原发性肝癌自发性破裂的诊断和治疗

1,5100602,(),,,,:2001-01-1912,27,6,66.6%(4ö6)21,,+,25.0%(1ö4),44.4%(4ö9),75.0%(6ö8),;;;;R735.7A100624761(2001)0520359203DIAGNOSISANDTREATMENTOFSPONTANEOUSLYRUPTUREDHEPATOCELLULARCARCINOMAZhuWeiqun,TangXianhuai.DepartmentofHepatobiliarySurgery,GuangzhouEighthPeople’sHospital,Guangzhou510060AbstractObjectiveTosummarizetheexperienceinthediagnosisandtreatmentofspontaneousruptureofprimaryhepatocellularcarcinoma,especiallyconservativetreatment.MethodsWeretrospectivelyreviewed27patientswithspontan2eouslyrupturedhepatocellularcarcinomafrom1990to1998.Someproblemsaboutmethodsoftreatmentwerediscussed.Res-ultsInthe27patients,sixofthemunderwentconservativetreatment,thehospitalmortalityratewas66.6%(4ö6).Twenty2oneofthemwereachievedbyhepatectomy,hepaticarterialligation,packingandsuturing,thehospitalmortalityratewere25.0%(1ö4),44.4%(4ö9),,75.0%(6ö8)respectively.ConclusionHepatectomyforspontaneousruptureofprimaryhepatocel2lularcarcinomaissafe,feasibleandeffective.Conservativetreatmentforselectedpatientswithrupturedhepatocellularcarci2nomaisnecessarytostudyfurther.KeywordsCarcinoma;Hepatocellular;Rupture;Diagnosis;Surgerytreatment;Conservativetreatment,19902219981227127,24;3,12121268,45.1,;:2518,2TAE23418(10kPa,P100ömin)24(+)27B12CT(1)1n(%)518.01140.0725.9414.81866.62488.82592.5:621227(2)(BCT);95320011095JournalofHepatobiliarySurgery,Vol.9,No.5,Oct.20012(%)4ö6(66.6)311ö4(25.0)1+4ö9(44.4)136ö8(75.0)42:,2.165:;;31,11,31,,vWF,2.2214,19,1,18,,18.12cm,4,235.4%14.5%[1],,,,3.1,,,,:,,,(+),:BCT,,,,,,,,BCT,,3.2,,[2][3],,,,90%[4],,,[5]:,,,,+,,:,,3.3,Chearani[4]26,84%(22ö36)[5]3153%(7ö31)666%(4ö6):,,,,,(1)(2)06320011095JournalofHepatobiliarySurgery,Vol.9,No.5,Oct.2001,(3),,,,,,(4)(delayedhepaticresection)(stagedhepatectomy),,,TAE,[6]1,3,:1YamagataM,MaedaT,IkedaY,etal.Surgicalresultsofsponta2neouslyrupturedhepatocellularcarcinoma.Hepatogastro2enterology,1995,42:4612463.2ChenMF,HwangTL,JengLB,etal.Clinicalexperiencewithresectionforrupturedhepatocellularcarceinoma.Hepatogastro2enlerology,1995,42:1662168.3,,..,1998,14(1):57258.4ChearanaiO,PlengvanitU,AsnichC,etal.Spontaneousruptureofprimaryhepatoma.Cancer,1983,15:154321536.5,,..,1999,5:(1):47248.6ShutoT,HirohashiK,KuboS,etal.Delayedhepaticresectionforrupturedhepatocellularcarcinoma.Surgery,1998,124(1):33237.()1,6350002636000(1955-),(),,,2000-11-23112R657.3E100624761(2001)0520361201,,53,2,3,,,,,,,,,5.1109öL,3.61012öL,110göL,3%;,488IUöL,31.7göL,1.2,AFP;B;CT:,,,,,,,,,11000ml,,,10%3%,500mlöd,,15d,(Casoni):,,,,,2050,11000ml,,CT,,4%,,Casoni,,,,B,,,,,Y()16320011095JournalofHepatobiliarySurgery,Vol.9,No.5,Oct.2001