原发性肝癌自发性破裂出血的治疗方法选择

目的总结原发性肝癌自发性破裂出血的治疗方法选择及疗效。方法回顾性分析2005年1月~2008年12月收治的32例非保守治疗的原发性肝癌自发性破裂出血患者的临床资料。结果开腹手术组19例，2例死于术后并发症；介入治疗组13例，无围手术期死亡。一期及二期根治性手术15例中生存2年内者7例，超过2年者6例，失访2例：姑息止血治疗组13例生存期均为2年内。结论①介入治疗止血满意，并为后续的根治性手术创造条件；②急诊手术具有一定的盲目性，围手术期并发症多，死亡率高；③术后生存期以根治性手术切除为佳。

The choice of treatments for the spontaneous rupture of hepatocellular carcinoma

Objective To study the rational treatment for the spontaneous rupture of hepatocellular carcinoma(SRHCC).Methods The clinical data of 32 patients with SRHCC treated by open surgery or international therapy,during four years,were retrospectively analyzed.Results Nineteen cases were treated with open surgery,2 of them died of postoperative complications.International therapy was done in 13 patients,no one died in preoperative period.In the radical operation group,of the survivors in preoperative period,15 cases totally,6 cases had life time more than 2 years,2 cases were lost to follow-up.In 9 cases of only interventional therapy,all had life time less than 2 years.Conclusion(1)International therapy maybe a better choice for the short-term effect,and profits the sequential treatment;(2)The blindness maybe exist in the emergency open surgery,because of more complications and higher mortality;(3)In the long-term survival,the radical hepatectomy should be the better choice.