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肝細胞癌合併自發性破裂－病例分析及文獻回顧
Spontaneous Rupture of Hepatocellular Carcinoma
摘要
三軍總醫院一般外科自民國74年1月至76年6月共手術治療肝細胞癌合併自發性破裂患者8例，占同期間內本院診斷為原發性肝細胞癌425例的1.9%。這8名患者全為男性，年齡由21到77歲，平均60.2 ± 18.4歲。其中合併肝硬化者有7例，乙型肝炎表面抗原陽性者6例。手術時採用壓止出血部位及縫合法的有3例，肝動脈結紮是4例，另外的1例則接受肝葉切除術。手術後，有6例在10天內死亡，另外2例則分別存活4個月和10個月。肝癌合併自發性破裂病人的預後雖然不佳，但是，臨床醫師若能保持高度的警覺，適切地選用診斷工具和治療方式，仍然有挽救病人性命的可能。本文旨在分析我們對這些患者診斷及治療的經驗，並對文獻加以回顧和討論。
並列摘要
Eight cases with spontaneous rupture of hepatocellular carcinoma (HCC) were surgically treated by our division from January, 1985 through June, 1987. They constituted 1.9% of the 425 cases of primary HCC in our hospital during the same period. All parients were males, ranging in age from 21 to 77 years with an average age of 60.2±18.4 years. Seven were found to have cirrhosis of the liver. HBsAg was positive in 6 cases. During surgery, packing and suturing was performed in 3 cases, hepatic artery ligation in 4, and lobectomy of the liver in one. There were 6 post-operative deaths and the other two survived 4 and 10 months respectively. Although the prognosis for patients with spontaneous rupture of HCC is poor, lives could be saved if the clinicians were alert and chose the appropriate diagnostic tools and interventions in time.
延伸閱讀
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