肝切除及肝动脉化疗栓塞治疗原发性肝癌

作者收集３００例原发性肝癌外科治疗,其中切除１０６例,肝动脉化疗栓塞（ＨＡＣＥ）１９４例,ＨＡＣＥ后二期切除２３例。肝癌患者Ｂ型肝炎带病毒率６９．８％,合并肝硬变８１．６％。临床资料研究显示,肝切除疗效优于ＨＡＣＥ,ＨＡＣＥ后早期局部复发的主要原因是坏死肿瘤周边有癌细胞残留。高供血型肝癌行ＨＡＣＥ有效,低供血型肝癌ＨＡＣＥ效果差。肝癌合并肝硬变时肝切除量的估计,主要依据术前５项生化指标（胆红素、谷丙转氨酶、白蛋白、凝血酶原时间和吲哚氰绿１５分钟潴留率）及术中观察肝脏形态学改变（早、中、晚期肝硬变）来综合判断。

Hepatic resection and hepatic arterial chemoembolization for primary liver carcinoma

Three hundreds of primary liver carcinoma (PLC)were subjected to hepatic resection and hepatic chemoembolization (HACE).Among them,hepatic resetion was performed in 106 cases,and HACE in 194.The two stage operation after HACE was performed in 23 cases.Hepatitis B antigen was positive in 69.8%.PLC with cirrhosis accounted for 81.6%.The effect of hepatic resection was superior to HACE.The cause of early local recurrence after HACE can be a valuable therapy in the hepervascular PLC.However,HACE should be unsuitable for ischemic PLC.Quantitative estimation of hepatic resection of PLC with cirrhosis was dependent on 5 parameters (ALT,serum bilirubin,PT and R15TCG),and morphological changes of cirrhotic liver.