原发性肝癌破裂出血的治疗现状
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尹大龙, 曲志博, 刘连新, 姜洪池
肝癌;破裂;出血;治疗,尹大龙,曲志博,刘连新,姜洪池,通讯作者:,电话:,收稿日期:,接受日期:,Currentstatusontreatmentforspontaneousruptureofprimaryhepatocellularcarcinoma,Da
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尹大龙, 曲志博, 刘连新, 姜洪池, 哈尔滨医科大学第一临床医学院普外科 黑龙江省哈尔滨市 150001
通讯作者: 刘连新, 150001, 黑龙江省哈尔滨市, 哈尔滨医科大学第一临床医学院普外科六病房. liulianxin@medmail.com.cn
电话: 0451-53658828
收稿日期: 2006-11-15 接受日期: 2007-01-04
Current status on treatment for spontaneous rupture of primary hepatocellular carcinoma
Da-Long Yin, Zhi-Bo Qu, Lian-Xin Liu, Hong-Chi Jiang
Da-Long Yin, Zhi-Bo Qu, Lian-Xin Liu, Hong-Chi Jiang,Department of General Surgery, the First Clinical College of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Correspondence to:Lian-Xin Liu, The Sixth Department of General Surgery, the First Clinical College of Harbin Medical University, Harbin 150001, Heilongjiang Province, China. liulianxin@medmail.com.cn
Received:2006-11-15 Accepted:2007-01-04
AbstractThe rupture of tumor with intraperitoneal hemorrhage is one of the life-threatening complications of primary hepatocellular carcinoma (HCC). It is relatively intractable to deal with this syndrome which occurs urgently with high mortality rate and risk of rebleeding during the process of clinical management. Before the 1980s, the treatment of hepatocellular carcinoma rupture is mainly focused on the field of the conservative therapy and surgical methods. As the interventional therapy develops, transarterial embolization (TAE) has become an effective way in controlling bleeding from ruptured hepatocellular carcinoma in acute phase. In recent years, some overseas scholars have successfully cured ruptured hepatocellular carcinoma through radiofrequency ablation (RFA) and bio-immunotherapy. In this paper, we summarized the treatments for the spontaneous rupture of primary hepatocellular carcinoma.
Key Words: Hepatocellular carcinoma; Rupture; Hemorrhage; Treatment
Yin DL, Qu ZB, Liu LX, Jiang HC. Current status on treatment for spontaneous rupture of primary hepatocellular carcinoma. Shijie Huaren Xiaohua Zazhi 2007;15(6):601-605
摘要肝癌破裂出血是原发性肝癌严重的并发症之一, 其发病急, 病死率及再出血率高, 临床治疗较为棘手. 1980年以前对肝癌破裂出血的治疗主要集中在保守方法和手术治疗. 随着介入技术的发展, 肝动脉栓塞术(TAE)成为急性期止血的有效方法. 近年有国外学者通过射频消融及生物免疫疗法等技术成功的治疗了肝癌破裂出血. 本文即对原发性肝癌自发性破裂出血的治疗作一综述.
关键词: 肝癌; 破裂; 出血; 治疗
尹大龙, 曲志博, 刘连新, 姜洪池. 原发性肝癌破裂出血的治疗现状. 世界华人消化杂志 2007;15(6):601-605
0 引言
原发性肝癌是我国常见的恶性肿瘤之一, 而肝癌破裂出血是原发性肝癌严重的并发症, 其发生率约为3%-15%[1]. 由于其发病急, 病死率高, 占肝癌死亡原因的9%-10%[2]; 且其再出血率高达43%[3], 而且患者出血后可导致肿瘤腹腔广泛转移[4-7], 预后差, 因此原发性肝癌破裂出血的治疗仍是目前临床工作中较为棘手的难题. 以往对肝癌破裂出血的治疗主要集中在保守方法和手术治疗, 随着介入技术的发展, 肝动脉栓塞术(transcatheter arterial embolization, TAE)已成为治疗肝癌破裂出血的有效方法之一. 近年来, 国外有学者通过射频消融及生物免疫疗法等技术成功的治疗了肝癌破裂出血. 我们对原发性肝癌自发性破裂出血的治疗作一综述, 以期对临床工作有一定的借鉴作用.
1 原发性肝癌破裂出血的病因及诊断原发性肝癌自发性破裂出血可发生于肿瘤早期, 也可发生于晚期[8]. 多见于结节型和块状型, 弥漫型肝癌少见[9]. 其机制可能与以下多种因素有关[10-13]: (1)肝癌在生长过程中由于膨胀生长, 瘤内压力高, 压迫回流静脉, 使瘤内瘀血; (2)肿瘤生长迅速, 瘤体内供血不足, 出现缺血缺氧或坏死; (3)肿瘤直接侵蚀血管出血; (4)肿瘤破溃或液化后合并感染; (5)肿瘤位置表浅, 包膜脆而薄弱; (6)肝功不良凝血因子缺乏导致凝血障°; (7)弹性蛋白及胶原质表达异常导致血管功能障°; (8)与肝硬化及门脉高压有一定的关系 ......
尹大龙, 曲志博, 刘连新, 姜洪池, 哈尔滨医科大学第一临床医学院普外科 黑龙江省哈尔滨市 150001
通讯作者: 刘连新, 150001, 黑龙江省哈尔滨市, 哈尔滨医科大学第一临床医学院普外科六病房. liulianxin@medmail.com.cn
电话: 0451-53658828
收稿日期: 2006-11-15 接受日期: 2007-01-04
Current status on treatment for spontaneous rupture of primary hepatocellular carcinoma
Da-Long Yin, Zhi-Bo Qu, Lian-Xin Liu, Hong-Chi Jiang
Da-Long Yin, Zhi-Bo Qu, Lian-Xin Liu, Hong-Chi Jiang,Department of General Surgery, the First Clinical College of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Correspondence to:Lian-Xin Liu, The Sixth Department of General Surgery, the First Clinical College of Harbin Medical University, Harbin 150001, Heilongjiang Province, China. liulianxin@medmail.com.cn
Received:2006-11-15 Accepted:2007-01-04
AbstractThe rupture of tumor with intraperitoneal hemorrhage is one of the life-threatening complications of primary hepatocellular carcinoma (HCC). It is relatively intractable to deal with this syndrome which occurs urgently with high mortality rate and risk of rebleeding during the process of clinical management. Before the 1980s, the treatment of hepatocellular carcinoma rupture is mainly focused on the field of the conservative therapy and surgical methods. As the interventional therapy develops, transarterial embolization (TAE) has become an effective way in controlling bleeding from ruptured hepatocellular carcinoma in acute phase. In recent years, some overseas scholars have successfully cured ruptured hepatocellular carcinoma through radiofrequency ablation (RFA) and bio-immunotherapy. In this paper, we summarized the treatments for the spontaneous rupture of primary hepatocellular carcinoma.
Key Words: Hepatocellular carcinoma; Rupture; Hemorrhage; Treatment
Yin DL, Qu ZB, Liu LX, Jiang HC. Current status on treatment for spontaneous rupture of primary hepatocellular carcinoma. Shijie Huaren Xiaohua Zazhi 2007;15(6):601-605
摘要肝癌破裂出血是原发性肝癌严重的并发症之一, 其发病急, 病死率及再出血率高, 临床治疗较为棘手. 1980年以前对肝癌破裂出血的治疗主要集中在保守方法和手术治疗. 随着介入技术的发展, 肝动脉栓塞术(TAE)成为急性期止血的有效方法. 近年有国外学者通过射频消融及生物免疫疗法等技术成功的治疗了肝癌破裂出血. 本文即对原发性肝癌自发性破裂出血的治疗作一综述.
关键词: 肝癌; 破裂; 出血; 治疗
尹大龙, 曲志博, 刘连新, 姜洪池. 原发性肝癌破裂出血的治疗现状. 世界华人消化杂志 2007;15(6):601-605
0 引言
原发性肝癌是我国常见的恶性肿瘤之一, 而肝癌破裂出血是原发性肝癌严重的并发症, 其发生率约为3%-15%[1]. 由于其发病急, 病死率高, 占肝癌死亡原因的9%-10%[2]; 且其再出血率高达43%[3], 而且患者出血后可导致肿瘤腹腔广泛转移[4-7], 预后差, 因此原发性肝癌破裂出血的治疗仍是目前临床工作中较为棘手的难题. 以往对肝癌破裂出血的治疗主要集中在保守方法和手术治疗, 随着介入技术的发展, 肝动脉栓塞术(transcatheter arterial embolization, TAE)已成为治疗肝癌破裂出血的有效方法之一. 近年来, 国外有学者通过射频消融及生物免疫疗法等技术成功的治疗了肝癌破裂出血. 我们对原发性肝癌自发性破裂出血的治疗作一综述, 以期对临床工作有一定的借鉴作用.
1 原发性肝癌破裂出血的病因及诊断原发性肝癌自发性破裂出血可发生于肿瘤早期, 也可发生于晚期[8]. 多见于结节型和块状型, 弥漫型肝癌少见[9]. 其机制可能与以下多种因素有关[10-13]: (1)肝癌在生长过程中由于膨胀生长, 瘤内压力高, 压迫回流静脉, 使瘤内瘀血; (2)肿瘤生长迅速, 瘤体内供血不足, 出现缺血缺氧或坏死; (3)肿瘤直接侵蚀血管出血; (4)肿瘤破溃或液化后合并感染; (5)肿瘤位置表浅, 包膜脆而薄弱; (6)肝功不良凝血因子缺乏导致凝血障°; (7)弹性蛋白及胶原质表达异常导致血管功能障°; (8)与肝硬化及门脉高压有一定的关系 ......
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