104例肝癌破裂出血治疗结果分析

目的：探讨肝癌破裂出血的临床处理。方法回顾性分析2001年1月至2014年12月在西南医科大学附属医院接受治疗的104例临床资料。结果小肝癌（＜5 cm ）11例，大肝癌（＞5 cm ）93例。手术切除治疗31例，介入方式止血44例，5例因肝衰竭死亡；非手术治疗29例，11例死亡，18例放弃医治出院。随访22例中小肝癌破裂出血手术切除肿瘤者，术后生存1～10年；8例巨大肝癌破裂出血者术后生存5～13个月；局部填压止血＋肝动脉结扎1例巨大肝癌破裂，术后34 d死于肿瘤再次破裂。介入治疗16例获得随访，14例生存3～10个月，2例分别生存3、5年。非手术治疗组未获随访。结论肝癌破裂出血局部及全身情况允许，应力争外科切除肿瘤，条件不具备则可介入方法治疗。

An analyses of 104 cases spontaneous rupture of hepatocellular carcinoma

Objective To investigate the clinical management of Spontaneous rupture of hepatocellular carcinoma(SRHCC) . Methods This was a retrospective review of the clinical data of patients with SRHCC who underwent treated in the affiliate hospi‐tal of Luzhou medical college from January 2001 to December 2014 .Results Among 104 patients ,small hepatocellular carcinoma (<5 cm) were found in 11 cases ,and large hepatocellular carcinoma(>5 cm) in 93 cases .Thirty‐one cases which underwent surgi‐cal treatment ,were cured;44 underwent transcatheter arterial embolization (TAE) ,5 cases died of liver function failure;29 cases were treated conservatively ,11 cases died of huge bleeding ,18 cases gave up discharged .Twenty‐two small and medium‐sized SRH‐CC cases underwent hepatectomy survived 1to‐10 years ;8 huge sized SRHCC cases survived 5to‐13 months;one case who under‐went partial filling pressure hemostasis and hepatic artery ligation ,but died of tumor rupture again after 34 days .Sixteen cases un‐derwent TAE were followed up ,14 cases survived 3to‐10 moths ,the survival time of two cases were 3 years and 5 years ,respective‐ly .Conservative treatment group has not been followed up .Conclusion The tumours should be surgical resection as soon as possi‐ble in those whose lesions confined to the liver and may be removed ,systemic condition is good;TAE should be used for other pa‐tients .