原发性肝癌破裂出血的诊断和治疗

DIAGNOSIS AND TREATMENT OF SPONTANEOUSLY RUPTURED WITH HEMORRHAGE IN PRIMARY LIVER CARCINOMA (

目的 探讨原发性肝癌破裂出血的诊断和治疗。方法 回顾性分析 2 1例原发性肝癌破裂出血的诊断及治疗结果。结果 2 1例患者中 ,8例行保守治疗 ,其院内病死率为 75 % (6 / 8) ,1 3例行手术治疗 ,手术方法有不规则肝切除手术 ,肝动脉结扎加网膜填塞缝扎术 ,单纯网膜填塞缝扎术、其病死率分别为 2 0 % (1 / 5 )、5 0 % (3/ 6 )、5 0 % (1 / 2 )。结论 原发性肝癌破裂出血的确诊和治疗对预后有重要意义 ,早期肝癌破裂肝功能良好者应争取急诊手术探查并争取行肝切除术 ,如病情不许可 ,可先行保守治疗 ,再争取行

Objective To summarize the diagnosis and treatment of spontaneous rupture of primary liver carcinoma.Methods The diagnosis and treatment of 21 patients with spontaneous rupture of primary liver carcinoma were analysed retrospectively.Result In the 21 patients,eight of them underwent conservative treatment,the hospital mortality rate was 75%(6/8),thirty of them were achieved by hepatectomy,hepatic arterial ligation,packing and suturing,the hospital mortality rate were 20%(1/5),50%(3/6),50%(1/2) respectively.Conclusion The diagnosis and treatment in time or not are very important to the prognosis of the spontaneous reptuure of primary liver carcinoma.Emergent hepatectomy should be reserved for patients with an easily resectable lesion whose liver function is very well.Early two stage of delayed hepatectony would be suitable for those patients,who are unsuitable for emergent operation.