原发性肝癌介入治疗后并发急性上消化道出血的原因及处理

目的 探讨原发性肝癌介入治疗后并发急性上消化道大出血的原因及其处理方法。方法 原发性肝癌258例经股动脉插管至肝固有动脉，注入化疗药及碘油（10～30mL）混悬剂。结果 27例介入治疗后出现上消化道出血，经降低门静脉压等治疗，19例出血停止，8例死亡。结论 碘油逆流入门静脉引起门静脉压升高和加重原有门静脉高压是出血的主要原因，降低门静脉压是治疗该症的有效方法。

Cause and management of acute hemorrhage of upper digestive tract after chemoembolization for primary hepatitic carcinoma (PHC)

Objective] To evaluate the cause of acute hemorrhage of upper digestive tract after chemo-embolization for PHC. Methods] 27 cases were encountered from 258 cases of PHC treated by chemo-embolization, including 21 males and 6 females. They were performed catheterization through femoral artery to proper hepatic artery 10-30 mL of a mixture of chemical agent and lipiodol was injected. Resutls] Acute hemorrhage of supper digestive tract occurred within 12 hours after interrentional therapy. Bleeding was controlled in 19 cases after reducing of portal hypertension and mechanical tamponade but 8 patients died. Conclusion] Portal hypertension caused by reflux of lipidoe to portal vein is considered the main cause of acute hemorrhage of upper digestive tract after chem-embolization for PHC. Reduction of the portal hypertension is an effective method to control the acute hemorrhage.