TACE后二期手术治疗小肝癌破裂出血的临床研究

目的 探讨小肝癌破裂出血行TACE后二期手术的治疗效果.方法 21例小肝癌破裂出血患者先行TACE治疗,并于1～2个月后行手术切除（联合治疗组）;同时以18例小肝癌破裂出血患者行急诊手术切除作为对照（对照组）;比较两组止血成功率、围手术期输血量、住院病死率、术后并发症、术后生存率和住院天数.结果 两组患者止血成功率均为100％,联合治疗组与对照组相比围手术期输血量少、并发症发生率低、住院天数短,差异有统计学意义（P＜ 0.01）,但病死率和生存率无差异（P＞0.05）.结论 TACE治疗后二期手术治疗小肝癌破裂出血虽然不能延长患者生存时间,但更具安全性,是临床值得应用的治疗方法.

The study of hepatectomy on patients of spontaneous rupture of small hepatocellular carcinoma after TACE

Objective To evaluate the hepatectomy effects on spontaneous rupture of small hepatocellular carcinoma after TACE.Methods Twenty-one patients with spontaneous rupture of small hepatocellular carcinoma were treated with TACE 1 to 2 months before operation （combined treatment group）,18 patients received emergency operation （control group）.The successful rates of hemostasis,amounts of blood transfusion,inhospital morality rates,complications,and postoperative survival rates and hospitalization days were compared between the two groups.Results The successful rates of hemostasis in two groups both were 100％.There were significant differences in amount of blood transfusion,postoperative complications,and hospitalization days between the 2 groups respectively （P＜0.01）,but there was no significant difference in in-hospital morality rates and postoperative survival rates （P＞0.05）.Conclusion Although hepatectomy after TACE can＇t increase long temm survival,but it is more safe,and it is a therapy worth to be used clinically.