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1979～1991年日本Otemate医院共做100例肝细胞癌(HCC)根治性肝切除术,其中5例术后1月死亡,4例1月后死亡,余91例在门诊密切随访。每2个月测血清α胎球蛋白值和每3个月行超声扫描,以便早期确诊复发。一年至少做一次CT检查。疑有HCC复发者则做血管造影和用CO_2微泡注入肝动脉强化超声扫描。91例平均随访36.1个月(1～112个月)。随访期间,36例在初次肝切除后2～81个月(平均23个月)出现HCC复发,其中6例行探查和酒精注射疗法,16例行肝切除。在22例再次手术病人中,19例为男性,3例为女性,原均有肝硬变,再次手术时平均年龄62.9岁(39～79岁)。第一次手术为肝叶切除2例,肝节段切除4例和部分肝切除16例。第二次为肝
From January 1979 to 1991, 100 cases of radical hepatectomy for hepatocellular carcinoma (HCC) were performed at Otemate Hospital in Japan. Among them, 5 cases died 1 month after surgery, 4 cases died after 1 month, and 91 cases were closely followed in the outpatient department. Serum alpha fetoprotein levels were measured every 2 months and ultrasound scans were performed every 3 months for early diagnosis and recurrence. At least one CT scan a year. In patients with suspected HCC recurrence, angiography was performed and CO2 microbubbles were injected into the hepatic artery for enhanced ultrasound scanning. 91 cases were followed up for an average of 36.1 months (1 to 112 months). During the follow-up period, 36 patients developed recurrence of HCC 2 to 81 months (average 23 months) after initial hepatectomy. Among them, 6 patients underwent exploratory and alcohol injections, and 16 patients underwent hepatectomy. Of the 22 reoperation patients, 19 were males and 3 were females, all had cirrhosis. The average age of reoperation was 62.9 years (39-79 years). The first operation was liver lobectomy in 2 cases, liver segment resection in 4 cases and partial hepatectomy in 16 cases. The second time is liver