终末期肝癌患者的治疗分析

目的探讨终末期原发性肝癌（PLC,以下简称肝癌）患者的治疗方法。方法回顾性分析97例终末期肝癌患者的临床资料,对不合理治疗情况进行统计分析。结果 97例终末期肝癌患者中,死亡前1个月内的治疗中存在如下问题：16例发生消化道出血及肝癌破裂出血前后,应用有潜在致出血作用的头孢类抗菌素;25例死亡时给予胸外心脏按压,5例死亡前给予气管插管呼吸机维持呼吸,32例行腹腔穿刺抽腹腔积液,1例给予人工肝血浆置换,4例给予TACE治疗;66例（68.0%）患者给予1～3种中药或免疫制剂静脉点滴治疗,76例（78.4%）给予1～3种保肝药物治疗,31例（32.0%）患者临终前日输液量达到2000ml以上,其中21例（21.7%）给予静脉营养支持。结论终末期肝癌患者存在着治疗不规范情况,应尽快制定包括肝癌在内的各种器官癌症终末期的诊断标准和治疗指南,并以此作为规范终末期癌症的诊断和治疗,以减轻终末期癌症患者的痛苦和节约社会资源。

Treatment of Patients with Terminal Liver Cancer

Objective To investigate the treatment of terminal primary liver cancer（PLC hereinafter referred to as HCC） patients.Methods We retrospectively analyzed the clinical date of 97 patients with terminal liver cancer.Results There existed the following problems in the treatment of 97 patients with terminal liver cancer patients who died within 1 month：16 patients who had gastrointestinal bleeding and rupture of hepatocellular carcinoma before and after were applicated of the potential role of cephalosporins caused by bleeding antibiotics,25 were given chest cardiac compression,5 were given the intubation ventilator to maintain breathing before died,32 patients underwent paracentesis,1 case for plasma exchange,4 patients were treated with TACE treatment,66 cases（68.0%） given by Chinese medicine for 1 to 3 intravenous therapy or immune agents,76 cases（78.4%） given by 1 to 3 hepatoprotective drug therapy,31（32.0%） patients were given infusion more than 2 000 ml every day,of which 21 cases（21.7%） for intravenous nutritional support.Conclusion There was an irregular situation in patients with terminal liver cancer.The diagnostic criteria and treatment guidelines should be formulated of terminal cancers as soon as possible,and as a clinical pathway to regulate the terminal cancer diagnosis and treatment to alleviate the suffering of terminal cancer patients and resource saving.