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目的探讨合并门脉高压症的肝癌患者手术切除疗效。方法分析东方肝胆医院1996年至2001年共626例肝癌患者的临床资料,随访终点为2008年9月1日,以死亡作为终点事件。对外科治疗的生存率及预后相关危险因素进行分析。结果合并门脉高压症患者术后1、3、5、10年生存率分别为79.9%、48.7%、37.3%和21.2%,非门脉高压症患者分别为82.7%、54.8%、42.4%和29.7%,两者差异无统计学意义(P>0.05);肿瘤数目>1个、微血管癌栓、肿瘤无包膜或不完整、肿瘤直径>10cm及HBsAg阳性是影响术后生存的独立危险因素。结论门脉高压症并不是肝癌外科手术的禁忌证,对于合并有门脉高压症的肝癌患者,只要肝功能储备良好,肝切除术仍能获得较好的术后生存率。
Objective To investigate the effect of surgical resection of hepatocellular carcinoma patients with portal hypertension. Methods Clinical data of 626 patients with hepatocellular carcinoma from 1996 to 2001 in Eastern Hepatobiliary Hospital were analyzed. The end of follow-up was September 1, 2008, with death as the end point. Surgical treatment of survival rates and prognostic risk factors were analyzed. Results The 1, 3, 5 and 10-year survival rates of patients with portal hypertension were 79.9%, 48.7%, 37.3% and 21.2%, respectively. The patients with non-portal hypertension were 82.7%, 54.8% and 42.4% 29.7%, there was no significant difference between the two groups (P> 0.05). The number of tumor> 1, tumor thrombus, tumor without capsule or incomplete tumor diameter> 10cm and HBsAg positive were the independent risk factors of postoperative survival . Conclusions Portal hypertension is not a contraindication to surgical treatment of liver cancer. For patients with hepatocellular carcinoma complicated with portal hypertension, hepatectomy can still achieve good postoperative survival as long as the liver function reserve is good.