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目的探讨原发性肝癌(PHC)手术切除治疗的临床经验。方法对29例行肝手术切除治疗的PHC患者的临床资料行回顾性分析,从术前综合评估、手术切口的选择、肝切除量、术中控制出血及肝断面的处理等方面进行分析。结果 29例均安全度过围手术期,术后并发胆漏2例,胸腔积液4例,膈下感染1例,对症治疗后全部治愈;随访术后半年内死亡2例,1年内死亡3例,3年内死亡17例,7例现仍存活,继续随访中。结论加强术前综合评估、有效控制术中出血以及正确处理肝断面及并发症,是PHC手术切除治疗取得良好疗效的基本保证。
Objective To investigate the clinical experience of surgical resection of primary liver cancer (PHC). Methods The clinical data of 29 patients with PHC who underwent hepatectomy were analyzed retrospectively. The results were as follows: preoperative comprehensive assessment, choice of surgical incision, amount of hepatectomy, intraoperative controlled bleeding and treatment of hepatic sections. Results All the 29 patients were safely operated during perioperative period. Two cases were complicated with bile leakage after operation, 4 cases with pleural effusion and 1 case with subphrenic infection. All patients were cured after symptomatic treatment. Two patients died in half a year after follow-up and died within one year For example, 17 cases died within 3 years, 7 cases are still alive, continue follow-up. Conclusion To strengthen preoperative comprehensive assessment, effectively control intraoperative bleeding and correct treatment of hepatic sections and complications, is the basic guarantee of good curative effect of PHC surgical resection.