Child-Pugh C级伴肝炎肝硬化的肝癌患者行肝癌切除术分析

目的：探讨Child-Pugh C级伴有肝炎肝硬化的肝癌患者行肝癌切除术增加可行性的方法,减少手术死亡率。方法：对我院2005年6月~2010年6月收治的33例行肝癌切除术的Child-Pugh C级伴有肝炎肝硬化的肝癌患者进行回顾性分析。结果：手术失血量为300～3 500 ml,平均（1 407.3±122.0）ml;手术时间2.3～9.0 h,平均（5.3±1.2）h。33例肝癌患者死亡5例,余28例术后出现腹水、胆漏、感染、急性肾功能衰竭等各种并发症62例次,经对症治疗均痊愈出院。结论：Child-Pugh C级伴肝炎肝硬化的肝癌患者行肝癌切除术难度大、风险大,但只要选择合理术式,术中控制出血量,加强围术期治疗,手术是相对可行和安全的。

Analysis on hepatectomy for hepatocellular carcinoma in the treatment of patients with Child-Pugh C class hepatocarcinoma associated wih liver cirrhosis

Objective： To investigate the method of increase the feasibility of hepatectomy for hepatocellular carcinoma in the treatment of patients with Child-Pugh C class hepatocarcinoma associated with cirrhosis.Methods： Data of 33 patients with hepatocarcinoma who were associated with cirrhosis were analyzed retrospectively in our hospital from June 2005 to June 2010.Results： In 33 patients,Surgical blood loss 300-3 500 ml,an average of（1 407.3±122.0） ml;operation time were 2.3-9.0 h with an average of（5.3±1.2） h;5 patients died,the other 28 cases occurred 62 times complications such as ascites,bile leakage,infection,and acute renal failure after the operation,the symptomatic were cured after treatment.Conclusion： Hepatectomy for hepatocellular carcinoma in the treatment of patients with Child-Pugh C class hepatocarcinoma who are associated with cirrhosis is difficult and risky,but as long as a reasonable surgical would be chose,intraoperative blood loss can be controlled,perioperative treatment can be strengthened,the surgery is relatively feasible and safe.