急诊肝切除治疗原发性肝癌破裂的预后分析

发布时间：2018-03-11 00:37

本文选题：肝肿瘤　切入点：破裂　出处：《中国普通外科杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的:探讨急诊肝切除治疗原发性肝癌破裂出血的临床效果。方法:回顾性分析2005年1月 2014年12月间57例肝癌破裂出血患者行急诊肝切除手术的临床资料。结果:所有患者顺利实施急诊手术治疗,住院病死率为10.5%。其1、3、5年总体生存率与无瘤生存率分别为77.6%、51.0%、32.7%与69.4%、40.8%、18.4%,中位生存时间为38.7个月。获得随访的49例患者中38例出现复发转移,其中肝内复发18例(47.4%),肝外转移20例(52.6%)。多因素分析显示瘤体10 cm(HR=2.43,P=0.031)和多发肿瘤结节(HR=0.46,P=0.028)是患者术后生存的独立影响因素。结论:经合理的选择,对可切除的肝癌破裂出血患者实施急诊肝切除手术治疗是挽救生命、获得良好远期疗效的一种治疗方式。
[Abstract]:Objective: to investigate the clinical effect of emergency hepatectomy in the treatment of rupture hemorrhage of primary liver cancer. Methods: the clinical data of 57 patients with rupture hemorrhage of liver cancer from January 2005 to December 2014 were analyzed retrospectively. Outcome: all patients were successfully treated with emergency surgery, The overall survival rate and tumor-free survival rate were 77.6% and 69.4%, respectively, and the median survival time was 38.7 months. 38 of the 49 patients followed up showed recurrence and metastasis. Among them, 18 cases of intrahepatic recurrence and 20 cases of extrahepatic metastasis were found to be independent factors of survival after operation. Multivariate analysis showed that the tumor was 10 cm / L HR2. 43 / P (0.031) and multiple tumor nodules were HR0. 46% P0. 028). Emergency hepatectomy for patients with ruptured hemorrhage of liver cancer is a method to save lives and obtain good long-term results.
【作者单位】：中南大学湘雅医院老年外科;中南大学湘雅医院普通外科;
【基金】：湖南省自然科学基金资助项目(13JJ3014)
【分类号】：R735.7

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