Sun Jun-Hui, Wang Li-Gang, Bao Hai-Wei, Lou Jian-Liang, Cai Li-Xia, Wu Chao, Chen Li-Ming, Zheng Shu-Sen
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Hepatogastroenterology. 2010 May-Jun;57(99-100):616-9.
BACKGROUND/AIMS: Rupture of hepatocellular carcinoma (HCC) following transcatheter arterial chemoembolization (TACE) is a rare and life-threatening complication. The purpose of the present study was to evaluate the utility of emergency embolization for treatment of ruptured HCC following TACE.
Five patients developed rupture of tumor after TACE in 1005 patients of HCC from October 2007 to February 2010, and were studied retrospectively. Emergency selective arterial embolization was performed in all 5 patients because of intractable hemorrhage in the peritoneal cavity or around the liver that could not be controlled by conservative method. The mean hemoglobin level before embolization was 75.6 g/L +/- 20.7 (mean +/- standard deviation).
Hepatic angiography did not revealed extravasation of contrast from the tumor in all 5 patients with rupture of HCC following TACE. After selective embolization of feeding arteries of the liver tumor, intraperitoneal bleeding from HCC was stopped immediately in all patients. The mean hemoglobin level after embolization in 48 hours was 102.6 g/L +/- 3.5. No severe complication related to emergency embolization was found after treatment.
Emergency arterial embolization is effective for hemostasis of ruptured HCC following TACE in patients with hemodynamically unstable condition.
背景/目的：经导管动脉化疗栓塞术（TACE）后肝细胞癌（HCC）破裂是一种罕见且危及生命的并发症。本研究的目的是评估急诊栓塞术治疗TACE后破裂HCC的效用。
回顾性研究2007年10月至2010年2月期间1005例HCC患者中5例TACE后发生肿瘤破裂的患者。由于腹腔或肝脏周围的顽固性出血无法通过保守方法控制，对所有5例患者均进行了急诊选择性动脉栓塞。栓塞前平均血红蛋白水平为75.6 g/L±20.7（平均值±标准差）。
所有5例TACE后HCC破裂患者的肝血管造影均未显示肿瘤有造影剂外渗。对肝肿瘤供血动脉进行选择性栓塞后，所有患者HCC的腹腔内出血立即停止。栓塞后48小时平均血红蛋白水平为102.6 g/L±3.5。治疗后未发现与急诊栓塞相关的严重并发症。
急诊动脉栓塞术对血流动力学不稳定的TACE后破裂HCC患者的止血有效。
