疗组(n=61)和对症处理组(n=9);积极治疗组再分为单纯胆道引流组(n=43)和综合治疗组(n=18)。积极治疗组接受胆道引流、手术和肝动脉化疗栓塞等治疗。随访所有病人的生存时间。结果 随访50例,随访率71.4％。积极治疗组和对症处理组平均生存时间分别为9.6个月和2.3个月,相差显著(t’=3.45,P<0.05)。综合治疗组和单纯胆道引流组平均生存时间分别为21.9个月和4.1个月,相差显著(t’=4.11,P<0.05)。结论 原发性肝癌合并阻塞性黄疸的病人如能及时解除黄疸,积极治疗肿瘤,仍可显著延长病人生命。

Objective To investigate the diagnosis and treatment of primary liver cancer with obstructive jaundice. Methods Between October 1996 and December 2002 seventy patients with primary liver cancer with obstructive jaundice received therapy in eastern hepatobiliary surgery hospital. The cases were divided into two groups:active treatment group(n=61) and general support treatment group (n=9). The cases of active treatment group were divided into two groups: biliary tract drainage group(n=43) and compositive treatment group (n=18). The cases of active treatment group received biliary tract drainage, operation and transcatheter hepatic arterial chemoembolization, et al. The survival time of all these cases was follow-up. Results 50(71.4%) cases were follow-up all along. The mean survival time of active treatment group and general support treatment group were 9.6 months and 2.3 months, respectively (t'=3.45, P<0.05). The mean survival time of compositive treatment group and biliary tract drainage group were 21.9 months and 4.1 months respectively (t'=4.11, P<0.05). Conclusions The survival time of the patients with primary liver cancer with obstructive jaundice would be prolonged markedly if the bile duct construction could be relieved and active treatments for tumor were performed.