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目的探讨原发性肝癌自发破裂出血的发生机制、临床特点及诊治原则。方法对35例原发性肝癌自发破裂出血患者行Ⅰ期手术切除,对临床资料进行回顾性分析。结果术后并发腹腔感染1例,胆漏1例,消化道出血2例,均经非手术治愈。本组无围手术期死亡病例。28例获得随访,18例生存1 a以上,10例术后6～10月死于肝功能衰竭。结论原发性肝癌自发破裂出血时,若无禁忌证,急诊行I期手术切除止血效果可靠,应作为首选治疗方法。
Objective To investigate the pathogenesis, clinical features, diagnosis and treatment of spontaneous rupture of primary liver cancer. Methods A total of 35 patients with primary hepatocellular carcinoma spontaneous rupture hemorrhage underwent stage Ⅰ surgical resection, the clinical data were retrospectively analyzed. Results One case of intra-abdominal infection, one case of bile leakage and two cases of gastrointestinal bleeding were cured by non-operation. This group no perioperative deaths. Twenty-eight patients were followed up, 18 patients survived for more than 1 year, and 10 patients died of liver failure from June to October. Conclusion Spontaneous rupture of primary hepatocellular carcinoma, without contraindications, I line emergency surgery to stop bleeding is reliable and should be used as the preferred method of treatment.