作　　者： (孙磊）; (王卫东）; (范晨）; (陆进）; (徐平）;

机构地区： 无锡市人民医院介入科,江苏省214023

出　　处： 《江苏医药》 2017年第16期1178-1180,共3页

摘　　要： 目的分析肝细胞癌经动脉化疗栓塞(TACE)术后肿瘤破裂的临床特点。方法对412例肝细胞癌患者实施TACE术985例次。回顾性分析TACE术后肿瘤破裂6例的危险因素及诊疗方法。结果 TACE术后肿瘤破裂发生率为1.46%(6/412)。破裂肿瘤均位于肝右叶,临近肝脏表面或向外突出;肿瘤最大直径7.6~14.9cm。4例碘油栓塞后未追加适量明胶海绵颗粒。肿瘤破裂后,2例行肝动脉栓塞术治疗,1例明确责任血管后予明胶海绵颗粒栓塞后出血止;1例未明确责任血管,栓塞后止血效果不满意,患者因多脏器功能衰竭死亡。另4例患者接受内科治疗,均死亡。结论肿瘤破裂是肝细胞癌TACE术后的严重并发症。肿瘤临近肝脏表面或向外突出、体积较大和栓塞不充分是其发生的危险因素。 Objective To analyze clinical features of hepatocellular carcinoma（HCC）rupture after transcatheter arterial chemoembolization（TACE）.Methods A total of 985 times of TACE was performed in 412 patients with HCC.The risk factors and managements for HCC rupture after TACE in six patients were respectively analyzed.Results The incidence of HCC rupture after TACE was 1.46%（6/412）.The ruptured tumors of 6 cases were all located in the right liver near the surface or protruding out,which were 7.6-14.9cm in diameter.The gelfoam particles were not added in 4 cases after iodine oil embolization.The transcatheter hepatic arterial embolization was performed in 2 cases after rupture.The bleeding stopped after gelfoam embolization of the responsible vessel in one case and the other 5 cases died after conservative treatment.Conclusion Ruptured HCC is an extremely dangerous complication after TACE.The tumors near the surface or protruding out the liver,larger size and inadequate embolization are the risk factors for the rupture after transcatheter hepatic arterial embolization.

关 键 词： 肝细胞癌 经动脉化疗栓塞 肿瘤破裂