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目的:探讨非休克型肝癌自发性破裂出血术后接受肝动脉栓塞术(TAE)治疗的远期效果。方法:收集162例非休克型肝癌自发性破裂出血并接受手术治疗患者的临床病理资料和随访资料,对影响预后的相关因素行单因素和多因素分析,并根据术后是否接受TAE治疗分为两组,用Kaplan-Meier法比较两组生存差异。结果:单因素分析表明,对于非休克型肝癌自发性破裂出血的患者,肿瘤直径(P=0.008)、肝硬化(P=0.03)、肿瘤位置(P=0.028)以及治疗方法(P=0.012)与预后有关。多因素分析提示,肿瘤直径(HR=1.954,95%CI=1.691~5.526,P=0.007),肝硬化(HR=1.544,95%CI=1.003~2.000,P=0.041),肿瘤位置(HR=1.785,95%CI=1.023~3.114,P=0.026),治疗方法(HR=1.692,95%CI=1.131~2.533,P=0.011)是影响非休克型肝癌自发性破裂出血患者预后的独立危险因素。生存分析表明术后接受TAE治疗者预后较单纯手术者好(P<0.001)。结论:术后接受TAE治疗可改善非休克型肝癌自发性破裂出血患者的预后。
Objective: To investigate the long-term effect of transcatheter arterial embolization (TAE) after spontaneous rupture of non-shock liver cancer. Methods: The clinical and pathological data and follow-up data of 162 non-HCC patients with spontaneous rupture of liver cancer were collected. Univariate and multivariate analysis were performed on the factors influencing the prognosis of patients with hepatocellular carcinoma. According to whether they were treated with TAE or not, The two groups were compared by Kaplan-Meier survival differences. Results: Univariate analysis showed that tumor diameter (P = 0.008), cirrhosis (P = 0.03), tumor location (P = 0.028) and treatment (P = 0.012) were significantly higher in patients with spontaneous rupture of non- And the prognosis. Multivariate analysis showed that tumor diameter (HR = 1.954, 95% CI = 1.691-5.526, P = 0.007), cirrhosis (HR = 1.544,95% CI = 1.003-2.00, P = 0.041) (HR = 1.692, 95% CI = 1.131-2.533, P = 0.011) was an independent risk factor for the prognosis of patients with spontaneous rupture of hepatocellular carcinoma after non-shock hepatocellular carcinoma (HCC, 1.785,95% CI = 1.023-3.11 4, P = 0.026) . Survival analysis showed that the prognosis of patients receiving TAE after surgery was better than that of surgery alone (P <0.001). Conclusion: The postoperative TAE treatment can improve the prognosis of patients with spontaneous rupture of non-shock liver cancer.