急诊 TACE 联合腹腔置管引流术治疗原发性肝癌破裂大出血的临床疗效

摘要

目的：探讨TACE联合腹腔置管引流术治疗原发性肝癌破裂合并大出血的临床疗效。方法对23例原发性肝癌破裂大出血者急诊行TACE术止血，同时行腹腔置管引流术（ PCD）充分引流腹腔内积血，并观察治疗效果。结果本组23例患者均得以有效止血，平均动脉压由术前（70．60±17．20）mmHg上升到（96．40±16．40）mmHg，心率由术前（121．80±10．20）次／min下降到（80．00±12．40）次／min，术后平均动脉压、心率较术前差异有统计学意义（P＜0．05）。随访1～3年，3、6、12、24个月的生存率分别为82．60％（19／23）、69．56％（16／23）、52．17（12／23）、21．73％（5／23）。无3年以上生存者。结论 TACE联合腹腔置管引流术治疗原发性肝癌破裂大出血创伤小，能降低腹腔内感染，为患者的后续治疗赢得了机会。%Objective To evaluate the clinical effect of TACE combined with intraperitoneal catheter drainage for mas -sive hemorrhage due to primary liver cancer ( PLC) with hemorrhage .Methods 23 patients with PLC rupture underwent emer-gency TACE and the peritoneal catheter drainage ( PCD) sufficient drainage hemoperitoneum ,and the therapeutic effect was ob-served.Results The hemostasis rate was 100%.The mean arterial pressure elevated from (70.60 ±17.20) mmHg to(96.40 ± 16.40)mmHg after TACE(P<0.05).Heart rate decreased from (121.80 ±10.20) times/min to (80.00 ±12.40) times/min after TACE(P<0.05).The survival rate was 82.60%(19/23)at 3 months,69.56%(16/23)at 6 months,52.17(12/23)at 12 months,21.73%(5/23)at 24 months.There was no 3-year survivors.Conclusion TACE combined with intraperitoneal catheter drainage has small trauma in the treatment of PLC rupture ,it reduce intra abdominal infection ,and offer the opportunity for follow-up treatment to patients .