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[肝硬化与肝癌——类型、临床病程及其治疗进展]

[Liver cirrhosis and liver cancer--types, clinical courses, and progress in their treatment].

作者信息

Kawata H

出版信息

Gan To Kagaku Ryoho. 1982 Jul;9(7):1129-39.

PMID:7184446
Abstract

There have been several controversies about classification of liver cirrhosis between Western countries and Japan. By the follow-up studies for 5 years on 478 cirrhotic patients diagnosed in Osaka area, relatively higher survival rates were found in cases without HBs-antigen and in heavy drinkers, whereas cases of cryptogenic type showed poor prognosis. The most marked progress in diagnostic procedures in this field seems to be several imaging techniques such as scintiphotography, U.S. echography and computed tomography. Analysis obtained by serial observations on imaging films would be valuable in differentiation between hepatoma and liver cirrhosis. Remarkable improvement has been shown in examinations on etiologic factors, degree of impairment of liver cell functions and precise evaluation of pathophysiological status of patients. Although it is our great regret that radical procedure to cure patients suffering from liver cirrhosis or hepatoma has not yet been known, several palliative treatments have become practical in recent years. For example, percutaneous transhepatic portal occlusion or injection of sclerosing agents for bleeding esophageal varices, parenteral feeding using adjusted amino acids pattern solution for impending coma and selective arterial embolization by sponges or coils infused with anticarcinogenic drugs for inoperable hepatoma have been used and effective to prolong survival period of these patients.

摘要

在西方国家和日本之间,关于肝硬化的分类存在一些争议。通过对大阪地区诊断出的478例肝硬化患者进行5年的随访研究发现,无乙肝表面抗原的患者和重度饮酒者的生存率相对较高,而隐源性肝硬化患者的预后较差。该领域诊断程序最显著的进展似乎是闪烁摄影、超声心动图和计算机断层扫描等几种成像技术。通过对成像胶片的连续观察所获得的分析,对于区分肝癌和肝硬化具有重要价值。在病因因素检查、肝细胞功能损害程度以及患者病理生理状态的精确评估方面都有了显著改善。虽然很遗憾目前尚未找到治愈肝硬化或肝癌患者的根治方法,但近年来一些姑息治疗方法已变得切实可行。例如,经皮经肝门静脉闭塞术或注射硬化剂治疗食管静脉曲张破裂出血,使用调整氨基酸模式溶液进行胃肠外营养治疗即将发生的昏迷,以及对无法手术的肝癌采用注入抗癌药物的海绵或线圈进行选择性动脉栓塞术等,这些方法已被用于延长这些患者的生存期并取得了成效。

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