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目的：探讨原发性肝癌获得二步切除的途径和围手术期的特点。方法：１９８９年１月至１９９６年９月，我科二步切除经治疗的原发性肝癌１３例。术中肝固有动脉结扎（ＨＡＬ）和肝肿瘤无水酒精注射（ＥＩＴ），术后放疗１例；术中多模式治疗，即ＯＡＥ，ＨＡＬ，ＥＩＴ和微波固化１例。１１例经导管或术中肝动脉化疗栓塞（ＴＡＥ）治疗１～５次。结果：此１３例肝癌治疗后，肿瘤最大径从１０．６±１．５ｃｍ缩小为６．６±１．８ｃｍ；２例ＡＦＰ降为正常，其中１例仍发现存活的肝癌细胞。手术方法均为不规则肝切除术。手术死亡１例，其余１２例中，术后４例并发肝功能不全。结论：ＴＡＥ是肝癌获得二步切除重要的途径，二步切除较易并发肝功能不全。
Objective: To explore the path and perioperative characteristics of primary liver cancer with two-step resection. Methods: From January 1989 to September 1996, 13 cases of primary hepatocellular carcinoma were treated in our department. Intraoperative hepatic prosthetic artery ligation (HAL) and liver cancer absolute ethanol injection (EIT), postoperative radiotherapy in 1 case; intraoperative multimodal therapy, namely OAE, HAL, EIT and microwave curing in 1 case. 11 cases were treated with catheter or intraoperative hepatic arterial chemoembolization (TAE) 1 to 5 times. Results: After the treatment of 13 cases of liver cancer, the maximum diameter of the tumor was reduced from 10.6±1.5cm to 6.6±1.8cm; 2 cases of AFP were reduced to normal, and 1 case of surviving liver cancer cells was still found. All surgical methods were irregular liver resection. One patient died of surgery, and the remaining 12 patients had liver dysfunction in 4 cases. Conclusion: TAE is an important way for liver cancer to obtain two-step resection, and two-step resection is more likely to be associated with hepatic insufficiency.