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目的探讨减少肝动脉化疗栓塞 ( TACE)术后严重并发症及降低近期病死率的有效途径。方法对 2 6 5例肝癌患者行 TACE术 ,分析其中 19例近期 (术后 2 0天 )死亡原因。结果死于肝功能衰竭 9例 ,死于肝癌破裂 4例 ,死于上消化道出血 2例 ,死于胃十二指肠穿孔、肺栓塞、心肌梗死、高钾血症各 1例。其中原发性肝癌及转移性肝癌病死率分别为 9.2、1.4 ( P<0 .0 5 )。结论对晚期不能切除肝癌尤其原发性肝癌患者行 TACE术时 ,应严格掌握适应症 ,选择合理的个体化治疗方案。
Objective To explore the effective ways to reduce serious complications and reduce the mortality rate of hepatic arterial chemoembolization (TACE). Methods TACE was performed on 265 HCC patients and the causes of death in 19 cases (20 days after surgery) were analyzed. Results died of hepatic failure in 9 cases, died of liver cancer rupture in 4 cases, died of upper gastrointestinal bleeding in 2 cases, died of gastroduodenal perforation, pulmonary embolism, myocardial infarction, hyperkalemia in 1 case. The mortality rates of primary liver cancer and metastatic liver cancer were 9.2 and 1.4 (P<0.05), respectively. Conclusion For patients with advanced unresectable hepatocellular carcinoma, especially primary hepatocellular carcinoma, TACE should be strictly controlled and a reasonable individualized treatment plan should be selected.