Matsumata T, Kanematsu T, Shirabe K, Sonoda T, Kitano S, Sugimachi K
Second Department of Surgery, Kyushu University, Faculty of Medicine, Fukuoka, Japan.
Hepatogastroenterology. 1990 Oct;37(5):489-93.
A retrospective study was done on 226 patients with hepatocellular carcinoma and coexisting esophageal varices treated at our institute between 1974 and 1988. The patients were divided into two groups: Group A containing patients treated between 1974 and 1982 (n = 92), and Group B comprising those treated between 1983 and 1988 (n = 134). Surgical treatments were applied to 64 patients (69.6%) and 37 patients (27.6%) in groups A and B, respectively (p less than 0.001). Ninety out of 134 patients (67.2%) in group B were prescribed regional chemotherapy. Forty-nine patients (53.3%) in group A, and 96 (71.6%) in group B had esophageal varices that were about to rupture as indicated endoscopically. Nineteen patients (38.8%) in group A, and 10 (10.4%) in group B were treated surgically (p less than 0.005). The varices in 76 out of 96 patients (79.2%) in group B were treated by endoscopic sclerotherapy. Survival rates during the first 5 years in groups A and B were 28% and 65%, 16% and 43%, 5% and 27%, 4% and 18%, and 4% and 6%, respectively. It would appear that appropriate conservative treatment of the poor surgical candidates will, in general, lead to good clinical results.
对1974年至1988年间在我院接受治疗的226例肝细胞癌合并食管静脉曲张患者进行了一项回顾性研究。患者分为两组：A组为1974年至1982年间接受治疗的患者（n = 92），B组为1983年至1988年间接受治疗的患者（n = 134）。A组和B组分别有64例（69.6%）和37例（27.6%）患者接受了手术治疗（p<0.001）。B组134例患者中有90例（67.2%）接受了区域化疗。A组49例（53.3%）和B组96例（71.6%）患者经内镜检查显示食管静脉曲张即将破裂。A组19例（38.8%）和B组10例（10.4%）患者接受了手术治疗（p<0.005）。B组96例患者中有76例（79.2%）的静脉曲张接受了内镜硬化治疗。A组和B组前5年的生存率分别为28%和65%、16%和43%、5%和27%、4%和18%、4%和6%。一般来说，对手术条件差的患者进行适当的保守治疗会取得良好的临床效果。
