肝癌破裂出血早期肝动脉栓塞治疗的价值

目的评价经导管动脉栓塞(TAE)抢救肝细胞性肝癌(HCC)自发性破裂出血的方法及效果。方法对15例HCC自发性破裂出血患者行急诊肝动脉插管,联合应用明胶海绵、碘油或加弹簧钢圈作出血动脉的栓塞治疗。结果15例行TAE后出血均得到完全控制。除1例术后第3天死于多器官功能衰竭外,其余14例均存活3月以上,半年生存率达86.7%(13/15),一年生存率为66.7%(10/15)。结论急诊TAE治疗HCC自发性破裂出血疗效好,对不能手术完全切除的肝癌患者,疗效优于其他外科止血方法。

Value of transcatheter arterial embolization in the early stage of spontaneous rupture of hepatocellular carcinoma

Objective To evaluate the value of transcatheter arterial embolization (TAE) in spontaneous rupture of hepatocellular carcinoma (HCC). Methods Emergent hepatic arterial catheterization was performed in 15 patients with spontaneous rupture of HCC, using sponge gelatin, iodized oil and coil to embolize bleeding arterial branch. Results Bleeding was completely controlled by TAE in all 15 cases, of which one patient died of severe hypohepatia and renal insufficiency 3 days later. Fourteen patients were followed up, and all of them remained to be alive after 3 months, 13 patients had been alive for 6 months,10 patients alive for 12 months. Conclusion Emergent arterial embolization is good method for treating spontaneous rupture of HCC, especially to the patients which could not completely removal the cancer, its effect is superior to other surgical operation for hemostasia.