自发性破裂肝细胞癌的治疗
Treatment of spontaneous ruptured hepatocellular carcinoma.
作者信息
Yoshida H, Onda M, Tajiri T, Umehara M, Mamada Y, Matsumoto S, Yamamoto K, Kaneko M, Kumazaki T
机构信息
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
出版信息
Hepatogastroenterology. 1999 Jul-Aug;46(28):2451-3.
BACKGROUND/AIMS: Spontaneous rupture with bleeding is a potentially life-threatening complication of hepatocellular carcinoma (HCC). We review our experience with treatments of ruptured HCC.
METHODOLOGY
Between January 1988 and December 1997, 18 patients with ruptured HCC were admitted. The patients were divided into 4 groups according to the treatment type of ruptured HCC. Group 1 consisted of 10 patients treated by transarterial embolization (TAE) followed by elective hepatectomy. Group 2 consisted of 2 patients treated by only TAE. Group 3 consisted of 3 patients treated by emergency operation. Group 4 consisted of 3 patients who could not be treated by TAE or surgery.
RESULTS
In Group 1, 4 of the 10 patients died; 3 from recurrent HCC and 1 from cerebral hemorrhage, and hospital mortality was absent. The 1-year survival rate was 87.5%. In Group 2, both patients recovered sufficiently well to be discharged. The 1-year survival rate was 50%. In Groups 3 and 4, hospital mortality rate was 100%.
CONCLUSIONS
TAE followed by elective hepatectomy was an effective treatment in patients with ruptured HCC.
背景/目的：自发性破裂出血是肝细胞癌（HCC）一种潜在的危及生命的并发症。我们回顾了我们对破裂性HCC的治疗经验。
方法
1988年1月至1997年12月，收治了18例破裂性HCC患者。根据破裂性HCC的治疗类型将患者分为4组。第1组由10例接受经动脉栓塞（TAE）后择期肝切除术的患者组成。第2组由2例仅接受TAE治疗的患者组成。第3组由3例接受急诊手术的患者组成。第4组由3例无法接受TAE或手术治疗的患者组成。
结果
第1组，10例患者中有4例死亡；3例死于复发性HCC，1例死于脑出血，无医院死亡病例。1年生存率为87.5%。第2组，2例患者均恢复良好并出院。1年生存率为50%。第3组和第4组，医院死亡率为100%。
结论
TAE后择期肝切除术是治疗破裂性HCC患者的有效方法。
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