| 60例隐匿性肝癌的临床诊疗策略 |
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| 引用本文： | 林帆,李瑜元,范少峰,罗育其,赖越元,翁杰峰,伍兆峰. 60例隐匿性肝癌的临床诊疗策略[J]. 中国现代手术学杂志, 2009, 13(6) |
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| 作者姓名： | 林帆 李瑜元 范少峰 罗育其 赖越元 翁杰峰 伍兆峰 |
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| 作者单位： | 广州医学院附属广州市第一人民医院肝胆外科,广州,510180 |
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| 基金项目： | 广东省医学科学研究基金，广东省自然科学基金 |
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| 摘 要： | 目的研究隐匿性肝癌治疗的临床诊疗策略。方法回顾性分析60例隐匿性肝癌患者的临床资料,其中45例合并肝硬化,47例HBsAg阳性;AFP<20μg/L 12例,20~400μg/L 31例,>400μg/L 17例;肝功能Ch ild-Pugh A级36例,B级24例。42例予不规则肝切除(7例同时行脾切除加贲门周围血管离断术),3例予不规则肝切除加无水酒精注射,15例予肝左外叶切除(2例同时取出门静脉左支癌栓)。结果术中中位出血量800(400~2 500)m l,输血745(400~2 000)m l,无围术期死亡,术后出现腹水12例(20.0%),胸腹积液6例(10.0%),上消化道出血、肺部感染、胆漏及肝创面渗血各1例(2.2%),均经非手术治疗治愈。术后1、3、5年生存率分别为85.0%,66.7%,40.0%。结论除AFP外,多种肝癌标志物的研究有可能提高隐匿性肝癌的诊断效果,手术切除是最有效的治疗方法,但应结合肿瘤位置、大小、患者肝功能分级等因素确定手术及综合治疗方案。
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| 关 键 词： | 肝肿瘤 肿瘤转移 复发 |
Clinical Strategy of Subclinical Hepatocellular Carcinoma (A Report of 60 Cases) |
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| LIN Fan,LI Yu-Yuan,FAN Shao-feng,LUO Qi-yu,LAI Yue-yuan,WEN Jie-feng,WU Zhao-feng. Clinical Strategy of Subclinical Hepatocellular Carcinoma (A Report of 60 Cases)[J]. Chinese Journal of Modern Operative Surgery, 2009, 13(6) |
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| Authors: | LIN Fan LI Yu-Yuan FAN Shao-feng LUO Qi-yu LAI Yue-yuan WEN Jie-feng WU Zhao-feng |
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| Affiliation: | LIN Fan; LI Yu-Yuan; FAN Shao-feng; LUO Qi-yu; LAI Yue-yuan; WEN Jie-feng; WU Zhao-feng(Department of Hepatobiliary Surgery; the First People s Hospital of Guangzhou; Guangzhou Medical College; Guangzhou 510180; Guangdong; China); |
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| Abstract: | Objective To summarize the experiences of the surgery strategies for the subclinical hepatocellular carcinoma(SHC).Methods The clinic data of 60 SHC cases were retrospectively analyzed.Among them,47 cases were HBsAg positive,and the fetoprotein level was <20μg/L in 12 cases,20~400μg/L in 31 cases and >400μg/L in 17 cases.The liver function of Child-Pugh A was found in 36 cases,B in 24 cases.42 cases underwent irregular hepatectomy(including 7 cases of splenectomy and vessel amputation of the pericardi... |
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| Keywords: | liver neoplasms neoplasm metastasis recurrence |
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