151例原发性肝细胞肝癌外科治疗体会.doc

151例原发性肝细胞肝癌外科治疗体会[摘要] 目的：总结分析原发性肝细胞肝癌手术切除病例的治疗效果。方法： 回顾性分析1998年1月~2003年12月河北省承德市肿瘤医院外科151例肝癌病人手术切除治疗情况。结果：澳抗阳性患者123人，占总例数的81.46%；109例患者AFP升高（＞100 μg/L），占总数的72.18%；116例合并有肝硬化，占总数的76.82%。术中平均出血量为（730.4 ± 465.5）（150~6 550）ml。术后随访中共有82例患者出现复发：一年内出现复发者52例（占34.4%）；肝内复发者72例（87.8%）。术后1年及3年生存率分别为74.1%和45.0%。结论：随着近年来早期诊断和外科技术的进步，肝切除术已经可以显著提高肝癌患者生存率。 [关键词] 肝癌；肝细胞；外科治疗；肝切除术 [中图分类号]R605 [文献标识码]A [文章编号]1673-7210（2007）06（b）-020-02 Experience in surgical treatment of hepatocellular carcinoma in 151 patientsLUAN Rui-shen ,XIN Jian-hui (The Tumour Hospital of Chengde, Chengde 067000，China) [Abstract] Objectives:We conducted a retrospective cohort study to investigate the effect of hepatectomy in treatment of hepatocellular carcinoma (HCC).Methods: 151 liver resections for HCC were retrospectively reviewed in recent 6 years (between Jan. 1998 and Dec. 2003). The relationship between clinicopathological findings and surgical outcomes was examined. Results:Of all the patients, 123(81.46 %) patients were complicated with presence of HBsAg marker. Alpha-fetoprotein ＞100μg/L were in 109(72.18%) patients; 116(76.82%) patients were complicated with liver cirrhosis. Perioperative average blood loss was (730.4 ±465.5 ) (range 150~6550)ml. The recurrence of HCC appeared in 82 patients, 52(34.4%) of them were in one year, the types of recurrence were mainly intrahepatic (87.8%). The 1-year and 3-year cumulative survival rate (%) of the patients treated with hepatic resection were 74.1% and 45.0%. Conclusion:Because of recent progress in early diagnosis and operative technique, results after liver resection have improved with survival rate. [Key words] Carcinoma;Hepatocellular; Surgical treatment; Hepatectomy 原发性肝癌(以下简称肝癌)是全世界目前为止，发病率仍在上升的少数几种恶性肿瘤之一[1]。尽管过去20余年在肝细胞癌领域内许多治疗方法获得很大进展，就世界范围来说，肝细胞癌仍然是癌症死亡的一个主要原因。近年来一些有经验的肝癌治疗中心，肝癌肝切除术后的5年生存率可达到50%，肝切除术后围手术期死亡率小于2%[2]。河北省承德市肿瘤医院外科最近6年来，共对151例肝癌患者进行了手术切除，现报道如下。 1 资料与方法 1.1 临床资料 151例，其中男123例，女28例(男∶女为4.39∶1)，平均年龄(52.3 ± 7.2