影响中晚期肝细胞肝癌手术切除预后的多因素分析

探讨影响中晚期肝细胞肝癌手术切除预后的因素。方法对130例中晚期大肝癌随访1～7年,采用单因素、多因素分析统计不同预后因素对患者生存率的影响。结果手术后1,3 ,5年生存率分别81.7%,24.3%,18.4%。单因素分析提示影响预后的因素为肝癌大小、是否早期复发、肝硬化情况、输血量;多因素分析提示肝癌大小、肿瘤早期复发是影响肝癌术后的预后因素。结论：中晚期肝癌手术切除预后仍不理想,重视围手术期处理,预防术后早期复发有望提高手术疗效 [英文摘要]Objective To study the prognostic factors in patients who received hepatectomy for large hepatocellular carcinoma(HCC). Methods 130 patients operated for large HCC were followed up for 1～7 years. Twenty possible factors were analyzed by Kaplan-Meier Log rank estimate. A multivariative survival analysis of these individal variable was undertaken using the cumulative survival rate by the computers COX proportional hazard. Result The overall cumulative survival rate at 1,3,5 years was 81.7%,24.3%,18.4% re..

阻塞性黄疸术后并发肝内胆汁淤积分析

目的　探讨阻塞性黄疸术后并发肝内胆汁淤积的的机制及治疗 ,总结该并发症的诊治经验。方法回顾性分析203例阻塞性黄疸行手术治疗后并发8例(3.9%)肝内胆汁淤积病例的病因及治疗体会。结果在并发术后肝内胆汁淤积组中,有术前、术中一过性低血压的发生率高于无并发术后肝内胆汁淤积组。8例肝内胆汁淤积予肾上腺皮质激素辅以利胆药物治疗后痊愈。结论阻塞性黄疸术后有可能并发肝内胆汁淤积。其原因可能为胆汁细菌感染 ,缺血再灌注损伤、乙肝病毒感染。其中缺血再灌注损伤及胆汁细菌感染可能起主要作用。治疗上以肾上腺皮质激素加利胆药物为主 【英文摘要】 Objective To probe into the mechanism and the treatment of intrahepatic cholestasis after the operation of obstructive jaundice,and sum marize the experiences of diagnosis and treatm entof the complication.Methods 2 0 3cases of ob- structive jaundice operation were analyzed retrospectively.Postoperative intrahepatic cholestasis occurred to 8patients(3. 9% ) .Bases of diagnosis:(1) No dilation in the intrahepatic ductsystem is found by B- ultrasonography or CT scan.(2 ) direct bilirubin / indirect bi..