肝癌破裂出血围手术期死亡危险因素分析

doi:10.13418/j.issn.1001-165x.2014.05.025

Abstract

Abstract:

Objective　Rupture of hepatocellular carcinoma (HCC) is a catastrophic emergency with high mortality. The aim of this study is to determine the factors associated with the prognosis and to assess the outcome of different management strategies.　Methods　Clinical and biochemical factors of 60 consecutive patients with rupture of HCC from 2005 to 2013 were studied. Univariate logistic regression analysis was performed to determine the relative factors leading to 30-day motality. Significant factors then entered into a multivariate logistic regression to determine independent factors associated with 30-day motality.　Results　In our study, 30-day mortality rate was 28.3% (n=17). Child’s C status, shock on admission, higher blood transfusion requirement and larger tumor size were with statistical significance on univariate analysis. On multivariate analysis, only shock on admission (P=0.001) and higher blood transfusion requirement (P=0.01) were significant independent factors affecting early post-operative mortality. A larger tumor size was identified as an independent factor related to post- TAE mortality. Curative resection was associated with a better 30-day survival as compared with conservative therapy or palliative operation.　Conclusions　Rupture of HCC is a salvageable complication of HCC. Poor prognosis is associated with poor liver reserve, advanced disease and severity of haemorrhage. Curative resection and TAE are better choices in selected patients.

Key words: Hepatocellular carcinoma (HCC), Spontaneous rupture, Hepatectomy

CLC Number:

R657.32

LIN Gao-Ming, SHU Jia, LI Guo-Lin, MIN Jun. Risk factors analysis of perioperative mortality in ruptured bleeding of hepatocellular carcinoma[J]. Chinese Journal of Clinical Anatomy, 2014, 32(5): 616-619.

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Risk factors analysis of perioperative mortality in ruptured bleeding of hepatocellular carcinoma

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