急诊肝切除治疗原发性肝癌自发性破裂

目的探讨急诊肝切除治疗原发性肝癌(PLC)自发性破裂的安全性和可行性。方法回顾性分析本院1995年1月至2002年12月肝切除治疗24例PLC自发性破裂患者的临床资料,比较急诊肝切除组(A组,n=14)和延期肝切除组(B组,n=10)的手术并发症发生率、围手术期病死率、中位生存期和1、3年生存率。结果A、B两组手术并发症发生率分别为35·7%和20·0%(P=0·653),围手术期病死率分别为7·1%和10·0%(P=1·000),中位生存期分别为18·0个月(CI7·0个月,29·0个月)和18·0个月(CI13·4个月,22·7个月),1年、3年生存率分别为78·6%、34·3%和70·0%、40·0%(P=0·588),差异均无统计学意义。结论只要严格掌握手术适应征,急诊肝切除治疗PLC自发性破裂是安全可行的,可作为治疗的优先选择。

Emergent hepatectomy for spontaneous rupture of primary liver carcinoma

Objective To evaluate the safety and feasibility of emergent hepatectomy for spontaneous rupture of primary liver carcinoma(PLC).Methods The clinical data of 24 patients with spontaneous rupture of PLC,who underwent hepatectomy from January 1995 to December 2002,were retrospectively reviewed.Patients were divided into two groups according to the time from admission to operation:the group of emergent hepatectomy(group A,n=14)and the group of delayed hepatectomy(group B,n=10).The operative complications,perioperative mortality,mean survival time,1-year and 3-year survival rates after operation between the two groups were compared.Results The operative complications rate was 35.7 vs.20.0(P=0.653),perioperative mortality 7.1 vs.10.0(P=1.000),mean survival time 18.0 months(CI 7.0 months,29.0 months)vs 18.0 months(CI 13.4 months,22.7 months),1-year and 3-year survival rates 78.6 and 34.3 vs.70.0 and 40.0(P=0.588)in group A and group B,respectively.Conclusion The emergent hepatectomy was safe and feasible for spontaneous rupture of PLC.