急诊与延期肝切除对可切除性肝癌破裂出血患者腹腔转移的影响
发布时间：2018-07-14 10:36
【摘要】：目的评价急诊与延期肝切除手术治疗可切除性原发性肝细胞癌(HCC)破裂出血的疗效,并分析手术时机对肝癌术后腹腔转移的影响。方法回顾性分析我院2011年8月至2016年1月收治的38例HCC破裂出血且行肝切除患者的临床资料,将入院后24小时内手术者归为急诊组,1周后手术者归为延期组,比较两组患者围手术期情况、术后生存率、无瘤生存率及复发转移率。结果急诊组术中出血量及输血量均多于延期组(均P0.05),住院期间死亡率差异无统计学意义(6%vs 0%,P0.05)。急诊组及延期组患者术后中位生存时间分别为22.5个月和14.2个月。急诊组术后半年、1年、3年总体生存率分别为88.2%、82.4%、30.3%,无瘤生存率分别为81.3%、54.7%、27.3%,1年生存率及半年无瘤生存率均高于延期组(均P0.05)。延期组术后腹腔转移率高于急诊组,但差异无统计学意义(38.1%vs 29.4%,P0.05)。单因素及多因素分析显示肿瘤直径≥10cm及AFP10000ug/L是肝癌破裂出血患者发生腹腔转移的危险因素。结论急诊肝切除术后患者短期预后优于延期组。延期肝切除不增加肝癌破裂出血患者腹腔种植转移的发生率。肿瘤直径≥10cm、AFP10000ug/L是肝癌破裂出血患者发生腹腔种植转移的危险因素。
[Abstract]:Objective to evaluate the efficacy of emergency and delayed hepatectomy in the treatment of ruptured hemorrhage in resectable primary hepatocellular carcinoma (HCC) and to analyze the influence of operative timing on postoperative peritoneal metastasis of HCC. Methods the clinical data of 38 patients with rupture and hemorrhage of HCC treated in our hospital from August 2011 to January 2016 were retrospectively analyzed. The patients who had been operated within 24 hours after admission were classified as the emergency group and the group with delayed operation after one week. The perioperative period, postoperative survival rate, tumor free survival rate and recurrence and metastasis rate were compared between the two groups. Results the amount of intraoperative bleeding and blood transfusion in emergency group was higher than that in delayed group (P0.05), and there was no significant difference in mortality during hospitalization (P0.05). The median survival time was 22.5 months in emergency group and 14.2 months in delayed group. In the emergency group, the overall survival rate for half a year, one year and three years after operation was 88.2or 82.4, respectively, and the tumor-free survival rate was 81.34.727.33.The 1-year survival rate and the half-year tumor-free survival rate were higher than those in the delay group (P0.05). The rate of abdominal metastasis in delayed group was higher than that in emergency group, but there was no significant difference (38.1%vs 29.4% P 0.05). Univariate and multivariate analysis showed that tumor diameter 鈮，
本文编号：2121375
[Abstract]:Objective to evaluate the efficacy of emergency and delayed hepatectomy in the treatment of ruptured hemorrhage in resectable primary hepatocellular carcinoma (HCC) and to analyze the influence of operative timing on postoperative peritoneal metastasis of HCC. Methods the clinical data of 38 patients with rupture and hemorrhage of HCC treated in our hospital from August 2011 to January 2016 were retrospectively analyzed. The patients who had been operated within 24 hours after admission were classified as the emergency group and the group with delayed operation after one week. The perioperative period, postoperative survival rate, tumor free survival rate and recurrence and metastasis rate were compared between the two groups. Results the amount of intraoperative bleeding and blood transfusion in emergency group was higher than that in delayed group (P0.05), and there was no significant difference in mortality during hospitalization (P0.05). The median survival time was 22.5 months in emergency group and 14.2 months in delayed group. In the emergency group, the overall survival rate for half a year, one year and three years after operation was 88.2or 82.4, respectively, and the tumor-free survival rate was 81.34.727.33.The 1-year survival rate and the half-year tumor-free survival rate were higher than those in the delay group (P0.05). The rate of abdominal metastasis in delayed group was higher than that in emergency group, but there was no significant difference (38.1%vs 29.4% P 0.05). Univariate and multivariate analysis showed that tumor diameter 鈮，
本文编号：2121375
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