原发性肝癌自发性破裂的外科处理

总结分析56例原发性肝癌（PHC）自发性破裂患者临床特点及处理。发现腹痛是PHC自发破裂最常见症状，其次有腹膜炎体征、休克等。治疗PHC自发破裂手术方式包括压迫、破裂修补、肝动脉结扎、栓塞、肝叶切除等措施。经以上综合治疗，患者肝切除后1，2，3，5年生存率分别为72.7％，36.4％，9.1％与9.1％。PHC自发破裂以切除病灶为首选术式，术中采用多种措施预防癌细胞残留种植，辅以门静脉系统化疗可提高PHC自发破裂患者生存率。

Dealing with Spontaneous Rupture of Primary Hepatocareinoma by Surgical Means

Fifty six cases of primary hepatocareinoma (PHC) were analysed about their clinical features and treatment. Abdominal pain is the most common symptom, the next common features are peritonitis, shock etc. Surgical means including pressing with gelatin, greater omentum suture, heppatic artery ligation, embolization, hepatic lobectomy etc were used to deal with spontaneous rupture of PHC. After applicating various surgical means on those cases, the 1,2,3 year survival rates were 28.6%,9. 1% and 4.6% respectively. Those treated by hepatic lobectomy got 1 - year survival rate 72.7%,2 - year survival rate 36.4%,3 - year and 5 - yeal sdrival rate both 9. 1%. It suggested that tumor resection is the first choice to those patients with spontaneous rupture of PHC. Using various methods to prevent tumor cells implantation and remaining, with portal vein system chemotherapy adjuvantly would increase the survival rate for them.