CAJ | 학술논문

目的：探讨肝癌破裂出血的各种诊治方法并评价其疗效。方法回顾性分析42例肝癌破裂出血患者的临床资料。根据治疗方式，分为3组：手术组（A组）14例，单纯介入组（B组）16例，保守治疗组（C组）12例。比较3组的止血率、30天内死亡率及6个月、1年、2年生存率。结果 A、B 2组的止血率分别为100%、93.8%（P＞0.05），均高于C组（41.7%）（P＜0.05）。30天内死亡率分别为0%、20.0%、66.7%。A组2年存活率为50%，高于B组（12.5%）和C组（0%）（P＜0.05）。结论对可行根治性手术的病例，只要严格掌握手术适应症，急诊行根治性肝切除术是安全有效的，应优先选择。对于无法行根治性手术的病例，可采用介入治疗，止血效果确切，亦能有效延长生存期。保守治疗效果差。
목적：탐토간암파렬출혈적각충진치방법병평개기료효。방법회고성분석42례간암파렬출혈환자적림상자료。근거치료방식，분위3조：수술조（A조）14례，단순개입조（B조）16례，보수치료조（C조）12례。비교3조적지혈솔、30천내사망솔급6개월、1년、2년생존솔。결과 A、B 2조적지혈솔분별위100%、93.8%（P＞0.05），균고우C조（41.7%）（P＜0.05）。30천내사망솔분별위0%、20.0%、66.7%。A조2년존활솔위50%，고우B조（12.5%）화C조（0%）（P＜0.05）。결론대가행근치성수술적병례，지요엄격장악수술괄응증，급진행근치성간절제술시안전유효적，응우선선택。대우무법행근치성수술적병례，가채용개입치료，지혈효과학절，역능유효연장생존기。보수치료효과차。
Objective To evaluate the treatments for the hemorrhage of ruptured hepatocellular carcinoma(HCC).Methods The clinical data of 42 patients with the hemorrhage of ruptured HCC were retrospectively reviewed. Patients were divided into three groups according to the therapeutic programs: group A(n=14),receiving operation; group B (n=16),receiving interventional therapy only, group C (n=12),receiving conservative therapy. The successful rate of hemostasis, 30-day mortality, 6-month, 1-year and 2-year survival rates were compared.Results The successful rate of hemostasis in group A, B was 100% and 93.8% (P>0.05), which was signiifcantly higher than that in group C (41.7%) (P<0.05). The 30-day mortality in group A,B and C was 0%,20.0%, 66.7%, respectively. The 2-year survival rate in group A was 50%, which was signiifcantly higher than those in group B(12.5%) and group C (0%) (P<0.05).ConclusionFor patients with a resectable HCC, the emergent hepatectomy which is safe and feasible, is recommended as the ifrst choice for the treatment. Interventional therapy can be adopted to prolong survival period for the patients who have no chance of radical resection.