肝癌介入治疗后并发急性上消化道大出血的原因分析及处理

目的：探讨肝癌介入治疗后并发急性上消化道大出血的原因，为临床治疗提供依据。方法：分析852例肝癌介入治疗后出现的11例此类并发症，男9例，女2例，经超声，CT及血管造影符合肝癌，经肝动脉插管至肝固有动脉，注入化疗药及碘油（15－20ml)的混悬剂，结果：介入后12h，出现上消化道大出务，经降门静脉压等治疗，9例出血停止，2例死亡，结论：碘油逆流入门静脉引起门脉高压或／和加重原有门静脉高压是出血的主要原因，降门静脉压是治疗该症的有效方法。

Cause and management of acute hemorrhage of upper digestive tract after chemo-embolization for hepatocellular carcinoma

Objective:To study the cause of acute hemorrhage of upperdigestive tract after chemo-embolization for HCC.Methods:11 cases of such complications were encountered from 852 cases of HCC treated by chemo-embolization,including male 9 and female 2, aged from 42-68 years,they were performed a catheterization through femoral artery to proper hepatic artery.15～20ml of a mixture of chemical agent and lipiodol was injected.Results:Acute hemorrhage of upper digestive tract occurred within 12 hours after interventional therapy.Bleeding was controlled in 9 cases after reducing of portal hypertension and mechanical tamponade but 2 patients died.Conclusion:Portal hypertension caused by reflux of lipiodol to portal vein is considered the main cause of acute hemorrhage of upper digestive tract after chemo-embolization for HCC.Reduction of portal hypertension is an effective method for controlling the acute hemorrhage.