肝动脉化疗栓塞术后并发上消化道出血23例临床分析

目的　探讨肝动脉化疗栓塞 (TACE)后并发上消化道出血原因及治疗方法 ,并为预防出血提供依据。方法　回顾总结分析 2 3例TACE后短期内并发上消化道出血患者的临床资料。结果　出血患者多有肝功能严重损害 ;出血以食道胃底静脉曲张破裂为主 ,其次胃、十二指肠粘膜病变及胆道出血。 73 9%出血发生在TACE术后 15d之内 ,2 6 1%出血发生在术后 16～ 30d ;因出血死亡患者占 13 0 %。结论　及时预防及正确治疗对延长肝癌患者生命和提高生存质量有着重要意义。

Clinical Analysis of 23 Cases of Hemorrhage of Upper Digestive Tract Complicated after TACE

Objective To discuss the cause of hemorrhage of upper digestive tract complicated after TACE and the treatment,and to provide basis for prevention.Methods Retrospective clinical analysis was given to 23 cases of hemorrhage of upper digestive tract complicated shortly after TACE.Results Most the patients with hemorrhage suffered from severe hepatic function failure;the rupture of varicosity in esophague and fundus of stomach was the main cause of hemorrhage and then were the pathologic change of mucous membrane in stomach and duodenum,and hemorrhage of the bile duct.73.9% of the hemorrhage occurred within 15 days after TACE,26.1% of the hemorrhage occurred within 16 to 30 days after TACE;13.0% of the total patients died of hemorrhage.Conclusions Timely prevention and correct treatment are of great significance in extending the life time of patients with hepatic cancer and in promoting their living quality.