关键词: 肝细胞性肝癌, 破裂, 肝切除术, 经肝动脉栓塞

Abstract: 【Abstract】 Objective〓To explore the management of patients with spontaneous rupture of hepatocellular carcinoma. Methods〓105 patients with spontaneously ruptured hepatocellular carcinoma between Jan. 1992 and Dec. 2013 in the Jiangmen People’s Hospital were enrolled in this retrospective review of clinical data. The first stage was from 1992 to 2002 (47 patients) and the second stage was from 2003 to 2013.(58 patients)..The patients underwent conservative treatment or emergency hepatectomy in first stage. And in second stage, conservative treatment, emergency hepatectomy and transcatheter arterial embolization was used..30-day survival rate,.1 year survival rate and the cumulative survival rate were contrasted in two stages. Results〓In first stage,.22 of 47 patients underwent conservative treatment,.and another 25 cases were performed emergency hepatectomy. Twenty-two patients died in 30 days in the first stage. In second stage of 58 patients, 12 underwent conservative treatment,.and emergency hepatectomy in 29 cases.(10 of whom received staged hepatectomy),.transcatheter arterial embolization in 17 patients..Sixteen patients died in 30 days at second stage. In two stage, the cumulative survival rate was higher in patients underwent hepatectomy than that in other treatments.(P<0.05)..The cumulative survival rate in the second stage was higher than that in the first stage.(P=0.036)..There were no difference in the cumulative survival rate of patients who received hepatectomy between two stage.(P=0.234)..Conclusion〓In present data, conservative treatment for patients with spontaneous rupture of hepatocellular carcinoma showed a poor prognosis..Transcatheter arterial embolization displayed an effective emergency hemostatic measure. Emergency hepatectomy or staged hepatectomy prolonged survival time of right patients.

Key words: Hepatocellular carcinoma, Rupture, Hepatectomy, Transcatheter arterial embolization