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目的:探讨外科手术治疗肝癌自发性破裂出血的效果。方法:56 例肝细胞性肝癌( 肝癌)自发性破裂出血患者,其中6 例行填塞术,13 例行单纯缝合术,8 例行肝固有动脉或选择性肝动脉结扎术,18 例行肝动脉化学栓塞术,11 例行肝切除术。结果:1) 手术止血率: 平均为93 .0% (52/56) ,其中填塞术为66.7 % (4/6) ,缝合术为84 .6% (11/13) ,肝动脉结扎术为100 % (8/8) ,肝动脉化学栓塞术为94 .6 % (17/18) ,肝切除术为100 % (11/11) ;2)1 年生存率:平均为26 .8% (15/56) ,填塞术为0(0/6) ,缝合术为15.4% (2/13) ,肝动脉结扎术为12.5 % (1/8) ,肝动脉化学栓塞术为22.2% (4/18) ,肝切除术为72 .7% (8/11) ;3) 平均住院死亡率为10 .7 % 。结论:手术仍是肝癌自发破裂的有效治疗手段,应根据患者的具体情况择不同的手术术式。
Objective: To investigate the effect of surgical treatment of spontaneous rupture of hepatocellular carcinoma. Methods: Fifty-six patients with hepatocellular carcinoma (hepatoma) spontaneous ruptured hemorrhage, 6 of whom underwent tamponade, 13 underwent suture alone, 8 underwent hepatic artery or selective hepatic artery ligation, and 18 underwent hepatic artery Chemoembolization, 11 routine liver resections. RESULTS: 1) The rate of surgical hemostasis: an average of 93.0% (52/56), of which 66.7 % (4/6) was tamponade, 84.6% (11/13) of sutures, and hepatic artery ligation was 100% (8/8), hepatic artery embolization was 94.6% (17/18), hepatectomy was 100% (11/11), and 2) 1-year survival rate: an average of 26.8% ( 15/56), tamponade was 0 (0/6), suture was 15.4% (2/13), hepatic artery ligation was 12.5% (1/8), and hepatic artery chemoembolization was 22.2% (4/ 18) Hepatectomy was 72.7% (8/11); 3) The average in-hospital mortality was 10.7%. Conclusion: Surgery is still an effective treatment for spontaneous rupture of liver cancer. Different surgical procedures should be selected according to the specific conditions of the patient.