肝细胞癌自发性破裂的介入治疗及其研究进展

Intervential Therapies of Ruptured Hepatocellular Carcinoma and Its Research Progress

肝细胞癌自发性破裂(ruptured hepatocellular carcinoma, rHCC)是一种危及肝细胞癌(hepatocellular carcinoma, HCC)患者生命的严重并发症,而且rHCC还有可能升高腹腔播散率,并对生存产生负面影响。目前rHCC的治疗主要包括急诊手术止血、介入治疗以及姑息治疗。本文描述了rHCC的临床表现、预后、并发症、介入治疗和目前已有的研究证据,总结了介入治疗止血对于大多数rHCC患者的必要性,甚至对一些Child-Pugh分级为C级的患者也是如此。根据目前所报道的临床证据,TAE/TACE联合分期肝切除术是一种较为有效的治疗rHCC的方法,对于大多数rHCC的患者,首选介入治疗能提供更多的后续分期手术的机会,预后也更好。

Rupture of HCC (rHCC) is a life-threatening complication of hepatocellular carcinoma (HCC), and rHCC may lead to a high rate of peritoneal dissemination and affect survival negatively. We described clinical presentation, prognosis, complication, interventional management, and current evidence of rHCC from the perspective of interventional radiologists. Overall, our review summarized that in-terventional therapies are necessary for most patients with rHCC to achieve hemostasis, even in some patients with Child-Pugh C. Moreover, TAE/TACE followed by staged hepatectomy is a benefi-cial treatment for rHCC according to current clinical evidence. TAE/TACE is the first choice for most patients with rHCC, and appropriate interventional treatment may provide staged surgery oppor-tunities.