摘要
目的 探讨原发性肝癌手术切除及 TACE术后并发胆囊炎胆囊结石的成因。方法 对原发性肝癌行手术切除及 TACE治疗 80 0例患者并发胆囊炎胆囊结石 193例的随访结果进行分析。结果 发病原因是多因素综合作用的结果。包括术前存在易患因素、机械因素、胆囊血液灌注不足、胆囊排空障碍、内源性凝血因子激活、细菌感染及化疗药物。其导致胆囊收缩功能减弱、胆汁淤滞、胆汁成份改变而引起胆囊炎症、胆囊结石形成。结论 1围手术期及行 TACE前后加强保肝治疗 ,减少肝功能损伤。 2术中避免过分牵拉胆囊及缩短肝门阻断时间 ,TACE治疗过程中 ,导管超选到位是避免胆囊炎发生的关键 ,同时 ,注意灌注药物的浓度、速度、防止药物和栓塞物返流也很重要。 3必要时行预防性胆囊切除。 4术后常规复查胆囊 ,若有炎症形成 ,及时治疗。
Objective To study the factors in primary live cancer complicated with cholecystitis or cholecystolityiasis after hepatectomy and TACE.Methods A retrospective analysis was made in the 193 cases with cholecystitis or cholecystolithiasis in 800 patients after hepatectomy or TACE.Results It was concluded that multiple factors participated in this process,including easy-taken reason,mechanic reason,insufficiency blood supply of gallbladder,dynamical disorder,activation of intrinsic coagulation factors,bacterial infections,drugs of chemiotherapy.Depressed function of choecyst constriction,cholestasis,changes of bile components resulted in the inflammation of cholecyst and the formation of gallstone.Conclusion (1) Reinforce the treatment in perioperative and between TACE to ensure liver,reduce the injure of liver function.(2) Do not pull the gallbladder excessively and shorten the time of portal hepatis occlusion between opetation,super-choice is key in TACE.(3) If necessarily,a preventive cholecystectomy should be made.(4) After operation,gallbladder should be checked routinely and treated whenever disorder occurres.
出处
《肝胆外科杂志》
2001年第4期293-295,共3页
Journal of Hepatobiliary Surgery
关键词
原发性肝癌
胆囊炎
胆囊结石
Primary hepatocellular carcinoma
Cholecystitis of cholecystolithiasis
