Child-Pugh C级伴肝炎肝硬化肝癌患者行肝癌切除术分析.docVIP

Child-Pugh C级伴肝炎肝硬化肝癌患者行肝癌切除术分析 　　[摘要] 目的：探讨Child-Pugh C级伴有肝炎肝硬化的肝癌患者行肝癌切除术增加可行性的方法，减少手术死亡率。方法：对我院2005年6月~2010年6月收治的33例行肝癌切除术的Child-Pugh C级伴有肝炎肝硬化的肝癌患者进行回顾性分析。结果：手术失血量为300～3 500 ml，平均（1 407.3±122.0） ml；手术时间2.3～9.0 h，平均（5.3±1.2） h。33例肝癌患者死亡5例，余28例术后出现腹水、胆漏、感染、急性肾功能衰竭等各种并发症62例次，经对症治疗均痊愈出院。结论：Child-Pugh C级伴肝炎肝硬化的肝癌患者行肝癌切除术难度大、风险大，但只要选择合理术式，术中控制出血量，加强围术期治疗，手术是相对可行和安全的。 　　[关键词] Child-Pugh C级；肝癌切除术；肝炎肝硬化 　　[中图分类号] R735.7 [文献标识码] B [文章编号] 1673-7210（2011）06（c）-187-02 　　 　　Analysis on hepatectomy for hepatocellular carcinoma in the treatment of patients with Child-Pugh C class hepatocarcinoma associated wih liver cirrhosis 　　YAO Weizhou 　　Department of General Surgery, The Peoples Hospital of Huaibei City, Anhui Province, Huaibei 235000, China 　　[Abstract] Objective: To investigate the method of increase the feasibility of hepatectomy for hepatocellular carcinoma in the treatment of patients with Child-Pugh C class hepatocarcinoma associated with cirrhosis. Methods: Data of 33 patients with hepatocarcinoma who were associated with cirrhosis were analyzed retrospectively in our hospital from June 2005 to June 2010. Results: In 33 patients, Surgical blood loss 300-3 500 ml, an average of (1 407.3±122.0) ml; operation time were 2.3-9.0 h with an average of (5.3±1.2) h; 5 patients died, the other 28 cases occurred 62 times complications such as ascites, bile leakage, infection, and acute renal failure after the operation, the symptomatic were cured after treatment. Conclusion: Hepatectomy for hepatocellular carcinoma in the treatment of patients with Child-Pugh C class hepatocarcinoma who are associated with cirrhosis is difficult and risky, but as long as a reasonable surgical would be chose, intraoperative blood loss can be controlled, perioperative treatment can be strengthened, the surgery is relatively feasible and safe. 　　[Key words] Child-Pugh C class; Hepatectomy for hepatocellular carcinoma; Hepatocarcinoma associated with cirrhosis 　　 　　肝癌切除术是肝癌患者获得长期生存的最有效