小肝癌手术治疗的体会(附41例报告)-东南大学学报医学版

小肝癌手术治疗的体会(附41例报告)

单位：东南大学医学院附属盐城医院普外科,江苏,盐城,224001

分类号：R657.3

出版年·卷·期（页码）：2004·23·第六期（412-414）

摘要：

目的:总结小肝癌手术治疗的经验.方法:回顾性分析本院近8年41例小肝癌患者的临床资料,其中39例合并肝硬化,32例HBsAg阳性;甲胎蛋白＜20μg·L-113例,20～400μg·L-117例,＞μg·L-1 11例;肝功能Child-Pugh A级27例,B级14例.29例予不规则肝切除(4例病人同时行脾切除加贲门周围血管离断术),5例予不规则肝切除加无水酒精注射,7例予肝左外叶切除(其中3例取出门静脉癌栓).结果:术后1、3、5年生存率依次为87.8%、73.2%、43.9%.结论:早发现、早诊断,施行合适的外科手术是提高生存率的关键.小肝癌合并门静脉高压症者,不能盲目追求根治性肿瘤切除及附加针对门静脉高压症的手术.

Objective To summarize experience in surgery for small hepatocellular carcinoma. Methods The clinic data of 41 c as es of small hepatocellular carcinoma in our hospital in recent 8 years were retr ospectively analyzed. Among them,32 cases were HBsAg positive;α-fetoprotein level was less tha n 2 0-μg·L -1 in 13 cases, 20-400-μg·L -1 in 17 and more than 400 -μg·L -1 in 11 cases ; liver function grade Child-Pugh A was found in 27 cases, B in 14. Twenty-n ine cases underwent irregular hepatectomy (including 4 cases received hepatectomy and oper ation for portal hypertension simultaneously), 5 cases underwent irregular and injection of absolute alcohol, 7 cases underwent left lateral lobectomy and 3 c ases underwent removal of the tumor emboli in left portal vein. Result The 1-,3-,5-year survival rates were 87.8%,73.2%,43.9%, respe ct ively. Conclusions Early detection and diagnosis, curative res e ction of tumor are the key points to prolong the survival time of patients.Radic al resection and other operation for portal hypertension during hepatectomy shou ld be cautiously performed on patients with small hepatocellular carcinoma,espe cially combined with portal hypertension at the same time.

参考文献：

[1] 孟兴凯, 彭淑牖, 史留斌. 肝细胞肝癌患者血清AFP值影响因素的分析. 东南大学学报(医学版)2001(2). doi:10.3969/j.issn.1671-6264.2001.02.010
[2] 吴孟超. 肝脏外科学, 2000
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