摘要
目的探讨原发性肝细胞肝癌破裂出血手术治疗的临床特点、影响以及预后的相关因素。方法回顾性分析90例原发性肝细胞肝癌破裂出血患者临床资料,入选者均实施手术治疗,术后随访2年,根据患者生存情况分为预后良好组与预后不良组,统计两组相关资料,分析影响原发性肝细胞肝癌破裂出血手术治疗预后的相关因素。结果随访2年,90例原发性肝细胞肝癌破裂出血患者中,有30例预后不良,占比为33.33%(30/90),预后不良组肿瘤直径>5 cm、手术时间>3 h、侵犯血管、合并肝硬化、术前AFP>400μg/l、术后未行预防性TACE治疗占比均高于预后良好组,差异有统计学意义(P<0.05);两组性别、年龄、肿瘤数量、手术方式、肝功能分级等对比,差异无统计学意义(P>0.05);Logistic回归分析:肿瘤直径>5 cm、手术时间>3 h、侵犯血管、合并肝硬化、术前AFP>400μg/l、术后未行预防性TACE治疗是原发性肝细胞肝癌破裂出血手术预后不良的独立危险因素(P<0.05且OR≥1)。结论原发性肝细胞肝癌破裂出血患者采用手术治疗切实可行,可获得长期甚至无瘤生存状态,术前准确评估、合理选择术式、控制手术时间、加强术后治疗能够改善患者预后,提高生存率。
Objective To investigate the clinical features,influence and prognostic factors of surgical treatment of primary hepatocellular carcinoma with ruptured hemorrhage.Methods The clinical data of 90 patients with primary hepatocellular carcinoma were retrospectively analyzed,All the candidates underwent surgical treatment,Follow up for 2 years,According to the survival of the patients,they were divided into good prognosis group and poor prognosis group,Statistics of the 2 groups were conducted,analyzed the prognostic factors of primary hepatocellular carcinoma with rupture and hemorrhage.Results 2 years follow-up,of the 90 patients with primary hepatocellular carcinoma,30 cases had poor prognosis,33.33%(30/90),The tumor diameter>5 cm,operation time>3 h,invasion of blood vessels,liver cirrhosis,400 preoperative AFP>,no preventive TACE treatment after operation in poor prognosis group were higher than those in the good prognosis group,the difference was statistically significant(P<0.05);Gender,age,tumor number,operation mode,liver function grade of the 2 groups had no statistically significant difference(P>0.05);Logistic regression analysis showed that tumor diameter>5 cm,operation time>3.invasion of blood vessels,complicated with cirrhosis,preoperative AFP>400μg/L,no prophylactic TACE treatment after operation were independent risk factor for poor prognosis in primary hepatocellular carcinoma with ruptured surgery(PAFP>0.05 and ORPAFP>1).Conclusion It is feasible for patients with primary hepatocellular carcinoma with ruptured hemorrhage to obtain long-term or even tumor-free survival.Accurate preoperative evaluation,reasonable choice of operation,control of operation time and strengthening of postoperative treatment can improve the prognosis and survival rate.
作者
马欣
梅展展
王光霞
MA Xin;MEI Zhanzhan;WANG Guangxia(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)
出处
《实用癌症杂志》
2021年第10期1663-1665,1689,共4页
The Practical Journal of Cancer
基金
河南省医学科技攻关项目(编号:LHGJ20191066)。
关键词
原发性肝细胞
肝癌破裂出血手术
临床特点
预后因素
Primary hepatocytes
Operation of ruptured and bleeding liver cancer
Clinical features
Prognostic factors
