摘要
肝癌破裂是肝癌的严重并发症,常以急腹症为首发症状,起病急,进展快,再出血风险大,病死率高,是肝胆外科的危急重症。临床上对于急腹症患者结合肝炎、肝硬化等相关病史、急腹症的临床表现和体征以及相关辅助检查等可明确诊断,主要的治疗方式包括保守治疗、介入治疗以及手术治疗等,其他还包括有射频消融、肝移植等。目前对于肝癌破裂的治疗适应证以及时机的选择尚未形成明确规范,临床上对于肝癌破裂的患者何时选择何种治疗方案一直以来存在争议,对临床医师来说,迅速诊断、有效止血、拯救患者生命的同时给患者带来最佳预后是当前临床工作的重点和难点。本文将对于肝癌破裂相关急腹症的诊疗进展进行回顾并总结,针对肝癌破裂相关急腹症的治疗方案规划,保守治疗、介入治疗以及手术治疗的时机选择、适应证等加以思考。
Liver cancer rupture is a serious complication of liver cancer,often with acute abdomen as the first symptom,which has features of acute onset,rapid progress,re-bleeding risk,high mortality,is a critical and severe disease of hepatobiliary surgery.Clinical diagnosis can be made by hepatitis cirrhosis and other related history,acute abdomen clinical manifestations and signs of acute abdomen and related auxiliary examination.The main treatment of acute abdomen associated with liver cancer rupture include conservative treatment,interventional therapy and surgical treatment,and other include radio-frequency ablation and liver transplantation and so on.However,the indications and timing of treatment for liver cancer rupture have not been clearly standardized,and it has been controversial when to choose the treatment plan for patients with liver cancer rupture.For clinicians,rapid diagnosis,effective hemostasis,saving the patient′s life and bringing the best prognosis are the key and difficult points of clinical work.In this paper,the progress of diagnosis and treatment of acute abdomen associated with liver cancer rupture is reviewed and summarized,and the treatment plan of acute abdomen associated with liver cancer rupture,the timing and indication of conservative treatment,interventional therapy and surgical treatment for liver cancer rupture are considered.
作者
尹兵
麻勇
Yin Bing;Ma Yong(Department of Hepatic Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150000,China)
出处
《国际外科学杂志》
2020年第10期649-654,共6页
International Journal of Surgery
基金
国家自然科学基金资助项目(81100305,81470876)
黑龙江省自然科学基金(LC2018037)
博士后研究人员落户黑龙江科研启动资助金(LBH-Q17097)。
关键词
肝肿瘤
急腹症
肝癌破裂
保守治疗
介入治疗
Liver neoplasms
Abdomen,acute
Liver cancer rupture
Conservative treatment
Interventional therapy
