Li T, Pi Z, Liu G
Second Affiliated Hospital, Hunan Medical University, Department of General Surgery, Changsha.
Hunan Yi Ke Da Xue Xue Bao. 1997;22(6):500-2.
Four hundred and ninety eight cases of primary hepatic carcinoma (PHC) were discovered complicating with cirrhosis in 608 PHC cases during 1974-1994. 63 cases of them were with severe cirrhosis and portal hypertension (10.4%). Laparotomy indication was evaluated according to Child's grade and image data such as BUS and CT etc. Operative extension should be limited as segment or wedge hepatectomy or semi-hepatic artery chemo-embolization. Splenic artery ligation plus venous ligalion of cardiac region of stomach were applied to portal hypertension and hypersplenism. Frusemide, antacid and insulin were used in the perioperation period. Three-year survival rate was 57%. It is considered that splenic artery ligation instead of splenectomy is the first choice for preventing and treating hypersplenism and digestive tract bleeding in PHC with severe cirrhosis.
1974年至1994年期间，在608例原发性肝癌（PHC）患者中发现498例合并肝硬化。其中63例伴有严重肝硬化和门静脉高压（10.4%）。根据Child分级以及BUS、CT等影像资料评估剖腹手术指征。手术范围应限制为肝段或楔形肝切除术或半肝动脉化疗栓塞术。采用脾动脉结扎加胃贲门区静脉结扎术治疗门静脉高压和脾功能亢进。围手术期使用速尿、抗酸剂和胰岛素。三年生存率为57%。认为对于合并严重肝硬化的原发性肝癌患者，脾动脉结扎而非脾切除术是预防和治疗脾功能亢进及消化道出血的首选方法。
