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目的 总结原发性肝癌的临床经验。方法 分析 130例原发性肝癌死亡病例的临床资料 ,包括性别、年龄、病史、诊断方法、肿瘤的性质、治疗方法、生存期和死亡原因等。结果 本组男 :女为 5 .5∶ 1,平均年龄 5 3.5岁。有乙型肝炎病史或病毒携带者占70 .8% ,合并肝硬化占 46 .2 %。本组病例均属中晚期 ,平均生存期为 6 .8个月 ,各组平均生存期 :手术切除组 (4例 )为 16 .0个月 ,手术切除 +经皮穿刺肝动脉插管化疗栓塞 (TACE)组 (17例 )为 16 .5个月 ,两组无明显差别 (P>0 .0 5 ) ;单纯 TACE组 (37例 )为 5 .4个月 ,其它治疗组 (72例 )为 4.7个月 ,两组无明显差别 (P>0 .0 5 ) ,但与前两组相比差异明显 (P<0 .0 1)。病人的死亡原因依次为上消化道大出血 (40 .8% )、肝功能衰竭 (30 .0 % )、全身衰竭 (15 .4% )、肝癌破裂出血 (10 .0 % )及其它 (3.8% )等。结论 中晚期原发性肝癌手术切除率低 (16 .2 % ) ,预后差 ,目前最好的治疗方法仍为手术切除 ,能明显延长病人的生存期 ,但 TACE及其它治疗方法不能改善病人的预后。上消化道大出血、肝功能衰竭、全身衰竭和肝癌破裂出血等为肝癌的主要死亡原因。
Objective To summarize the clinical experience of primary liver cancer. Methods The clinical data of 130 cases of primary liver cancer deaths were analyzed, including gender, age, history, diagnostic methods, tumor properties, treatment methods, survival time, and cause of death. The results of this group of men: women were 5 .5: 1, the average age of 5 3.5 years. There were 70.8% of patients with a history of hepatitis B or viral carriers, and 46. 2% of patients with cirrhosis. This group of patients are in the middle and late stages, the average survival period was 6.8 months, the average survival time of each group: surgical resection group (4 cases) was 16. 0 months, surgical resection + percutaneous transhepatic arterial catheterization chemoembolization (TACE) group (17 cases) was 16.5 months, there was no significant difference between the two groups (P> 0.05); TACE group (37 cases) was 5.4 months, other treatment groups (72 cases) At 4.7 months, there was no significant difference between the two groups (P>0.05), but there was a significant difference from the previous two groups (P < 0.01). The causes of death for patients were, in turn, massive upper gastrointestinal bleeding (40.8%), liver failure (30.0%), systemic failure (15.4%), hepatocellular rupture (10.0%), and others (3.8%). )Wait. Conclusions The resection rate of primary liver cancer is low (16. 2%) and the prognosis is poor. At present, the best treatment is still surgical resection, which can significantly prolong the patient’s survival time. However, TACE and other treatment methods can not improve the patient’s Prognosis. Upper gastrointestinal bleeding, liver failure, systemic failure and hemorrhage of liver cancer are the main causes of liver cancer.