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目的探讨原发性肝癌自发性破裂大出血介入治疗的临床疗效及安全性。方法回顾性分析2005年4月至2010年4月收治的71例原发性肝癌自发性破裂大出血患者的临床资料,按照其治疗方式进行分组,介入组患者48例,手术组患者23例,比较两组患者的临床疗效及安全性。结果两组患者腹腔积血、止血成功率差异无统计学意义(P>0.05),介入组患者治疗过程中出血及接受输血量显著低于手术组患者(P<0.05)。介入组患者并发症发生率为8.3%(4/48),手术组患者并发症发生率为65.2%(15/23),介入组患者并发症发生率显著低于手术组。两组患者1年生存率差异无统计学意义(P>0.05),介入组患者2年、3年生存率均显著高于手术组,差异有统计学意义(P<0.05)。结论介入治疗可达到有效的控制出血、预防再出血作用,同时,该方法能够有效保证患者的生存率,安全性良好,在今后急诊治疗时应将介入治疗作为首选方案,以改善患者的预后。
Objective To investigate the clinical efficacy and safety of interventional therapy for spontaneous rupture of primary liver cancer. Methods The clinical data of 71 patients with spontaneous rupture of hepatocellular carcinoma who were admitted to our hospital from April 2005 to April 2010 were retrospectively analyzed. According to their treatment, 48 patients were involved in the intervention group and 23 patients in the operation group were compared. Clinical efficacy and safety of two groups of patients. Results There was no significant difference in the success rate of hematocele and hemostasis between the two groups (P> 0.05). The bleeding volume and blood transfusion in the intervention group were significantly lower than those in the operation group (P <0.05). The intervention group had a complication rate of 8.3% (4/48), the incidence of complications in the surgery group was 65.2% (15/23), and the incidence of complications in the intervention group was significantly lower than that in the surgery group. There was no significant difference in 1-year survival rate between the two groups (P> 0.05). The 2-year and 3-year survival rates of the intervention group were significantly higher than those of the operation group (P <0.05). Conclusion Interventional therapy can effectively control bleeding and prevent hemorrhage. At the same time, this method can effectively ensure the survival rate and safety of patients. In the future, interventional therapy should be the first choice to improve the prognosis of patients.