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目的探讨肝癌介入手术后并发急性肝功能衰竭的原因,预防措施,临床检查及治疗和防范引发纠纷的措施.方法原发性中晚期肝癌病人80例均接受经导管肝动脉化疗栓塞治疗.结果2例病人出现急性肝功能衰竭症状,高热、右上腹痛,恶心呕吐、轻度黄疸.实验室检查显示血清转氨酶升高,血氨升高,白蛋白降低,持续时间超过2周.经过3周治疗后好转.其余78例有轻度肝功能异常表现,术后予以护肝、抗炎、利尿及营养支持疗法,经过1周至2周的治疗,肝功能基本恢复正常.无一例发生医疗事故和医疗纠纷.结论肝癌介入治疗后并发急性肝功能衰竭是一种少见而严重的并发症,若治疗不及时可致死亡.因此,对术前有肝功能异常的病人,在介入治疗前后应加强观察,先进行术前护肝治疗,待肝功能恢复、改善后,再进行介入治疗.术前制定恰当的化疗方案,介入手术应按规范进行,术前医患双方慎重签定手术计划书和知情同意书,以保证介入手术的公正和合法,确保手术顺利地按计划完成.术后及时进行实验室检查,以期及时早期诊断,及时治疗.
Objective To investigate the causes, precautionary measures, clinical examination and treatment of precautionary measures and prevention of acute liver failure after interventional operation of hepatocellular carcinoma.Methods 80 cases of primary hepatocellular carcinoma were treated with transcatheter arterial chemoembolization.Results 2 Cases of patients with symptoms of acute liver failure, fever, right upper quadrant pain, nausea and vomiting, mild jaundice. Laboratory tests showed elevated serum transaminase, elevated serum ammonia, albumin decreased for more than 2 weeks .After 3 weeks of treatment The remaining 78 patients had mild abnormal liver function, after liver protection, anti-inflammatory, diuretic and nutrition support therapy, after 1 week to 2 weeks of treatment, liver function returned to normal. No case of medical malpractice and medical disputes .Conclusion Acute liver failure complicated by hepatic cancer after interventional therapy is a rare and serious complication.If it is not treated in time, it can cause death.Therefore, we should strengthen the observation before and after interventional therapy for patients with preoperative liver dysfunction Preoperative liver protection treatment until the liver function recovery, improvement, and then interventional treatment.Preoperative to develop appropriate chemotherapy, interventional procedures should be standardized, preoperative The two sides signed a careful surgical plan and informed consent, in order to ensure fair and lawful interventional procedures to ensure the smooth operation completed as planned. After laboratory tests in a timely manner, in order to timely early diagnosis and prompt treatment.