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[目的]探讨肝癌介入治疗后并发急性上消化道大出血的原因及防治措施。[方法]2512例肝癌患者采用Seldinger技术经股动脉穿刺,将导管插至肝固有动脉以远,一次性注入化疗药物及碘油混悬剂。[结果]12例于介入治疗后12h内出现上消化道大出血,经降门静脉压及止血等治疗后,10例出血停止,2例死亡。[结论]碘油逆流入门静脉引起门脉高压和(或)加重原有门静脉高压,导致食管下段胃底静脉破裂是出血的主要原因,降门静脉压是治疗的有效方法。
[Objective] To investigate the causes and prevention and treatment of acute upper gastrointestinal bleeding after hepatic cancer interventional therapy. [Methods] Totally 2512 patients with liver cancer were treated with femoral artery puncture using Seldinger technique. The catheter was inserted far beyond the hepatic artery and the chemotherapeutic drugs and lipiodol suspension were injected simultaneously. [Results] 12 cases of upper gastrointestinal bleeding within 12h after interventional treatment, the lower portal vein pressure and bleeding and other treatment, bleeding stopped in 10 cases, 2 patients died. [Conclusions] The main cause of bleeding is the rupture of the gastric fundus in the lower esophagus caused by the reflux of iodized oil into the portal vein and / or exacerbation of the original portal hypertension. The lowering of the portal vein pressure is an effective method of treatment.