血色病性肝硬化肝癌病人的外科治疗

摘要

Objective A retrospective analysis was carried out in 3 cases of hepatocellular carcinoma (HCC) and liver cirrhosis associated with haemochromatosis in our hospital, to investigate the effect of surgery, radio frequency ablation (RFA) and erythroapheresis in such patients. Methods 8 operations including partial liver resection and ultrasound-guided percutaneous transhepatic RFA were performed in 3 male patients with HCC and liver cirrhosis arising from haemochromatosis.Capecitabine was used in 2 patients. Erythroapheresis was performed in all 3 patients. Result Pathological examination showed hepatocellular carcinoma and liver cirrhosis. Positive Prussian blue staining confirmed the diagnosis of haemochromatosis. The mean survival time of 3 patients was 86 months (from 39 to 154 months). Conclusion It is important to discover HCC in patients with haemochromatosis as early as possible. The curative therapy is liver transplantation and hepatic resection. For patients with recurrent HCC, the combined therapy including RFA, chemotherapy and erythroapheresis could prolong their survival.%目的 对卫生部北京医院3例血色病性肝硬化肝癌病人的外科治疗进行回顾性分析,探讨手术、射频消融、红细胞单采的治疗效果.方法 3例病人均为男性,术前诊断为血色病性肝硬化、肝癌.3例病人共进行8次外科治疗,包括手术切除、B超引导下经皮经肝肿瘤射频消融治疗.2例病人术后进行了希罗达化疗.3例病人均接受了红细胞单采治疗.结果 手术病理证实为肝细胞肝癌、肝硬化,普鲁士蓝染色阳性,诊断为血色病.3例病人术后平均存活86个月(39～154个月).结论 对血色病肝癌病人而言,最重要的是早期发现,肝移植或切除是首选治疗.对于再次复发的病人,采用包括射频消融、化疗、红细胞单采治疗等在内的综合治疗可以有效延长病人生存.