急诊肝动脉栓塞治疗原发性肝癌自发性破裂出血

目的　评价肝动脉栓塞 (TAE)在原发性肝癌自发性破裂出血抢救治疗中的作用。方法　 35例原发性肝癌自发性破裂出血患者 ,根据不同的治疗方法分为 2组 :TAE组 2 3例和内科保守治疗组 1 2例。结果　TAE组 2 3例腹腔动脉造影 ,有 1 4例可见造影剂外渗 ,其余是肿瘤血供染色明显 ,止血有效率91 3% ,一年生存率为 4 7 8%。内科保守治疗组止血有效率 33 3% ,一年生存率为 0 ,两组差异有显著性(P <0 0 1 )。结论　TAE是原发性肝癌自发性破裂急诊止血的有效、安全措施。对可切除的肝癌患者 ,TAE后择期手术切除应作为首选的治疗方案

Emergency transcatheter arterial embolization for ruptured hepatocellular carcinoma

Objective To evaluate the efficacy of transcatheter arterial embolization(TAE) for ruptured hepatocellular carcinoma(HCC).Methods 35 patients with ruptured HCC were divided into two groups according to their different treatment:Group TAE 23,Group medical conservative management 12.Results Celiac arteriography done before the treatment showed extravasation of contrast material in 14(60 9%) of the 23 patients,and hypervascular tumor was observed in the rest.The hemostasis success rate of group TAE was 91 3%,which was much higher than those of group medical conservative management.The 1 year survival rate of Group TAE(47 8%) was higher than those of group medical conservative management.Conclusion Transcatheter arterial embolization is safe and effective for hemorrhage due to spontaneous rupture in hepatocelluar carcinoma.